Comprehensive therapy of a fusion between a mandibular lateral incisor and supernumerary tooth: case report.

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Onçag, Ozant; Candan, Umit; Arikan, Fatih

2005-08-01

The term fusion is used to define a developmental anomaly characterised by the union of two adjacent teeth. In the case reported here, clinical and radiographic examinations suggested a unilateral fusion between the mandibular left permanent incisor and a super-numerary tooth. Radiographs showed that the fused teeth had two distinct pulp chambers and canals. A diagnosis of chronic periapical abscess of the supernumerary tooth was made. Before root canal therapy, a periodontal surgical procedure was performed to section the central incisor and its fused supernumerary. Also, odontoplasty was performed on the roots, to establish an anatomy consistent with a normal central incisor. Later, the chronic apical abscess on the supernumerary tooth was instrumented chemo-mechanically, root canal filling was performed and an anterior composite resin restoration was placed. The patient was evaluated for one year after root canal therapy. The tooth was asymptomatic, not exhibiting any pathological root resorption or alveolar resorption, and the anterior composite restoration was intact. Instead of extracting the supernumerary tooth, the application of endodontic, periodontal, and restorative procedures proved to be an alternative treatment.

Worldwide pattern of antibiotic prescription in endodontic infections.

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Segura-Egea, Juan José; Martín-González, Jenifer; Jiménez-Sánchez, María Del Carmen; Crespo-Gallardo, Isabel; Saúco-Márquez, Juan José; Velasco-Ortega, Eugenio

2017-08-01

Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections. Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated. The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis. Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions. © 2017 FDI World Dental Federation.

Ceramic onlay for endodontically treated mandibular molar

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Roopadevi Garlapati

2014-01-01

Full Text Available Restoration of endodontically treated teeth is important for the success of endodontic treatment. In full coverage restorations, maximum amount of tooth structure is compromised, so as to conserve the amount of tooth structure partial coverage restorations, can be preferred. This case report is on fabrication of a conservative tooth colored restoration for an endodontically treated posterior tooth. A 22-year-old male patient presented with pain in the mandibular left first molar. After endodontic treatment, composite material was used as postendodontic restoration. The tooth was then prepared to receive a ceramic onlay and bonded with self-adhesive universal resin cement. Ceramic onlay restoration was periodically examined up to 2 years.

Fusion of a supernumerary tooth to right mandibular second molar: a case report and literature review.

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Zhu, Min; Liu, Chao; Ren, Shuangshuang; Lin, Zintong; Miao, Leiying; Sun, Weibin

2015-01-01

Gemination or fusion is a rare occurrence in the mandibular posterior teeth. The aim of this article is to describe the problems encountered and the strategy employed in treating such cases. A 34 years old patient came with the complaint of spontaneous and radiating pain in the right mandibular posterior region. The tooth in concern was an anomalous 'double' second mandibular molar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin. The present case emphasizes the importance of identifying anatomical anomalies during treatment of fused teeth with supernumerary tooth, and the need for the use of advanced imaging modalities like CBCT which is a critical aid in the diagnosis of such cases. Fused teeth can be managed quite efficiently by an overall combined treatment including both endodontic and periodontal therapy.

Currently used systems of dental posts for endodontic treatment

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Machado, Joana; Almeida, Paulo; Fernandes, Sampaio; Marques, Arcelina; Vaz, Mário

2017-01-01

An advanced stage of a tooth decay promotes an extremely damaged tooth that needs endodontic treatment to be restored. When satisfactory coronal tooth structure remains, an artificial crown can be placed without a post. On the other hand, the treatment of seriously damaged teeth often require an endodontic post. The main reason for using post is to enable rebuilding of the tooth structure prior to crown restoration. Dentists believe that endodontic posts provide a stable ...

[Theory and practice of minimally invasive endodontics].

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Jiang, H W

2016-08-01

The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient. Thus, minimally invasive endodontics(MIE)has received increasing attention at present. MIE aims to preserve the maximum of tooth structure during root canal therapy, and the concept covers the whole process of diagnosis and treatment of teeth. This review article focuses on describing the minimally invasive concepts and operating essentials in endodontics, from diagnosis and treatment planning to the access opening, pulp cavity finishing, root canal cleaning and shaping, 3-dimensional root canal filling and restoration after root canal treatment.

Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis.

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Rôças, Isabela N; Siqueira, José F

2018-01-01

Acute apical abscess is caused by bacteria that leave the infected dental root canal to invade the periodontal tissues. Most species occurring in abscesses are also found in asymptomatic infections; therefore, the possibility exists that not only the presence of certain species but also their specific counts influence the appearance of symptoms. This molecular study compared the frequency and levels of several candidate endodontic pathogens in teeth with acute apical abscesses and asymptomatic apical periodontitis. Samples were taken from the root canals of teeth with asymptomatic apical periodontitis (n = 73) and by aspiration of purulent exudate from acute abscesses (n = 55). DNA was extracted from samples and bacterial identifications were performed by a closed-ended semi-quantitative reverse-capture checkerboard approach targeting 40 bacterial species/phylotypes. Bacterial DNA was detected in all cases. In abscesses, the most prevalent taxa were Fusobacterium nucleatum (60%), Porphyromonas endodontalis (53%), Parvimonas micra (51%), and Streptococcus species (45%). The most frequently detected taxa in asymptomatic teeth were P. endodontalis (63%), Dialister invisus (58%), Olsenella uli (56%), and F. nucleatum (51%). None of the targeted taxa were significantly associated with abscesses when only mere presence was evaluated (p>0.05). However, semi-quantitative data demonstrated that P. endodontalis, Prevotella baroniae, Treponema denticola and Streptococcus species were significantly more frequent at levels >105 in abscesses than in asymptomatic cases (p<0.05). None of the target species/phylotypes were associated with abscesses in terms of frequency. However, some taxa were significantly found in higher levels in abscesses. Presence of a potentially virulent pathogen in high counts may increase the collective pathogenicity of the bacterial community and give rise to symptoms.

Microbial transformation from normal oral microbiota to acute endodontic infections

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Hsiao William WL

2012-07-01

Full Text Available Abstract Background Endodontic infections are a leading cause of oro-facial pain and tooth loss in western countries, and may lead to severe life-threatening infections. These infections are polymicrobial with high bacterial diversity. Understanding the spatial transition of microbiota from normal oral cavities through the infected root canal to the acute periapical abscess can improve our knowledge of the pathogenesis of endodontic infections and lead to more effective treatment. We obtained samples from the oral cavity, infected root canal and periapical abscess of 8 patients (5 with localized and 3 with systemic infections. Microbial populations in these samples were analyzed using next-generation sequencing of 16S rRNA amplicons. Bioinformatics tools and statistical tests with rigorous criteria were used to elucidate the spatial transition of the microbiota from normal to diseased sites. Results On average, 10,000 partial 16S rRNA gene sequences were obtained from each sample. All sequences fell into 11 different bacterial phyla. The microbial diversity in root canal and abscess samples was significantly lower than in the oral samples. Streptococcus was the most abundant genus in oral cavities while Prevotella and Fusobacterium were most abundant in diseased samples. The microbiota community structures of root canal and abscess samples were, however, more similar to each other than to the oral cavity microbiota. Using rigorous criteria and novel bioinformatics tools, we found that Granulicatella adiacens, Eubacterium yurii, Prevotella melaninogenica, Prevotella salivae, Streptococcus mitis, and Atopobium rimae were over-represented in diseased samples. Conclusions We used a novel approach and high-throughput methodologies to characterize the microbiota associated normal and diseased oral sites in the same individuals.

Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis

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Rôças, Isabela N.

2018-01-01

Introduction Acute apical abscess is caused by bacteria that leave the infected dental root canal to invade the periodontal tissues. Most species occurring in abscesses are also found in asymptomatic infections; therefore, the possibility exists that not only the presence of certain species but also their specific counts influence the appearance of symptoms. This molecular study compared the frequency and levels of several candidate endodontic pathogens in teeth with acute apical abscesses and asymptomatic apical periodontitis. Methods Samples were taken from the root canals of teeth with asymptomatic apical periodontitis (n = 73) and by aspiration of purulent exudate from acute abscesses (n = 55). DNA was extracted from samples and bacterial identifications were performed by a closed-ended semi-quantitative reverse-capture checkerboard approach targeting 40 bacterial species/phylotypes. Results Bacterial DNA was detected in all cases. In abscesses, the most prevalent taxa were Fusobacterium nucleatum (60%), Porphyromonas endodontalis (53%), Parvimonas micra (51%), and Streptococcus species (45%). The most frequently detected taxa in asymptomatic teeth were P. endodontalis (63%), Dialister invisus (58%), Olsenella uli (56%), and F. nucleatum (51%). None of the targeted taxa were significantly associated with abscesses when only mere presence was evaluated (p>0.05). However, semi-quantitative data demonstrated that P. endodontalis, Prevotella baroniae, Treponema denticola and Streptococcus species were significantly more frequent at levels >105 in abscesses than in asymptomatic cases (pabscesses in terms of frequency. However, some taxa were significantly found in higher levels in abscesses. Presence of a potentially virulent pathogen in high counts may increase the collective pathogenicity of the bacterial community and give rise to symptoms. PMID:29293651

The 'E' factor -- evolving endodontics.

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Hunter, M J

2013-03-01

Endodontics is a constantly developing field, with new instruments, preparation techniques and sealants competing with trusted and traditional approaches to tooth restoration. Thus general dental practitioners must question and understand the significance of these developments before adopting new practices. In view of this, the aim of this article, and the associated presentation at the 2013 British Dental Conference & Exhibition, is to provide an overview of endodontic methods and constantly evolving best practice. The presentation will review current preparation techniques, comparing rotary versus reciprocation, and question current trends in restoration of the endodontically treated tooth.

Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst.

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MacGee, Scott

2014-01-01

Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis.

Peritonsillar Abscess

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... tonsils). But they can also be caused by mononucleosis (also called mono), or tooth and gum infections. ... Family Health, Kids and Teens, Men, WomenTags: abscess, mononucleosis, peritonsillar abscess, pharyngitis, Throat Pain, tonsilitis, tonsils September ...

Regenerative endodontics--biologically-based treatment for immature permanent teeth: a case report and review of the literature.

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Thomson, A; Kahler, B

2010-12-01

A paradigm shift in the treatment of immature, necrotic teeth has occurred with biologically-based principles and regenerative endodontic protocols replacing traditional 'apexification' procedures. Preliminary research suggests that stem and progenitor cells from the pulp and/or periodontium contribute to continued root development when regenerative procedures are followed. A mandibular premolar tooth with a chronic periapical abscess was irrigated with sodium hypochlorite with minimal instrumentation and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was evoked in the canal by irritating periapical tissues and the canal sealed with mineral trioxide aggregate, glass ionomer cement and composite resin. Resolution of apical periodontitis and the draining sinus, continued root maturation and apical closure occurred over an 18-month period. The tooth became responsive to pulp sensibility testing. It is important that dentists recognize the potential of regenerative endodontics in the treatment of necrotic, immature teeth. Initial management should involve irrigation with sodium hypochlorite only. Intra-canal medicaments, such as calcium hydroxide, are contraindicated as they inhibit further root growth. This report uses a variation of the tri-antibiotic paste currently recommended for regenerative procedures that avoided the discolouration of the crown associated with current protocols. Regenerative endodontics with continued root growth may reduce the risk of fracture and premature tooth loss associated with traditional 'apexification' procedures where the root remains thin and weak. © 2010 Australian Dental Association.

Assessment of the Effect of Orthodontic Treatment on the Periodontal Health of Endodontically Restored Tooth.

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Jalaluddin, Md; Goyal, Vinod; Naqvi, Zuber A; Gupta, Bhaskar; Asnani, Mohil M; Sonigra, Hitesh M

2017-07-01

Intorduction: Patients usually undergo orthodontic treatment for achieving ideal interocclusal relationship between the dental tissue and bony tissue along with improving the speech, mastication, and facial esthetic appearance. Literature quotes paucity in the studies evaluating the effect of orthodontic treatment on the periodontal health of endodontically treated teeth. Hence, we planned the present study to assess the effect of orthodontic treatment on the periodontal health of endodonti-cally restored tooth. The present study included assessment of 80 patients who underwent orthodontic treatment. All the patients were divided broadly into two study groups: groups I and II. Group I included patients with the absence of endodontically treated teeth, while group II included patients which maxillary central incisors were resorted endodontically. Examination of the periodontal health of the patients was done using the community periodontal index of treatment need (CPITN) around the selected teeth. All the values were recorded during the preorthodontic time, postorthodontic time, and after the first 6 months of starting of the orthodontic treatment. All the results were recorded separately and analyzed. In the groups I and II, 28 and 25 patients respectively, had score of 1, while 10 patients in group I and 12 patients in group II had score of 2. Nonsignificant results were obtained while comparing the CPITN score in between the two study groups when measured at the pre-, intra-, and postortho time. In patients undergoing orthodontic treatment, having endodontically resorted teeth, no difference exists in relation to the periodontal health. Orthodontic treatment can be safely carried in patients with endodontically restored teeth.

Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide

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Vinaya Kumar Kulkarni

2012-01-01

Full Text Available Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation.

Chondroblastic osteosarcoma mimicking periapical abscess.

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Yamamoto-Silva, Fernanda Paula; Silva, Brunno Santos de Freitas; Batista, Aline Carvalho; Mendonça, Elismauro Francisco de; Pinto-Júnior, Décio Dos Santos; Estrela, Carlos

2017-01-01

The present report describes a case of chondroblastic osteosarcoma in the periapical region of teeth #29, #30, and #31 of an 18-year-old male. Clinical history showed self-reported discomfort in the right posterior gingiva for over a month. Physical examination showed a small expansion and redness of the right mandibular buccal and lingual cortical plates, but no signs of pain or inflammation were observed. All the teeth responded positively to pulp sensibility. Periapical and panoramic radiographs showed slight periapical radiolucency in the roots of teeth #29 and #30, clear periodontal ligament space widening, and evident loss of lamina dura. Incisional biopsy was performed, and based on microscopic findings the diagnosis of chondroblastic osteosarcoma was confirmed. Non-endodontic diseases associated with tooth root apex, such as chondroblastic osteosarcoma, should be included in differential diagnosis of jaw lesions that resemble periapical abscess.

Influence of Cone-beam Computed Tomography on Endodontic Retreatment Strategies among General Dental Practitioners and Endodontists.

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Rodríguez, Gustavo; Patel, Shanon; Durán-Sindreu, Fernando; Roig, Miguel; Abella, Francesc

2017-09-01

Treatment options for endodontic failure include nonsurgical or surgical endodontic retreatment, intentional replantation, and extraction with or without replacement of the tooth. The aim of the present study was to determine the impact of cone-beam computed tomographic (CBCT) imaging on clinical decision making among general dental practitioners and endodontists after failed root canal treatment. A second objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. Eight patients with endodontically treated teeth diagnosed as symptomatic apical periodontitis, acute apical abscess, or chronic apical abscess were selected. In the first session, the examiners were given the details of each case, including any relevant radiographs, and were asked to choose 1 of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 8 cases with the additional information from the CBCT data. The examiners altered their treatment plan after viewing the CBCT scan in 49.8% of the cases. A significant difference in the treatment plan between the 2 imaging modalities was recorded for endodontists and general practitioners (P < .05). After CBCT evaluation, neither group altered their self-reported level of difficulty when choosing a treatment plan (P = .0524). The extraction option rose significantly to 20% after viewing the CBCT scan (P < .05). CBCT imaging directly influences endodontic retreatment strategies among general dental practitioners and endodontists. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Periodontal-endodontic lesion of a three-rooted maxillary premolar: report of a case.

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Blanchard, Steven B; Almasri, Amjad; Gray, Jonathon L

2010-05-01

A 43-year-old African American male initially presented for a dental evaluation of a recurrent swelling on the buccal aspect of tooth #12. His medical history was unremarkable except for a 20-pack year history of smoking. He was eventually diagnosed as having a necrotic pulp #12, and received root canal treatment. The patient's problem was unresolved, and he was subsequently referred for a periodontal evaluation with a presumptive diagnosis of a periodontal abscess. A flap was reflected from teeth #11 through #15. A buccal furcation invasion was discovered on #12. Shortly thereafter, three distinct roots with three grade III furcation invasions were located. The tooth was deemed untreatable, and was extracted. The thin buccal plate of the extraction socket was preserved using freeze-dried bone allograft to facilitate future prosthodontic replacement. Healing was uneventful. Periodontal open flap debridement surgery was provided for the remainder of the mouth, and the patient was placed on a 3-month recall program. Periodontitis associated with endodontic lesions are among the most daunting diagnostic and therapeutic challenges faced by periodontists. This is particularly true for maxillary premolars with multiple roots. The tooth in this case, once periodontally involved, had a very poor prognosis. The prognosis was further compromised by the pulpal involvement. Therapy consisted of extraction of the tooth to relieve the patient's discomfort and treating the adjacent teeth with periodontal open flap debridement surgery. A review of the literature pertinent to the diagnosis and management of periodontal-endodontic lesions is also presented.

Endodontic therapy for a fused mandibular molar.

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Rotstein, I; Moshonov, J; Cohenca, N

1997-06-01

Variations in tooth morphology present a clinical challenge when endodontic treatment is required. A case of conservative endodontic therapy for a fused mandibular second and third molar is presented.

Oxidative stress in patients with endodontic pathologies.

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Vengerfeldt, Veiko; Mändar, Reet; Saag, Mare; Piir, Anneli; Kullisaar, Tiiu

2017-01-01

Apical periodontitis (AP) is an inflammatory disease affecting periradicular tissues. It is a widespread condition but its etiopathogenetic mechanisms have not been completely elucidated and the current treatment options are not always successful. To compare oxidative stress (OxS) levels in the saliva and the endodontium (root canal [RC] contents) in patients with different endodontic pathologies and in endodontically healthy subjects. The study group of this comparison study included 22 subjects with primary chronic apical periodontitis (pCAP), 26 with posttreatment or secondary chronic apical periodontitis (sCAP), eight with acute periapical abscess, 13 with irreversible pulpitis, and 17 healthy controls. Resting saliva samples were collected before clinical treatment. Pulp samples (remnants of the pulp, tooth tissue, and/or previous root filling material) were collected under strict aseptic conditions using the Hedström file. The samples were frozen to -80°C until analysis. OxS markers (myeloperoxidase [MPO], oxidative stress index [OSI], 8-isoprostanes [8-EPI]) were detected in the saliva and the endodontium. The highest MPO and 8-EPI levels were seen in pCAP and pulpitis, while the highest levels of OSI were seen in pCAP and abscess patients, as well as the saliva of sCAP patients. Controls showed the lowest OxS levels in both RC contents and saliva. Significant positive correlations between OxS markers, periapical index, and pain were revealed. Patients with pain had significantly higher OxS levels in both the endodontium (MPO median 27.9 vs 72.6 ng/mg protein, p =0.004; OSI 6.0 vs 10.4, p <0.001; 8-EPI 50.0 vs 75.0 pg/mL, p <0.001) and saliva (MPO 34.2 vs 117.5 ng/mg protein, p <0.001; 8-EPI 50.0 vs 112.8 pg/mL, p <0.001) compared to pain-free subjects. OxS is an important pathomechanism in endodontic pathologies that is evident at both the local (RC contents) and systemic (saliva) level. OxS is significantly associated with dental pain and bone

Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth--report of two cases.

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Tsesis, I; Steinbock, N; Rosenberg, E; Kaufman, A Y

2003-05-01

Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.

Single-visit endodontic treatment of mature teeth with chronic apical abscesses using mineral trioxide aggregate cement: a randomized clinical trial.

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Alsulaimani, Reem Siraj

2016-08-23

Mature teeth with chronic apical abscesses characterized by intermittent discharge of pus through an associated sinus tract. This communication between oral mucosa and periapical inflammation is challenging for the sealing ability of root canal obturation material. Therefore, the study aim was to compare the outcomes of endodontic treatment using mineral trioxide aggregate (MTA) cement to the conventional gutta-percha cone and root canal sealer as an obturation material in mature teeth with chronic apical abscesses. Mature teeth with chronic apical abscesses referred to our clinic for root canal treatment between 2010 and 2012 were treated in a single visit and distributed among treatment (T) and control (C) groups using a predetermined randomization block (TCTC). After chemo-mechanical preparation, teeth in group T received MTA cement mixed in a 0.26 water to powder ratio, and teeth group C received gutta-percha and root canal sealer using the warm vertical technique. The treatment outcomes were defined as obturation length, periapical healing, resorption of extruded material, and survival rate at least 2.5 years after treatment. Three endodontists blinded to the type of obturation material documented treatment outcomes. Statistical analysis at P chronic apical abscesses using MTA cement were better, but not statistically significant, compared to conventional treatment. ISRCTN15285974 . Registered retrospectively 23 June 2015.

Maxillary sinusitis and periapical abscess following periodontal therapy: a case report using three-dimensional evaluation.

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Huang, Chih-Hao; Brunsvold, Michael A

2006-01-01

Maxillary sinusitis may develop from the extension of periodontal disease. In this case, reconstructed three-dimensional images from multidetector spiral computed tomographs were helpful in evaluating periodontal bony defects and their relationship with the maxillary sinus. A 42-year-old woman in good general health presented with a chronic deep periodontal pocket on the palatal and interproximal aspects of tooth #14. Probing depths of the tooth ranged from 2 to 9 mm, and it exhibited a Class 1 mobility. Radiographs revealed a close relationship between the root apex and the maxillary sinus. The patient's periodontal diagnosis was localized severe chronic periodontitis. Treatment of the tooth consisted of cause-related therapy, surgical exploration, and bone grafting. A very deep circumferential bony defect at the palatal root of tooth #14 was noted during surgery. After the operation, the wound healed without incidence, but 10 days later, a maxillary sinusitis and periapical abscess developed. To control the infection, an evaluation of sinus and alveolus using computed tomographs was performed, systemic antibiotics were prescribed, and endodontic treatment was initiated. Two weeks after surgical treatment, the infection was relieved with the help of antibiotics and endodontic treatment. Bilateral bony communications between the maxillary sinus and periodontal bony defect of maxillary first molars were shown on three-dimensional computed tomographs. The digitally reconstructed images added valuable information for evaluating the periodontal defects. Three-dimensional images from spiral computed tomographs (CT) aided in evaluating and treating the close relationship between maxillary sinus disease and adjacent periodontal defects.

Clinical considerations for regenerative endodontic procedures.

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Geisler, Todd M

2012-07-01

The management of a tooth with incomplete root maturation and a necrotic pulp is an endodontic and a restorative challenge. Apexification procedures alone leave the tooth in a weakened state and at risk for reinfection. Regenerative endodontic procedures potentially offer advantages, including the possibility of hard tissue deposition and continued root development. Case studies have reported regeneration of human pulplike tissues in vivo, but there is no protocol that reliably regenerates pulplike tissue. This article summarizes historical, current, and future regenerative treatment approaches. Copyright © 2012 Elsevier Inc. All rights reserved.

From stem to roots: Tissue engineering in endodontics

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Kala, M.; Banthia, Priyank; Banthia, Ruchi

2012-01-01

The vitality of dentin-pulp complex is fundamental to the life of tooth and is a priority for targeting clinical management strategies. Loss of the tooth, jawbone or both, due to periodontal disease, dental caries, trauma or some genetic disorders, affects not only basic mouth functions but aesthetic appearance and quality of life. One novel approach to restore tooth structure is based on biology: regenerative endodontic procedure by application of tissue engineering. Regenerative endodontics is an exciting new concept that seeks to apply the advances in tissue engineering to the regeneration of the pulp-dentin complex. The basic logic behind this approach is that patient-specific tissue-derived cell populations can be used to functionally replace integral tooth tissues. The development of such ‘test tube teeth’ requires precise regulation of the regenerative events in order to achieve proper tooth size and shape, as well as the development of new technologies to facilitate these processes. This article provides an extensive review of literature on the concept of tissue engineering and its application in endodontics, providing an insight into the new developmental approaches on the horizon. Key words:Regenerative, tissue engineering, stem cells, scaffold. PMID:24558528

Outcomes of endodontic therapy in general practice

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Bernstein, Susan D.; Horowitz, Allan J.; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A.; Collie, Damon; Matthews, Abigail G.; Curro, Frederick A.; Thompson, Van P.; Craig, Ronald G.

2014-01-01

Background The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Methods Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for

Diversity of spirochetes in endodontic infections.

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Sakamoto, Mitsuo; Siqueira, José F; Rôças, Isabela N; Benno, Yoshimi

2009-05-01

The diversity of spirochetes in primary endodontic infections of teeth with chronic apical periodontitis or acute apical abscesses was investigated using 16S rRNA gene clone library analysis. The prevalences of three common cultivable oral Treponema species were also determined using species-specific nested PCR. All detected spirochetes belonged to the genus Treponema. Overall, 28 different taxa were identified from the 431 clones sequenced: 9 cultivable and validly named species, 1 cultivable as-yet-uncharacterized strain, and 18 as-yet-uncultivated phylotypes, 17 of which were novel. The large majority of clones (94%) were from cultivable named species. The numbers of Treponema species/phylotypes per selected positive sample ranged from 2 to 12. Species-specific nested PCR detected T. denticola, T. socranskii, and T. maltophilum in 59 (66%), 33 (37%), and 26 (29%) of the 90 cases of primary endodontic infections, respectively. Clone library analysis revealed diverse Treponema species/phylotypes as part of the microbiota associated with asymptomatic and symptomatic (abscess) endodontic infections. Although several as-yet-uncultivated Treponema phylotypes were disclosed, including novel taxa, cultivable named species were more abundant and frequently detected.

Long-term observation of endodontic surgical intervention to treat root perforation and apical periodontitis: a case report of an amalgam-restored tooth.

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Tsurumachi, Tamotsu; Hayashi, Makoto

2003-10-01

A case of crestal root perforation and periapical lesion in a maxillary left lateral incisor is reported. Teeth with root perforation present technical difficulties in their clinical management because of their complex defects. In the present case, surgical endodontic treatment was chosen. The apical and lateral pathology was curetted, the tooth root was resected, and a retrograde root restoration of amalgam was placed in a root-end cavity and perforation site. A 10-year follow-up clinical and radiographic examination showed an asymptomatic tooth with osseous healing proceeding.

Endodontic management of nonrestorable teeth in patients at risk of developing osteonecrosis of the jaw: Case series

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Fahd Alsalleeh

2016-01-01

Full Text Available Osteoradionecrosis of the jaws is one of the most serious oral complications of head and neck cancer radiation therapy. It is a self-progressive process of bone destruction that is very difficult to treat. In this report, four patients who are susceptible to osteonecrosis of the jaw presented for endodontic management of nonrestorable teeth. The first patient had two molar teeth with necrotic pulp and was treated with nonsurgical root canal therapy (NSRCT followed by crown amputation and hemisection. The second patient had a molar tooth that was previously treated with acute apical abscess. Crown amputation and hemisection were performed. The third patient had a molar tooth with necrotic pulp and asymptomatic apical periodontitis. NSRCT followed by occlusal reduction were completed. The fourth patient had a molar tooth with necrotic pulp and symptomatic apical periodontitis. NSRCT and crown amputation were performed. All cases had a minimum recall of 12-months. The tooth in case #1 developed a periapical pathosis, and other teeth in case #1–#3 had healing of periapical lesions. The tooth in case #4 was exfoliated. None had developed osteonecrosis. These results suggest that NSRCT is the treatment option to manage nonrestorable teeth in postradiation patients or patients taking bisphosphonate drugs to prevent osteonecrosis.

[Periodontal abscess: etiology, diagnosis and treatment].

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Vályi, Péter; Gorzó, István

2004-08-01

The periodontal abscess is an acute destructive process in the periodontium resulting in localized collections of pus communicating with the oral cavity through the gingival sulcus or other periodontal sites and not arising from the tooth pulp. The prevalence of periodontal abscess is relatively high and it affects the prognosis of the tooth. Periodontal abscesses can develop on the base of persisting periodontitis but can also occur in the absence of periodontitis. The cause of the development of periodontal abscess originating from chronic periodontitis is the marginal closure of a periodontal pocket, or the pocket lumen might be too tight to drain the increased suppuration due to changes in the composition of subgingival microflora, alteration of bacterial virulence or host defenses. Diagnosis of a periodontal abscess is based on medical and dental history as well as oral examination (pocket depth, swelling, suppuration, mobility, sensibility of the tooth). The most prevalent group of bacteria: P. gingivalis, P. intermedia, B. forsythus, F. nucleatum and P. micros. Previous studies have suggested that the complete therapy of the periodontitis patients with acute periodontal abscess has to do in two stages: the first stage is the management of acute lesions, then the second stage is the appropriate comprehensive treatment of the original and/or residual lesions. The management of acute lesions includes establishing drainage via pocket lumen, subgingival scaling and root planing, curettage of the lining pocket epithelia and seriously inflamed connective tissue, compressing pocket wall to underlying tooth and periodontal support, and maintaining tissue contact. Some authors recommend the incision or to establish drainage and irrigation, or a flap surgery, or even extraction of hopeless teeth. We recommend the use of systemic antibiotics as a preventive measure of systemic disease or in case of systemic symptoms.

Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.

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Cope, Anwen; Francis, Nick; Wood, Fiona; Mann, Mala K; Chestnutt, Ivor G

2014-06-26

publication when searching the electronic databases. Randomised controlled trials of systemic antibiotics in adults with a clinical diagnosis of symptomatic apical periodontitis or acute apical abscess, with or without surgical intervention (considered in this situation to be extraction, incision and drainage or endodontic treatment) and with or without analgesics. Two review authors screened the results of the searches against inclusion criteria, extracted data and assessed risk of bias independently and in duplicate. We calculated mean differences (MD) (standardised mean difference (SMD) when different scales were reported) and 95% confidence intervals (CI) for continuous data and, where results were meta-analysed, we used a fixed-effect model as there were fewer than four studies. We contacted study authors to obtain missing information. We included two trials in this review, with 62 participants included in the analyses. Both trials were conducted in university dental schools in the USA and compared the effects of oral penicillin V potassium (penicillin VK) versus a matched placebo given in conjunction with a surgical intervention (total or partial pulpectomy) and analgesics to adults with acute apical abscess or symptomatic necrotic tooth (no signs of spreading infection or systemic involvement (fever, malaise)). We assessed one study as having a high risk of bias and the other study as having unclear risk of bias.The primary outcome variables presented were participant-reported pain and swelling (one trial also reported participant-reported percussion pain). One study reported the type and number of analgesics taken by participants. One study recorded the incidence of postoperative endodontic flare-ups (people who returned with symptoms that necessitated further treatment). Adverse effects as reported in one study were diarrhoea (one participant, placebo group) and fatigue and reduced energy postoperatively (one participant, antibiotic group). No studies reporting

Viral-bacterial associations in acute apical abscesses.

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Ferreira, Dennis C; Rôças, Isabela N; Paiva, Simone S M; Carmo, Flávia L; Cavalcante, Fernanda S; Rosado, Alexandre S; Santos, Kátia R N; Siqueira, José F

2011-08-01

Viral-bacterial and bacterial synergism have been suggested to contribute to the pathogenesis of several human diseases. This study sought to investigate the possible associations between 9 candidate endodontic bacterial pathogens and 9 human viruses in samples from acute apical abscesses. DNA extracts from purulent exudate aspirates of 33 cases of acute apical abscess were surveyed for the presence of 9 selected bacterial species using a 16S ribosomal RNA gene-based nested polymerase chain reaction (PCR) approach. Single or nested PCR assays were used for detection of the human papillomavirus (HPV) and herpesviruses types 1 to 8. Two-thirds of the abscess samples were positive for at least one of the target viruses. Specifically, the most frequently detected viruses were HHV-8 (54.5%); HPV (9%); and varicella zoster virus (VZV), Epstein-Barr virus (EBV), and HHV-6 (6%). Bacterial DNA was present in all cases and the most prevalent bacterial species were Treponema denticola (70%), Tannerella forsythia (67%), Porphyromonas endodontalis (67%), Dialister invisus (61%), and Dialister pneumosintes (57.5%). HHV-8 was positively associated with 7 of the target bacterial species and HPV with 4, but all these associations were weak. Several bacterial pairs showed a moderate positive association. Viral coinfection was found in 6 abscess cases, but no significant viral association could be determined. Findings demonstrated that bacterial and viral DNA occurred concomitantly in two-thirds of the samples from endodontic abscesses. Although this may suggest a role for viruses in the etiology of apical abscesses, the possibility also exists that the presence of viruses in abscess samples is merely a consequence of the bacterially induced disease process. Further studies are necessary to clarify the role of these viral-bacterial interactions, if any, in the pathogenesis of acute apical abscesses. Copyright © 2011 Mosby, Inc. All rights reserved.

Microbiologic endodontic status of young traumatized tooth.

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Baumotte, Karla; Bombana, Antonio C; Cai, Silvana

2011-12-01

Traumatic dental injuries could expose the dentin and, even the pulp, to the oral environment, making possible their contamination. The presence of microorganisms causes pulpal disease and further a tecidual clutter in the periradicular region. The therapy of periradicular pathosis is the consequence of a correct diagnoses which depends on the knowledge of the nature and complexity of endodontic infections. As there is no information on the microbiology of primary endodontic infection in young teeth, the aim of the current study was to investigate the microbiologic status of root canals from permanent young teeth with primary endodontic infection. Twelve patients with the need for endodontic treatment participated in the study. The selected teeth were uniradicular and had an incomplete root formation. They had untreated necrotic pulp. After the access preparation, nineteen microbiologic samples were obtained from the root canals with sterile paper points. Afterwards, the paper points were pooled in a sterile tube containing 2 ml of prereduced transport fluid. The samples were diluted and spread onto plates with selective medium for Enterococcus spp. and for yeast species and onto plates with non-selective medium. A quantitative analysis was performed. The mean number of cultivable bacterial cells in the root canals was 5.7 × 10(6). In four samples (21.05%) black pigmented species were recovered and the mean number of cells was 6.5 × 10(5). One specimen (5.25%) showed the growth of Enterococcus species and the mean number of cells in this case was of 1.5 × 10(4) . The results showed a root canal microbiota with similar design as seen in completely formed teeth. © 2011 John Wiley & Sons A/S.

Orthodontic Movement after Regenerative Endodontic Procedure: Case Report and Long-term Observations.

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Chaniotis, Antonis

2018-03-01

Although regenerative treatment approaches in teeth with incomplete root formation and pulp necrosis have become part of the suggested therapeutic endodontic spectrum, little is known about the effect of orthodontic movement in the tissue that has been regenerated. Furthermore, as the number of adults undergoing orthodontic treatment increases, there is an increasing need to investigate the changes that these tissues may undergo during orthodontic movement. Here we describe the alterations observed after the application of orthodontic forces in a case of an apically root-fractured necrotic immature root that had been managed with regenerative endodontic procedures in the past. A 9-year-old male patient was referred after suffering the third incidence of trauma in the anterior maxilla. Radiographic evaluation revealed a periapical rarefaction associated with an apically root-fractured immature central incisor. Clinical evaluation revealed a buccal abscess and grade 3 tooth mobility. Periodontal probing was within normal limits. The tooth was accessed and disinfected by using apical negative pressure irrigation of 6% NaOCl. Intracanal dentin conditioning was achieved by using 17% EDTA for 5 minutes. A blood clot was induced from the periapical area, and calcium silicate-based cement was placed in direct contact with the blood clot at the same visit. The composite resin restoration was accomplished in the same appointment. Recall radiographic examination after 24 months revealed healing of the periapical lesion and signs of continuous root development despite the apical root fracture. Clinical evaluation revealed normal tooth development, normal mobility, and a resolving buccal infection. The tooth was subjected to orthodontic treatment because of Class II division 1 malocclusion with an overjet of 11 mm. After completion of the orthodontic treatment, 5.5 years after the initial intervention, the radiographic image revealed marked remodeling of the periapical

Antibacterial efficacy and drug-induced tooth discolouration of antibiotic combinations for endodontic regenerative procedures.

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Mandras, N; Roana, J; Allizond, V; Pasqualini, D; Crosasso, P; Burlando, M; Banche, G; Denisova, T; Berutti, E; Cuffini, A M

2013-01-01

Elimination of microbial contamination from the root canal system is a precondition for successful root canal treatment. Teeth with immature root development, necrotic pulps and apical periodontitis present multiple challenges for successful treatment. Disinfection is achieved by irrigation followed by the placement of an intracanal medicament. A mixture of ciprofloxacin, metronidazole and minocycline (3-MIX S) has been shown to be very effective in eliminating endodontic pathogens in vitro and in vivo. Among the components of the mixture, minocycline can induce tooth discolouration after long-term oral use. Therefore, the elimination of minocycline from the above-mentioned combination has been suggested to prevent the occasion of this undesirable effect. The aim of this study was to investigate the potential antimicrobial efficacy of alternative antibiotic combinations [3-MIX C (clarithromycin); 3-MIX F (fosfomycin)] against bacteria from infected root canals. An additional objective was to evaluate their discolouration potential as possible alternatives to minocycline-based intracanal medicaments. Our in vitro results clearly demonstrated that 3-MIX C and 3-MIX F had a greater antimicrobial activity than 3-MIX S, underlying that clarithromycin still had a higher capacity to kill endodontic pathogens in vitro compared to fosfomycin. Both 3-MIX C and 3-MIX F were able to avoid the permanent staining effect of the crown.

The annual frequency of root fillings, tooth extractions and pulp-related procedures in Danish adults during 1977-2003

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Bjørndal, L.; Reit, C.

2004-01-01

endodontic epidemiology, frequency of root fillings, pulp capping, stepwise excavation, tooth extractions......endodontic epidemiology, frequency of root fillings, pulp capping, stepwise excavation, tooth extractions...

Traumatic bone cyst suggestive of a chronic periapical abscess: a case report.

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Kahler, Bill

2011-08-01

Traumatic bone cysts can mimic the signs and symptoms of an endodontic lesion. This case reports on a 19-year-old male patient who was referred for endodontic assessment of a symptomatic tooth with a gingival swelling and a draining sinus at the furcation of a mandibular second molar. Radiographically, a periradicular radiolucency is evident. A prior history of trauma as well as removal of the wisdom teeth was determined. After careful diagnosis unnecessary endodontic intervention was avoided. Surgical exploration, curettage and the generation of a blood clot resulted in healing at the 6 month review appointment. The tooth remained responsive to pulp sensibility testing at that time. © 2010 The Author. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature.

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Venskutonis, Tadas; Plotino, Gianluca; Juodzbalys, Gintaras; Mickevičienė, Lina

2014-12-01

To obtain essential information in clinical endodontics, cone-beam computed tomographic (CBCT) imaging can be used in all phases of treatment including diagnosis, treatment planning, during the treatment phase, and through post-treatment assessment and follow-up. The purpose of this article was to review the use of CBCT imaging in the diagnosis, treatment planning, and assessing the outcome of endodontic complications. Literature was selected through a search of PubMed electronic databases for the following keywords: tooth root injuries, tooth root radiography, tooth root perforation, tomography, cone-beam computed tomography, endodontic complications, tooth root internal/external resorption, root fractures, and broken instruments. The research was restricted to articles published in English. One hundred twelve articles met the inclusion criteria and were included in this review. Currently, intraoral radiography is the imaging technique of choice for the management of endodontic disease, but CBCT imaging appears to have a superior validity and reliability in the management of endodontic diagnosis and complications. Endodontic cases should be judged individually, and CBCT imaging should be considered in situations in which information from conventional imaging systems may not yield an adequate amount of information to allow the appropriate management of endodontic problems. CBCT imaging has the potential to become the first choice for endodontic treatment planning and outcome assessment, especially when new scanners with lower radiation doses will be available. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root canal treatment of mandibular second premolar tooth with taurodontism

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Vujašković Mirjana

2008-01-01

Full Text Available INTRODUCTION Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

[Endodontically treated teeth. Success--failure. Endorestorative treatment plan].

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Zabalegui, B

1990-01-01

More and more often the general dentist is finding the presence of endodontically treated teeth during his treatment planning procedure. He has to ask himself if the endo-treated tooth functions and will continue to function function successfully, when deciding which final endo-restorative procedure to apply. For this reason the dentist or the endodontist with whom he works should clinically evaluate these teeth, establish a diagnostic criteria of their success or failure and a treatment plan according to the prognosis. The purpose of this article is to offer an organized clinical view of the steps to follow when evaluating an endodontically treated tooth and how to establish a final endo-restorative plan.

Peritonsillar Abscess (For Teens)

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... t that common these days because doctors use antibiotics to treat tonsillitis. Tooth and gum disease can increase the chances of a peritonsillar abscess, as can smoking — more good reasons to brush your teeth and not smoke. ...

Oxidative stress in patients with endodontic pathologies

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Vengerfeldt V

2017-08-01

Full Text Available Veiko Vengerfeldt,1 Reet Mändar,2,3 Mare Saag,1 Anneli Piir,2 Tiiu Kullisaar2 1Institute of Dental Sciences, Faculty of Medicine, University of Tartu, 2Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, 3Competence Centre on Health Technologies, Tartu, Estonia Background: Apical periodontitis (AP is an inflammatory disease affecting periradicular tissues. It is a widespread condition but its etiopathogenetic mechanisms have not been completely elucidated and the current treatment options are not always successful.Purpose: To compare oxidative stress (OxS levels in the saliva and the endodontium (root canal [RC] contents in patients with different endodontic pathologies and in endodontically healthy subjects.Patients and methods: The study group of this comparison study included 22 subjects with primary chronic apical periodontitis (pCAP, 26 with posttreatment or secondary chronic apical periodontitis (sCAP, eight with acute periapical abscess, 13 with irreversible pulpitis, and 17 healthy controls. Resting saliva samples were collected before clinical treatment. Pulp samples (remnants of the pulp, tooth tissue, and/or previous root filling material were collected under strict aseptic conditions using the Hedström file. The samples were frozen to −80°C until analysis. OxS markers (myeloperoxidase [MPO], oxidative stress index [OSI], 8-isoprostanes [8-EPI] were detected in the saliva and the endodontium. Results: The highest MPO and 8-EPI levels were seen in pCAP and pulpitis, while the highest levels of OSI were seen in pCAP and abscess patients, as well as the saliva of sCAP patients. Controls showed the lowest OxS levels in both RC contents and saliva. Significant positive correlations between OxS markers, periapical index, and pain were revealed. Patients with pain had significantly higher OxS levels in both the endodontium (MPO median 27.9 vs 72.6 ng/mg protein, p=0.004; OSI 6.0 vs 10.4, p<0

A Rare Case of Type III Dens Invaginatus in a Mandibular Second Premolar and Its Nonsurgical Endodontic Management by Using Cone-beam Computed Tomography: A Case Report.

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Agrawal, Pritesh Kisanlal; Wankhade, Jyoti; Warhadpande, Manjusha

2016-04-01

Invaginated teeth present technical difficulties in clinical management because of their abnormal anatomic configuration. Endodontic clinical management of type III dens invaginatus can be greatly enhanced by newer techniques and materials such as cone-beam computed tomography (CBCT), mineral trioxide aggregate, and platelet-rich fibrin. This case report presents a 13-year-old male patient with type III dens invaginatus (DI) in left mandibular second premolar with history of recurrent swelling. Pulp testing revealed no response with the tooth. Dens invaginatus type III with an immature apex and periapical lesion was seen on radiograph. The case was diagnosed as Oehlers type III DI with pulp necrosis and chronic apical abscess. The treatment was planned and performed by using CBCT imaging. CBCT was performed to see the canal anatomy and to know the size of periapical lesion. Root canal treatment was completed in 2 visits. Calcium hydroxide dressing was placed in the first visit. In the second visit MTA was used for apexification in the main canal, and warm vertical compaction technique with gutta-percha was used in the invaginated canal. At the 2-year reevaluation, the patient was asymptomatic, and his tooth had remained functional since the treatment was completed. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Combinations of bacterial species associated with symptomatic endodontic infections in a Chinese population.

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Qi, Z; Cao, H; Jiang, H; Zhao, J; Tang, Z

2016-01-01

To use microarrays to detect 11 selected bacteria in infected root canals, revealing bacterial combinations that are associated with clinical symptoms and signs of primary endodontic infections in a Chinese population. DNA was extracted from 90 samples collected from the root canals of teeth with primary endodontic infections in a Chinese population, and the 16S rRNA gene was amplified by polymerase chain reaction (PCR). The PCR products were hybridized to microarrays containing specific oligonucleotide probes targeting 11 species, and the arrays were screened with a confocal laser scanner. Pearson's chi-squared test and cluster analysis were performed to investigate the associations between the bacterial combinations and clinical symptoms and signs using SAS 8.02. Seventy-seven samples (86%) yielded at least one of the 11 target species. Parvimonas micra (56%), Porphyromonas endodontalis (51%), Tannerella forsythia (48%), Prevotella intermedia (44%) and Porphyromonas gingivalis (37%) were the most prevalent taxa and were often concomitant. The following positive associations were found between the bacterial combinations and clinical features: P. endodontalis and T. forsythia with abscess; P. gingivalis and P. micra with sinus tract; P. gingivalis and P. endodontalis or P. micra and P. endodontalis with abscess and sinus tract; and the combination of P. endodontalis, P. micra, T. forsythia and P. gingivalis with sinus tract (P endodontalis, T. forsythia and P. gingivalis may contribute to abscesses or sinus tracts of endodontic origin with bacterial synergism in a Chinese population. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

One-visit endodontics.

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Ashkenaz, P J

1984-10-01

I would like to conclude with some personal observations and comments on the use of single-visit endodontics in private practice based on my 12 years of experience utilizing this procedure. I cannot stress in strong enough terms that one-visit endodontics should not be undertaken by the novice. As an evolutionary philosophy of treatment, its use grows out of a full understanding of fundamental endodontic principles by the experienced practitioner. It is only after considering all of the indications and contraindications in each case on an individual basis, that a decision should be made as to whether or not it can be completed in a single visit. However, it is also important for the practitioner to have a clinical sense of what can be accomplished once the rubber dam has been placed and work commenced on the tooth. I submit to you that this very important clinical sense can be gained only after many years of clinical experience. Therefore, the endodontic competence of the practicing dentist becomes the overriding factor in determining the outcome of any one particular case. This is not to say that only a specialized few can and should perform this procedure. However, it does mean that a high degree of clinical skill is necessary to perform it in a successful manner. The performance of better endodontics in multiple visits will ensure success in single visits. Therefore, it is incumbent upon the individual practitioner to objectively evaluate his or her endodontic skills. The clinician should critically evaluate every aspect of his or her endodontic practice by determining the incidences of biomechanical errors such as ledging, perforations, overinstrumentation, broken instruments, interappointment flare-ups, and failures. For only after evaluating these areas will the clinician have an indication as to his or her level of endodontic skill and whether or not future study and practice need be done in one or more specific aspects of endodontic practice. Once a high

Regenerative endodontics.

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Simon, S; Smith, A J

2014-03-01

Significant advances in our understanding of the biological processes involved in tooth development and repair at the cellular and molecular levels have underpinned the newly emerging area of regenerative endodontics. Development of treatment protocols based on exploiting the natural wound healing properties of the dental pulp and applying tissue engineering principles has allowed reporting of case series showing preservation of tissue vitality and apexogenesis. To review current case series reporting regenerative endodontics. Current treatment approaches tend to stimulate more reparative than regenerative responses in respect of the new tissue generated, which often does not closely resemble the physiological structure of dentine-pulp. However, despite these biological limitations, such techniques appear to offer significant promise for improved treatment outcomes. Improved biological outcomes will likely emerge from the many experimental studies being reported and will further contribute to improvements in clinical treatment protocols.

Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth.

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Garcia-Godoy, Franklin; Murray, Peter E

2012-02-01

The regeneration of immature permanent teeth following trauma could be beneficial to reduce the risk of fracture and loss of millions of teeth each year. Regenerative endodontic procedures include revascularization, partial pulpotomy, and apexogenesis. Several case reports give these procedures a good prognosis as an alternative to apexification. Care is needed to deliver regenerative endodontic procedures that maintain or restore the vitality of teeth, but which also disinfect and remove necrotic tissues. Regeneration can be accomplished through the activity of the cells from the pulp, periodontium, vascular, and immune system. Most therapies use the host's own pulp or vascular cells for regeneration, but other types of dental stem cell therapies are under development. There are no standardized treatment protocols for endodontic regeneration. The purpose of this article is to review the recent literature and suggest guidelines for using regenerative endodontic procedures for the treatment of permanent immature traumatized teeth. Recommendations for the selection of regenerative and conventional procedures based on the type of tooth injury, fracture type, presence of necrosis or infection, periodontal status, presence of periapical lesions, stage of tooth development, vitality status, patient age, and patient health status will be reviewed. Because of the lack of long-term evidence to support the use of regenerative endodontic procedures in traumatized teeth with open apices, revascularization regeneration procedures should only be attempted if the tooth is not suitable for root canal obturation, and after apexogenesis, apexification, or partial pulpotomy treatments have already been attempted and have a poor prognosis. © 2011 John Wiley & Sons A/S.

Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment.

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Shimizu, Emi; Ricucci, Domenico; Albert, Jeffrey; Alobaid, Adel S; Gibbs, Jennifer L; Huang, George T-J; Lin, Louis M

2013-08-01

Revitalization procedures have been widely used for the treatment of immature permanent teeth with apical periodontitis. The treatment procedures appear to be capable of encouraging continued root development and thickening of the canal walls. The nature of tissues formed in the canal space and at the root apex after revitalization has been shown histologically in several animal studies; similar studies in humans were recently reported. A 9-year-old boy had a traumatic injury to his upper anterior teeth. Tooth #9 suffered a complicated crown fracture with a pulp exposure, which was restored with a composite resin. The tooth developed a chronic apical abscess. Revitalization procedures were performed on tooth #9 because it was an immature permanent tooth with an open apex and thin canal walls. Twenty-six months after revitalization, the tooth had a horizontal crown fracture at the cervical level and could not be restored. The tooth was extracted and processed for routine histological and immunohistochemical examination to identify the nature of tissues formed in the canal space. Clinically and radiographically, the revitalization of the present case was successful because of the absence of signs and symptoms and the resolution of periapical lesion as well as thickening of the canal walls and continued root development. The tissue formed in the canal was well-mineralized cementum- or bone-like tissue identified by routine histology and immunohistochemistry. No pulp-like tissue characterized by the presence of polarized odontoblast-like cells aligning dentin-like hard tissue was observed. The tissues formed in the canal of revitalized human tooth are similar to cementum- or bone-like tissue and fibrous connective tissue. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The periodontal abscess: a review.

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Herrera, D; Roldán, S; Sanz, M

2000-06-01

The periodontal abscess is a frequent periodontal condition in which periodontal tissues may be rapidly destroyed. Its importance is based on the possible need of urgent care, the affectation of tooth prognosis, and the possibility of infection spreading. There is scant information in the scientific literature regarding this condition and most of it has been published as case reports and text books, where conclusions are not evidence-based, but rather empirical observations made by recognised clinicians. The aim of this review was to critically analyse all available information on this subject in the dental and medical literature, including information on its prevalence, proposed etiologies and pathogenesis, diagnosis, microbiology and treatment alternatives. The periodontal abscess is the 3rd most frequent dental emergency, and it is specially prevalent among untreated periodontal patients and periodontal patients during maintenance. Different etiologies have been proposed, and 2 main groups can be distinguished, depending on its relation with periodontal pockets. In the case of a periodontitis-related abscess, the condition may appear as an exacerbation of a non-treated periodontitis or during the course of periodontal therapy. In non-periodontitis related abscesses, impaction of foreign objects, and radicular abnormalities are the 2 main causes. The abscess microflora seems to be similar to that of adult periodontitis, and it is dominated by gram-negative anaerobic rods, including well-known periodontal pathogens. Complications and consequences include tooth loss and the spread of the infection to other body sites. Diagnosis and treatment is mainly based on empiricism, since evidence-based data are not available. The role of systemic antibiotics, in the treatment of periodontal abscesses, is especially controversial.

Metaproteome analysis of endodontic infections in association with different clinical conditions.

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José Claudio Provenzano

Full Text Available Analysis of the metaproteome of microbial communities is important to provide an insight of community physiology and pathogenicity. This study evaluated the metaproteome of endodontic infections associated with acute apical abscesses and asymptomatic apical periodontitis lesions. Proteins persisting or expressed after root canal treatment were also evaluated. Finally, human proteins associated with these infections were identified. Samples were taken from root canals of teeth with asymptomatic apical periodontitis before and after chemomechanical treatment using either NaOCl or chlorhexidine as the irrigant. Samples from abscesses were taken by aspiration of the purulent exudate. Clinical samples were processed for analysis of the exoproteome by using two complementary mass spectrometry platforms: nanoflow liquid chromatography coupled with linear ion trap quadrupole Velos Orbitrap and liquid chromatography-quadrupole time-of-flight. A total of 308 proteins of microbial origin were identified. The number of proteins in abscesses was higher than in asymptomatic cases. In canals irrigated with chlorhexidine, the number of identified proteins decreased substantially, while in the NaOCl group the number of proteins increased. The large majority of microbial proteins found in endodontic samples were related to metabolic and housekeeping processes, including protein synthesis, energy metabolism and DNA processes. Moreover, several other proteins related to pathogenicity and resistance/survival were found, including proteins involved with adhesion, biofilm formation and antibiotic resistance, stress proteins, exotoxins, invasins, proteases and endopeptidases (mostly in abscesses, and an archaeal protein linked to methane production. The majority of human proteins detected were related to cellular processes and metabolism, as well as immune defense. Interrogation of the metaproteome of endodontic microbial communities provides information on the

Metaproteome analysis of endodontic infections in association with different clinical conditions.

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Provenzano, José Claudio; Siqueira, José F; Rôças, Isabela N; Domingues, Romênia R; Paes Leme, Adriana F; Silva, Márcia R S

2013-01-01

Analysis of the metaproteome of microbial communities is important to provide an insight of community physiology and pathogenicity. This study evaluated the metaproteome of endodontic infections associated with acute apical abscesses and asymptomatic apical periodontitis lesions. Proteins persisting or expressed after root canal treatment were also evaluated. Finally, human proteins associated with these infections were identified. Samples were taken from root canals of teeth with asymptomatic apical periodontitis before and after chemomechanical treatment using either NaOCl or chlorhexidine as the irrigant. Samples from abscesses were taken by aspiration of the purulent exudate. Clinical samples were processed for analysis of the exoproteome by using two complementary mass spectrometry platforms: nanoflow liquid chromatography coupled with linear ion trap quadrupole Velos Orbitrap and liquid chromatography-quadrupole time-of-flight. A total of 308 proteins of microbial origin were identified. The number of proteins in abscesses was higher than in asymptomatic cases. In canals irrigated with chlorhexidine, the number of identified proteins decreased substantially, while in the NaOCl group the number of proteins increased. The large majority of microbial proteins found in endodontic samples were related to metabolic and housekeeping processes, including protein synthesis, energy metabolism and DNA processes. Moreover, several other proteins related to pathogenicity and resistance/survival were found, including proteins involved with adhesion, biofilm formation and antibiotic resistance, stress proteins, exotoxins, invasins, proteases and endopeptidases (mostly in abscesses), and an archaeal protein linked to methane production. The majority of human proteins detected were related to cellular processes and metabolism, as well as immune defense. Interrogation of the metaproteome of endodontic microbial communities provides information on the physiology and

Regenerative endodontics: a comprehensive review.

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Kim, S G; Malek, M; Sigurdsson, A; Lin, L M; Kahler, B

2018-05-19

The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics. © 2018 International Endodontic Journal. Published by

CALCIUM HYDROXIDE IN ENDODONTIC TREATMENT OF PERIAPICALLY INFECTED TEETH

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Rahmi Alma Farah Adang

2006-04-01

Full Text Available An inadequate endodontic treatment may affect the root canal system and spread beyond its apical foramina that elicit periodontal tissue developing into abscess, granuloma and radicular cyst. Periodical lesions can be treated with non surgical endodontic treatment using calcium hydroxide dressing. This case study is reporting teeth 11 with periodical lesions and infection. Evidence of a clinical healing and radiographic assessments were followed by a non surgical endodontic therapy. Successful treatment outcome is related to the elimination of infection agents from the root canal. This can activate a stimulation zone to promote regeneration. Calcium hydroxide used as a root canal dressing may promote alkalinity at the adjacent tissue , create favourable environmental condition in which hard tissue formation can occur, interfere the bactericidal activity, increase mineralization, and induce healing.

Regenerative endodontics: A state of the art

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Rashmi Bansal

2011-01-01

Full Text Available Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue grafting, tissue engineering, molecular biology and the human genome project provide the basis for the introduction of new technologies into dentistry. Non-vital infected teeth have long been treated with root canal therapy (for mature root apex and apexification (for immature root apex, or doomed to extraction. Although successful, current treatments fail to re-establish healthy pulp tissue in these teeth. But, what if the non-vital tooth could be made vital once again? That is the hope offered by regenerative endodontics, an emerging field focused on replacing traumatized and diseased pulp with functional pulp tissue. Restoration of vitality of non-vital tooth is based on tissue engineering and revascularization procedures. The purpose of this article is to review these biological procedures and the hurdles that must be overcome to develop regenerative endodontic procedures.

Effective exposure level and diagnostic performance in endodontic radiography

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Okano, T.; Wiebe, J.D.; Webber, R.L.; Wagner, R.F.

1983-01-01

Image quality is limited by the information capacity of the image-forming system and can be computed from three parameters: contrast, resolution, and noise. These parameters can be combined to yield a single measure which determines the maximum amount of information obtainable from any x-ray system and is called the noise-equivalent number of quanta (NEQ) per unit area. The effects of image quality, expressed as noise-equivalent number of quanta (NEQ) per unit area, on the radiographic performance by dentists reading the position of an endodontic file in a root canal were studied. Three different speed films were used in conjunction with a fixed screen. Components of variance associated with the position of the tooth apex and the tip of an endodontic file in a root canal were compared for the effect of different NEQs and observers. Results show that the standard deviation in locating a file tip and tooth apex may be a linear function of log NEQ. These findings indicate that a significant reduction in exposure would have a relatively small effect on the precision of endodontic distance measurements

Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

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Nima Moradi Majd

2014-01-01

Full Text Available Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

Effect of gamma radiation and endodontic treatment on mechanical properties of human and bovine root dentin

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Novais, Veridiana Resende; Soares, Priscilla Barbosa Ferreira; Guimaraes, Carlla Martins; Schliebe, Lais Rani Sales Oliveira; Braga, Stella Sueli Lourenco; Soares, Carlos Jose, E-mail: carlosjsoares@ufu.br [Universidade Federal de Uberlandia (UFU), MG (Brazil)

2016-11-15

This study evaluated the effect of gamma radiation and endodontic treatment on the microhardness and flexural strength of human and bovine root dentin. Forty single rooted human teeth and forty bovine incisor teeth were collected, cleaned and stored in distilled water at 4 °C. The human and bovine teeth were divided into 4 groups (n=10) resulting from the combination of two study factors: first, regarding the endodontic treatment in 2 levels: with or without endodontic treatment; and second, radiotherapy in two levels: with or without radiotherapy by 60 Gy of Co-60 gamma radiation fractioned into 2 Gy daily doses five days per week. Each tooth was longitudinally sectioned in two parts; one-half was used for the three-point bending test and the other for the Knoop hardness test (KHN). Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). No significant difference was found for flexural strength values. The human dentin had significantly higher KHN than the bovine. The endodontic treatment and radiotherapy resulted in significantly lower KHN irrespective of tooth origin. The results indicated that the radiotherapy had deleterious effects on the microhardness of human and bovine dentin and this effect is increased by the interaction with endodontic therapy. The endodontic treatment adds additional negative effect on the mechanical properties of radiated tooth dentin; the restorative protocols should be designed taking into account this effect. (author)

Effect of gamma radiation and endodontic treatment on mechanical properties of human and bovine root dentin

International Nuclear Information System (INIS)

Novais, Veridiana Resende; Soares, Priscilla Barbosa Ferreira; Guimaraes, Carlla Martins; Schliebe, Lais Rani Sales Oliveira; Braga, Stella Sueli Lourenco; Soares, Carlos Jose

2016-01-01

This study evaluated the effect of gamma radiation and endodontic treatment on the microhardness and flexural strength of human and bovine root dentin. Forty single rooted human teeth and forty bovine incisor teeth were collected, cleaned and stored in distilled water at 4 °C. The human and bovine teeth were divided into 4 groups (n=10) resulting from the combination of two study factors: first, regarding the endodontic treatment in 2 levels: with or without endodontic treatment; and second, radiotherapy in two levels: with or without radiotherapy by 60 Gy of Co-60 gamma radiation fractioned into 2 Gy daily doses five days per week. Each tooth was longitudinally sectioned in two parts; one-half was used for the three-point bending test and the other for the Knoop hardness test (KHN). Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). No significant difference was found for flexural strength values. The human dentin had significantly higher KHN than the bovine. The endodontic treatment and radiotherapy resulted in significantly lower KHN irrespective of tooth origin. The results indicated that the radiotherapy had deleterious effects on the microhardness of human and bovine dentin and this effect is increased by the interaction with endodontic therapy. The endodontic treatment adds additional negative effect on the mechanical properties of radiated tooth dentin; the restorative protocols should be designed taking into account this effect. (author)

The microbiota of acute apical abscesses.

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Siqueira, J F; Rôças, I N

2009-01-01

As the breadth of bacterial diversity in the oral cavity has been deciphered by molecular studies, several newly identified species/phylotypes have emerged as potential pathogens. We hypothesized that many of these species/phylotypes could also be involved with the etiology of endodontic abscesses. Abscess aspirates from 42 persons were analyzed for the presence of 81 species/phylotypes by means of a reverse-capture checkerboard hybridization assay. Associations between the most frequently detected taxa were calculated. The most prevalent taxa were Fusobacterium nucleatum, Parvimonas micra, and Porphyromonas endodontalis. Other frequently found taxa included Olsenella uli, streptococci, Eikenella corrodens, some as-yet-uncultivated phylotypes (Bacteroidetes clone X083 and Synergistes clone BA121), and newly named species (Prevotella baroniae and Dialister invisus). Several positive bacterial associations were disclosed. Findings not only strengthen the association of many cultivable species with abscesses, but also include some newly named species and uncultivated phylotypes in the set of candidate pathogens associated with this disease.

Hepatic abscess linked to oral actinomycetes: a case report.

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De Farias, Deborah G

2015-01-01

Organ abscesses are rare, life-threatening complications that can be caused by bacteremia from oral infections. Metastatic infection is a well-established concept. Dental and periapical infections can cause infections in distant organs and tissues. The frequency of these systemic infections and systemic diseases is open to debate, as some patients are more susceptible to infections than others. This article presents the case report of a 52-year-old woman who was hospitalized with a hepatic abscess after a routine periodontal maintenance procedure. The patient had poor oral health, involving several nonrestorable teeth, multiple failed endodontic treatments, and asymptomatic chronic periapical pathologies. Her dental history included previous diagnoses of moderate generalized chronic periodontitis and advanced localized periodontitis. It was possible that bacteremia developed during her most recent dental treatment, leading to the hepatic abscess. Systemic antibiotic therapy, drainage of the hepatic abscess, and oral rehabilitation resulted in complete recovery.

Periodontal abscess during supportive periodontal therapy: a review of the literature.

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Silva, Geraldo L M; Soares, Rodrigo V; Zenóbio, Elton G

2008-09-01

The aim of this review is to present the current status of the occurrence and management of a periodontal abscess during supportive periodontal therapy (SPT). A periodontal abscess depicts typical features and has been described in patients under SPT in clinical trials. Common periodontal pathogens have been observed in this lesion and some etiologic factors may be responsible for its recurrence. This condition can be isolated or associated with factors that can change the prognosis of affected teeth. Although it has been frequently noticed in untreated periodontitis, the periodontal abscess can also occur in patients under SPT and has been regarded as one of the possible complications of SPT. Patients with a high susceptibility to periodontal disease lost more teeth than those with a healthy periodontium. Early diagnosis and appropriate intervention for periodontal abscesses in patients under SPT are extremely important for the management of the periodontal abscess since this condition can lead to loss of the involved tooth. A single case of a tooth diagnosed with periodontal abscess that responds favorably to adequate treatment does not seem to affect its longevity. An accurate diagnosis and adequate treatment can preserve the longevity of affected teeth.

Orthograde endodontic retreatment of teeth with individual cast posts: Report of two cases

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Ramić Bojana

2012-01-01

Full Text Available Introduction. The failure of primary endodontic treatment is manifested by various clinical symptoms following endodontic therapy or, more frequently, by the development of chronic inflammatory process in the apex region without any subjective symptoms. In case of unfavorable outcome of the primary endodontic treatment, orthograde endodontic retreatment is the method of choice for a prolonged therapy. Outline of Cases. Two female patients, 47 and 44 years old, were presented at the Dental Clinic of Vojvodina for endodontic retreatment of teeth 22, 23 and 13, within the repeated prosthetic restoration. Intraradicular individual cast posts were removed using ultrasonic instruments. Remains of gutta-percha were removed by engine driven rotary re-treatment files, root canals were shaped and cleaned using the crown-down technique, and obturated with gutta-percha and epoxy-resin-based sealer using the lateral compaction technique. Conclusion. When there are metal posts or broken instruments in the root canal, the use of ultrasonic instruments is considered a safe method characterized by negligible tooth substance loss and minimal root damage causing fractures and perforations, and the entire procedure is effective and predictable. Non-surgical orthograde endodontic retreatment, when properly performed in accessible and penetrable root canals, achieves a high cure rate, good and lasting results and eliminates the need for radical procedures, such as apical surgery or tooth extraction. When nonsurgical endodontic retreatment is done, treated teeth must be restored by full coronal coverage as soon as possible, to prevent coronal leakage or fracture.

Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis.

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Fahmy, Mina D; Luepke, Paul G; Ibrahim, Mohamed S; Guentsch, Arndt

2016-01-01

Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different treatment interventions. Practical Implication. Periodontic-endodontic lesions can be successfully treated if dental professionals follow a concerted treatment protocol that integrates endodontic and periodontic specialties. General dentists can be the gatekeepers in managing these cases.

Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis

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Mina D. Fahmy

2016-01-01

Full Text Available Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different treatment interventions. Practical Implication. Periodontic-endodontic lesions can be successfully treated if dental professionals follow a concerted treatment protocol that integrates endodontic and periodontic specialties. General dentists can be the gatekeepers in managing these cases.

Endodontic treatment in geriatric patients

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Milly Armilya Andang

2007-11-01

Full Text Available With the increased number of geriatric population, it is predicted that the need for dental treatment also increases. The needs for esthetic factors and function of geriatric patient are maybe similar to young patient. The number of geriatric patients who refuse dental extraction is increasing if there are still other alternative. They can be more convinced when the clinician said that the dental disease experienced is a focal infection so that the loss of the tooth can be accepted as the best option. But if it is possible, they will prefer endodontic treatment, because they want to keep their teeth according to the treatment plan or based on patient's request, as a less traumatic alternative compared to extraction.Endodontic treatment consideration for geriatric patient is quite similar to younger patients. The technique is also the same, although the problem may be bigger. The problem or obstacle that may arise in endodontic treatment for geriatric patient relates to the visit duration, problems during x-ray, problems in defining root canal location, vertical root fracture, and in some cases, decreased pulp tissue recovery ability. Due to the fact that the challenge is quite big, the success of endodontic treatment in geriatric patients needs to be considered. This paper will explain the endodontic treatment prognosis for geriatric patients.

Endodontic treatment associated with photodynamic therapy: Case report.

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Firmino, Ramon Targino; Brandt, Lorenna Mendes Temóteo; Ribeiro, Gustavo Leite; Dos Santos, Katia Simone Alves; Catão, Maria Helena Chaves de Vasconccelos; Gomes, Daliana Queiroga de Castro

2016-09-01

The complete elimination of bacteria inside the root canal is a difficult task, and inconsistent removal of the innermost layer of contaminated dentin leaves bacteria behind. PDT is an adjunct to conventional endodontic treatment due to its potential to reduce bacteria and its biocompatibility. Report a case of endodontic treatment associated with Photodynamic Therapy (PDT). A patient with chronic dentoalveolar abscess with radiolucent lesion next to the apexes of teeth 11 and 21 was submitted to conventional endodontic treatment associated with PDT. The canals were filled after two PDT sessions with an interval of 15days between applications. After six months, total regression of apical periodontitis and no fistula or associated symptoms were observed. The treatment proposed is a viable option for the clinician as it is easy to perform, has relatively low-cost and allows the improvement of symptoms in a short period of time. Copyright © 2016 Elsevier B.V. All rights reserved.

Endodontic retreatment of dens invaginatus presenting with gutta-percha overfilling at the attached gingiva and chronic apical periodontitis: unusual clinical report.

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Robazza, Carlos Roberto Colombo; Alves e Motta, Julio Cesar; de Carli, Marina Lara; de Oliveira Pedreira, Fernanda Rafaelly; Hanemann, Joao Adolfo Costa

2013-05-01

This work describes the retreatment of an unusual case of dens invaginatus with gutta-percha overfilling at the gingival mucosa and chronic apical periodontitis in a 34-year-old woman. Initial periapical radiograph showed the presence of type II dens invaginatus with poor quality obturation, root perforation and chronic apical periodontitis of tooth 22. Dens invaginatus is a tooth malformation caused by infolding of the dental papilla during tooth development. This anomaly has been associated with increased prevalence of pulpal and periapical diseases. Conventional endodontic retreatment was performed using rotary files and calcium hydroxide paste as intracanal dressing. After 7 days, root canal was filled with guttapercha points and Sealapex® sealer. Obturation was radiographically followed and, after 3 years, absence of fistula and periapical radiolucency was observed, thus conventional endodontic therapy proved to be successful. Conventional endodontic retreatment of type II dens invaginatus has been successful for a 3-year period, showing a better treatment alternative. Conservative endodontic retreatment of dens invaginatus should be considered to promote periapical healing with complete reconstitution of bone and periodontal ligament regeneration without signs of recurrence over a period of 3 years. Moreover, it preserves the entire tooth.

Evaluation of Related Factors in the Failure of Endodontically Treated Teeth: A Cross-sectional Study.

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Olcay, Keziban; Ataoglu, Hanife; Belli, Sema

2018-01-01

The aim of this study was to review the factors related to the failure and extraction of unsuccessful endodontically treated teeth. A total of 1000 teeth treated with nonsurgical root canal therapy were analyzed, and the following information was recorded for each patient: reasons for failure and extraction, type of tooth, presence and type of coronal restoration, smoking status, age, gender, and level of education. One main reason was recorded for each failed tooth. The associations between reasons for failure, patient, and tooth were tested by using χ 2 analysis. Of the 1000 endodontically failed teeth analyzed in this study, 28.1% (n = 281) were extracted, 66% (n = 660) were re-treated, and 5.9% (n = 59) were treated with apical surgery. Among the reasons for failure, restorative and endodontic reasons were seen most frequently (43.9%, n = 439), whereas orthodontic reasons were seldom seen (0.1%, n = 1). The most common reason for extraction was for prosthetic reasons (40.8%), and perforation/stripping was the least common (2.9%). The mandibular first molars were the most frequently extracted teeth (27.4%, n = 77). The most common reason for the extraction of endodontically treated teeth was for prosthetic reasons. Among the reasons for failure, restorative and endodontic reasons were the most frequently seen, and orthodontic reasons were the most seldom. The teeth that failed most frequently were mandibular first molars, and the teeth that failed least frequently were maxillary third molars. The most common reason for the extraction of failed endodontically treated teeth was for prosthetic reasons. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The periodontal abscess (I). Clinical and microbiological findings.

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Herrera, D; Roldán, S; González, I; Sanz, M

2000-06-01

Little information is available regarding the diagnosis and microbiology of periodontal abscesses. The aim of this descriptive clinical and microbiological study was to provide more information in order to help in the characterisation of the periodontal abscess associated to periodontitis. 29 consecutive patients with a periodontal abscess were studied by the assessment of clinical variables, including both subjective (pain, edema, redness and swelling) and objective (bleeding on probing, suppuration, probing pocket depth, tooth mobility and cervical lymphadenopathy) parameters. Microbiological samples were taken for anaerobic microbiology and processed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards. 62% of the abscesses affected untreated periodontitis patients, and 69% were associated with a molar tooth. More than 75% of the abscesses had moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all abscesses, while suppuration on sampling was detected in 66%. Mean associated pocket depth was 7.28 mm, and 79% of teeth presented some degree of mobility. Cervical lymphadenopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% of the patients. High prevalences of putative periodontal pathogens were found, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Prevotella intermedia and Bacteroides forsythus. The periodontal abscess has clear clinical characteristics and is usually associated with severe periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacterial mass with a high prevalence of well-recognised periodontal pathogens.

Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

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Marília Pacífico Lucisano

2016-01-01

Full Text Available The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11 had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

Nonsurgical endodontic retreatment of fused teeth with transposition: a case report

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Miguel Agostinho Beco Pinto Cardoso

2016-05-01

Full Text Available Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

Odontogenic abscess mimicking acute dacryocystitis.

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Mansour, Ahmad M; Kheir-Jurdi, Wajiha; Hadi, Usamah El; Awar, Ghassan

2017-04-28

A middle-aged poorly controlled diabetic man developed left-sided orbital and facial swelling several days after extraction of a left upper wisdom tooth. The clinical impression was that of acute dacryocystitis. Opening the skin above the lacrimal sac failed to reveal an inflamed sac establishing the diagnosis of deep facial cellulitis. Complete resolution occurred few weeks after systemic antibiotics and repeated dental drainage of the tooth abscess. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Relationship between crown placement and the survival of endodontically treated teeth.

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Aquilino, Steven A; Caplan, Daniel J

2002-03-01

Crowns have been considered the restoration of choice for endodontically treated teeth, but their selection has been based primarily on anecdotal evidence. This study tested the hypothesis that crown placement (coronal coverage) is associated with improved survival of endodontically treated teeth when preaccess, endodontic, and restorative factors are controlled. A University of Iowa College of Dentistry treatment database was used to identify permanent teeth that had undergone initial obturation between July 1, 1985, and December 31, 1987. Study patients were restricted to persons with at least 1 dental visit in each 2-year interval from 1985 to 1996; a simple random sample of 280 patients (n = 400 teeth) was selected. Dental charts, radiographs, and computerized databases were examined to ascertain variables of interest and to verify study inclusion criteria. Kaplan-Meier survival estimates were generated for the 203 teeth that satisfied study inclusion criteria. Multivariate Cox proportional hazards regression models were developed, with standard errors adjusted to account for clustering of teeth within patients. When tooth type and radiographic evidence of caries at access were controlled, the final Cox model showed that endodontically treated teeth not crowned after obturation were lost at a 6.0 times greater rate than teeth crowned after obturation (95% confidence interval: 3.2 to 11.3). Within the limitations of this study, a strong association between crown placement and the survival of endodontically treated teeth was observed. These results may impact treatment planning if long-term tooth retention is the primary goal.

Probable biofilm formation in the cheek as a complication of soft tissue filler resulting from improper endodontic treatment of tooth 16

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Marusza W

2012-03-01

Full Text Available Wojciech Marusza1, Grazyna Mlynarczyk2, Romuald Olszanski3, Irina Netsvyetayeva2, Michael Obrowski1, Tommaso Iannitti4, Beniamino Palmieri51Academy of Face Sculpturing, 2Department of Microbiology, Medical University of Warsaw, 3Military Institute of Health Services, Warsaw, Poland; 4Department of Physiology, School of Medicine, University of Kentucky Medical Center, KY, USA; 5Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, ItalyAbstract: Injectable filling agents offer the promise of a better appearance without surgery and, among them, hyaluronic acid is the most commonly used. Although complications are rare, it is necessary to know the possible side effects and complications in order to be prepared for their management. That is why many researchers have been focusing on the interactions between hyaluronic acid and pathogens, inflammatory mediators, the immune system, and markers of oxidative stress to achieve efficient drug delivery, given that hyaluronic acid has widening applications in the field of nanomedicine. Here we report the case of a 37-year-old female patient who returned to our clinic with an abscess in her left cheek 3 months after a deep injection of 1 mL of stabilized hyaluronic acid in both cheeks. Steroid and antibiotic therapy was initiated without success, and abscess drainage was performed. Extraction of tooth 16 was performed 11 days after insertion of drains into the abscess. Laboratory blood tests showed acute inflammation of presumed bacterial etiology. Microbiological examination of pus was negative. Bacterial cultures were found in the extracted tooth. After antibiotic therapy, a complete reversal of the pathological process was observed. The present report highlights the need to assess periodontal problems prior to any aesthetic facial treatment. Analyses of further case reports and clinical studies are necessary to understand

Summary of: Regenerative endodontics.

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Clark, Stephen J

2014-03-01

Significant advances in our understanding of the biological processes involved in tooth development and repair at the cellular and molecular levels have underpinned the newly emerging area of regenerative endodontics. Development of treatment protocols based on exploiting the natural wound healing properties of the dental pulp and applying tissue engineering principles has allowed reporting of case series showing preservation of tissue vitality and apexogenesis. To review current case series reporting regenerative endodontics. Current treatment approaches tend to stimulate more reparative than regenerative responses in respect of the new tissue generated, which often does not closely resemble the physiological structure of dentine-pulp. However, despite these biological limitations, such techniques appear to offer significant promise for improved treatment outcomes. Improved biological outcomes will likely emerge from the many experimental studies being reported and will further contribute to improvements in clinical treatment protocols.

Outcomes of endodontic therapy in general practice: a study by the Practitioners Engaged in Applied Research and Learning Network.

Science.gov (United States)

Bernstein, Susan D; Horowitz, Allan J; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A; Collie, Damon; Matthews, Abigail G; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

2012-05-01

The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy. Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical

Radiographic bone fill following debridement of a periodontal abscess. A case report.

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Khocht, A; Faldu, M G

1998-01-01

A periodontal abscess often develops in association with deepened periodontal pockets. Traditional management is by establishing drainage and prescribing antibiotics. This is usually followed by surgical pocket reduction. This case report discusses the remarkable healing of a periodontal abscess by establishing drainage alone without resorting to surgical pocket reduction. A 42-year-old white male presented with swollen gingivae associated with the mesiolingual of tooth #23. Increased probing depth and suppuration were evident. Radiographic bone loss on mesial #23 was present. A diagnosis of periodontal abscess was established. The abscess was drained through the orifice of the pocket. The patient failed to return for follow-up as instructed. A year later, the patient came back. Clinical evaluation showed healthy gingival tissues with probing depth of 3 mm on the mesiolingual of tooth #23. Radiographic evaluation showed bone fill of the osseous defect on the mesial of #23. The results of this case suggest that sufficient time should be allowed for healing prior to surgical pocket reduction.

Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report

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Musaed Fahad Al-Tammami

2017-02-01

Full Text Available A revascularization procedure was shown to be the best alternative therapy for immature teeth with necrotic pulp and apical infection. A 12 year old female with a history of trauma to her upper central incisor and a sinus tract was referred for endodontic treatment. She was an active orthodontic patient and had undergone regenerative endodontic treatment for the past 2 years. Clinical examination revealed no response to sensibility, percussion, and palpation tests. The preoperative radiograph showed an open apex and apical rarefaction. The case was diagnosed as previously treated tooth with asymptomatic apical periodontitis. Regenerative endodontic retreatment was performed, and the case was followed for 3 years. Clinical, radiographic, and cone-beam computed tomography follow-up examination revealed an asymptomatic tooth, with evidence of periapical healing and root maturation.

Treatment of a Periodontic-Endodontic Lesion in a Patient with Aggressive Periodontitis

OpenAIRE

Fahmy, Mina D.; Luepke, Paul G.; Ibrahim, Mohamed S.; Guentsch, Arndt

2016-01-01

Case Description. This case report describes the successful management of a left mandibular first molar with a combined periodontic-endodontic lesion in a 35-year-old Caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. In spite of anticipated poor prognosis, the tooth lesion healed. This case report also discusses the rationale behind different tr...

Bleaching of the discolored traumatized tooth

DEFF Research Database (Denmark)

Dahl, Jon E.; Kopperud, Siemen E.; Pallesen, Ulla

2018-01-01

This chapter focuses on the treatment of discolored traumatized teeth, most of them being non-vital and subsequently, endodontically treated. Tooth bleaching based upon hydrogen peroxide as the active agent, applied directly or produced in a chemical reaction from sodium perborate or carbamide pe...

Endodontic treatment-related antibiotic prescribing patterns of South African oral health professionals.

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Lalloo, R; Solanki, G; Ramphoma, K; Myburgh, N G

2017-11-01

To assess the antibiotic prescribing patterns of South African dentists for patients undergoing endodontic treatment. This study used data from 2013 health insurance claims submitted by South African oral health professionals to determine the antibiotic prescribing patterns related to endodontic treatment. A logistic regression model was used to test the fully adjusted statistical significance of the association between the exploratory variables (gender, age group, event type, abscess treatment, chronic health) and the dependent variable (antibiotic prescription). Odds ratios with 95% confidence intervals (CI) are reported, and a 95% CI excluding 1 was considered statistically significant. Almost 10% of endodontic treatments were prescribed an antibiotic. There were no significant differences in prescribing patterns by gender, age and chronic health status. Prescriptions were more common at the preparatory stage (9.4%) of root canal treatment compared to the therapy (4.7%) and canal filling (2%) stages. Patients who received apical surgery (OR = 2.28; 95% CI 1.38-3.76) and treatment of an abscess (OR = 2.57; 95% 1.82-3.63) had a significantly increased odds of being prescribed an antibiotic. Almost three-quarters of prescriptions were for narrow spectrum antibiotics. The frequency of antibiotic prescribing by South African dental practitioners for patients undergoing endodontic treatment is relatively low and predominantly involved narrow spectrum antibiotics. It, however, remains important that antibiotics are only prescribed when clinically essential, such as when there are obvious systemic effects. These include fever above 37 degrees, malaise, lymphadenopathy, trismus, increase swelling, cellulitis, osteomyelitis and persistent infection. The wider dissemination and adherence to clear evidence-based prescribing guidelines for antibiotics in this clinical area are important. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Progression of periapical cystic lesion after incomplete endodontic treatment

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Jong-Ki Huh

2016-05-01

Full Text Available We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

Nuclear Magnetic Resonance Imaging in Endodontics: A Review.

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Di Nardo, Dario; Gambarini, Gianluca; Capuani, Silvia; Testarelli, Luca

2018-04-01

This review analyzes the increasing role of magnetic resonance imaging (MRI) in dentistry and its relevance in endodontics. Limits and new strategies to develop MRI protocols for endodontic purposes are reported and discussed. Eligible studies were identified by searching the PubMed databases. Only original articles on dental structures, anatomy, and endodontics investigated by in vitro and in vivo MRI were included in this review. Original articles on MRI in dentistry not concerning anatomy and endodontics were excluded. All the consulted studies showed well-defined images of pathological conditions such as caries and microcracks. The enhanced contrast of pulp provided a high-quality reproduction of the tooth shape and root canal in vitro and in vivo. Assessment of periapical lesions is possible even without the use of contrast medium. MRI is a nonionizing technique characterized by high tissue contrast and high image resolution of soft tissues; it could be considered a valid and safe diagnostic investigation in endodontics because of its potential to identify pulp tissues, define root canal shape, and locate periapical lesions. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Current overview on challenges in regenerative endodontics

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Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

2015-01-01

Introduction: Regenerative endodontics provides hope of converting the non-vital tooth into vital once again. It focuses on substituting traumatized and pathological pulp with functional pulp tissue. Current regenerative procedures successfully produce root development but still fail to re-establish real pulp tissue and give unpredictable results. There are several drawbacks that need to be addressed to improve the quality and efficiency of the treatment. Aim: The aim of this review article is to discuss major priorities that ought to be dealt before applications of regenerative endodontics flourish the clinical practice. Materials and Methods: A web-based research on MEDLINE was done using filter terms Review, published in the last 10 years and Dental journals. Keywords used for research were “regenerative endodontics,” “dental stem cells,” “growth factor regeneration,” “scaffolds,” and “challenges in regeneration.” This review article screened about 150 articles and then the relevant information was compiled. Results: Inspite of the impressive growth in regenerative endodontic field, there are certain loopholes in the existing treatment protocols that might sometimes result in undesired and unpredictable outcomes. Conclusion: Considerable research and development efforts are required to improve and update existing regenerative endodontic strategies to make it an effective, safe, and biological mode to save teeth. PMID:25657518

Tooth fractures in canine clinical practice

International Nuclear Information System (INIS)

Capik, I.; Ledecky, V.; Sevcik, A.

2001-01-01

Tooth fractures constitute a considerable fraction of all tooth diseases. Out of the 5,370 dogs treated during four years, 492 were presented with dental problems and 28.3 % of the latter were treated for tooth fractures. Canines were the most frequently affected teeth (38.8 %), followed by premolars (33.1 %), incisors (25.9 %), and molars (2.2 %), 55.4 % of the patients with canine and incisor fractures being large breed dogs. Fractures of premolars (mostly of 108, 208) were divided evenly irrespective of breed or body size. Nonsurgical endodontic treatment yielded good therapeutic results in most cases, but repeated treatment was necessary in some patients

Etiopathogenesis of post-endodontic periapical scar formation

Czech Academy of Sciences Publication Activity Database

Horká, E.; Foltán, R.; Hanzelka, T.; Pavlíková, G.; Klíma, K.; Šedý, Jiří

2012-01-01

Roč. 3, č. 1 (2012), s. 5-15 ISSN 2155-8213 R&D Projects: GA MŠk 1M0538; GA MŠk(CZ) LC554; GA ČR GAP304/10/0320 Grant - others:UK(CZ) UNCE 204021 Institutional research plan: CEZ:AV0Z50390703 Keywords : postendodontic scar * endodontics * tooth Subject RIV: FH - Neurology

Prevalence and clonal analysis of Porphyromonas gingivalis in primary endodontic infections.

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Siqueira, José F; Rôças, Isabela N; Silva, Marlei G

2008-11-01

This study investigated the prevalence of Porphyromonas gingivalis in 62 teeth with primary endodontic infections by using a species-specific 16S rRNA gene-based nested polymerase chain reaction assay. P. gingivalis isolates recovered from 2 infected root canals were also analyzed for clonal diversity by using arbitrarily primed PCR. Overall, P. gingivalis was found in 48% of the samples. This species was specifically detected in 36% of canals of teeth with chronic apical periodontitis, in 46% of the cases of acute apical periodontitis, and in 67% of acute apical abscesses. P. gingivalis was significantly more frequent in abscess aspirates than in canals of teeth with chronic apical periodontitis (P abscesses, and demonstrated that different clonal types of this species can colonize the root canal in the same individual.

Successful nonsurgical endodontic outcome of a severely affected permanent maxillary canine with dens invaginatus Oehlers type 3.

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Brooks, John K; Ribera, Michael J

2014-10-01

The morphogenic complexities of dens invaginatus (DI) Oehlers type 3 in maxillary canines offer significant endodontic challenges. A case report is provided of a 14-year-old female patient who presented with an anomalous-looking permanent maxillary canine associated with a sinus tract. Pulp testing revealed a normal response on the distal aspect of the tooth, whereas the mesial segment tested nonresponsive. A radiolucent lesion was seen on the mesiolateral radicular area adjacent to the severely distended pulp chamber. A gutta-percha point inserted into the sinus tract traced to this same region. The diagnosis was normal pulp coincident with DI Oehlers type 3 with pulp necrosis and chronic apical abscess. Despite a concerted effort to limit the root canal therapy to only the necrotic canal, its proximity to the normal canal obviated this possibility, entailing endodontic treatment of the entire root canal system. The necrotic pulp space was subjected to sustained irrigation with 5.25% sodium hypochlorite and then completed with 17% ethylenediaminetetraacetic acid. A bolus of gutta-percha was used to create an apical barrier, and then the remainder of the enlarged pulp space was obturated with injectable thermoplasticized gutta-percha. At a 4.5-year recall, there was no clinical and radiographic evidence of infection. Endodontic success was accomplished with meticulous efforts of disinfection. Thermoplasticized gutta-percha can offer utility for obturation of anatomically complicated pulp spaces. The use of the dental operating microscope is an invaluable aid for discernment of the intricacies of teeth affected with DI type 3 variant and can enhance clinical outcomes. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Polymerase chain reaction detection of Propionibacterium propionicus and Actinomyces radicidentis in primary and persistent endodontic infections.

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Siqueira, José F; Rôças, Isabela N

2003-08-01

Propionibacterium propionicus and the recently described species Actinomyces radicidentis have been isolated from infections of endodontic origin; nevertheless, the possibility exists that their actual prevalence may have been underestimated by culture. The purpose of our study was to assess the occurrence of these 2 species in different types of endodontic infections by using the sensitive 16S rDNA-based nested polymerase chain reaction approach. To detect these 2 species, nested polymerase chain reaction was performed directly in samples taken from primary endodontic infections associated with asymptomatic periradicular lesions, acute apical periodontitis, or acute periradicular abscesses and in samples from patients in whom endodontic therapy had failed. DNA was extracted from the samples and initially amplified by using universal 16S rDNA primers. In the second round of amplification, the first polymerase chain reaction products were used to detect a specific 16S rDNA fragment of either P propionicus or A radicidentis. P propionicus was detected in 6/21 (29%) root canal samples from teeth with chronic periradicular lesions, in 5/10 (50%) cases diagnosed as acute apical periodontitis, and in 7/19 (37%) pus samples aspirated from acute periradicular abscesses. Overall, this species was found in 18/50 (36%) samples taken from primary endodontic infections. Of the root canal samples obtained from root-filled teeth with chronic periradicular lesions, P propionicus was detected in 7/12 (58%) cases. A radicidentis was detected in 1/21 (5%) root canal samples from teeth with chronic periradicular lesions and in 1/10 (10%) cases of acute apical periodontitis. No pus sample yielded this species. In general, A radicidentis was detected in 2/50 (4%) samples taken from primary endodontic infections and in 1/12 (8%) root canal samples taken from patients in whom endodontic treatment had failed. P propionicus was found in a relatively large number of patients with primary and

Endodontic management of maxillary second molars fused with paramolar tubercles diagnosed by cone beam computed tomography - two case reports.

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Preetham Jain

2014-12-01

Full Text Available The main objective of nonsurgical endodontic treatment is to eliminate micro-organisms from the root canal system. Adequate knowledge of the root canal morphology and its complexities is essential to render successful endodontic treatment. Variations in tooth form and morphology may be found in the form of anomalous cusps in the crown region or additional roots. In permanent molars, changes in the crown morphology may occur either in the form of an additional tooth (paramolar or supernumerary cusp termed as "paramolar tubercle".

Regenerative endodontics as a tissue engineering approach: past, current and future.

Science.gov (United States)

Malhotra, Neeraj; Mala, Kundabala

2012-12-01

With the reported startling statistics of high incidence of tooth decay and tooth loss, the current interest is focused on the development of alternate dental tissue replacement therapies. This has led to the application of dental tissue engineering as a clinically relevant method for the regeneration of dental tissues and generation of bioengineered whole tooth. Although, tissue engineering approach requires the three main key elements of stem cells, scaffold and morphogens, a conductive environment (fourth element) is equally important for successful engineering of any tissue and/or organ. The applications of this science has evolved continuously in dentistry, beginning from the application of Ca(OH)(2) in vital pulp therapy to the development of a fully functional bioengineered tooth (mice). Thus, with advances in basic research, recent reports and studies have shown successful application of tissue engineering in the field of dentistry. However, certain practical obstacles are yet to be overcome before dental tissue regeneration can be applied as evidence-based approach in clinics. The article highlights on the past achievements, current developments and future prospects of tissue engineering and regenerative therapy in the field of endodontics and bioengineered teeth (bioteeth). © 2012 The Authors. Australian Endodontic Journal © 2012 Australian Society of Endodontology.

[Bio-Oss collagen bone grafting in the treatment of endodontic-periodontic lesion].

Science.gov (United States)

Sun, Jiang; Liu, Qiong

2009-09-01

To study the effect of Bio-Oss collagen for bone grafting in the treatment of endodontic-periodontic lesion. Thirty patients (37 teeth) with endodontic-periodontic lesions received root canal therapy and periodontal treatment. Four weeks after the treatment, Bio-Oss collagen was grafted in these teeth. Clinical examinations were performed 1, 3, 6, 9, and 12 months after the surgery. The mobility of these teeth improved 1 month after the surgery. At 3, 6, 9, and 12 months after the surgery, the pocket depth reduced obviously good attachment and further improvement of the tooth mobility. Bio-Oss collagen for bone grafting can achieve good therapeutic effect for endodontic-periodontic lesions.

A New Classification of Endodontic-Periodontal Lesions

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Khalid S. Al-Fouzan

2014-01-01

Full Text Available The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

A new classification of endodontic-periodontal lesions.

Science.gov (United States)

Al-Fouzan, Khalid S

2014-01-01

The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

Regeneration and Repair in Endodontics-A Special Issue of the Regenerative Endodontics-A New Era in Clinical Endodontics.

Science.gov (United States)

Saoud, Tarek Mohamed A; Ricucci, Domenico; Lin, Louis M; Gaengler, Peter

2016-02-27

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of 'regenerative endodontics' emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists' Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are

Fatal thalamic abscess secondary to dental infection.

Science.gov (United States)

Basyuni, Shadi; Sharma, Valmiki; Santhanam, Vijay; Ferro, Ashley

2015-12-17

We present the case of poor neurological recovery and subsequent death secondary to a thalamic abscess in a 53-year-old man. This patient initially presented with sudden dysarthria and left hemiparesis while driving. Neuroimaging showed a multilobular abscess involving the right thalamus with oedema extending to the basal ganglionic region and brainstem. The source of the abscess was initially unknown and it required draining multiple times while the different causes were being explored. The patient's neurological state along with intubation made for a difficult and inconclusive oral examination. It was only after neuroimaging included tooth-bearing areas that it became evident that this patient had extensive periodontal disease with multiple areas of periapical radiolucencies. The patient underwent complete dental clearance alongside repeated drainage of the abscess. Despite initial postoperative improvement, the patient never recovered from the neurological damage and died 3 weeks later. 2015 BMJ Publishing Group Ltd.

Searching for Helicobacter pylori and Chlamydia pneumoniae in primary endodontic infections.

Science.gov (United States)

Rôças, Isabela N; Siqueira, José F

2012-04-01

The purpose of this study was to search samples from primary endodontic infections for the presence of two common human bacterial pathogens - Helicobacter pylori and Chlamydia pneumoniae. Genomic DNA isolated from samples taken from 25 root canals of teeth with asymptomatic (chronic) apical periodontitis and 25 aspirates from acute apical abscess was initially amplified by the multiple displacement amplification approach and then used as template in species-specific polymerase chain reaction (PCR) for detection of H. pylori and C. pneumoniae. All clinical samples were positive for the presence of bacterial DNA. However, no clinical sample was positive for either H. pylori or C. pneumoniae. Neither H. pylori nor C. pneumoniae were found in samples from primary endodontic infections. These findings suggest that these species are not candidate endodontic pathogens and that the necrotic root canal does not serve as a reservoir for these human pathogens in healthy patients.

HEMISECTION: A TREATMENT OPTION FOR AN ENDODONTICALLY TREATED MOLAR WITH VERTICAL ROOT FRACTURE

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Anitha

2015-05-01

Full Text Available Vertical root fractures in endodontically treated teeth have long been reported and pose diagnostic difficulties. A h emisection/Root resection procedure which removes the fractured fragments completely, and retains a portion of the compromised tooth offers a predictable treatment option. The key to this rests in ideal case selection invol ving balancing all indications and contraindications. The success of the treatment depends on careful case selection based on a firm set of guidelines. This article presents a case with vertical root fracture in an endodontic treated molar. This article de scribes the case of a 60 - year - old man with a vertical root fracture on the mesial root and a healthy periodontium supporting the distal root making it ideal for retention as well as restoration and support of the final prosthesis. Also, the patient was mot ivated to try and save as much of the tooth as possible. Post - operatively no untoward complication was reported making it an alternative treatment option in patients with vertical root fracture in a molar, willing to retain the remaining tooth portion. Wit h all other factors balanced, it allows for retaining the remaining intact portion of the tooth structure.

Effect of Ibuprofen on masking endodontic diagnosis.

Science.gov (United States)

Read, Jason K; McClanahan, Scott B; Khan, Asma A; Lunos, Scott; Bowles, Walter R

2014-08-01

An accurate diagnosis is of upmost importance before initiating endodontic treatment; yet, there are occasions when the practitioner cannot reproduce the patient's chief complaint because the patient has become asymptomatic. Ibuprofen taken beforehand may "mask" or eliminate the patient's symptoms. In fact, 64%-83% of patients with dental pain take analgesics before seeing a dentist. The purpose of this study was to examine the possible "masking" effect of ibuprofen on endodontic diagnostic tests. Forty-two patients with endodontic pain underwent testing (cold, percussion, palpation, and bite force measurement) and then received either placebo or 800 mg ibuprofen. Both patients and operators were blinded to the medication received. One hour later, diagnostic testing was repeated and compared with pretreatment testing. Ibuprofen affected testing values for vital teeth by masking palpation 40%, percussion 25%, and cold 25% on affected teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. There was no observed masking effect in the placebo group on palpation, percussion, or cold values. When nonvital teeth were included, the masking effect of ibuprofen was decreased. However, little masking occurred with the bite force measurement differences. Analgesics taken before the dental appointment can affect endodontic diagnostic testing results. Bite force measurements can assist in identifying the offending tooth in cases in which analgesics "mask" the endodontic diagnosis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Distribution of Porphyromonas gingivalis fimA genotypes in primary endodontic infections.

Science.gov (United States)

Rôças, Isabela N; Siqueira, José F

2010-03-01

Long fimbriae (FimA) are important virulence factors of Porphyromonas gingivalis. Based on the diversity of the fimA gene, this species is classified into 6 genotypes. This study surveyed samples from primary endodontic infections for the presence of these P. gingivalis fimA variants. Genomic DNA isolated from samples taken from 25 root canals of teeth with chronic apical periodontitis and 25 aspirates from acute apical abscess was used as template in polymerase chain reaction (PCR) assays directed toward the detection of the different P. gingivalis fimA genotypes. Porphyromonas gingivalis was detected by a 16S rRNA gene-based PCR in 36% of the total number of cases sampled (44% of chronic apical periodontitis and 28% of abscess aspirates). In cases of chronic apical periodontitis, P. gingivalis variant type IV was the most prevalent (24%), followed by types I (20%), II (16%), and III (8%). In acute abscess samples, variant type II was the most prevalent (12%), followed by types III and IV (8% of each) and type I (4%). Combinations of up to 3 different genotypes were detected in a few cases. No single fimA genotype variant or combination thereof was significantly associated with symptoms. Overall, fimA types IV (16%), II (14%), and I (12%) were the most prevalent. Findings demonstrated that different P. gingivalis fimA genotypes can be present in primary endodontic infections. Copyright 2010 Mosby, Inc. All rights reserved.

Endodontic Treatment of Hypertaurodontic Mandibular Molar Using Reciprocating Single-file System: A Case Report.

Science.gov (United States)

C do Nascimento, Adriano; A F Marques, André; C Sponchiado-Júnior, Emílio; F R Garcia, Lucas; M A de Carvalho, Fredson

2016-01-01

Taurodontism is a developmental tooth disorder characterized by lack of constriction in the cementoenamel junction and consequent vertical stretch of the pulp chamber, accompanied by apical displacement of the pulpal floor. The endodontic treatment of teeth with this type of morpho-anatomical anomaly is challenging. The purpose of this article is to report the successful endodontic treatment of a hypertaurodontic mandibular molar using a reciprocating single-file system.

New bacterial composition in primary and persistent/secondary endodontic infections with respect to clinical and radiographic findings.

Science.gov (United States)

Tennert, Christian; Fuhrmann, Maximilian; Wittmer, Annette; Karygianni, Lamprini; Altenburger, Markus J; Pelz, Klaus; Hellwig, Elmar; Al-Ahmad, Ali

2014-05-01

The aim of the present study was to analyze the microbiota of primary and secondary/persistent endodontic infections of patients undergoing endodontic treatment with respect to clinical and radiographic findings. Samples from the root canals of 21 German patients were taken using 3 sequential sterile paper points. In the case of a root canal filling, gutta-percha was removed with sterile files, and samples were taken using sterile paper points. The samples were plated, and microorganisms were then isolated and identified morphologically by biochemical analysis and sequencing the 16S rRNA genes of isolated microorganisms. In 12 of 21 root canals, 33 different species could be isolated. Six (50%) of the cases with isolated microorganisms were primary, and 6 (50%) cases were endodontic infections associated with root-filled teeth. Twelve of the isolated species were facultative anaerobic and 21 obligate anaerobic. Monomicrobial infections were found for Enterococcus faecalis and Actinomyces viscosus. E. faecalis was most frequently isolated in secondary endodontic infections (33%). Moraxella osloensis was isolated from a secondary endodontic infection that had an insufficient root canal filling accompanied by a mild sensation of pain. A new bacterial composition compromising Atopobium rimae, Anaerococcus prevotii, Pseudoramibacter alactolyticus, Dialister invisus, and Fusobacterium nucleatum was recovered from teeth with chronic apical abscesses. New bacterial combinations were found and correlated to clinical and radiographic findings, particularly to chronic apical abscesses. M. osloensis was detected in root canals for the second time and only in German patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Microbiology and Treatment of Acute Apical Abscesses

Science.gov (United States)

Rôças, Isabela N.

2013-01-01

SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease. PMID:23554416

Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth.

Science.gov (United States)

Pickenpaugh, L; Reader, A; Beck, M; Meyers, W J; Peterson, L J

2001-01-01

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of prophylactic amoxicillin on the occurrence of endodontic flare-up in asymptomatic, necrotic teeth. Seventy patients participated and had a clinical diagnosis of an asymptomatic, necrotic tooth with associated periapical radiolucency. One hour before endodontic treatment, patients randomly received either 3 g of amoxicillin or 3 g of a placebo control in a double-blind manner. After endodontic treatment, each patient received: ibuprofen; acetaminophen with codeine (30 mg); and a 5 1/2-day diary to record pain, swelling, percussion pain, and number and type of pain medication taken. The results demonstrated 10% of the 70 patients had a flare-up characterized by moderate-to-severe postoperative pain or swelling that began approximately 30 h after endodontic treatment and persisted for an average of 74 h. Of the seven patients who had flare-ups, 4 were in the amoxicillin group and 3 were not. Prophylactic amoxicillin did not significantly (p = 0.80) influence the endodontic flare-up. We concluded that a prophylactic dose of amoxicillin before endodontic treatment of asymptomatic, necrotic teeth had no effect on the endodontic flare-up.

Outcome of Endodontically Treated Teeth Diagnosed With Cracked Tooth

Science.gov (United States)

2015-06-01

However, variable symptoms complicate the diagnosis (9). In a study of 32 patients presenting with diffuse longstanding orofacial pain eventually...883-92. 22)Byrnjulsen A, Fristad I, Grevstad T, Hals-Kvinnsland I. Incompletely fractured teeth associated with diffuse longstanding orofacial pain ...cracked tooth is highly associated with discomfort. Patients often describe a momentary, sudden, sharp, lancinating pain that results in continuous tooth

Role of Thr399Ile and Asp299Gly polymorphisms of toll-like receptor-4 gene in acute dental abscess.

Science.gov (United States)

Miri-Moghaddam, Ebrahim; Farhad-Mollashahi, Narges; Baghaee, Elnaz; Bazi, Ali; Garme, Yasaman

2017-02-01

Apical Periodontitis (AP) is an inflammatory disease that affects the tissues surrounding the root end of a tooth. The disease which is caused by endodontic infections presents in different clinical ways including development of an acute abscess. Recent studies have provided information suggesting role of a multitude of factors in pathogenesis of acute apical abscess (AAA). In this case-control study, our goal was to evaluate the frequency and potential role of two common polymorphisms of toll like receptor-4 (TLR-4) gene; Thr399Ile (1196 C>T) and Asp299Gly (+896 A>G), in 50 patients with AAA as cases and 50 patients with asymptomatic apical periodontitis (AAP) as controls. Saliva sample containing mucosal epithelial cells was used for DNA extraction. Polymorphisms were detected by Tetra-ARMS (Amplification Refractory Mutation System) PCR method. Statistical analyses were carried out in SPSS 21 software. Homozygous wild type (CC) and heterozygous (CT) genotypes of Thr399Ile polymorphism were detected in 84% and 16% of AAA patients respectively. In controls, respective ratios were 94% (CC) and 6% (CT). Observed difference was not statistically significant ( P >0.05) for distribution of these genotypes. The mutant homozygous (TT) genotype of this polymorphism was identified in neither of the participants. Overall, T allele frequency was obtained 8% in AAA and 3% in AAP (OR=2.6, 95% CI; 0. 6-10.6, p >0.05). For Asp299Gly polymorphism, no individual was detected with the mutant allele in case or control groups. Our results indicated a possible role for Thr399Ile polymorphism in acute presentations of abscess in AAA. However, the impact of this polymorphism needs to be more assessed in future studies. Key words: Genetic polymorphism, periapical abscess, periapical periodontitis, toll-like receptor 4.

CAD/CAM Preparation Design Effects on Endodontically Treated and Restored Molars

Science.gov (United States)

2016-05-24

teeth remains a challenge for clinicians, as endodontic treatment results in a tooth that represents a stark biomechanical difference compared to...using a LED-based visible light curing ( VLC ) unit (Bluephase G2, lvoclar-Vivadent, Amherst, NY, USA) whose irradiance was periodically verified (1000 mW

Treatment of combined endodontic-periodontic lesions using guided tissue regeneration: clinical case and histology.

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Ghezzi, Carlo; Virzì, Mauro; Schupbach, Peter; Broccaioli, Alessandro; Simion, Massimo

2012-08-01

The aim of this case report is to histologically evaluate periapical healing after combined endodontic-periodontic treatment. A maxillary left central incisor was treated with conventional endodontic therapy, followed by periodontal surgery. The facial bony defect was filled with a mixture of autologous bone and Bio-Oss. A resorbable membrane was used. Histology showed the presence of new cementum, ligament, and bone around the apex of the treated tooth. This finding was clinically associated with minimal residual probing depth and maximum attachment gain. This histologic report demonstrates the possibility of true regeneration in a case of severe periodontal attachment loss resulting from an endodontic-periodontic lesion.

Outcome of Endodontically Treated Cracked Teeth

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2016-06-01

directed by: CAPT Te!Ty Webb, D.D.S., M.S. A " cracked tooth" is defined as a thin surface enamel and dentin disruption of unknown depth, and is often...OUTCOME OF ENDODONTICALL Y TREATED CRACKED TEETH by David Michael Dow II, D.D.S. Lieutenant Commander, Dental Corps United States Navy A thesis...copyrighted material in the thesis manuscript titled: "Outcome ofEndodontically Treated Cracked Teeth" is appropriately acknowledged and, beyond

[Significance of the bacterial flora in the etiology of apical periodontitis. Qualitative, quantitative and topographical aspects].

Science.gov (United States)

Accorsi, S; Lavagnoli, G; Frigeri, S; Fiamminghi, L

1990-01-01

In the international literature it is shown the central role of root canal infection in the etiology of periapical lesions. As a matter of fact it has been proved (13) that sterile necrotic pulp tissue is completely unable to cause inflammatory reactions at the periapex. Infection of endodontic origin extends to the supporting tissues of the tooth only in the case of their acute inflammation (e.g. acute apical periodontitis, acute alveolar abscess, phoenix abscess). On the other hand in chronic inflammation bacteria remain confined in the endodontic space. Only few exceptions to this general rule have been experimentally proved. In endodontics we deal with a mixed infection which is composed by obligate anaerobes and by facultative anaerobes. The most frequently found obligate anaerobes are Bacteroides sp. and Fusobacterium sp. (Gram- rods) Anaerobic Diphtheroides (Gram+ rods) Peptostreptococcus sp. (Gram+ cocci) and Veilonella sp. (Gram- cocci). Actinomyces sp., Lactobacillus sp., Streptococcus sp., and Staphilococcus sp. are the facultative anaerobes most frequently found.

Are clinical decisions in endodontics influenced by the patient's fee-paying status?

Science.gov (United States)

Walker, I; Gilbert, D; Asimakopoulou, K

2015-12-01

We explored whether the fee status of a UK patient influences clinical decision-making in endodontics. In a randomised-controlled vignette study describing either an 'NHS-funded', 'Privately-funded' or undisclosed fee-status patient, we examined the importance vocational trainer dentists placed on a series of factors normally considered when deciding whether to offer patients endodontic treatment as opposed to extracting the tooth. N = 119 experienced (M years post qualification = 20.01) dentists participated. Having read a vignette describing a hypothetical patient who could potentially be treated either endodontically or through an extraction, dentists rated a series of factors they would normally consider (for example, poor oral hygiene, the rest of their mouth is unfilled and caries-free), before recommending either endodontic treatment or an extraction. The patient's funding status had no influence on these dentists' clinical decision-making when considering endodontic treatment as an option (p >0.05) with the exception of a single item relating to infrequent attendance where the NHS patient was more likely than the 'undisclosed-fee' patient, to be offered extractions (F (2, 116) 3.43, p endodontic treatment by experienced dentists.

Periapical abscess of the maxillary teeth and its fistulizations: Multi ...

African Journals Online (AJOL)

Sherif A. Shama

2012-12-14

Dec 14, 2012 ... Two cases (10%) of fracture of the maxillary alveolar process complicating tri- als of previous ... Tooth decay is the most common chronic illness in the pediat- ... with resultant apical periodontitis, granuloma, abscess, and fi-.

Rotary endodontics in primary teeth - A review.

Science.gov (United States)

George, Sageena; Anandaraj, S; Issac, Jyoti S; John, Sheen A; Harris, Anoop

2016-01-01

Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the "gold-standard" over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel-titanium (Ni-Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel-titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.

Visualization of Tooth for Non-Destructive Evaluation from CT Images

Energy Technology Data Exchange (ETDEWEB)

Gao, Hui; Chae, Ok Sam [Kyung Hee University, Seoul (Korea, Republic of)

2009-06-15

This paper reports an effort to develop 3D tooth visualization system from CT sequence images as a part of the non-destructive evaluation suitable for the simulation of endodontics, orthodontics and other dental treatments. We focus on the segmentation and visualization for the individual tooth. In dental CT images teeth are touching the adjacent teeth or surrounded by the alveolar bones with similar intensity. We propose an improved level set method with shape prior to separate a tooth from other teeth as well as the alveolar bones. Reconstructed 3D model of individual tooth based on the segmentation results indicates that our technique is a very conducive tool for tooth visualization, evaluation and diagnosis. Some comparative visualization results validate the non-destructive function of our method.

Dentoalveolar abscess among children attending a dental clinic in Nigeria.

Science.gov (United States)

Azodo, C C; Chukwumah, N M; Ezeja, E B

2012-09-01

To determine the incidence and causes of dentoalveolar abscess among children attending an outpatient dental clinic in Nigeria. This is a retrospective study of paediatric dental patients treated in University of Benin Teaching Hospital, Benin City from October 2010 to September 2011. The incidence of dentoalveolar abscess was 6.4% (53/824). However only 42 cases had their case notes retrieved for final research analysis. It occurred mostly in the lower right quadrant of the mouth. The affected children were majorly males and first or second child of monogamous family. A total 17 (40.5%) of the affected children were in the 6-11 years age group. This was the first dentist consultation among 35 (83.3%) of the children. The presenting complaint was toothache among two-thirds of the children. History of asthma, tonsillitis, peptic ulcer disease and previous surgery were medical history elicited from 6 (14.3) of the patients. The most implicated tooth was deciduous first molar. The causes of abscess include untreated dental caries 35 (83.3%), trauma 5 (11.9%), failed restoration 1 (2.4%) and periodontal diseases 1 (2.4%). Periapical radioluscency was predominant radiological finding among affected children. Tooth extraction was commonest treatment done. The incidence of dentoalveolar abscess among children was significant. The high frequency of untreated dental caries as the cause of dentoalveolar abscess indicates the need for school and community-based preventive strategies like encouraging infant oral health and preventive dentistry programs and early treatment intervention and dental health education.

Comparison of the effect of endodontic-periodontal combined lesion on the outcome of endodontic microsurgery with that of isolated endodontic lesion: survival analysis using propensity score analysis.

Science.gov (United States)

Song, Minju; Kang, Minji; Kang, Dae Ryong; Jung, Hoi In; Kim, Euiseong

2018-05-01

The purpose of this retrospective clinical study was to evaluate the effect of lesion types related to endodontic microsurgery on the clinical outcome. Patients who underwent endodontic microsurgery between March 2001 and March 2014 with a postoperative follow-up period of at least 1 year were included in the study. Survival analyses were conducted to compare the clinical outcomes between isolated endodontic lesion group (endo group) and endodontic-periodontal combined lesion group (endo-perio group) and to evaluate other clinical variables. To reduce the effect of selection bias in this study, the estimated propensity scores were used to match the cases of the endo group with those of the endo-perio group. Among the 414 eligible cases, the 83 cases in the endo-perio group were matched to 166 out of the 331 cases in the endo group based on propensity score matching (PSM). The cumulated success rates of the endo and endo-perio groups were 87.3 and 72.3%, respectively. The median success period of the endo-perio group was 12 years (95% CI: 5.507, 18.498). Lesion type was found to be significant according to both Log-rank test (P = 0.002) and Cox proportional hazard regression analysis (P = 0.001). Among the other clinical variables, sex (female or male), age, and tooth type (anterior, premolar, or molar) were determined to be significant in Cox regression analysis (P lesions had a negative effect on the clinical outcome based on an analysis that utilized PSM, a useful statistical matching method for observational studies. Lesion type is a significant predictor of the outcome of endodontic microsurgery.

ENDODONTIC TREATMENT AND POST-CORE RESTORATION

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Evi Hafifah

2006-04-01

Full Text Available Endodontic root canal treatment is to maintain the tooth as long as possible in the arch’s width in a good functional status. In order to reach that goal, all irritation to the pulp should be eliminated so that the tooth has a healthy periodontal tissue support. A female patient, aged 37 years, came for her upper front tooth which had been restored with a pin crown a year ago. One month ago she had a swelling accompanied with throbbing pain. There was no history of general diseases and her oral hygiene was good. Clinically 11 was restored with a pin crown and the radiographic picture showed a narrow pulp chamber, normal roots with normal canals, thickened periodontium, broken laminar dura, and diffuse periapical rarefaction. The tooth was diagnosed with pulpal necrosis. A conventional root canal treatment was performed followed by the insertion of a post core crown. The result showed a satisfactory treatment plan, a good restoration, successful treatment in this case was due to the role of the dentist to create healthy soft and hard tissues in the oral cavity before restoration, and also due to patient cooperation.

Autogenous Transplantation for Replacing a Hopeless Tooth.

Science.gov (United States)

Zakershahrak, Mehrsa; Moshari, Amirabbas; Vatanpour, Mehdi; Khalilak, Zohreh; Jalali Ara, Afsoon

2017-01-01

Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption.

Stem cells in endodontic therapy

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Sita Rama Kumar M, Madhu Varma K, Kalyan Satish R, Manikya kumar Nanduri.R, Murali Krishnam Raju S, Mohan rao

2014-11-01

Full Text Available Stem cells have the remarkable potential to develop into many different cell types in the body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells as long as the person or animal is still alive. However, progress in stem cell biology and tissue engineering may present new options for replacing heavily damaged or lost teeth, or even individual tooth structures. The goal of this review is to discuss the potential impact of dental pulp stem cells on regenerative endodontics.

[The application of laser in endodontics].

Science.gov (United States)

He, W X; Liu, N N; Wang, X L; He, X Y

2016-08-01

Since laser was introduced in the field of medicine in 1970's, its application range has continuously expanded. The application of laser in endodontics also increased due to its safety and effectiveness in dental treatments. The majority of the laser application researches in dentistry focused on dentin hypersensitivity, removal of carious tissues, tooth preparations, pulp capping or pulpotomy, and root canal treatment. In this article, we reviewed literature on the effects of laser in the treatments of dental and pulp diseases.

Possibility of magnetic resonance imaging application in teaching preclinical dentistry - endodontic and prosthetic treatment prognosis

International Nuclear Information System (INIS)

Tanasiewicz, T.

2010-01-01

Background. The necessary condition for successful both endodontic and prosthetic reconstruction treatment is the precise mapping of the shape of dental cavities. The aim of this work is an elaboration and verification of the possibility of using 3D Spin Echo MRI techniques in teaching preclinical dentistry both in endodontic and prosthetics specialty. Objectives. Author' aim was to obtain an elaboration and a verification, whether there exists a possibility to use, at the level of in vitro analysis, techniques of the Magnetic Resonance Imaging, which are based on the 3D sequence of the Spin Echo that may in the future find employment in the teaching of preclinical dentistry, clinical dental therapy and diagnostics within the scope of: a dimensional imaging of the inner topography of teeth and spatial structure of a chamber and root canals of teeth for the therapeutic and didactic aims; introduction of a nondestructive and a non-impressional method of reconstruction of the topography of the inner spaces of the human teeth for the purposes of the reconstructive dentistry. Material and Methods. 6 extracted molar teeth were used for measurements without additional preparation, after endodontic and prosthetic preparation. MR measurements were carried out on a 4.7 T research MRI system equipped with Maran DRX console. Results. Figures show 3D images of outer surface, inner space of the teeth before and after endodontic preparation and internal tooth fixation constructed using both classical methods (polymer mass impression) and non-impressional methods (MRI representation). The sizes of the presented volumes were calculated. Internal tooth volumes were determined before and after endodontic treatment; total tooth volumes were also measured. Research proceedings made it possible to compare the quality of internal tooth space after preparation for inner root canals fixations constructed using both classical methods and non-impressional MRI method. Conclusions. The results

Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

OpenAIRE

Patel, Surbhi; Patel, Pawan

2012-01-01

Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal r...

The evaluation of endodontic flare-ups and their relationship to various risk factors

OpenAIRE

Onay, Emel Olga; Ungor, Mete; Yazici, A. Canan

2015-01-01

Background To evaluate the incidence of flare-ups and identify the risk factors including age, gender, tooth type, number of root canals, initial diagnosis, the type of irrigation regimen, treatment modality and the number of visits, in patients who received root canal treatment from January 2002 to January 2008. Methods Records of 1819 teeth belonging to 1410 patients treated by 1 endodontics specialist during 6-year period were kept. Patient, tooth, and treatment characteristics were evalua...

Detection of antibiotic resistance genes in samples from acute and chronic endodontic infections and after treatment.

Science.gov (United States)

Rôças, Isabela N; Siqueira, José F

2013-09-01

The purpose of this study was twofold: survey samples from acute and chronic endodontic infections for the presence of genes encoding resistance to beta-lactams, tetracycline and erythromycin, and evaluate the ability of treatment to eliminate these genes from root canals. DNA extracts from samples of abscess aspirates (n=25) and root canals of teeth with asymptomatic apical periodontitis (n=24) were used as template for direct detection of the genes blaTEM, cfxA, tetM, tetQ, tetW, and ermC using real-time polymerase chain reaction (PCR). Bacterial presence was determined using PCR with universal bacterial primers. Root canals of the asymptomatic cases were also sampled and evaluated after chemomechanical procedures using NiTi instruments with 2.5% NaOCl irrigation. All abscess and initial root canal samples were positive for bacteria. At least one of the target resistance genes was found in 36% of the abscess samples and 67% of the asymptomatic cases. The most prevalent genes in abscesses were blaTEM (24%) and ermC (24%), while tetM (42%) and tetW (29%) prevailed in asymptomatic cases. The blaTEM gene was significantly associated with acute cases (p=0.02). Conversely, tetM was significantly more prevalent in asymptomatic cases (p=0.008). Treatment eliminated resistance genes from most cases. Acute and chronic endodontic infections harboured resistance genes for 3 classes of widely used antibiotics. In most cases, treatment was effective in eliminating these genes, but there were a few cases in which they persisted. The implications of persistence are unknown. Direct detection of resistance genes in abscesses may be a potential method for rapid diagnosis and establishment of proactive antimicrobial therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Radicular Cyst With Actinomycotic Infection in an Upper Anterior Tooth

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Shuei-Kuen Tseng

2009-10-01

Full Text Available Actinomycosis is an infection caused by filamentous, branching, Gram-positive anaerobic bacteria. It rarely infects the jawbone. This case report describes a patient with a left maxillary central incisor with an apical lesion and actinomycotic infection. A 23-year-old male patient underwent conventional root canal treatment of tooth 21, in a local dental clinic for about 1 year. However, percussion pain and a sinus tract that originated from tooth 21 were still present after treatment. Nonsurgical root canal treatment of tooth 21 was performed again but failed to relieve the symptoms. Therefore, apicoectomy and retrograde filling of the apical root canal with mineral trioxide aggregate were carried out. Periradicular bony defect was grafted by biocompatible material, and postoperative antibiotics (250 mg amoxicillin were given three times daily for 5 days. Pathological examination of the removed periapical tissue showed a radicular cyst with actinomycosis. At the 9-month postoperative recall, the sinus tract had disappeared and radiographic examination showed healing of the apical lesion. Periradicular actinomycosis is one important reason for failure of nonsurgical endodontic treatment. Clinically, if the tooth shows a recurrent sinus tract and poor response to conventional root canal treatment combined with antibiotic control, apical actinomycotic infection should be highly suspected, and an alternative endodontic surgical approach is needed for successful treatment.

Rotary endodontics in primary teeth – A review

Science.gov (United States)

George, Sageena; Anandaraj, S.; Issac, Jyoti S.; John, Sheen A.; Harris, Anoop

2015-01-01

Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the “gold-standard” over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel–titanium (Ni–Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel–titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed. PMID:26792964

Rotary endodontics in primary teeth – A review

Directory of Open Access Journals (Sweden)

Sageena George

2016-01-01

Full Text Available Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the “gold-standard” over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel–titanium (Ni–Ti rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel–titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.

Morphologic variations of maxillary molars palatal root and the importance of its knowledge for endodontic practice: a case series.

Science.gov (United States)

Scarparo, Roberta Kochenborger; Pereira, Leticia; Moro, Diana; Grundling, Grasiela; Gomes, Maximiliano; Grecca, Fabiana Soares

2011-03-01

The present report describes and discusses root canal variations in the internal morphology of maxillary molars. Dental internal anatomy is directly related to all the technical stages of the endodontic treatment. Even though, in some situations a typical anatomical characteristics can be faced, and the professional should be able to identify them. This clinical report describes five cases with different pulpar and periapical diagnostics where the endodontic treatment was performed, in which during the treatment the unusual occurrence of two or three canals in the palatal root 'or even two distinct palatal roots' of first and second maxillary molars, were described and important details for achieving treatment success were discussed. The knowledge of tooth internal anatomy must be considered during clinical and radiographic examinations. This should be valued not only to find atypical canals but also to enable calcified canals cleaning and shaping, once they are frequently omitted during endodontic therapy. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. The complexity of the root canal system and the importance of identifying its internal anatomy for planning endodontic treatment increase the chances of success.

Endodontic Treatment in Submerged Roots: A Case Report

Directory of Open Access Journals (Sweden)

Hemalatha Pameshwar Hiremath

2010-06-01

Full Text Available Alveolar ridge resorption has long been considered an unavoidable consequence of tooth extraction. While the extent and pattern of resorption is variable among individuals, there is a progressive loss of ridge contour as a result of physiologic bone remodeling. Even today, with best modalities of tooth preservation, there is a group of elderly individuals who do not benefit from modern preventive practices and who now present a dilemma in terms of maintaining the masticatory apparatus necessary for nutrition. Even with excellent dental care, such patients experience abrasion of the natural tooth crowns with age, and embedded roots are left within the alveolar bone. According to old concepts of dental care, extraction of these roots would have been recommended, but today’s goal of excellence in endodontics dictates otherwise. We report a case in which vital and non-vital root submergence was carried out to prevent alveolar ridge reduction.

Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery.

Science.gov (United States)

Song, Minju; Kim, Hyeon-Cheol; Lee, Woocheol; Kim, Euiseong

2011-11-01

This study examined the clinical causes of failure and the limitation of a previous endodontic treatment by an inspection of the root apex and resected root surface at 26× magnification during endodontic microsurgery. The data were collected from patients in the Department of Conservative Dentistry at the Dental College, Yonsei University in Seoul, Korea between March 2001 and January 2011. All root-filled cases with symptomatic or asymptomatic apical periodontitis were enrolled in this study. All surgical procedures were performed by using an operating microscope. The surface of the apical root to be resected or the resected root surface after methylene blue staining was examined during the surgical procedure and recorded carefully with 26× magnification to determine the state of the previous endodontic treatment by using an operating microscope. Among the 557 cases with periapical surgery, 493 teeth were included in this study. With the exclusion of unknown cases, the most common possible cause of failure was perceived leakage around the canal filling material (30.4%), followed by a missing canal (19.7%), underfilling (14.2%), anatomical complexity (8.7%), overfilling (3.0%), iatrogenic problems (2.8%), apical calculus (1.8%), and cracks (1.2%). The frequency of possible failure causes differed according to the tooth position (P < .001). An appreciation of the root canal anatomy by using an operating microscope in nonsurgical endodontic treatment can make the prognosis more predictable and favorable. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Operator-related aspects in endodontic malpractice claims in Finland.

Science.gov (United States)

Vehkalahti, Miira M; Swanljung, Outi

2017-04-01

We analyzed operator-related differences in endodontic malpractice claims in Finland. Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002-2006 and 2011-2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient's age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist's age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses. Patients' mean age was 44.7 (range 8-85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients' gender, dentists' age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator's age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists. Operator-related factors had no impact on endodontic malpractice claims.

Restorative outcomes for endodontically treated teeth in the Practitioners Engaged in Applied Research and Learning network.

Science.gov (United States)

Spielman, Howard; Schaffer, Scott B; Cohen, Mitchell G; Wu, Hongyu; Vena, Donald A; Collie, Damon; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

2012-07-01

The authors aimed to determine the outcome of and factors associated with success and failure of restorations in endodontically treated teeth in patients in practices participating in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. Practitioner-investigators (P-Is) invited the enrollment of all patients seeking care at participating practices who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years earlier. P-Is classified endodontically reated teeth as restorative failures if the restoration was replaced, the restoration needed replacement or the tooth was cracked or fractured. P-Is from 64 practices enrolled in the study 1,298 eligible patients who had endodontically treated teeth that had been restored. The mean (standard deviation) time to follow-up was 3.9 (0.6) years. Of the 1,298 enrolled teeth, P-Is classified 181 (13.9 percent; 95 percent confidence interval [CI], 12.1-15.8 percent) as restorative failures: 44 (3.4 percent) due to cracks or fractures, 57 (4.4 percent) due to replacement of the original restoration for reasons other than fracture and 80 (6.2 percent) due to need for a new restoration. When analyzing the results by means of multivariate logistic regression, the authors found a greater risk of restorative failure to be associated with canines or incisors and premolars (P = .04), intracoronal restorations (P < .01), lack of preoperative proximal contacts (P < .01), presence of periodontal connective-tissue attachment loss (P < .01), younger age (P = .01), Hispanic/Latino ethnicity (P = .04) and endodontic therapy not having been performed by a specialist (P = .04). These results suggest that molars (as opposed to other types of teeth), full-coverage restorations, preoperative proximal contacts, good periodontal health, non-Hispanic/Latino ethnicity, endodontic therapy performed by a specialist and older patient age are associated with restorative success for

[Treatment of a fractured endodontical instrument in the root canal].

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Schipper, M; Peters, L B

2015-12-01

A 53-year-old woman with continuing pain coming from a lower first molar was diagnosed with apical periodontitis, with a retained fractured instrument in the root canal. There are a variety of treatment options for dealing with a corpus alienum in a root canal. In this case it was decided to treat the tooth endodontically, and leave the fractured instrument fragment in situ. The selection of this treatment option was made on the basis of knowledge of the original diagnosis and the success rates of the various treatment options as described in the relevant literature, weighed against the possible risks and their effects on the prognosis. This suggested that the use of a dental operating microscope has a positive impact on the success rates of endodontic treatment The prognosis for endodontic treatment when a fractured instrument fragment is left within the root canal, as in this case, is not significantly reduced. The presence of preoperative periapical pathology, however, is a more clinically significant prognostic indicator.

Endodontic management of permanent mandibular molars with 6 root canals: report of 3 cases.

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Malhotra, Amit; Ahlawat, Jyoti; Bansal, Chirag; Tahiliani, Divya

2016-01-01

Aberrations in the internal dental anatomy present challenges for clinicians performing endodontic therapy. These challenges have been partly resolved in recent years by a more comprehensive knowledge of root canal anatomy as well as advancements in the endodontic armamentarium. The aim of this case series is to describe successful root canal treatment, under magnification, in 3 cases of mandibular first molars with 6 root canals. Two of these teeth had 2 roots (mesial and distal) with 3 canals in each root; the third tooth had 3 root canals located mesially and 3 present distally as well as a radix entomolaris. A distal root with 3 canals is rare; however, it is important to look for such anatomical variations to ensure successful endodontic therapy.

Influence of endodontic instrument-holder on sterilization efficacy. A pilot in-vitro study.

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Angelo Carrizo

2013-08-01

Full Text Available Infection control is crucial in dentistry and various methods have been designed to assure its efficacy. However, little information exists regarding the influence it could have the instrument-holder of endodontic files. The aim of this research was to determine the influence of three instruments-holders on sterilization efficacy of endodontic files. Methods: A pilot in-vitro study. 60 endodontic files were contaminated by biomechanical preparation of extracted molars with periapical abscess, then processed according to the standard washing method. The endodontic files were divided into 3 groups (n=20 and assigned to 3 instrument-holders: Metallic box (MB, surgical gauze (SG and synthetic sponge (SS. Then, the files were packaged and sterilized by autoclaving (134°C/45min. Microbiological culture was performed in thioglycolate solution for each endodontic file (37ºC/5days. Results: The overall sterilization efficacy was 91.7%, 80% for MB, 100% for SS, and 95% for SG, with no statistically significant differences (p=0.06 between the groups. Conclusions: The lack of differences in the efficacy of sterilization may be due to the reduced sample; therefore, a full-size study is necessary to confirm this outcomes. The results of this study discourage the use of the MB as instrument-holder until a full-size study can confirm this data.

Flare-up rate in molars with periapical radiolucency in one-visit vs two-visit endodontic treatment.

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Akbar, Iftikhar; Iqbal, Azhar; Al-Omiri, Mahmoud K

2013-05-01

The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency. A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit. 10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p>0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p>0.05). One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asymptomatic molar teeth with periapical radiolucency.

Infection and microleakage the caused of endodontic failure

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Kurniasri Amas Achiar

2008-03-01

Full Text Available The success of endodontic treatment depends on the quality of endodontic treatment and the final restoration. The mean reason for endodontic treatment failure is usually microleakage. That is why it becomes one of the priorities for dental research to prevent microleakage. Infection during the root canal treatment can be prevented. First, by employing strict aseptic clinical techniques follows by cleaning all bacteria and preoperative necrotic pulp-tissue remnants from the root canal. Irrigants are essential in this phase. The shaping of the canal is also an important prerequisite for endodontic success. Removal of the smear layer can enhance seal ability. Second, obturation of the root canal should leave the tooth in the most biological inert condition possible, and it must prevent reinfection as well as the growth of any microorganisms remaining in the canal. The application of an antibacterial dressing between appointments is absolutely necessary or the root canal has to be obturated at the first appointment in order to deprive the microorganisms of nutrients and space to multiply. The temporary filling must be at least 3.5 mm thick. Failure occurs because of missed canals, iatrogenic events and radicular fractures have to be avoided. At the end, clinicians have to confirm that the root canal is cleaned and hermetically obturated because hermetic root canal filling will prevent the leakage of an irritant to the apical area.

In Vitro Evaluation of the Effect of Tooth Structure Loss on Fracture Resistance of Endodontically Treated Teeth

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Shirinzad M

2017-06-01

Full Text Available Introduction: Since preserving the structure of treated teeth is a critical success factor, studying the effects of tooth structure loss on fracture resistance of the tooth tissue appears necessary. The aim of this study was to evaluate the consequences of the loss of different tissues regarding fracture resistance of teeth undergoing root canal treatment without the use of indirect restorations. Methods :In this experimental study, 70 healthy maxillary first premolar teeth were randomly divided into 7 groups of 10 members, including control group, endodontic access preparation only, MOD cavity preparation, cutting buccal cusp, cutting palatal cusp, cutting buccal cusp and marginal ridge, and cutting the palatal cusp and marginal ridge. The coronal section of teeth was restored incrementally with light cure composite. Finally, samples underwent compressive load with 45˚ angle from each cusp slope in the middle of cusp with an instant speed of 1 mm per min in the Instron machine. Fracture resistance was measured and samples were examined under stereo-microscope to evaluate the mode of failure. Results: The resistance to fracture in root canal treated teeth in different groups in order from first to seventh was 797.13 ± 52.92, 722.50 ± 131.40, 432.15 ± 203.20, 592.66 ± 195.86 124.53 ± 33.09, 85.17 ± 18.45, and 26.03 ± 5.21 Newton. ANOVA test showed statistically significant differences between the groups in terms of their fracture resistance (P = 0.000. Conclusions: The results showed that fracture resistance levels of teeth were significantly affected by amount of their tissue loss. In this study, removal of teeth palatal cusp and marginal ridge had a significant effect on decreasing the fracture resistance, while removing the buccal cusps alone cannot have a significant effect.

Use of ultrasound Doppler to determine tooth vitality in a discolored tooth after traumatic injury: its prospects and limitations

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Yong-Wook Cho

2014-02-01

Full Text Available When a tooth shows discoloration and does not respond to the cold test or electric pulp test (EPT after a traumatic injury, its diagnosis can be even more difficult due to the lack of proper diagnostic methods to evaluate its vitality. In these case reports, we hope to demonstrate that ultrasound Doppler might be successfully used to evaluate the vitality of the tooth after trauma, and help reduce unnecessary endodontic treatments. In all three of the present cases, the teeth were discolored after traumatic injuries and showed negative responses to the cold test and EPT. However, they showed distinctive vital reactions in the ultrasound Doppler test during the whole observation period. In the first case, the tooth color returned to normal, and the tooth showed a positive response to the cold test and EPT at 10 wk after the injury. In the second case, the tooth color had returned to its normal shade at 10 wk after the traumatic injury but remained insensitive to the cold test and EPT. In the third case, the discoloration was successfully treated with vital tooth bleaching.

Coronal microleakage of four temporary restorative materials in Class II-type endodontic access preparations

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Sang-Mi Yun

2012-02-01

Full Text Available Objectives The purpose of this study was to evaluate the microleakage of 4 temporary materials in teeth with Class II-type endodontic access preparations by using a glucose penetration model. Materials and Methods Glucose reaction test was performed to rule out the presence of any reaction between glucose and temporary material. Class II-type endodontic access preparations were made in extracted human premolars with a single root (n = 10. Each experimental group was restored with Caviton (GC, Spacer (Vericom, IRM (Dentsply-Caulk, or Fuji II(GC. Microleakage of four materials used as temporary restorative materials was evaluated by using a glucose penetration model. Data were analyzed by the one-way analysis of variance followed by a multiple-comparison Tukey test. The interface between materials and tooth were examined under a scanning electron microscope (SEM. Results There was no significant reaction between glucose and temporary materials used in this study. Microleakage was significantly lower for Caviton and Spacer than for Fuji II and IRM. SEM observation showed more intimate adaptation of tooth-restoration interfaces in Caviton and Spacer than in IRM and Fuji II. Conclusions Compared to IRM and Fuji II, Caviton and Spacer can be considered better temporary sealing materials in Class II-type endodontic access cavities.

The evaluation of endodontic flare-ups and their relationship to various risk factors.

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Onay, Emel Olga; Ungor, Mete; Yazici, A Canan

2015-11-14

To evaluate the incidence of flare-ups and identify the risk factors including age, gender, tooth type, number of root canals, initial diagnosis, the type of irrigation regimen, treatment modality and the number of visits, in patients who received root canal treatment from January 2002 to January 2008. Records of 1819 teeth belonging to 1410 patients treated by 1 endodontics specialist during 6-year period were kept. Patient, tooth, and treatment characteristics were evaluated and the relationships between these characteristics and flare-ups were studied. Statistical analysis was carried out by using Pearson Chi-square test, Fisher's Exact test, and Binary Logistic regression analyses. The incidence of flare-ups was 59 (3.2 %) out of 1819 teeth that received endodontic therapy. Pulpal necrosis without periapical pathosis was the most common indication for flare-up (6 %) (p flare-ups compared to those with single appointments (OR: 3.14, CI: 1.414-7.009, p flare-ups regarding to age, gender, tooth type, number of root canals, treatment modality, and the irrigation solutions that used during the treatment. The incidence of flare-up is minimal when teeth are treated in one visit. Absence of a periapical lesion in necrotic teeth is a significant risk factor for flare-ups.

Factors associated with endodontic flare-ups: a prospective study.

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Imura, N; Zuolo, M L

1995-09-01

The purpose of this prospective study was to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment by the two authors in their respective practices during a period of one year, and also to examine the correlation with pre-operative and operative variables. The results showed an incidence of 1.58% for flare-ups from 1012 endodontically treated teeth. Statistical analysis using the chi-square test (Pflare-ups were found to be positively correlated with multiple appointments, retreatment cases, periradicular pain prior to treatment, presence of radiolucent lesions, and patients taking analgesic or anti-inflammatory drugs. In contrast, there was no correlation between flare-up, and age, sex, different arch/tooth groups and the status of the pulp.

Endodontic sealers: Intratubular penetration and permeability to Enterococcus faecalis

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Bortolini Maria Cecilia

2010-01-01

Full Text Available Aim : Evaluate in vitro the intratubular penetration and permeability of endodontic sealers in teeth contaminated with Enterococcus faecalis. Materials and Methods : Human canines were filled with AHPlus ® , Endo CPM-sealer ® or EndoRez ® sealers. To evaluate permeability, the coronary portion of each tooth was contaminated with E. faecalis, then the apical portion was immersed in brain heart infusion (BHI broth, and medium turbidity was observed for thirty days. Scanning electron microscope (SEM was used to evaluate the intratubular penetration of each sealer at the cervical, middle, and apical thirds of the tooth. Results : Only one tooth from the Endo CPM-sealer ® group presented broth contamination. EndoRez ® showed increased intratubular penetration compared to AHPlus ® and Endo CPM-sealer ® . Conclusions : Endo CPM-sealer ® showed greater permeability to E. faecalis and EndoRez ® showed increased intratubular penetration.

Three dimensional mathematical model of tooth for finite element analysis

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Puškar Tatjana

2010-01-01

Full Text Available Introduction. The mathematical model of the abutment tooth is the starting point of the finite element analysis of stress and deformation of dental structures. The simplest and easiest way is to form a model according to the literature data of dimensions and morphological characteristics of teeth. Our method is based on forming 3D models using standard geometrical forms (objects in programmes for solid modeling. Objective. Forming the mathematical model of abutment of the second upper premolar for finite element analysis of stress and deformation of dental structures. Methods. The abutment tooth has a form of a complex geometric object. It is suitable for modeling in programs for solid modeling SolidWorks. After analyzing the literature data about the morphological characteristics of teeth, we started the modeling dividing the tooth (complex geometric body into simple geometric bodies (cylinder, cone, pyramid,.... Connecting simple geometric bodies together or substricting bodies from the basic body, we formed complex geometric body, tooth. The model is then transferred into Abaqus, a computational programme for finite element analysis. Transferring the data was done by standard file format for transferring 3D models ACIS SAT. Results. Using the programme for solid modeling SolidWorks, we developed three models of abutment of the second maxillary premolar: the model of the intact abutment, the model of the endodontically treated tooth with two remaining cavity walls and the model of the endodontically treated tooth with two remaining walls and inserted post. Conclusion Mathematical models of the abutment made according to the literature data are very similar with the real abutment and the simplifications are minimal. These models enable calculations of stress and deformation of the dental structures. The finite element analysis provides useful information in understanding biomechanical problems and gives guidance for clinical research.

Post-endodontic treatment of incisors and premolars among dental practitioners in Saarland: an interactive Web-based survey.

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Mitov, Gergo; Dörr, Michael; Nothdurft, Frank P; Draenert, Florian; Pospiech, Peter R

2015-06-01

The aim of the present study was to evaluate the trend of dental practitioners in the federal state of Saarland in Germany in regard to restoring endodontically treated teeth using a Web-based survey. An interactive Web-based survey instrument was developed, including seven clinical scenarios, presented by photographs of natural incisor and premolar with different types of cavities. Following a decision tree adapted to the clinical treatment, questions on different aspects of the post-endodontic treatment were asked. All 615 members of the Saarland Dental Association (SDA) were asked to participate in the survey. A total of 33 % completed the survey. The majority of the participants believed in the reinforcement effect of the ferrule design, as well as the post placement. The vast majority of the responding practitioners (92 %) adapted their treatment strategies to a high extent to the destruction degree of the endodontically treated tooth. Fiber-reinforced composite (FRC) posts are the most popular prefabricated post type, regardless of the cavity size and tooth localization. Significant differences between the dentists according to the degree of experience were detected only for the use of glass-ionomer cements as core buildup material. The predominant post-endodontic treatment strategies of German dental practitioners are only partly in agreement with the current literature. There is a clear trend toward the increasing use of metal-free post and core materials. Although the participants showed a general adoption of modern materials and techniques, different patterns of post-endodontic treatment were revealed that were not consistent with approaches supported by the literature.

Dental management of patients with X-linked hypophosphatemia

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Bin-Na Lee

2017-05-01

Full Text Available X-linked hypophosphatemia (XLH is a hereditary metabolic disease caused by the loss of phosphate through the renal tubules into the urine, and an associated decrease in serum calcium and potassium phosphate. Its dental features include spontaneous dental abscesses that occur in the absence of trauma or dental caries. The aim of this case report was to describe the dental problems of XLH patients and to evaluate limitations in their treatment. A 14 year old male and a 38 year old female with XLH were referred to the Department of Conservative Dentistry for endodontic treatment. The dental findings were periapical abscesses without obvious trauma or caries. Conservative endodontic treatment was performed in teeth with pulp necrosis and abscess. In case 1, the treated teeth showed improvements in bone healing, without clinical symptoms. However, in case 2, the implants and the treated tooth showed hypermobility, and the final restoration was therefore postponed. Early diagnosis, periodic examinations, and communication with the patient's pediatrician are important in the dental management of patients with XLH

[Developmental radicular groove as a cause of endodontic failure].

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Fabra Campos, H; Millet Part, J

1989-01-01

A clinical case of apical injury on an upper lateral incisor with endodontical and surgical failures in its treatment is presented. Extraction of the incisor and its study at the stereoscopic microscope showed the existence of a developmental groove running from the cingulum to the end of the root, establishing a communication between the crevice and the apical part of the tooth. Bacterial infection through the groove could provide an explanation for treatment failure.

Revascularization procedure in an open apex tooth with external root resorption: A case report

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Mahsa Dastpak

2017-06-01

Full Text Available External inflammatory root resorption (EIR represents a challenge in endodontic practice. EIR commonly occurs after dental trauma that results in periodontal ligament injury, pulp necrosis and subsequent infection.  Treatment of EIR is based on disinfecting the root canal system through chemomechanical procedures and then filling it with calcium hydroxide or triple antibiotic paste. Dental trauma commonly occurs in young patients whose teeth are not fully formed and have thin dentinal walls and open apices. Revascularization therapy has proven to be suitable for treatment of root canals of teeth with pulp necrosis and open apices. This case report presents successful revascularization treatment of a permanent immature tooth with external root resorption and chronic apical periodontitis. The tooth was treated by the protocol suggested by the American Association of Endodontics (AAE, consisted of disinfecting the root canal system, filling it with blood clot and sealing the root canal with mineral trioxide aggregate followed by bonded resin restoration. The symptoms disappeared, the size of the periapical lesion reduced and the tooth was asymptomatic during the 12 month follow up period.

3D printed replicas for endodontic education.

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Reymus, M; Fotiadou, C; Kessler, A; Heck, K; Hickel, R; Diegritz, C

2018-06-14

To assess the feasibility of producing artificial teeth for endodontic training using 3D printing technology, to analyse the accuracy of the printing process, and to evaluate the teeth by students when used during training. Sound extracted human teeth were selected, digitalized by cone beam computed tomography (CBCT) and appropriate software and finally reproduced by a stereolithographic printer. The printed teeth were scanned and compared with the original ones (trueness) and to one another (precision). Undergraduate dental students in the third and fourth years performed root canal treatment on printed molars and were subsequently asked to evaluate their experience with these compared to real teeth. The workflow was feasible for manufacturing 3D printed tooth replicas. The absolute deviation after printing (trueness) ranged from 50.9μm to 104.3μm. The values for precision ranged from 43.5μm to 68.2μm. Students reported great benefits in the use of the replicated teeth for training purposes. The presented workflow is feasible for any dental educational institution who has access to a CBCT unit and a stereolithographic printer. The accuracy of the printing process is suitable for the production of tooth replicas for endodontic training. Undergraduate students favoured the availability of these replicas and the fairness they ensured in training due to standardization. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Catonella morbi and Granulicatella adiacens: new species in endodontic infections.

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Siqueira, José F; Rôças, Isabela N

2006-08-01

This study intended to examine samples from primary endodontic infections for the presence of Catonella morbi and Granulicatella adiacens, 2 species that have been recently suggested to be involved with infections in other oral sites. Genomic DNA was isolated directly from samples taken from teeth with different forms of apical periodontitis, and a devised culture-independent 16S rRNA gene-based heminested PCR assay was used to determine the prevalence of these 2 target species. Species-specific primers were developed by aligning closely related 16S rRNA gene sequences. Species-specificity for each primer pair was confirmed by running PCR against a panel of oral bacteria and by sequencing of DNA from representative positive samples. C morbi and G adiacens were detected in 33% and 19%, respectively, of the root canals associated with chronic apical periodontitis; 30% and 10%, respectively, of the cases diagnosed as acute apical periodontitis, and 16% and 11%, respectively, of the pus samples taken from acute apical abscesses. Overall, C morbi occurred in 26% and G adiacens in 14% of the samples taken from primary endodontic infections. Our findings demonstrate that C morbi and G adiacens can take part in the microbiota associated with primary endodontic infections, and their specific role in the disease process warrants further elucidation.

Mandibular lateral incisor with four root canals: A unique case of double tooth diagnosed using multidetector computed tomography

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Gupta, Sunil Kumar; Acharya, Shashi Rashmi; Ather, Amber; Gupta, Jaya

2013-01-01

Double tooth is a dental anomaly consequent to fusion of two or more teeth or gemination of a single tooth. This report describes a unique case of double tooth in relation to a mandibular lateral incisor exhibiting the presence of four root canals. The role of conventional radiography and advanced three-dimensional imaging techniques in the better assessment of complex root canal systems and their aid in endodontic management has also been highlighted.

Apexification in a non-vital tooth: By control of infection

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Basgauda R Patil

2010-01-01

Full Text Available Endodontic management of immature non-vital permanent teeth in young pediatric patients is a great challenge to dentists. When the pulp of an incompletely formed tooth loses its vitality, then the entire root system has also lost its ability to continue to develop. The walls of the root canals are frequently divergent and open apices make debridement and obturation difficult. Thus, closure of the root apex is very essential for the success of endodontic treatment. Many different materials are used for the apexification procedure, for apical barrier formation and healing. However, in this present case the apical closure was achieved only by means of infection control.

Periodontal and endodontic infectious/inflammatory profile in primary periodontal lesions with secondary endodontic involvement after a calcium hydroxide-based intracanal medication.

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Duque, Thais M; Prado, Maira; Herrera, Daniel R; Gomes, Brenda P F A

2018-03-23

The aim of the present study was to investigate the effects of a calcium hydroxide-based intracanal medication (ICM) on periodontal and endodontic infectious/inflammatory contents and on periodontal clinical parameters in teeth with primary periodontal lesion and secondary endodontic involvement. Ten patients with abnormal pulp test results and deep probing depth derived from primary periodontal disease with secondary endodontic involvement were included. Samples were collected from root canals (RC) and periodontal pockets (PP) in order to investigate the microbiological status, levels of endotoxin (LPS), cytokines, and matrix metalloproteinases (MMP), before and after ICM. PCR was used for microbiological assessment. The kinetic-chromogenic LAL assay was used for LPS quantification. Quantikine ELISA kits were used for measurement of IL-1 α, IL-1 β, TNF-α, PGE 2 , MMP-2, MMP-3, MMP-8, MMP-9, and MMP-13 levels. The statistical analyses were made using the Friedman and Wilcoxon tests (p  0.05); however, the levels of the other MMPs and cytokines were reduced (p < 0.05). After 1 year of the root canal treatment, tooth mobility was significantly reduced (p ≤ 0.05). The use of a calcium hydroxide-based ICM showed positive effects for periodontal treatment prognosis, as it reduced LPS, cytokine, and MMP levels in periodontal pockets. Patients presenting deep probing depth and undergoing periodontal treatment for at least 6 months, with no positive response to periodontal therapy, might benefit with the endodontic treatment.

Broken instrument retrieval with indirect ultrasonics in a primary molar.

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Pk, Musale; Sc, Kataria; As, Soni

2016-02-01

The separation of a file during pulpectomy is a rare incident in primary teeth due to inherently wider and relatively straighter root canals. A broken instrument hinders the clinician from optimal preparation and obturation of the root canal system invariably leading to failure, although in such teeth, an extraction followed by suitable space maintenance is considered as the treatment of choice. This case report demonstrates successful nonsurgical retrieval of a separated H file fragment in 84. A 7-year-old girl was referred to the Department of Paedodontics and Preventive Dentistry for endodontic management of a primary tooth 84 with a dento-alveolar abscess. Her medical history was noncontributory. After diagnosing a broken H file in the mesio-lingual canal, the tooth was endodontically treated in two appointments. At the first session, a broken file was successfully retrieved after using low intensity ultrasonic vibrations through a DG 16 endodontic explorer viewed under an operating microscope. After abscess resolution, Vitapex root canal obturation with a preformed metal crown cementation was completed at a second session. The patient was recalled at 3, 6, 12 and 15 month interval and reported to be clinically asymptomatic and radiographically with complete furcal healing. Integration of microscopes and ultrasonics in paediatric dental practice has made it possible to save such teeth with a successful outcome. Favourable location of the separated file, relatively straighter root canal system and patient cooperation resulted in successful nonsurgical management in this case.

Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

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Saeed Asgary

2014-05-01

Full Text Available As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

The impact of loupes and microscopes on vision in endodontics.

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Perrin, P; Neuhaus, K W; Lussi, A

2014-05-01

To report on an intraradicular visual test in a simulated clinical setting under different optical conditions. Miniaturized visual tests with E-optotypes (bar distance from 0.01 to 0.05 mm) were fixed inside the root canal system of an extracted maxillary molar at different locations: at the orifice, a depth of 5 mm and the apex. The tooth was mounted in a phantom head for a simulated clinical setting. Unaided vision was compared with Galilean loupes (2.5× magnification) with integrated light source and an operating microscope (6× magnification). The influence of the dentists' age within two groups was evaluated: endodontic instruments. Dentists over 40 years of age were dependent on the microscope to inspect the root canal system. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

[The clinical effect of root amputation in the treatment of periodontal/alveolar abscess].

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Tan, Baochun; Wu, Wenlei; Sun, Weibin; Xiao, Jianping

2012-06-01

To study the clinical effect of root amputation in the treatment of periodontal/alveolar abscess teeth with one severe lesion root. 30 periodontal/alveolar abscess teeth with one severe lesion root were chosen in the study. After root canal treatment, supragingival scaling, subgingival scaling and root planning, occlusal adjustment were done. Then the teeth were treated by root amputation. The clinical effect was evaluated 3 months, 6 months and 1 year after surgery. One year after surgery, 27 of 30 teeth were successful, 1 mandibular molar occurred root fracture, 1 mandibular molar was removed because of tooth loosening secondary to periodontal damage. 1 patient lost. Root amputation is an effective solution of periodontal/alveolar abscess.

Root Canal Stripping: Malpractice or Common Procedural Accident-An Ethical Dilemma in Endodontics.

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Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena

2016-01-01

Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.

Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

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Sanjeev Kumar Salaria

2016-01-01

Full Text Available Radicular cyst (RC is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.

Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography.

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Venskutonis, Tadas; Plotino, Gianluca; Tocci, Luigi; Gambarini, Gianluca; Maminskas, Julius; Juodzbalys, Gintaras

2015-02-01

The purpose of this study was to present a new periapical and endodontic status scale (PESS) that is based on the complex periapical index (COPI), which was designed for the identification and classification of periapical bone lesions in cases of apical periodontitis, and the endodontically treated tooth index, which was designed for endodontic treatment quality evaluation by means of cone-beam computed tomographic (CBCT) analysis. Periapical and endodontic status parameters were selected from the already known indexes and scientific literature for radiologic evaluation. Radiographic images (CBCT imaging, digital orthopantomography [DOR], and digital periapical radiography) from 55 patients were analyzed. All parameters were evaluated on CBCT, DOR, and digital periapical radiographic images by 2 external observers. The statistical analysis was performed with software SPSS version 19.0 (SPSS Inc, Chicago, IL). Chi-square tests were used to compare frequencies of qualitative variables. The level of significance was set at P ≤ .05. Overall intraobserver and interobserver agreements were very good and good, respectively. CBCT analysis found more lesions and lesions of bigger dimension (P < .001). CBCT imaging was also superior in locating lesions in the apical part on the side compared with DOR and in the diagnosis of cortical bone destruction compared with both methods (P < .001). Through CBCT analysis, more root canals and more canals associated with lesions were found. The most informative and reproducible periapical and endodontic status parameters were selected, and a new PESS was proposed. The classification proposed in the present study seems to be reproducible and objective and adds helpful information with respect to the existing indexes. Future studies need to be conducted to validate PESS. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Squamous cell carcinoma presenting as an endodontic-periodontic lesion.

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Levi, Paul A; Kim, David M; Harsfield, Scott L; Jacobson, Erica R

2005-10-01

Regardless of advances in diagnosis and treatment during the past 40 years, the overall 5-year survival rates for oral and oropharyngeal squamous cancers have only slightly improved and remain around 50%. Thus, the early diagnosis and treatment of carcinoma by health care providers are essential in achieving a good prognosis. We report a case of invasive squamous cell carcinoma that presented as a benign endodontic-periodontic lesion with a 7-mm periodontal pocket on tooth #15 in a 40-year-old, non-smoking woman. The subsequent management of the case is also discussed. The study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2000. Our patient was seen for a comprehensive periodontal examination including a periodontal charting, occlusal analysis, study casts, electronic pulp test for tooth #15, and complete mouth periapical radiographs. As there was a periapical radiolucency, an endodontic consultation was obtained. A periodontal flap surgical procedure was performed on teeth #13 to #15, and as there was bone erosion into the maxillary sinus, a biopsy of the soft tissue was submitted to the local hospital for histological analysis. The biopsied lesion was diagnosed as invasive, moderately differentiated squamous cell carcinoma with focal spindle and clear cell differentiation (grade II to III of IV). Bone invasion was also identified. The treatment of the carcinoma involved a hemimaxillectomy with the removal of the maxillary left posterior teeth. The patient remained free of tumor for 5 years after the initial presentation. Patient education and periodic oral cancer examinations by dental professionals are necessary to reduce diagnostic delay and improve prognosis. This case report emphasizes the important role of dental professionals, especially periodontists and endodontists, of being aware that squamous cell carcinoma may manifest itself clinically and/or radiographically as a common periodontal or endodontic lesion.

Campylobacter gracilis and Campylobacter rectus in primary endodontic infections.

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Siqueira, J F; Rôças, I N

2003-03-01

A species-specific nested polymerase chain reaction (PCR) assay was used to investigate the occurrence of Campylobacter gracilis and C. rectus in primary root canal infections. Samples were collected from 57 single-rooted teeth with carious lesions, necrotic pulps and radiographic evidence of periradicular disease. Twenty-eight cases were diagnosed as chronic asymptomatic periradicular lesions, 12 cases as acute apical periodontitis, and 17 cases as acute periradicular abscess. DNA was extracted from the samples and initially amplified using universal 16S rDNA primers. A second round of amplification using the first PCR products was performed to specifically detect C. gracilis or C. rectus in the samples. Campylobacter gracilis and C. rectus were, respectively, detected in 21.4 (6 of 28) and 30% (6 of 20) of the root canals associated with chronic asymptomatic periradicular lesions. Campylobacter gracilis was found in 16.7% (2 of 12) of the cases diagnosed as acute apical periodontitis, whilst C. rectus was found in 33.3% (two of six cases). In the abscessed cases, C. gracilis and C. rectus were detected in 23.5 (4 of 17) and 11.8% (2 of 17) of the cases, respectively. No association of these species with clinical symptoms was observed (P > 0.01) In general, species-specific nPCR allowed the detection of C. gracilis in 21.1% (12 of 57) and C. rectus in 23.3% (10 of 43)of the samples taken from primary endodontic infections. Findings confirmed the assertion that both C. gracilis and C. rectus participate in infections of endodontic origin and suggest a pathogenetic role with regard to periradicular diseases.

Human tooth germ stem cell response to calcium-silicate based endodontic cements

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Esra Pamukcu Guven

2013-07-01

Full Text Available OBJECTIVE: The aim of this study was to compare the cytotoxic effects of endodontic cements on human tooth germ stem cells (hTGSCs. MTA Fillapex, a mineral trioxide aggregate (MTA-based, salicylate resin containing root canal sealer, was compared with iRoot SP, a bioceramic sealer, and AH Plus Jet, an epoxy resin-based root canal sealer. MATERIAL AND METHODS: To evaluate cytotoxicity, all materials were packed into Teflon rings (4 mmµ3 mm and co-cultured with hTGSCs with the aid of 24-well Transwell permeable supports, which had a pore size of 0.4 µm. Coverslips were coated with MTA Fillapex, iRoot SP and AH Plus Jet and each coverslip was placed onto the bottom of one well of a six-well plate for scanning electron microscopy (SEM analysis. Before the cytotoxicity and SEM analysis, all samples were stored at 37ºC and at 95% humidity and 5% CO2 for 24 hours to set. The cellular viability was analyzed using MTS test (3-(4,5-dimethyl-thiazol-2-yl-5-(3-carboxy-methoxy-phenyl-2-(4-sulfo-phenyl-2H-tetrazolium. The cytotoxic effects and SEM visualization of the tested materials were analyzed at 24-hour, 72-hour, one-week and two-week periods. RESULTS: On the 1st day, only MTA Fillapex caused cytotoxicity compared to negative control (NC group (p0.05. After 14 days of incubation with the test materials, MTA Fillapex exhibited significantly higher cytotoxicity compared with iRoot SP, AH Plus Jet and the NC group (P<0.008. In the SEM analysis, the highest levels of cell attachment were observed for iRoot SP and the control group. After 24 hours, MTA Fillapex reduced the number of cells attached to the surface. CONCLUSIONS: Within the limitations of this study, sealers exerted different cytotoxic effects on hTGSCs. Although all materials have exerted cellular toxicity, iRoot SP and AH Plus Jet may promote better attachment to hTGSCs.

Endodontic pathogens causing deep neck space infections: clinical impact of different sampling techniques and antibiotic susceptibility.

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Poeschl, Paul W; Crepaz, Valentina; Russmueller, Guenter; Seemann, Rudolf; Hirschl, Alexander M; Ewers, Rolf

2011-09-01

The aims of the present study were to compare microbial populations in patients suffering from deep neck space abscesses caused by primary endodontic infections by sampling the infections with aspiration or swabbing techniques and to determine the susceptibility rates of the isolated bacteria to commonly used antibiotics. A total of 89 patients with deep neck space abscesses caused by primary endodontic infections requiring extraoral incision and drainage under general anesthesia were included. Either aspiration or swabbing was used to sample microbial pus specimens. The culture of the microbial specimens and susceptibility testing were performed following standard procedures. A total of 142 strains were recovered from 76 patients. In 13 patients, no bacteria were found. The predominant bacteria observed were streptococci (36%), staphylococci (13%), Prevotella (8%), and Peptostreptococcus (6%). A statistically significant greater number of obligate anaerobes were found in the aspiration group. The majority of patients presented a mixed aerobic-anaerobic population of bacterial flora (62%). The antibiotic resistance rates for the predominant bacteria were 10% for penicillin G, 9% for amoxicillin, 0% for amoxicillin clavulanate, 24% for clindamycin, and 24% for erythromycin. The results of our study indicated that a greater number of anaerobes were found when sampling using the aspiration technique. Penicillin G and aminopenicillins alone are not always sufficient for the treatment of severe deep neck space abscesses; beta-lactamase inhibitor combinations are more effective. Bacteria showed significant resistant rates to clindamycin. Thus, its single use in penicillin-allergic patients has to be carefully considered. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Combined endodontic-periodontic treatment of a palatal groove: a case report.

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Schwartz, Scott A; Koch, Michael A; Deas, David E; Powell, Charles A

2006-06-01

The palatal groove is a developmental anomaly that predisposes the tooth involved to a severe periodontal defect. When further complicated by pulp necrosis, these grooves often present a diagnostic and treatment planning challenge that requires an interdisciplinary treatment approach. This case report describes the successful collaborative management of a maxillary lateral incisor with an extensive palatal groove using a combination of nonsurgical endodontic therapy, odontoplasty, and periodontal regenerative techniques.

Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil.

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Chambrone, Luiz A; Chambrone, Leandro

2006-10-01

The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (> 60 years) and smoking were statistically significant (p < 0.05). The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss.

Odontogenic Keratocyst Looks Can Be Deceptive, Causing Endodontic Misdiagnosis

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K. M. Veena

2011-01-01

Full Text Available Odontogenic keratocyst (OKC is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. When the cyst is multilocular and located at the molar ramus area, it may be confused to ameloblastoma. Lots of cases have been reported in the literature where OKC is associated with the nonvital tooth. So trauma could be one of the reasons in inducing this cyst. In our case, it was in the anterior region at the periapex of nonvital tooth having traumatic occlusion. Hence, the diagnosis of radicular cyst was made and endodontic treatment was done.

[Comparative study of two treatment methods for acute periodontal abscess].

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Jin, Dong-mei; Wang, Wei-qian

2012-10-01

The aim of this short-term study was to compare the clinical efficacy of 2 different methods to treat acute periodontal abscesses. After patient selection, 100 cases of acute periodontal abscess were randomly divided into two groups. The experimental group was treated by supra- and subgingival scaling, while the control group was treated by incision and drainage. A clinical examination was carried out to record the following variables: subjective clinical variables including pain, edema, redness and swelling; objective clinical variables including gingival index(GI), bleeding index(BI), probing depth(PD),suppuration, lymphadenopathy and tooth mobility. The data was analyzed with SPSS 19.0 software package. RESULES: Subjective clinical variables demonstrated statistically significant improvements with both methods from the first day after treatment and lasted for at least 30 days(P0.05), but the experimental group showed more improvement in edema and redness than the control group(Pperiodontal abscesses.

The historical aspects, principles and philosophy of endodontics: A syllabus

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A. Ghazinori

1987-08-01

Full Text Available The area of endodontics has expanded in recent years to include operations that formerly were not done. e.g hemisection, intentional or unintentional replantations and treatment of periodontally-endodontically involved teeth. However, treatment of pulpitis and infected root canals occupy the major part of endodontic practice. The radical treatment of pulpless teeth by extraction which was so prevalent a few decades ago has given away to conservative treatment and retention of such teeth. What was brought about this change? Essentially, it has been due to a gradual veering away from the focal infection theory, simplification of strategic pulpless teeth as abutments. Research studies that indicated the pulpless tooth were either bacteriologic or roentgenologic in most of them the method of study was erroneous and unscientific. Roentgenologic studies condemned the pulpless tooth even more than the bacteriologic studies.It remained for an Englishman, E.W.Fish, to clarify the dark points of endodontic treatments by his experiments. he cauterized the gingiva and gingival sulcuses of extracted teeth and proved that contamination of root surfaces was due to above sources.Fish carried out an even more important experiment by establishing foci of infection in the jaws of guinia pigs and found four distinct areas around the focus of infection. These areas are called as zone of infection, zone of contamination, zone of irritation and zone of stimulation, with their special characteristics.From an endodontic stand point this study has considerable significance, as it explains both the disease process occurring in bone and repair following endodntic treatment. The focus of infection is always in the root canal. The periapical tissue is essentially strile except for occasional inroads, despite this focus. As the microorganisms grow out of the root canal and into the periapical tissue they are destroyed by the polymorphonuclear  leucocytes. In such cases where

Efficiency of Intraligamentary Anesthesia of Inferior Molars for Endodontic Treatment

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Peycheva K.

2014-12-01

Full Text Available The periodontal ligament injection appears to be the most consistently reliable in achieving clinically adequate pulpal anaesthesia. Materials and Methods: 130 inferior molar teeth; technique: The tooth was first cleaned with chlorhexidine 0.2% solution. The penetration of the ligament is performed with special intraligamentary needle (30 G - 9, 17,21 mm “sliding” along the side of the tooth, 300º angle between the needle and the tooth, having taken the care of determining support points which will prevent the needle from twisting. The penetration must be deep enough to obtain the seal required for the injection, injection for each root in particular points; volume of solution per root is 0.2-0.4 ml. Results: In 125 cases the technique was absolutely efficient. In only 5 cases with pulpitis chronica ulcerosa there was need for additional intrapulpal anesthesia. Conclusions: The method could be used as a primary anesthetic method for endodontic treatment.

[Irrigants and intracanal medicaments in endodontics].

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Zehnder, Matthias; Lehnert, Birgit; Schönenberger, Kathrin; Waltimo, Tuomas

2003-01-01

Modern, biologic root canal therapy should be performed with suitable irrigating solutions and intracanal medicaments. The goal of endodontic treatment is to free the treated tooth from infection and prevent reinfection as thoroughly as possible by means which do not put the organism at risk. In this review of the literature, an evidence-based concept for irrigation and medication of root canal systems is presented. Irrigants and medicaments are discussed with respect to their antimicrobial, tissue-dissolving and endotoxin-decontaminating capacity in relation to their systemic toxicity. Recent findings pertaining to interactions of root canal medicaments and irrigating solutions and their impact on a sound irrigating and medicating concept are discussed.

Alkaline Materials and Regenerative Endodontics: A Review

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Bill Kahler

2017-12-01

Full Text Available Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the canal wall. These goals are valid for immature teeth that have been subjected to trauma and dental caries or that are the result of developmental anomalies that expose the tooth to the risk of pulp necrosis and consequently result in the cessation of root maturation. Regenerative endodontic procedures (REPs have been described as a “paradigm shift” in the treatment of immature teeth with pulp necrosis and underdeveloped roots, as there is the potential for further root maturation and return of vitality. Treatment with REPs is advocated as the treatment of choice for immature teeth with pulp necrosis. REP protocols involve the use of alkaline biomaterials, primarily sodium hypochlorite, calcium hydroxide, mineral trioxide aggregates and Biodentine, and are the essential components of a successful treatment regimen.

Antibiotic prescribing for endodontic therapies: a comparative survey between general dental practitioners and final year Bachelor of Dental Surgery students in Cardiff, UK.

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Al Masan, A A; Dummer, P M H; Farnell, D J J; Vianna, M E

2018-07-01

To evaluate the views of final year dental surgery students (BDS; G1) at Cardiff University and general dental practitioners (GDPs; G2) within the geographic area of Cardiff, Wales, on antibiotic prescribing for endodontic conditions, and investigate the potential differences between the two groups. A cross-sectional online questionnaire-based survey of 12 qualitative and quantitative questions was distributed to 76 final year BDS Cardiff University students and 55 dental practices within Cardiff, UK. Six questions recorded general information, and the remaining questions included a series of hypothetical clinical scenarios, where the participants were asked to state whether they would or would not prescribe antibiotics. The data were analysed using spss version 23 to produce descriptive statistics, contingency tables and to run chi-square (χ²) tests, Fisher's exact tests and relative risk calculations. The response rate was 60% (n = 79). All G1 participants were aware of the consequences of antibiotic overuse. Approximately 60% of responders were aware of guidelines for antibiotic use in endodontic therapies, and 83% would only use antibiotics for a limited selection of patients (e.g. patients with systemic complications). G1 responses to clinical scenarios indicated overall that they were comparable to the ideal answers except for acute apical abscess (64% believed that antibiotics were indicated). The majority of G2 were aware of the consequences of antibiotic overuse. Only 28% of G2 were aware of guidelines for antibiotic use in endodontic therapies. Overall responses revealed that antibiotics would be prescribed for: systemic complications (78%), acute apical abscess (72%) and symptomatic apical periodontitis (28%). The clinical scenarios revealed G1 were more likely to prescribe antibiotics compared to G2 for cases of necrotic pulp with symptomatic apical periodontitis without systemic complications (incorrect answer) and less likely to other clinical

Intraradicular Splinting with Endodontic Instrument of Horizontal Root Fracture

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Ersan Çiçek

2015-01-01

Full Text Available Introduction. Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors. Methods. A 14-year-old female patient was referred to our clinic three days after a traffic accident. In radiographic examination, the right maxillary central incisor was fractured horizontally in apical thirds. Initially, following local infiltrative anesthetics, the coronal fragment was repositioned and this was radiographically confirmed. Then the stabilization splint was applied and remained for three months. After three weeks, according to the results of the vitality tests, the right and left central incisors were nonvital. For the right central incisor, both the coronal and apical fragments were involved in the endodontic preparation. Results. For the right central tooth, both the coronal and apical root fragments were endodontically treated and obturated at a single visit with white mineral trioxide aggregate whilst the fragments were stabilized internally by insertion of a size 40 Hedstrom stainless-steel endodontic file into the canal. Conclusion. Four-year follow-up examination revealed satisfactory clinical and radiographic findings with hard tissue repair of the fracture line.

Detection of vertical root fractures in vivo in endodontically treated teeth by cone-beam computed tomography scans

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Metska, M.E.; Aartman, I.H.A.; Wesselink, P.R.; Özok, A.R.

2012-01-01

Introduction The presence of a vertical root fracture (VRF) in an endodontically treated tooth has an immense impact on the treatment’s outcome. Early diagnosis of a VRF is imperative to avoid overtreatment and extensive bone loss. Our study aimed to examine the validity of 2 cone-beam computed

Prevalence of treponema species detected in endodontic infections: systematic review and meta-regression analysis.

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Leite, Fábio R M; Nascimento, Gustavo G; Demarco, Flávio F; Gomes, Brenda P F A; Pucci, Cesar R; Martinho, Frederico C

2015-05-01

This systematic review and meta-regression analysis aimed to calculate a combined prevalence estimate and evaluate the prevalence of different Treponema species in primary and secondary endodontic infections, including symptomatic and asymptomatic cases. The MEDLINE/PubMed, Embase, Scielo, Web of Knowledge, and Scopus databases were searched without starting date restriction up to and including March 2014. Only reports in English were included. The selected literature was reviewed by 2 authors and classified as suitable or not to be included in this review. Lists were compared, and, in case of disagreements, decisions were made after a discussion based on inclusion and exclusion criteria. A pooled prevalence of Treponema species in endodontic infections was estimated. Additionally, a meta-regression analysis was performed. Among the 265 articles identified in the initial search, only 51 were included in the final analysis. The studies were classified into 2 different groups according to the type of endodontic infection and whether it was an exclusively primary/secondary study (n = 36) or a primary/secondary comparison (n = 15). The pooled prevalence of Treponema species was 41.5% (95% confidence interval, 35.9-47.0). In the multivariate model of meta-regression analysis, primary endodontic infections (P apical abscess, symptomatic apical periodontitis (P < .001), and concomitant presence of 2 or more species (P = .028) explained the heterogeneity regarding the prevalence rates of Treponema species. Our findings suggest that Treponema species are important pathogens involved in endodontic infections, particularly in cases of primary and acute infections. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Flare-ups in endodontics and their relationship to various medicaments.

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Ehrmann, Ernest H; Messer, Harold H; Clark, Robert M

2007-12-01

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare-ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare-up rates at both the 4-h and 24-h periods between the three modalities. Further research is required using the above definition of a flare-up and standardising treatment protocols.

Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery.

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Çalışkan, M K; Kaval, M E; Tekin, U; Ünal, T

2016-11-01

To determine the histology of persistent periapical lesions associated with nonsurgical endodontic treatment failures and to compare radiographically the sizes of periapical lesions and the presence or absence of the radiopaque lamina with the histological findings. Ninety-three anterior teeth designated for apical microsurgery were included in the study. After taking standard radiographs of all cases using the parallel technique, the films were scanned and evaluated for the size of periapical radiolucent lesions and the presence or absence of radiopaque lamina by two calibrated observers. Biopsy specimens were obtained during apical microsurgery and examined under light microscopy by oral pathologists. Histological analysis established diagnoses of granuloma, cyst, abscess and scar tissue. Interobserver agreement was evaluated by the kappa test, and the relationship between histological diagnosis and lesion size was analysed by the Pearson's chi-square test. The 93 specimens consisted of 72% periradicular granulomas; 21.5% radicular cysts, including two keratocysts; 4.3% abscesses; and 2.2% scar tissue. Cystic prevalence increased as the size of the periapical lesion increased; however, there was no correlation between the presence of a radiopaque lamina and histological diagnosis of cyst. Neither radiographic size nor presence of an associated radiopaque line alone was sufficient to determine the type of lesion. Histological examination is required in order to reach to a definitive diagnosis. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Skin abscess

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Abscess - skin; Cutaneous abscess; Subcutaneous abscess; MRSA - abscess; Staph infection - abscess ... Skin abscesses are common and affect people of all ages. They occur when an infection causes pus ...

A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique.

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Tseng, C C; Harn, W M; Chen, Y H; Huang, C C; Yuan, K; Huang, P H

1996-12-01

Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion.

Prescription pattern of antibiotic and analgesic in endodontic treatment in Kuwaiti population: A self-administered Survey

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Manal J Al-Maslamani

2014-01-01

Full Text Available Introduction: Surgical and non-surgical endodontic treatment of involved teeth can necessitate prescription of analgesics and antimicrobials. The literature suggests confusion amongst practitioners regarding the need for adjunctive medication, mainly during non-surgical endodontic treatment, often leading to over-prescription. Aim: The aim of this study was to determine the current clinical practice of dentists participated in this study with respect to antibiotic and analgesic prescription patterns in their endodontic treatment management in Kuwait. Materials and Methods: Prescription patterns for antibiotics and analgesics were analyzed based on the responses to self-administered questionnaire (n = 169. Information was collected based on different clinical endodontic diagnostic scenarios. Statistical analysis was performed with SPSS software version 17.0 to determine relationships between prescription patterns, age, gender, and dental qualification (specialists and general dentists. Results: Ninety-two percent of dentists prescribed analgesics for the management of endodontic pain. While 16% prescribed antibiotics for severe dental pain; 62% prescribed antibiotics for acute apical abscesses. Significantly more male dentists prescribed antibiotics for dental pain than female dentists. No significant difference was found between general dental practitioners′ and specialists′ attitude toward drug prescriptions. Amoxicillin and ibuprofen were the most commonly prescribed medications. Conclusion: While the majority of dentists appeared to prescribe antibiotics and analgesics appropriately, some did not. This research confirmed previous studies and established a need for imparting information of evidence-based prescriptions protocols for the dentists surveyed in this study in Kuwait.

Conservative management of dens evaginatus and attached supernumerary tooth/odontome in mandibular premolar with dual radiolucencies

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Naseem Shah

2015-01-01

Full Text Available Recently, an innovative, nonsurgical regenerative endodontic treatment protocol “SealBio” was introduced to manage mature nonvital permanent teeth with periapical lesions. This paper explains the management of an unusual case of dens evaginatus and an attached supernumerary tooth/an odontome associated with two distinct radiolucencies in a mandibular premolar with “SealBio” technique and discusses the various hypotheses on the pathogenesis of unusual malformation and associated pericervical cyst-like radiolucency in the involved tooth.

Single-rooted maxillary first molar with a single canal: endodontic retreatment.

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de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José

2008-12-01

This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.

Prevalence of periapical lesions in endodontic treatment teeth

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Juliana Machado Barroso

2013-01-01

Full Text Available The aim of this study was to determine the prevalence of of persistent periapical lesions after conventional endodontic therapy. The persistent periapical lesions were removed paraendodontic surgery, followed by apicoectomy. The root ends were retroprepared with ultrasound and retrofilling with MTA. The specimens were stored in formaldehyde 10%, making a total of 107 samples. The lesions were referred to the Department of Pathology, FOB-USP for microscopic analysis using the technique of serial sections. The present results showed periapical cyst (48, granuloma (43, Crohn's abscess (2, apical fibrosis (3 and others (11. . Among the lesions analyzed in this study it can be observed a higher incidence of apical periodontal cyst, followed by apical granuloma and other pathologies.

PREVALENCE OF PERIAPICAL LESIONS IN ENDODONTIC TREATMENT TEETH

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Francisco Carlos Ribeiro

2013-04-01

Full Text Available The aim of this study was to determine the prevalence of of persistent periapical lesions after conventional endodontic therapy. The persistent periapical lesions were removed paraendodontic surgery, followed by apicoectomy. The root ends were retroprepared with ultrasound and retrofilling with MTA. The specimens were stored in formaldehyde 10%, making a total of 107 samples. The lesions were referred to the Department of Pathology, FOB-USP for microscopic analysis using the technique of serial sections. The present results showed periapical cyst (48, granuloma (43, Crohn's abscess (2, apical fibrosis (3 and others (11. . Among the lesions analyzed in this study it can be observed a higher incidence of apical periodontal cyst, followed by apical granuloma and other pathologies.

Why not to treat the tooth canal to solve external root resorptions? Here are the principles!

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Alberto Consolaro

Full Text Available ABSTRACT This paper aims at exposing the foundations or reasons why, in cases of external tooth resorption, including those of orthodontic origin, one should not perform a root canal to treat it. That should be done only to teeth with contamination or pulp necrosis, to remove the periapical inflammation induced by microbial products. When facing cases of external tooth resorption, one's conduct must always respect the following sequence of steps: first of all, identifying the cause accurately; then, planning the therapeutic approach and, finally, adopting the conducts in a very well-founded way. The situations in which endodontic treatment is recommended for tooth resorptions are those when there are: a pulp necrosis with microbial contamination, b aseptic pulp necrosis, c developing calcific metamorphosis of the pulp and d diagnosis of internal resorption. It is not possible, through the pulp, to control the resorption process that is taking place in the external part, after all, the causes are acting in the periodontal ligament. There is no evidence that justifies applying endodontic treatment, by means of root canal, to control external resorption processes, when the pulp shows vitality.

Micro-surgical endodontics.

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Eliyas, S; Vere, J; Ali, Z; Harris, I

2014-02-01

Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

The use of cone-beam computed tomography and virtual reality simulation for pre-surgical practice in endodontic microsurgery.

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Suebnukarn, S; Rhienmora, P; Haddawy, P

2012-07-01

To design and evaluate the impact of virtual reality (VR) pre-surgical practice on the performance of actual endodontic microsurgery.   The VR system operates on a laptop with a 1.6-GHz Intel processor and 2 GB of main memory. Volumetric cone-beam computed tomography (CBCT) data were acquired from a fresh cadaveric porcine mandible prior to endodontic microsurgery. Ten inexperienced endodontic trainees were randomized as to whether they performed endodontic microsurgery with or without virtual pre-surgical practice. The VR simulator has microinstruments to perform surgical procedures under magnification. After the initial endodontic microsurgery, all participants served as their own controls by performing another procedure with or without virtual pre-surgical practice. All procedures were videotaped and assessed by two independent observers using an endodontic competency rating scale (from 6 to 30). A significant difference was observed between the scores for endodontic microsurgery on molar teeth completed with virtual pre-surgical practice and those completed without virtual presurgical practice, median 24.5 (range = 17-28) versus median 18.75 (range = 14-26.5), P = 0.041. A significant difference was observed between the scores for osteotomy on a molar tooth completed with virtual pre-surgical practice and those completed without virtual pre-surgical practice, median 4.5 (range = 3.5-4.5) versus median 3 (range = 2-4), P = 0.042. Pre-surgical practice in a virtual environment using the 3D computerized model generated from the original CBCT image data improved endodontic microsurgery performance. © 2012 International Endodontic Journal.

Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

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Surbhi Patel

2012-01-01

Full Text Available Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal roots and canals. Clinical examination and radiographs showed the presence of two palatal roots during the root canal procedure. The canals were biomechanically prepared with crown-down technique and obturated using lateral condensation technique with AH-Plus sealer.

Clinical management of a fused upper premolar with supernumerary tooth: a case report

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Kyu-Min Cho

2014-11-01

Full Text Available n dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.. The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.

Laser scanning dental probe for endodontic root canal treatment

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Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.

2011-03-01

Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.

Occurrence of two newly named oral treponemes - Treponema parvum and Treponema putidum - in primary endodontic infections.

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Rôças, I N; Siqueira, J F

2005-12-01

Recent evidence from molecular genetic studies has revealed that oral Treponema species are involved in infections of endodontic origin. This study assessed the occurrence of two newly named oral treponemes - Treponema parvum and Treponema putidum - in primary endodontic infections using a culture-independent identification technique. Genomic DNA was isolated directly from clinical samples, and a 16S rRNA gene-based nested polymerase chain reaction (PCR) assay was used to determine the presence of T. parvum and T. putidum. Species-specific primer pairs were developed by aligning closely related 16S rRNA gene sequences. The specificity for each primer pair was validated by running PCR against a panel of oral bacteria and by sequence analysis of PCR products from positive clinical samples. T. parvum was detected in 52% of the root canals associated with chronic apical periodontitis, in 20% of the cases diagnosed as acute apical periodontitis, and in no abscessed case. In general, T. parvum was detected in 26% of the samples from primary endodontic infections. T. putidum was found in only one case of acute apical periodontitis (2% of the total number of cases investigated). The devised nested PCR protocol was able to identify both T. parvum and T. putidum directly in clinical samples and demonstrated that these two treponemes can take part in endodontic infections.

Nonsurgical management of an extensive endodontic lesion in an orthodontic patient by calcium-enriched mixture apical plug

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Saeed Asgary

2014-01-01

Full Text Available Periapical lesion is a general term used to describe the periapical inflammatory process that occurs in response to the invasion of micro-organisms in the root canal system as well as inflamed vital pulp. This phenomenon necessitates endodontic intervention and if the necrosis has occurred prior to tooth maturation, wide patency of the apical foramen requires some treatment modalities such as apexification or apical plug. Orthodontic treatment, on the other hand, is cautiously done for previously traumatized teeth due to increased risk for necrosis of the compromised tooth. This article tends to review the successful treatment process with calcium-enriched mixture (CEM cement apical plug for an immature previously traumatized incisor tooth with an extensive periapical lesion, which was under orthodontic treatment as well.

Abscess

International Nuclear Information System (INIS)

Van Sonnenberg, E.

1984-01-01

Sonography has had major impact on the current approach to abscesses. Perhaps its greatest influence is the immediacy with which it enables the detection and diagnosis of abscess to be established. Previously, delay in the diagnosis had been the single worst harbinger of a fatal outcome. The history of sonograpghy in abscess work during the past decade has been one of the continued improvement and expansion into new areas. During the early 1970s, the accuracy of abscess detection was improved by ultrasound, as compared with previous methods. High-resolution gray-scale contact scanners and advances in real-time ultrasound further refined the technique. Fine needle aspiration under ultrasound guidance was a major diagnostic advance. During the past 5 years, ultrasound-guided percutaneous catheter drainage has expanded the role of sonography into the treatment of abscesses. This chapter focuses on classic and atypical sonographic findings of abscesses, as well as pitfalls and technical aids. Knowledge of abdominal anatomy and characteristic appearances in organs and abdominal compartments is essential. Noninfected fluid collections occasionally may be differentiated from abscesses, but frequently needle aspiration is required. These ultrasound-guided aspiration techniques and catheter drainage of abscesses are highlighted

Cermet reinforcement of a weakened endodontically treated root: a case report.

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Lui, J L

1992-08-01

Many clinical applications have been recommended for glass-cermet cement because of its improved properties compared to the original glass-ionomer cements. It has also been accepted as a dentinal substitute that can strengthen teeth. In this paper, an additional clinical application for glass-cermet cement, the reinforcement of weakened endodontically treated roots, is suggested. This technique is in keeping with the trends of tooth conservation and the use of an adhesive restorative material in the restoration of severely damaged teeth by a conservative approach.

Endodontics Simplified

OpenAIRE

Kansal, Rohit; Talwar, Sangeeta; Yadav, Seema; Chaudhary, Sarika; Nawal, Ruchika

2014-01-01

The preparation of the root canal system is essential for a successful outcome in root canal treatment. The development of rotary nickel titanium instruments is considered to be an important innovation in the field of endodontics. During few last years, several new instrument systems have been introduced but the quest for simplifying the endodontic instrumentation sequence has been ongoing for almost 20 years, resulting in more than 70 different engine-driven endodontic instrumentation system...

Survival rates against fracture of endodontically treated posterior teeth restored with full-coverage crowns or resin composite restorations: a systematic review

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Warattama Suksaphar

2017-07-01

Full Text Available This systematic review aims to summarize the current clinical studies that investigated survival rates against fracture of endodontically treated posterior teeth restored with crowns or resin composite restorations. Literature search were performed using keywords. Publications from 1980 to 2016 were searched in PubMed, ScienceDirect, Web of Science, MEDLINE, and SCOPUS. Included studies were selected based on inclusion and exclusion criteria. Three clinical studies were included: 1 randomized controlled trial and 1 prospective and 1 retrospective cohort studies. Pooled survival rates ranged from 94%–100% and 91.9%–100% for crowns and resin composite, respectively. The majority of teeth had no more than 3 surface loss of tooth structure. The studies included were heterogeneous, and were not appropriate for further meta-analysis. Current evidence suggested that the survival rates against the fracture of endodontically treated posterior teeth restored with crowns or resin composites were not significantly different in the teeth with minimum to moderate loss of tooth structure.

Subareolar abscess

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Abscess - areolar gland; Areolar gland abscess; Breast abscess - subareolar ... an ultrasound or other imaging test of the breast is recommended. A blood count and a culture of the abscess, if drained, may be ordered.

An application framework of three-dimensional reconstruction and measurement for endodontic research.

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Gao, Yuan; Peters, Ove A; Wu, Hongkun; Zhou, Xuedong

2009-02-01

The purpose of this study was to customize an application framework by using the MeVisLab image processing and visualization platform for three-dimensional reconstruction and assessment of tooth and root canal morphology. One maxillary first molar was scanned before and after preparation with ProTaper by using micro-computed tomography. With a customized application framework based on MeVisLab, internal and external anatomy was reconstructed. Furthermore, the dimensions of root canal and radicular dentin were quantified, and effects of canal preparation were assessed. Finally, a virtual preparation with risk analysis was performed to simulate the removal of a broken instrument. This application framework provided an economical platform and met current requirements of endodontic research. The broad-based use of high-quality free software and the resulting exchange of experience might help to improve the quality of endodontic research with micro-computed tomography.

The properties of chlorhexidine and undesired effects of its use in endodontics.

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Bernardi, Anarela; Teixeira, Cleonice Silveira

2015-01-01

The purpose of this article was to review the literature on the properties of chlorhexidine (CHX) and the adverse effects that may occur from its use in endodontics. In addition, adverse effects that may result from its use, such as dark staining of teeth, chemical interaction with sodium hypochlorite and formed flocculate, biologic hazards, and interactions with the filling material were evaluated. Relevant publications on the use CHX in endodontics were thoroughly reviewed from the literature published between the years 2007 and 2014. The authors conducted an electronic search using the English language databases Medline and PubMed. According to the reviewed studies, it was concluded that CHX has proven antimicrobial activity, excellent substantivity, low surface tension, and low cytotoxicity and genotoxicity that depend on the dose and exposed area. There is scientific evidence showing the possibility of tooth staining and formation of brown precipitate when its use is associated with sodium hypochlorite. On the other hand, it is not well established that its use interferes with the quality of endodontic fillings. With respect to the biologic risks, the degradation of CHX may generate para-chloroaniline and free radicals, which are harmful to the vital tissues. There is no established consensus on the potential risk of CHX. The final considerations of this review will encourage researchers to seek scientific evidence demonstrating the safety of the use and applicability of CHX in endodontic therapy.

Natural Tooth Pontic: An Instant Esthetic Option for Periodontally Compromised Teeth—A Case Series

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Rishi Raj

2016-01-01

Full Text Available Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to trauma, periodontal disease, or endodontic failure. The treatment options for replacing the missing tooth can vary between removable prosthesis, tooth-supported prosthesis, and implant-supported prosthesis. Irrespective of the final treatment, the first line of management would be to provisionally restore the patient’s esthetic appearance at the earliest, while functionally stabilizing the compromised arch. Using the patient’s own natural tooth as a pontic offers the benefits of being the right size, shape, and color and provides exact repositioning in its original intraoral three-dimensional position. Additionally, using the patient’s platelet concentrate (platelet rich fibrin facilitates early wound healing and preservation of alveolar ridge shape following tooth extraction. The abutment teeth can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chair side thereby avoiding laboratory costs. This helps the patient better tolerate the effect of tooth loss psychologically. The article describes a successful, immediate, and viable technique for rehabilitation of three different patients requiring replacement of a single periodontally compromised tooth in an esthetic region.

Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview.

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Sharma, Ritu; Hegde, Vivek; Siddharth, M; Hegde, Rashmi; Manchanda, Gunsha; Agarwal, Pratul

2014-11-01

Endodontic and periodontal microsurgery has surpassed the success rates for traditional endodontic and periodontal surgical procedures. Excellent healing results are being attributed to both the techniques, when employed, for isolated endodontic or periodontal defects. Combined endodontic-periodontal lesions have been referred to as a true challenge, requiring not only endodontic microsurgical management but also concurrent bone grafting and membrane barriers techniques. The prevention of epithelial downgrowth and regeneration of periodontal cementum, fiber, and bone seals the fate of these cases. Achieving primary closure with submergence of grafts has a positive effect on GTR outcome. New techniques of periodontal microsurgery, such as minimally invasive papilla preserving flaps with passive internal mattress suturing, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and conditioning has also shown to be beneficial for GTR. Endodontic microsurgery for the combined lesion has not integrated these advances yet. These advances, along with a recently suggested treatment strategy, are ushering in the level next in management of the combined lesions. This article offers an overview of the combined lesion, the disease, its classification, treatment strategy, regenerative tools, microsurgical recommendations, and outcome studies.

Retrospective evaluation of the clinical management of patients with periodontal abscesses attending a teaching hospital

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Modupeoluwa Omotunde Soroye

2016-01-01

Full Text Available Aim: This study aimed to examine the clinical management of patients who attended a Nigerian teaching hospital with periodontal abscesses. Setting and Design: This is a retrospective study among patients who attended the Periodontics Clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between January 2008 and December 2015. Patients and Methods: Information about the diagnosis was obtained from the departmental log book, and case notes were retrieved from record department. Data collection elicited information on age, sex, tribe, frequency of tooth brushing, dental attendance, medical history, clinical features, involved tooth/teeth, and treatment received. Statistical Analysis Used: Epi info version 3.5.1 was used for statistical analysis. Results: Patients aged between 15 and 87 years, with a mean age of 35.53 ± 19.30 years. Majority of patients were males, had minor ethnic extractions, had some form of education, first dental clinic attendees, indulged in once-daily toothbrushing, fully dentate, and had fair/poor oral hygiene. A total of 8.8% and 31.6% of the participants smoked cigarettes and consumed alcohol, respectively. A fifth of the participants had systemic diseases such as hypertension, diabetes mellitus, and peptic ulcer disease. Majority of the participants (91.2% had severe pain. About two-fifths had periodontal abscess around the incisors and the molars. The upper right quadrant was mostly involved (31.6%. Two-fifth of the patients had extraction done. Conclusion: Data from this study revealed periodontal abscess as a severely painful condition in naÏve dental patients, successfully treated mainly through extraction of the implicated tooth/teeth. This implies that oral health awareness and regular dental attendance may prevent its occurrence.

Brain abscess caused by Haemophilus para phrophilus following a dental treatment in a girl. Report of a case

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Vázquez Toledo María Eugenia

2014-07-01

Full Text Available We report the case of a six year old girl who developed three brain abscesses following a dental intervention (extraction of a tooth two weeks before. The etiologic agent was identified as Haemophilus paraprophilus, a gramnegative microorganism bacillus native mi- crobiota of the oropharynx nasopharynx and the gastrointestinal tract. 1 The patient was given ceftriaxone due to the sensitivity of the microorganism and metronidaole -because we couldn’t discard etiology by anaerobic- during six weeks. Surgical drainage of the abscesses was performed successfully. To date the patient has minimal neurologic sequelae. The importance of this case is that is the second report in the international literature of brain abscess secondary to Haemophilus paraprophilus in a pediatric patient and without associated heart disease.

C-shaped root canal configuration in mandibular second premolar: Report of an unusual case and its endodontic management

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Dipali Y Shah

2012-01-01

Full Text Available The C-shaped root canal system is an aberration of the root canal system in which a characteristic fin or web connects individual canals, resulting in a C-shaped cross section. This configuration has been rarely reported in the mandibular second premolar. The only other known reported case of a C-shaped canal, with its configuration, in relation to mandibular second premolar is of an extracted tooth. The purpose of this report is to describe the diagnosis, configuration and endodontic management of C-shaped root canal in mandibular second premolar. Clinical techniques to addresses the challenges in endodontic disinfection as well as cleaning and shaping of the C-shaped canal, which is prone to endodontic mishaps, are also discussed in this case report. Reporting of this case emphasizes the need and added advantage of using the dental operating microscope hand in hand with conventional radiography in management of the C-shaped root canal configuration.

Recurrent periodontal abscess associated with “teeth as a tool”

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Bhat, G. Subraya; Singh, Vishal; Bhat, K. Mahalinga

2012-01-01

We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertak...

Comparison of an adaptive local thresholding method on CBCT and µCT endodontic images

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Michetti, Jérôme; Basarab, Adrian; Diemer, Franck; Kouame, Denis

2018-01-01

Root canal segmentation on cone beam computed tomography (CBCT) images is difficult because of the noise level, resolution limitations, beam hardening and dental morphological variations. An image processing framework, based on an adaptive local threshold method, was evaluated on CBCT images acquired on extracted teeth. A comparison with high quality segmented endodontic images on micro computed tomography (µCT) images acquired from the same teeth was carried out using a dedicated registration process. Each segmented tooth was evaluated according to volume and root canal sections through the area and the Feret’s diameter. The proposed method is shown to overcome the limitations of CBCT and to provide an automated and adaptive complete endodontic segmentation. Despite a slight underestimation (-4, 08%), the local threshold segmentation method based on edge-detection was shown to be fast and accurate. Strong correlations between CBCT and µCT segmentations were found both for the root canal area and diameter (respectively 0.98 and 0.88). Our findings suggest that combining CBCT imaging with this image processing framework may benefit experimental endodontology, teaching and could represent a first development step towards the clinical use of endodontic CBCT segmentation during pulp cavity treatment.

Internal and external resorption in a lower molar with an associated endodontic-periodontic lesion: a case report.

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Komabayashi, Takashi; Zhu, Qiang

2012-08-01

This article describes a unique case in which both internal and external inflammatory resorption and endodontic-periodontic lesions were present at the same time in the patient's left mandibular first molar. Based on clinical and radiographic findings, it was determined that the nature of this case was a pulpal infection-induced inflammatory resorption and furcation lesion. After root canal therapy, the furcation lesion and external inflammatory resorption were completely resolved. This case indicates that the correct diagnosis of the stimulating factor for tooth resorption and determination of the primary origin of endodontic-periodontic lesions are critical for clinical management and success. Published 2011. This article is a U.S. Government work and is in the public domain in the USA.

Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption.

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Pai, Ar Vivekananda; Khosla, Manak

2012-07-01

This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.

A survey of attitude and opinions of endodontic residents towards regenerative endodontics

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Utneja, Shivani; Nawal, Ruchika Roongta; Ansari, Mohammed Irfan; Talwar, Sangeeta; Verma, Mahesh

2013-01-01

Aim: The objective of this survey was to study the level of awareness, current state of knowledge and opinions towards regenerative endodontic treatments amongst the endodontic residents of India. Settings and Design: Questionnaire based survey was designed. Materials and Methods: After approval from the organizing committee of 26th Federation of Operative Dentistry of India and 19th Indian Endodontic Society National conference 2011, 200 copies of the questionnaire were circulated amongst the endodontic residents in conservative dentistry and endodontics at various colleges across the country about regenerative endodontic procedures. The survey included profile of the respondents and consisted of 23 questions about their knowledge, attitude and opinions regarding use of these procedures as part of future dental treatment. Results: The survey showed that half the participants (50.6%) had received continued education in stem cells and/or regenerative dental treatments. The majority of participants were of the opinion (86.6%) that regenerative therapy should be incorporated into dentistry, and most of them (88%) were willing to acquire training in learning this new treatment strategy. The results indicated that half of the participants (52.6%) were already using some type of regenerative therapy in their clinical practice; however, with a majority of these limited to use of membranes, scaffolds or bioactive materials. Conclusions: These results reflect that endodontic residents are optimistic about the use of regenerative endodontic procedures; however, a need for more research and training was felt. PMID:23956532

Endodontic and periodontal management of a severely affected maxillary lateral incisor having combined mucosal fenestration and palatogingival groove

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Sarang Sharma

2015-01-01

Full Text Available Mucosal fenestrations, wherein the tooth root apices are clinically discernible in the oral cavity subsequent to loss of overlying alveolar bone and mucosa, are rare pathologic entities. Palato gingival grooves- anatomic aberrations are also infrequent occurrences that notoriously predispose to periodontal pathologies of varying extent. Both conditions independently are known to popularly affect maxillary lateral incisors. Coexistent fenestration defect and palato gingival groove in the same tooth is extremely rare and undoubtedly is a perfect combination to precipitate severe endodontic-periodontal consequences. In this report, a 34-year-old patient presented to the dental department with complaint of esthetics in relation to exposed root of right maxillary lateral incisor. On closer inspection, a palato gingival groove in addition to fenestration defect was evident on the root surface along with a periodontal pocket of >5 mm. An interdisciplinary treatment was instituted which included endodontic treatment followed by root end resection, osseous bone graft placement and guided tissue regeneration procedures for repair of mucosal fenestration defect. Debridement of the palatal pocket, with saucerization of the groove and restoration with glass ionomer cement were simultaneously employed to correct the palatal defect.

A study of flare-ups following single-visit root canal treatment in endodontic patients.

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Kalhoro, Feroze Ali; Mirza, Assad Javed

2009-07-01

To determine the frequency of flare-ups in single-visit endodontic treatment and the associated factors. Observational. Baqai Dental College Hospital, Karachi, from November 2005 to May 2006. One hundred patients were assigned for single-visit root canal treatment. Patients that defaulted after the first appointment (incomplete treatment) were excluded from the study. For each tooth treated, the clinical factors and conditions existing before and after the completion of treatment were recorded. This data included patient's age, gender, type of tooth, pre-operative status of pulp and periapical tissues and recording pain and swelling (flare-ups) postoperatively after 1 day, 7 days and 1 month. The significance of results was obtained by applying paired-sample t-test and Pearson X2 test. Three of one hundred cases showed flare-ups after treated in single appointment. On the other hand, a marked number (n=97) of cases did not show flare-ups during the study period. None of the studied variables showed any statistically significant bearing on rate of flare-ups in single appointment root canal treatment. The single-visit root canal treatment was safe in terms of endodontic flare-ups as far as results of this study are concerned. It was safer in both vital and non-vital teeth, and even in teeth with periapical pathosis.

Assessment of the Incidence of Posttreatment Endodontic Flare-ups in Patients undergoing Single-sitting Root Canal Therapies: A Clinical Study.

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Priyank, Harsh; Devi, T M Chaitra; Goel, Pallavi; Sahu, Nivedita; Nihalani, Shweta; Shandilya, Ashutosh

2016-10-01

Endodontic therapy is one of the commonly used procedures for treating the teeth affected by various pathologies. One of the major problems for endodontists despite the advancements in the root canal procedures is the posttreatment endodontic flare-ups. Much debate exists regarding the completion of endodontic therapy in a single sitting or multiple sittings. Hence, we assessed the incidence of endodontic flare-ups in patients undergoing single-sitting root canal therapies. The present study included 200 patients who underwent single-sitting endodontic therapy. Clinical details and conditions of each and every tooth of every patient were recorded before and after the completion of endodontic therapy. Irrigation during the root canal procedures was done by 2.5% NaOCl solution in most of the cases while others were irrigated with various combinations of ethylenediaminetetraacetic acid (EDTA) and cycloheximide (CHX) solutions. Follow-up records and readings of the patents were noted and were subjected to statistical analysis. Four groups were formed which divided the patients equally on the basis of their age. Out of 50 patients in the age group of 21 to 30 years, only 4 showed posttreatment endodontic flare-ups, while no endodontic flare-up was recorded in patients with age group of 31 to 50 years. Only two male and four females showed flare-ups postoperatively. A nonsignificant correlation was obtained when flare-up cases were compared on the basis of type of irrigation solution used during canal preparation. Single-sitting endodontic therapy appears to be a successful procedure with good prognosis and minimal posttreatment flare-up results, even in patients with periapical pathologies. Single-sitting root canal procedures can be successfully carried in patients with vital or nonvital pulp tissues and also in patients with periapical lesions.

Platelet-rich fibrin-mediated revitalization of immature necrotic tooth

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Navin Mishra

2013-01-01

Full Text Available Contemporary studies have shown that the regeneration of tissues and root elongation is possible in necrotic immature permanent teeth. The purpose of this case report is to add a new vista in regenerative endodontic therapy by using platelet rich fibrin for revitalization of immature non vital tooth. An 11year old boy with the history of trauma was diagnosed with the pulpal necrosis and symptomatic apical periodontitis in tooth #21. Intra oral periapical radiograph showed open apex and associated immature supernumerary tooth with respect to tooth #21. Access preparation and minimal instrumentation was done to remove necrotic debris under copious irrigation with 2.5% sodium hypochlorite. Triple antibiotic paste was packed in the canal for four weeks. During second visit, 5 mL of whole blood was drawn from the medial cubital vein of the patient and blood was then subjected to centrifugation at 2400 rpm for 12 minutes for the preparation of Platelet rich fibrin (PRF utilizing Choukroun′s method. Triple antibiotic paste was removed and canal was dried. PRF clot was pushed to the apical region of tooth #21 using hand pluggers. Three milimetres of Mineral trioxide (MTA was placed in cervical part of the root canal and permanent restoration was done three days later. Clinical examination at 6 and 12 months revealed no sensitivity to percussion and palpation in tooth #21and it responded positively to both electric pulp and cold tests. Radiographic examination showed resolution of periapical rarefaction, further root development and apical closure of the tooth #21 and its associated supernumerary tooth. On the basis of successful outcome of the present case it can be stated that PRF clot may serve as a scaffold for regeneration of necrotic immature teeth.

[The management of 126 cases of posterior cracked crown of tooth and its effective observation].

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Chen, L L

2000-06-01

To detect the treatment and effect of posterior cracked tooth. 162 posterior cracked teeth of 158 cases, including enamel fissure and dentin fissure, all there cases undergone the synthetical treatment and follow up in different period, the longest observation period was 2.5 years. The healing and improved rate of 162 cracked teeth 90.74%. Among cases of failure, we have founded 6 cases of acute pulpitis (3.7%), 3 cases of alveodental abscess (1.85%), 2 cases of chronic apical periodontitis (1.24%), 4 cases of tooth fracture (2.4%). Cracked tooth was caused by multiple factors. Early diagnosis, synthetical treatment, and follow up in different period are 3 main factors in treatment.

Combined endodontic therapy and periapical surgery with MTA and bone graft in treating palatogingival groove.

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Mittal, Mudit; Vashisth, Pallavi; Arora, Rachita; Dwivedi, Swati

2013-04-18

A 37-year-old male patient reported to our department with chief complaint of pain and pus discharge from the labial marginal gingiva in the maxillary right lateral incisor region since last 4 months. Clinically, the tooth was hypersensitive to percussion and palpation but failed to respond to pulp sensitivity testing. After periodontal probing, a palatal groove was observed which started at the cingulum and travelled apically and laterally, associated with a pocket depth of 8 mm. Occlusal radiograph showed circumscribed radiolucency measuring 5 mm×7 mm in diameter at the apex of the tooth. A clinical diagnosis of chronic apical abscess was established. The case was treated with a combination of mineral trioxide aggregate and bone graft. At the 6-month follow-up visit, the tooth showed progressive healing without sinus track and sulcular bleeding.

Effect of amalgam cuspal coverage on the fracture resistance of endodontically treated teeth

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Mahshid Mohammdi Basir

2013-05-01

Full Text Available   Background and Aims: Endodontically treated teeth are prone to fracture because they loose a big amount of their structure. The treatment plan of those teeth is completed when they are rehabilitated with a strong and functional restoration. The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth restored with amalgam cuspal coverage in comparison with other restorative techniques.   Materials and Methods: 40 human healthy maxillary premolars were divided into 4 groups: group1 (S: sound teeth, group 2(Co: endodontically treated teeth with MOD cavity restored with bonding and composite, group 3(Am-B: endodontically treated teeth with MOD cavity restored with bonding and amalgam and group 4 (Am-CC: endodontically treated teeth with MOD cavity restored with amalgam cuspal coverage. Then the restorations were stored in water and room temperature for 100 days at then thermocycled for 500 cycles between water baths at (5.5 ± 1 and (55 ± 1 0 C. The fracture resistance was evaluated by universal testing machine (Instron, 1195 UK with the compressive force of about 2000 N in 0.5 mm/min. The fracture modes were evaluated in four groups by a stereomicroscope. Statistical analysis (Scheffe test was done for all groups (P0.05. The lowest fracture resistance was found in group 2 (Co (384 ± 137.4 N that had no significant difference with group 3 (Am-B (P>0.05. The fracture resistance in group 4 was significantly higher than group 2 (Co and 3 (Am-B. The fracture mode in group 1 was cohesive within tooth and in group 2 (Co and 3 (Am-B was mixed cohesive and adhesive, and in group 4 was cohesive within in restorative material.   Conclusion: The highest fracture resistance was found in teeth that received amalgam cuspal coverage.

Role of calcium-enriched mixture in endodontics

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Pradeep Kabbinale

2015-01-01

Full Text Available Calcium-enriched mixture (CEM has been recently introduced as a hydrophilic tooth-colored cement. The CEM cement powder is composed of calcium oxide, calcium sulfate, phosphorus oxide, and silica as major elements. CEM is alkaline cement (pH~11 that releases calcium hydroxide (CH during and after setting. The physical properties of CEM, such as flow, film thickness, and primary setting time are favorable. This cement is biocompatible and induces formation of cementum, dentin, bone and periodontal tissues. This novel cement has an antibacterial effect comparable to CH and superior to mineral trioxide aggregate (MTA and sealing ability similar to MTA. Its clinical applications include pulp capping, pulpotomy, root-end filling and perforation repair. This review describes the composition, properties and clinical applications of CEM in endodontics.

The use of platelet rich plasma in the treatment of immature tooth with periapical lesion: a case report

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Günseli Güven Polat

2014-08-01

Full Text Available This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP. The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure. Keywords: Immature permanent tooth; Periapical lesions; Platelet rich plasma

Prevalence of new candidate pathogens Prevotella baroniae, Prevotella multisaccharivorax and as-yet-uncultivated Bacteroidetes clone X083 in primary endodontic infections.

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Rôças, Isabela N; Siqueira, José F

2009-10-01

Culture-independent studies have revealed a broad spectrum of oral bacterial taxa that may be associated with disease. This study investigated the prevalence of three new candidate oral pathogens: Prevotella baroniae, Prevotella multisaccharivorax, and as-yet-uncultivated Bacteroidetes oral clone X083 in primary endodontic infections using a devised culture-independent approach. Genomic DNA was isolated from samples taken from 52 teeth with different forms of apical periodontitis and used as template in a taxon-specific 16S rRNA gene-based nested polymerase chain reaction assay to determine the prevalence of the 3 target taxa. Bacteroidetes clone X083, P. baroniae, and P. multisaccharivorax were respectively detected in 81%, 43%, and 38% of the root canals of teeth associated with chronic apical periodontitis, in 60%, 40% and 40% of the canals of teeth with acute apical periodontitis, and in 14%, 24%, and 5% of the pus aspirates from acute apical abscesses. No targeted taxon was positively associated with abscesses or clinical symptoms. Overall, Bacteroidetes clone X083, P. baroniae, and P. multisaccharivorax were found in 50%, 35%, and 25% of the samples taken from primary endodontic infections, respectively. Findings confirmed that the two newly named species and the uncultivated phylotype targeted in this study are associated with different forms of apical periodontitis, and a pathogenetic or at least an ecologic role is suspected.

SEM and microCT validation for en face OCT imagistic evaluation of endodontically treated human teeth

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Negrutiu, Meda L.; Nica, Luminita; Sinescu, Cosmin; Topala, Florin; Ionita, Ciprian; Bradu, Adrian; Petrescu, Emanuela L.; Pop, Daniela M.; Rominu, Mihai; Podoleanu, Adrian Gh.

2011-03-01

Successful root canal treatment is based on diagnosis, treatment planning, knowledge of tooth anatomy, endodontic access cavity design, controlling the infection by thorough cleaning and shaping, methods and materials used in root canal obturation. An endodontic obturation must be a complete, three-dimensional filling of the root canal system, as close as possible to cemento-dentinal junction, without massive overfilling or underfilling. There are several known methods which are used to assess the quality of the endodontic sealing, but most are invasive. These lead to the destruction of the samples and often no conclusion could be drawn in respect to the existence of any microleakage in the investigated areas of interest. Using an time domain en-face OCT system, we have recently demonstrated real time thorough evaluation of quality of root canal fillings. The purpose of this in vitro study was to validate the en face OCT imagistic evaluation of endodontically treated human teeth by using scanning electron microscopy (SEM) and microcomputer tomography (μCT). SEM investigations evidenced the nonlinear aspect of the interface between the endodontic filling material and the root canal walls and materials defects in some samples. The results obtained by μCT revealed also some defects inside the root-canal filling and at the interfaces between the material and the root canal walls. The advantages of the OCT method consist in non-invasiveness and high resolution. In addition, en face OCT investigations permit visualization of the more complex stratified structure at the interface between the filling material and the dental hard tissue.

Endodontic treatment of dens evaginatus by performing a splint guided access cavity.

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Mena-Álvarez, Jesús; Rico-Romano, Cristina; Lobo-Galindo, Ana Belén; Zubizarreta-Macho, Álvaro

2017-11-12

Dens evaginatus (DE) is described as an unusual dental malformation. Tooth structure variations attached to this anatomical disturbance complicates the performance of a conservative access cavity for a conventional root canal treatment. Author's purpose is to describe the treatment of a type V DE by using splits as guides to perform access cavity. This clinical case shows a root canal treatment of a type V DE diagnosed by using a cone beam computed tomography (CBCT). Access cavity was planned through an osseointegrated implant planning software and guided by a stereolithographied split. After endodontic treatment, tooth was sculpted for placing a veneer, processed by a chair-side system in a single session. CBCT is an effective method for obtaining internal anatomical information of teeth with anatomical malformations. The osseointegrated implant planning software is an effective method for planning root canal treatment and designing stereolithograped splits (for performing minimally invasive access cavities). Stereolithographed splints allow performing a guided and conservative access cavity of teeth affected by dental malformations whereas digital technology allows us to esthetically reconstruct a tooth in a single session. © 2017 Wiley Periodicals, Inc.

Endodontic management of mandibular second premolar with three roots and three root canals: A case report

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Nidhi Shrivastava

2014-01-01

Full Text Available High level of success in endodontic treatment requires an understanding of root canal anatomy and morphology. The clinician must be prepared to identify those teeth that tend to vary generally from norm. Thorough debridement and obturation of such teeth can be challenging and failing to do so can lead to treatment failure. Mandibular premolars have earned the reputation for having aberrant anatomy. However, the occurrence of three separate canals with three separate foramina in mandibular premolars is very rare. The incidence of three canals is as high as 23% in mandibular first premolars, whereas in second premolars incidence is as low as 0.4%. Three rooted mandibular second premolar is reported to be 0.2%. This case report describes endodontic management of one such tooth with unusual morphological variations in canal anatomy of mandibular second premolar.

Combined periodontic-orthodontic-endodontic interdisciplinary approach in the treatment of periodontally compromised tooth

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Deepa D

2010-01-01

Full Text Available Orthodontic treatment in adult patients is one of the most frequently encountered components involving multidisciplinary approaches. In the present report, a 28-year-old male patient was treated for localized chronic periodontitis with pocket formation, mobility, pathologic migration and malalignment of maxillary left lateral incisor tooth #22. The periodontal therapy included motivation, education and oral-hygiene instructions (O.H.I., scaling and root planing and periodontal flap surgery. Subsequently on resolution of periodontal inflammation, orthodontic therapy was carried out using the orthodontic aligner for a period of 6 months. Post-treatment (3 years results showed complete resolution of infrabony pocket with significant bone fill, reduced tooth mobility and complete alignment of the affected maxillary left lateral incisor, thus restoring the esthetics and function.

Abscess in the Lungs

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... Home Lung and Airway Disorders Abscess in the Lungs Abscess in the Lungs Causes Symptoms Diagnosis Treatment Resources ... here for the Professional Version Abscess in the Lungs Abscess in the Lungs A lung abscess is a ...

Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

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Nosrat, Ali; Schneider, S Craig

2015-07-01

Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A Comparison of Coronal Tooth Discoloration Elicited by Various Endodontic Reparative Materials

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2015-06-17

operating microscope at 12.8x magnification to be completely intact and free of restorations, cracks , and/or defects. Each tooth was stored separately in...microscope. The buccal enamel -dentin thickness was standardized to 3mm using spring calipers. Teeth were irrigated with 6% NaOCl and dried. All

Endodontic-periodontal management of two rooted maxillary lateral incisor associated with complex radicular lingual groove by using spiral computed tomography as a diagnostic aid: a case report.

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Gandhi, A; Kathuria, A; Gandhi, T

2011-06-01

To present the successful endodontic and periodontal management of a two rooted maxillary lateral incisor tooth with a complex radicular lingual groove and severe periodontal destruction using spiral computed tomography as a diagnostic aid. A 30-year-old male patient presented with a chief complaint of mobility and discharge of pus in an upper front tooth. Clinical examination revealed a sinus tract on the labial gingival surface and a 10-mm-deep periodontal pocket associated with maxillary left lateral incisor tooth. On the lingual side, a groove emerging from cingulum, continuing mesioapically down the lingual aspect of tooth was found. Intraoral periapical radiographs demonstrated a lateral periodontal defect around the mesial aspect and a diffuse radiolucency at the apex of maxillary left lateral incisor tooth. The sinus tract was traced with gutta-percha to the maxillary left lateral incisor that showed an accessory root surrounded by a large radiolucent area. A spiral computed tomographic scan for better understanding of the complicated root canal morphology of the tooth was performed. Based on the clinical, radiographic and spiral computed tomographic findings, a diagnosis of an endo-perio lesion in tooth 22 was made. Management consisted of conventional root canal treatment, radiculoplasty, root resection of accessory root and surgical curettage of the periodontal defect. Follow-up with radiographic examination at 3 months and 1 year was performed. At 1-year recall, the patient was asymptomatic, there was no evidence of the sinus tract and a 3-mm nonbleeding pocket was present in relation to tooth 22. Progression of hard tissue healing was observed in the periapical radiograph taken 1 year postoperatively. The key to achieving favourable results in this particular type of developmental anomaly is accurate diagnosis and treatment planning. The health of the periapical osseous tissues appears to be the provital factor for tooth retention. A favourable outcome

Incidence of Endodontic Flare-ups and Its Related Factors: A Retrospective Study.

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Nair, Manuja; Rahul, J; Devadathan, A; Mathew, Josey

2017-01-01

The aim and objective of the study were to determine the incidence of flare-ups during endodontic treatment and to identify the risk factors associated with flare-ups. A total of 1725 patients who were treated during the time period of 2009-2014 by the same endodontist were reviewed. Incidence of flare-up, patients' age, gender, status of pulp, tooth position, number of roots, and treatment provided were taken from their dental records. Relationship between these factors and flare-ups was examined. Statistical analysis was done using Pearson Chi-square test and Fisher's exact test. A total of 2% incidence of endodontic flare-ups was seen out of 1725 cases. Patient's age, gender, and diagnosis had a significant effect on the development of flare-ups ( P flare-up incidence. Diagnosis plays an important role in predicting the incidence of flare-ups. Patients in the age group of 40-60 years had a higher risk of developing flare-ups. Women compared to men are more prone to flare-ups.

An emboligenic pulmonary abscess leading to ischemic stroke and secondary brain abscess

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Albrecht Philipp

2012-11-01

Full Text Available Abstract Background Ischemic stroke by septic embolism occurs primarily in the context of infective endocarditis or in patients with a right-to-left shunt and formation of a secondary cerebral abscess is a rare event. Erosion of pulmonary veins by a pulmonary abscess can lead to transcardiac septic embolism but to our knowledge no case of septic embolic ischemic stroke from a pulmonary abscess with secondary transformation into a brain abscess has been reported to date. Case presentation We report the case of a patient with a pulmonary abscess causing a septic embolic cerebral infarction which then transformed into a cerebral abscess. After antibiotic therapy and drainage of the abscess the patient could be rehabilitated and presented an impressive improvement of symptoms. Conclusion Septic embolism should be considered as cause of ischemic stroke in patients with pulmonary abscess and can be followed by formation of a secondary cerebral abscess. Early antibiotic treatment and repeated cranial CT-scans for detection of a secondary abscess should be performed.

Regenerative endodontic treatment for necrotic immature permanent premolar: A report of case

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Sheetal B Ghivari

2017-01-01

Full Text Available Regenerative endodontic procedures provide new hope of converting nonvital tooth into vital once again. These potential regenerative approaches include root canal revascularization, postnatal stem-cell therapy, pulp implant, scaffold implant, three-dimensional cell printing, injectable scaffolds, and gene therapy. In this article, we describe successful revascularization treatment of necrotic permanent premolar tooth. Clinical and radiographic examination showed pulp involvement due to deep pit defect and periapical infection. Examination findings suggested revascularization treatment which was started with irrigation of canals using 1.25% of sodium hypochlorite and saline, followed by placement of 3-week dressing of triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline. After removal of triple antibiotic paste blood clot was induced and mineral trioxide aggregate was placed on the blood clot followed by sealing the canal with glass ionomer cement. During radiographic and clinical follow-ups, the patient was asymptomatic and periapical lesion was healed, roots continued to develop, and root apex maturogenesis was complete.

Perianal Abscess

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Luke Walls-Smith

2018-01-01

Full Text Available History of present illness: 31-year-old male with history of human immunodeficiency virus (HIV presented with complaints of pain and redness to the right inner buttock; vital signs were within normal limits. On exam, he had an 8 cm x 2.5 cm area of induration, fluctuance, erythema, and tenderness to the right buttock along the gluteal cleft. There was no induration, tenderness, or purulent drainage noted on rectal exam. Significant findings: Computed Tomography (CT of the Pelvis with intravenous (IV contrast revealed a 5.7 cm x 2.4 cm air-fluid collection in the right perianal soft tissue along the right gluteal cleft, with surrounding fat stranding, consistent with a perianal abscess with cellulitis. Discussion: Perianal abscess typically presents as severe pain in the anorectal area that is constant and unrelated to bowel movement. Physical exam signs include perianal erythema with an associated palpable, often fluctuant, mass.1 However, physical examination may not adequately differentiate between a perianal abscess and perirectal abscess.2 A pelvic CT with IV contrast can be used to differentiate between a perianal abscess, which is located beneath the skin of the anal canal and does not transverse the external sphincter, and a perirectal abscess, which is located beyond the external anal sphincter. Ultrasound is emerging as a possible alternative imaging modality; however magnetic resonance imaging (MRI and CT scans remain the modalities of choice. 3, 4, 5, 6 Recommended treatment for uncomplicated perianal abscesses is prompt drainage to avoid fistula formation, whereas complicated perirectal abscesses require a surgical consult.7 Patients younger than 40 and non-diabetics both have an increased risk (>2 and 2.69-fold, respectively of fistula formation and chronic perianal abscess.8 Antibiotics are recommended for patients at risk of future infection, but have not been shown to reduce the incidence of fistula formation.9

Single versus multiple visits for endodontic treatment of permanent teeth.

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Manfredi, Maddalena; Figini, Lara; Gagliani, Massimo; Lodi, Giovanni

2016-12-01

Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament). The success of RoCT depends on a number of variables related to the preoperative condition of the tooth, as well as the endodontic procedures. This review updates the previous version published in 2007. To determine whether completion of root canal treatment (RoCT) in a single visit or over two or more visits, with or without medication, makes any difference in term of effectiveness or complications. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 14 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 5), MEDLINE Ovid (1946 to 14 June 2016), and Embase Ovid (1980 to 14 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 14 June 2016. We did not place any restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (RCTs) and quasi-RCTs of people needing RoCT. We excluded surgical endodontic treatment. The outcomes of interest were tooth extraction for endodontic problems; radiological failure after at least one year, i.e. periapical radiolucency; postoperative pain; swelling or flare-up; painkiller use; sinus track or fistula formation; and complications (composite outcome including any adverse event). We collected data using a specially designed extraction form. We contacted trial authors for further details where these were unclear. We

Metastatic endophthalmitis and thyroid abscess complicating liver abscess

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Seon-Jae Kim

2018-03-01

Full Text Available The thyroid is resistant to infection due to its anatomical and physiological characteristics. We present a rare case of invasive liver abscess with metastatic thyroid abscess and endogenous endophthalmitis in a previously healthy 55-year-old female patient without diabetes or other medical illness. This report raises an important question of the virulence of Klebsiella pneumoniae as an increasingly common causative agent of liver abscess.

Direct restoration of endodontically treated maxillary central incisors: post or no post at all?

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von Stein-Lausnitz, Manja; Bruhnke, M; Rosentritt, M; Sterzenbach, G; Bitter, K; Frankenberger, R; Naumann, M

2018-04-30

The aim of this ex-vivo study was to evaluate the impact of cavity size and glass-fiber post (GFP) placement on the load capability of endodontically treated maxillary incisors directly restored with resin composite. Ninety-six extracted human maxillary central incisors were endodontically treated and distributed to four groups (n = 24): access cavity (A), access cavity and uni-proximal class III cavity (U), access cavity and bi-proximal class III cavity (B), and decoronated tooth (D). Specimens were restored with resin composite, and 12 specimen of each group received an adhesively placed glass-fiber post (P). Prior to linear loading, specimens were exposed to thermo-mechanical loading (TCML). Statistical analysis was performed using log-rank test after TCML, Kruskall-Wallis and Mann-Whitney U test to compare load capabilities (F max) . Significantly more failures occurred in group D for specimens without GFP during TCML (p = 0.001). F max (mean (SD) in N was (A) 513 (124), (AP) 554 (201), (U) 438 (171), (UP) 537 (232) (B) 483 (219), (BP) 536 (281), D 143 (181), and DP 500 (331), and differed significantly among groups (p = 0.003). Pair-wise comparison revealed lower F max values for group D compared to all other groups (p central incisors with cavity sizes up to bi-proximal class III may be successfully directly restored with resin composite. Post placement shows no additional effect except for decoronated endodontically treated incisors. Endodontically treated incisors with access cavities to class III cavities can be successfully restored with resin composite. Post placement for decoronated ETT is recommended.

Comparison of the Effect of 800 mg Ibuprofen and 30 mg Predenisolone on Relief of Post Endodontic Pain

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S.M. Jalalzadeh

2009-04-01

Full Text Available Introduction & Objective: One of the important problems in dentistry is post endodontic pains .The purpose of this study was comparison of the effect of prophylactic oral ibuprofen 800mg and oral predenisolone 30mg on prevention of post endodontic pain.Materials & Methods: The present study is a double-blind, randomized and controlled trial. It was conducted on 60 patient (16men and 44 women between the ages of 18-63 who needed endodontic treatment. Inclusive criteria for selecting of patients were: need for root canal therapy in one of the posterior teeth, having no systemic problem, no evidence of abscess; not taking analgesic or similar drug for at least 6 hours before treatment. Patients were divided into three experimental groups randomly taking one of the drugs before the treatment {ibuprofen 800 mg, prednisolone30mg and placebo (oral dextrose}. Patients completed VAS at 6,12 and 24 hours post root canal therapy and analyzed using the spss15 by chi-square, ANOVA test and Tukey test.Results: During 24 hours after treatment post endodontic pain is 95%- 100% in the placebo group. The prevalence of no-pain was not significant 6, 12 and 24 hours after treatment between the ibuprofen and predenisolone groups. The mean scale of pain in ibuprofen and predenisolone groups was significantly lower than placebo group 6, 12 and 24 hours after treatment. Differences between the drug groups are significant only on 6 and 12 hours after treatment.Conclusion: Post endodontic pains are present 24 hours after treatment. 6 and 12 hours after treatment 30 mg predenisolone are significantly better for pain relief than 800 mg ibuprofen. But after 24 hours it is not significant.

Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.

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Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Moritz, Andreas; Ulm, Christian

2017-03-01

Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection. A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach. This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth. The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Biocorrosion of Endodontic Files through the Action of Two Species of Sulfate-reducing Bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis.

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Heggendorn, Fabiano Luiz; Gonçalves, Lucio Souza; Dias, Eliane Pedra; de Oliveira Freitas Lione, Viviane; Lutterbach, Márcia Teresa Soares

2015-08-01

This study assessed the biocorrosive capacity of two bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis on endodontic files, as a preliminary step in the development of a biopharmaceutical, to facilitate the removal of endodontic file fragments from root canals. In the first stage, the corrosive potential of the artificial saliva medium (ASM), modified Postgate E medium (MPEM), 2.5 % sodium hypochlorite (NaOCl) solution and white medium (WM), without the inoculation of bacteria was assessed by immersion assays. In the second stage, test samples were inoculated with the two species of sulphur-reducing bacteria (SRB) on ASM and modified artificial saliva medium (MASM). In the third stage, test samples were inoculated with the same species on MPEM, ASM and MASM. All test samples were viewed under an infinite focus Alicona microscope. No test sample became corroded when immersed only in media, without bacteria. With the exception of one test sample between those inoculated with bacteria in ASM and MASM, there was no evidence of corrosion. Fifty percent of the test samples demonstrated a greater intensity of biocorrosion when compared with the initial assays. Desulfovibrio desulfuricans and D. fairfieldensis are capable of promoting biocorrosion of the steel constituent of endodontic files. This study describes the initial development of a biopharmaceutical to facilitate the removal of endodontic file fragments from root canals, which can be successfully implicated in endodontic therapy in order to avoiding parendodontic surgery or even tooth loss in such events.

Current perspectives of bio-ceramic technology in endodontics: calcium enriched mixture cement - review of its composition, properties and applications

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Nawal, Ruchika Roongta; Talwar, Sangeeta; Verma, Mahesh

2015-01-01

Advancements in bio-ceramic technology has revolutionised endodontic material science by enhancing the treatment outcome for patients. This class of dental materials conciliates excellent biocompatibility with high osseoconductivity that render them ideal for endodontic care. Few recently introduced bio-ceramic materials have shown considerable clinical success over their early generations in terms of good handling characteristics. Calcium enriched mixture (CEM) cement, Endosequence sealer, and root repair materials, Biodentine and BioAggregate are the new classes of bio-ceramic materials. The aim of this literature review is to present investigations regarding properties and applications of CEM cement in endodontics. A review of the existing literature was performed by using electronic and hand searching methods for CEM cement from January 2006 to December 2013. CEM cement has a different chemical composition from that of mineral trioxide aggregate (MTA) but has similar clinical applications. It combines the biocompatibility of MTA with more efficient characteristics, such as significantly shorter setting time, good handling characteristics, no staining of tooth and effective seal against bacterial leakage. PMID:25671207

Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach.

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Mendes, Luiz; Laxe, Laisa; Passos, Leandro

2017-01-01

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes.

Detection of Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia in primary endodontic infections in a Chinese population.

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Cao, H; Qi, Z; Jiang, H; Zhao, J; Liu, Z; Tang, Z

2012-08-01

To assess the prevalence of three black-pigmented bacterial species (Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia) using microarray technology in root canals of teeth associated with primary endodontic infections in a Chinese population. Microbial samples were taken from root canals of 80 teeth with pulp necrosis and primary endodontic infections in a Chinese population. DNA extracted from the samples was amplified by PCR with universal bacterial primers based on 16S rRNA gene sequences, and the products hybridized with the microarrays in which the specific oligonucleotide probes were added. The results of hybridization were screened by a confocal laser scanner. Pearson chi-square test and the two-sided Fisher exact test were used to analyse whether a significant association existed between the species and symptoms as well as in co-existence of two target organisms by a statistical software package (SAS 8.02). The 16S rRNA gene microarray detected at least one of the three test species in 76% of the study teeth. P. endodontalis, P. gingivalis and P. intermedia were found in 50%, 33% and 45%, respectively. A significant association was found in the presence of the pair P. endodontalis / P. gingivalis (P endodontalis (P endodontalis and P. gingivalis was also associated with the presence of a sinus tract (Pendodontalis were associated with the presence of sinus tract and abscess formation. © 2012 International Endodontic Journal.

Endodontic management of mandibular third molar with three mesial roots using spiral computed tomography scan as a diagnostic aid: a case report.

Science.gov (United States)

Tomar, Deepak; Dhingra, Anil; Tomer, Anil; Sharma, Shalini; Sharma, Vivek; Miglani, Anjali

2013-05-01

Aberrant root canal anatomy is diagnostically and clinically challenging for clinicians. The most common root canal configuration of human molars is 2 roots and 3 canals, but various combinations may still exist. Third molars are known to have the most unusual anatomy among human teeth. Restorative, prosthetic, and orthodontic considerations often require endodontic treatment of third molars in order for them to be retained as functional components of the dental arch. The present case report demonstrates unusual root canal morphology of the mandibular third molar. Roentgenographic examination, which included spiral CT scan, revealed 3 separate mesial roots in tooth #48 with 3 independent canals and 3 canal orifices, indicating an endodontic rarity. The present case report puts impetus on exploration of additional canals using advanced diagnostic aids, such as spiral computed tomography, which can have a huge impact on the successful outcome of endodontic therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

Microbial flora of odontogenic abscesses in pet guinea pigs.

Science.gov (United States)

Minarikova, A; Hauptman, K; Knotek, Z; Jekl, V

2016-10-01

Abscesses of odontogenic origin in guinea pigs pose a serious health problem and need to be treated with a combination of surgical and medical therapy. The aim of this prospective study was to describe the microbial flora of odontogenic abscesses associated with osteomyelitis in 24 pet guinea pigs, to perform antibiotic sensitivity testing, and to make recommendations for practitioners on the antibiotics of first choice. Inclusion criteria for the study included the animal being diagnosed with an odontogenic abscess which underwent surgery and was not pre-treated with an antibiotic. Inclusion criteria matched for 24 guinea pigs. Samples (pus, capsule and affected tooth/bone) for bacteriological examination were collected under sterile conditions during the surgical procedure. The most commonly isolated bacteria from abscesses of odontogenic origin were Bacteroides fragilis in 12.8 per cent (6/47) of cases, Pasteurella multocida in 10.6 per cent (5/47) and Peptostreptococcus anaerobius in 8.5 per cent (4/47). Aerobic bacterial species only were isolated in 29.2 per cent (7/24) of cases, anaerobic bacteria only were isolated in 33.3 per cent (8/24), and mixed infection with anaerobic and aerobic bacterial species was seen in 37.5 per cent (9/24). Aerobes (n=20) were sensitive to enrofloxacin and marbofloxacin in 100 per cent of samples, benzylpenicillin potassium (penicillin G, PNCG) in 90 per cent, cephalotin in 85 per cent, amoxicillin-clavulanate in 75 per cent, doxycycline in 70 per cent, gentamicin in 65 per cent and trimethoprim-sulfamethoxazole in 55 per cent. Anaerobes (n=27) were sensitive to amoxicillin-clavulanate in 100 per cent of cases, clindamycin in 96.3 per cent, metronidazole in 92.6 per cent, PNCG in 92.6 per cent and cephalotin in 74.1 per cent. As guinea pigs are strictly herbivorous animals, based on the results of this study the recommended antibiotic treatment for odontogenic abscesses is a combination of fluoroquinolones and metronidazole

Pyogenic liver abscess

Science.gov (United States)

Liver abscess; Bacterial liver abscess ... There are many possible causes of liver abscesses, including: Abdominal infection, such as appendicitis , diverticulitis , or a perforated bowel Infection in the blood Infection of the bile draining tubes ...

Endodontic applications of 3D printing.

Science.gov (United States)

Anderson, J; Wealleans, J; Ray, J

2018-02-27

Computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies can leverage cone beam computed tomography data for production of objects used in surgical and nonsurgical endodontics and in educational settings. The aim of this article was to review all current applications of 3D printing in endodontics and to speculate upon future directions for research and clinical use within the specialty. A literature search of PubMed, Ovid and Scopus was conducted using the following terms: stereolithography, 3D printing, computer aided rapid prototyping, surgical guide, guided endodontic surgery, guided endodontic access, additive manufacturing, rapid prototyping, autotransplantation rapid prototyping, CAD, CAM. Inclusion criteria were articles in the English language documenting endodontic applications of 3D printing. Fifty-one articles met inclusion criteria and were utilized. The endodontic literature on 3D printing is generally limited to case reports and pre-clinical studies. Documented solutions to endodontic challenges include: guided access with pulp canal obliteration, applications in autotransplantation, pre-surgical planning and educational modelling and accurate location of osteotomy perforation sites. Acquisition of technical expertise and equipment within endodontic practices present formidable obstacles to widespread deployment within the endodontic specialty. As knowledge advances, endodontic postgraduate programmes should consider implementing 3D printing into their curriculums. Future research directions should include clinical outcomes assessments of treatments employing 3D printed objects. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Bacterial lung abscess

International Nuclear Information System (INIS)

Groskin, S.A.; Panicek, D.M.; Ewing, D.K.; Rivera, F.; Math, K.; Teixeira, J.; Heitzman, E.R.

1987-01-01

A retrospective review of patients with bacterial lung abscess was carried out. Demographic, clinical, and radiographical features of this patient group are compared with similar data from patients with empyema and/or cavitated lung carcinoma; differential diagnostic points are stressed. The entity of radiographically occult lung abscess is discussed. Complications associated with bacterial lung abscess are discussed. Current therapeutic options and treatment philosophy for patients with bacterial lung abscess are noted

A new software for dimensional measurements in 3D endodontic root canal instrumentation

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Raffaele Sinibaldi

2012-01-01

Full Text Available The main issue to be faced to get size estimates of 3D modification of the dental canal after endodontic treatment is the co-registration of the image stacks obtained through micro computed tomography (micro-CT scans before and after treatment. Here quantitative analysis of micro-CT images have been performed by means of new dedicated software targeted to the analysis of root canal after endodontic instrumentation. This software analytically calculates the best superposition between the pre and post structures using the inertia tensor of the tooth. This strategy avoid minimization procedures, which can be user dependent, and time consuming. Once the co-registration have been achieved dimensional measurements have then been performed by contemporary evaluation of quantitative parameters over the two superimposed stacks of micro-CT images. The software automatically calculated the changes of volume, surface and symmetry axes in 3D occurring after the instrumentation. The calculation is based on direct comparison of the canal and canal branches selected by the user on the pre treatment image stack.

Renal and perirenal abscesses

International Nuclear Information System (INIS)

Patterson, J.E.; Andriole, V.T.

1987-01-01

Our knowledge of the spectrum of renal abscesses has increased as a result of more sensitive radiologic techniques. The classification of intrarenal abscess now includes acute focal bacterial nephritis and acute multifocal bacterial nephritis, as well as the previously recognized renal cortical abscess, renal corticomedullary abscess, and xanthogranulomatous pyelonephritis. In general, the clinical presentation of these entities does not differentiate them; various radiographic studies can distinguish them, however. The intrarenal abscess is usually treated successfully with antibiotic therapy alone. Antistaphylococcal therapy is indicated for the renal cortical abscess, whereas therapy directed against the common gram-negative uropathogens is indicated for most of the other entities. The perinephric abscess is often an elusive diagnosis, has a more serious prognosis, and is more difficult to treat. Drainage of the abscess and sometimes partial or complete nephrectomy are required for resolution. 73 references

[A clinical study of endodontic flare-ups].

Science.gov (United States)

Yeh, S J; Lin, Y T; Lu, S Y

1994-06-01

The purpose of this study was to investigate the clinical variables influencing endodontic flare-ups. Three hundred and thirteen teeth receiving endodontic treatment at the Endodontic Department, Chang Gung Memorial Hospital were studied from December 1992 to February 1993. Among them, 21 teeth with significant pain and 9 with apical swelling were noted after the first appointment of treatment. Three teeth with persistent pain and one with apical swelling were also found one week after completion of endodontic therapy. The results showed significant improvement of clinical symptoms and signs one week after completion of endodontic treatment in comparison with pretreatment and after the first appointment (p endodontic flare-ups after the first appointment of treatment (P endodontic flare-ups.

Managing sub-gingival fracture by multi-disciplinary approach: Endodontics-forced orthodontic extrusion and prosthetic rehabilitation

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Rakesh Mittal

2013-01-01

Full Text Available Traumatized anterior teeth with sub-gingival crown fractures are a challenge to treat. The management of sub-gingival fractures includes exposing the cervical margin followed by appropriate coronal restoration. The treatment modalities, which involve exposing the cervical margin, are surgical crown lengthening and orthodontic extrusion. This paper reports a case of fractured maxillary anterior tooth at the sub-gingival level that was managed by forced orthodontic extrusion after endodontic treatment followed by esthetic rehabilitation, a much forgotten technique not utilized routinely yet conservative and cost-effective.

Challenges in reconstructing an isolated anterior tooth with a metal-free crown

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Max Doria Costa

2013-01-01

Full Text Available Introduction: Currently, new esthetic treatments are available to the dentist due to the advent of ceramic-ceramic prostheses. A new option has become part of daily clinical practice, with the promise of esthetic optimization through the elimination of metal in prosthetic crowns. The translucence of these new systems allows the transmission of light through the tooth structure, minimizing gingival darkness and producing a vibrant and natural appearance. Case Report: The patient, 30 years old, female, showed with a fractured tooth crown at the cervical level in the right lateral incisive. It was observed that the tooth had prior adequate endodontic treatment. A metal-free restorative system was selected. A plaster model was obtained for subsequent tooth preparative scanning and manufacture of ceramic framework. After receiving the framework, adjustments were made and the color choice of covering ceramic, following the protocol of choice for a chroma suboptimal aiming further characterization. After the ceramics application, adjustments in shape, texture, and occlusion were made. The crown was characterized by exterior paint, getting a favorable result, restoring esthetics and function. Discussion : The metal-free systems are a viable alternative to the restorative treatment when esthetics is desired, allowing a natural and harmonious smile, combined with the reliability of the restorative material.

Nasolacrimal obstruction caused by root abscess of the upper canine in a cat.

Science.gov (United States)

Anthony, James M G; Sandmeyer, Lynne S; Laycock, Amanda R

2010-03-01

A 10-year-old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.

Learning experience in endodontics: Brazilian students' perceptions.

Science.gov (United States)

Seijo, Marilia O S; Ferreira, Efigênia F; Ribeiro Sobrinho, Antônio P; Paiva, Saul M; Martins, Renata C

2013-05-01

Including students' perceptions in the educational process is considered a key component in monitoring the quality of academic programs. This study aimed to evaluate the concept of one's learning experience in endodontic teaching from the perspective of a group of Brazilian students. A total of 126 self-administered, structured questionnaires were distributed to undergraduate dental students enrolled in endodontics courses during the second semester of the 2009 academic year. The questionnaires were administered during final examinations and focused on students' opinions concerning learning during endodontic treatments, time spent during endodontic treatments, difficulties found during endodontic treatments, quality of endodontic treatments performed, characteristics of the technique employed, and suggestions to improve endodontic teaching. Ninety-one percent of the questionnaires were returned for evaluation. The obtained answers were discussed and analyzed, thereby generating quantitative and qualitative data showing students' perceptions of their experiences in endodontics courses. The main points that can affect the teaching of endodontics, according to the undergraduate students, included patients' absences and delays, selection of patients, preclinical and clinical training, difficulties found, type of technique employed, and teachers' orientation during endodontic treatment. The students' perceptions provided valuable information about the development of the course and the teacher-student relationship, together with the added intention of enhancing the teaching of endodontics as well as other courses.

CT of abdominal abscesses

International Nuclear Information System (INIS)

Korobkin, M.T.

1987-01-01

The imaging search for a suspected abdominal abscess is common in hospitalized patients, especially after recent abdominal surgery. This paper examines the role of CT in the detection, localization, and treatment of abdominal abscess. The accuracy, limitations, and technical aspects of CT in this clinical setting are discussed. The diagnosis of an abscess is based on the demonstration of a circumscribed abnormal fluid collection. Although percutaneous aspiration with gram stain and culture is usually indicated to differentiate abscess from other fluid collections, the CT-based detection of extraluminal gas bubbles makes the diagnosis of an abscess highly likely. CT is compared with conventional radiographic studies, US, and radio-nuclide imaging. Specific CT and clinical features of abscesses in the following sites are emphasized: subphrenic space, liver, pancreas, kidneys, psoas muscle, appendix, and colonic diverticula. Most abdominal abscesses can be successfully treated with percutaneous drainage techniques. The techniques, results, and limitations of percutaneous abscess drainage are reviewed

Abdominal wall abscess secondary to spontaneous rupture of pyogenic liver abscess

Directory of Open Access Journals (Sweden)

Maurizio Zizzo

2016-01-01

Conclusion: Pyogenic liver abscess is a serious and life-threatening illness. Abscess rupture might occur. Many authors consider this complication a surgical emergency, but the site of abscess rupture changes the clinical history of the disease: in case of free rupture into the peritoneum, emergency surgery is mandatory, while a rupture localized in neighboring tissues or organs can be successfully treated by a combination of systemic antibiotics and fine needle aspiration and/or percutaneous drainage of the abscess.

Antimicrobial Irrigants in the Endodontic Therapy

OpenAIRE

Iqbal, Azhar

2012-01-01

This paper highlights the importance of root canal disinfection. It discusses the different endodontic irrigants available and comments on how these can be used most effectively. Eliminating bacteria from the root canal system is an essential stage in endodontic therapy. An objective of endodontic treatment is removal of diseased tissue, elimination of bacteria from the canal system and prevention of recontamination. (1) Disinfection of the root canal system, as part of endodontic therapy, by...

Mental nerve paresthesia secondary to initiation of endodontic therapy: a case report

Science.gov (United States)

Alam, Sharique; Zia, Afaf; Khan, Masood Hasan; Kumar, Ashok

2014-01-01

Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment. PMID:25110646

Endo-periodontal lesion--endodontic approach.

Science.gov (United States)

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system.

Lasers in endodontics: an overview

Science.gov (United States)

Frentzen, Matthias; Braun, Andreas; Koort, Hans J.

2002-06-01

The interest in endodontic use of dental laser systems is increasing. Developing laser technology and a better understanding of laser effects widened the spectrum of possible endodontic indications. Various laser systems including excimer-, argon+-, diode-, Nd:YAG-, Er:YAG- and CO2-lasers are used in pulp diagnosis, treatment of hypersensitivity, pulp capping, sterilization of root canals, root canal shaping and obturation or apicoectomy. With the development of new delivery systems - thin and flexible fibers - for many different wavelengths laser applications in endodontics may increase. Since laser devices are still relatively costly, access to them is limited. Most of the clinical applications are laser assisted procedures such as the removing of pulp remnants and debris or disinfection of infected root canals. The essential question is whether a laser can provide improved treatment over conventional care. To perform laser therapy in endodontics today different laser types with adopted wavelengths and pulse widths are needed, each specific to a particular application. Looking into the future we will need endodontic laser equipment providing optimal laser parameters for different treatment modalities. Nevertheless, the quantity of research reports from the last decade promises a genuine future for lasers in endodontics.

21 CFR 872.3830 - Endodontic paper point.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endodontic paper point. 872.3830 Section 872.3830...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3830 Endodontic paper point. (a) Identification. An endodontic paper point is a device made of paper intended for use during endodontic therapy to dry...

Laser Doppler flowmetry in endodontics: a review.

Science.gov (United States)

Jafarzadeh, H

2009-06-01

Vascular supply is the most accurate marker of pulp vitality. Tests for assessing vascular supply that rely on the passage of light through a tooth have been considered as possible methods for detecting pulp vitality. Laser Doppler flowmetry (LDF), which is a noninvasive, objective, painless, semi-quantitative method, has been shown to be reliable for measuring pulpal blood flow. The relevant literature on LDF in the context of endodontics up to March 2008 was reviewed using PubMed and MEDLINE database searches. This search identified papers published between June 1983 and March 2008. Laser light is transmitted to the pulp by means of a fibre optic probe. Scattered light from moving red blood cells will be frequency-shifted whilst that from the static tissue remains unshifted. The reflected light, composed of Doppler-shifted and unshifted light, is returned by afferent fibres and a signal is produced. This technique has been successfully employed for estimating pulpal vitality in adults and children, differential diagnosis of apical radiolucencies (on the basis of pulp vitality), examining the reactions to pharmacological agents or electrical and thermal stimulation, and monitoring of pulpal responses to orthodontic procedures and traumatic injuries. Assessments may be highly susceptible to environmental and technique-related factors. Nonpulpal signals, principally from periodontal blood flow, may contaminate the signal. Because this test produces no noxious stimuli, apprehensive or distressed patients accept it more readily than current methods of pulp vitality assessment. A review of the literature and a discussion of the application of this system in endodontics are presented.

Complicated untreated apical periodontitis causing paraesthesia: A case report.

Science.gov (United States)

Ricucci, Domenico; Loghin, Simona; Siqueira, José F

2017-08-14

The purpose of this article was to report a case of untreated apical periodontitis resulting in severe late complications. A patient with an asymptomatic crowned root canal-treated mandibular molar revealing a radiographic substandard endodontic treatment and a slight periapical radiolucency was made aware of the treatment options and opted for no treatment. The lesion slightly increased in size after 6 years, but the tooth remained asymptomatic and endodontic retreatment was again refused. After 4 more years, the patient presented with an abscess and severe pain, complicated by paraesthesia of the left chin and lip. Radiographic examination revealed that the lesion had increased considerably to involve the mandibular canal. The treatment protocol included long-term intracanal medication with calcium hydroxide and follow-ups revealed complete resolution of the periapical radiolucency and the paraesthesia had completely subsided. © 2017 Australian Society of Endodontology Inc.

The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care.

Science.gov (United States)

Grönholm, L; Lemberg, K K; Tjäderhane, L; Lauhio, A; Lindqvist, C; Rautemaa-Richardson, R

2013-01-01

The aim of this study was to evaluate clinical and radiological findings and the role of periapical infection and antecedent dental treatment of infected focus teeth in odontogenic maxillofacial abscesses requiring hospital care. In this retrospective cohort study, we evaluated medical records and panoramic radiographs during the hospital stay of patients (n = 60) admitted due to odontogenic maxillofacial infection originating from periapical periodontitis. Twenty-three (38 %) patients had received endodontic treatment and ten (17 %) other acute dental treatment. Twenty-seven (45 %) had not visited the dentist in the near past. Median age of the patients was 45 (range 20-88) years and 60 % were males. Unfinished root canal treatment (RCT) was the major risk factor for hospitalisation in 16 (27 %) of the 60 cases (p = .0065). Completed RCT was the source only in 7 (12 %) of the 60 cases. Two of these RCTs were adequate and five inadequate. The initiation of inadequate or incomplete primary RCT of acute periapical periodontitis appears to open a risk window for locally invasive spread of infection with local abscess formation and systemic symptoms. Thereafter, the quality of the completed RCT appears to have minor impact. However, a considerable proportion of the patients had not received any dental treatment confirming the importance of good dental health. Thus, thorough canal debridement during the first session is essential for minimising the risk for spread of infection in addition to incision and drainage of the abscess. If this cannot be achieved, tooth extraction should be considered. Incomplete or inadequate canal debridement and drainage of the abscess may increase the risk for spread of endodontic infection.

Assessment of residual coronal tooth structure postendodontic cavity preparation using digital dental impressions and micro-computed tomography.

Science.gov (United States)

Al-Nuaimi, Nassr; Patel, Shanon; Foschi, Federico; Mannocci, Francesco; Austin, Rupert S

To evaluate the in vitro accuracy of digital impressions for three-dimensional (3D) volumetric measurement of residual coronal tooth structure postendodontic cavity preparation, with reference to micro-computed tomography (μCT). Quantification of the accuracy and precision of the intraoral digital scanner (3M True Definition Scanner - IOS) was performed using a metrology gauge block and a profilometric calibration model. Thirty-four human extracted molars with endodontic access cavities were scanned using both intraoral scanning (test scanner) in high-resolution mode, and µCT (reference scanner: GE Locus SP μCT scanner) in high- (HiResCT) and low- (LoResCT) resolution modes. Comparisons of volumetric accuracy and 3D profilometric deviations were performed using surface metrology software. One-way repeated measures analysis of variance (ANOVA), in combination with the Bonferroni post hoc test, was implemented to compare the differences in volume measurements between scanning methods. Digital scanning revealed smaller volume measurements by 1.36% and 0.68% compared to HiResCT and LoResCT, respectively. There was a statistically significant difference in the volumetric measurements obtained from the IOS scanner and both HiResCT and LoResCT scans (P digital scanner was able to reliably measure the extra- and intracoronal aspect of the endodontically accessed tooth.

An Innovative Regenerative Endodontic Procedure Using Leukocyte and Platelet-rich Fibrin Associated with Apical Surgery: A Case Report.

Science.gov (United States)

Pinto, Nelson; Harnish, Alexandra; Cabrera, Carolina; Andrade, Catherine; Druttman, Tony; Brizuela, Claudia

2017-11-01

Regenerative endodontic procedures (REPs) associated with apical surgery could represent an alternative treatment strategy for patients whose teeth present incomplete root formation and extensive apical lesions. Leukocyte platelet-rich fibrin (L-PRF) has potential benefits in REPs; it could promote apical root formation and optimal bone healing. The aim of this case report was to describe innovative regenerative endodontic therapy using L-PRF in the root canal and an extensive apical lesion in an immature tooth with dens invaginatus and asymptomatic apical periodontitis. A healthy 20-year-old woman was referred to the dental clinic of the Universidad de Los Andes, Santiago, Chile, for endodontic treatment in tooth # 22 with incomplete root development and an extensive apical lesion. The diagnosis was asymptomatic apical periodontitis associated with dens invaginatus type II. The patient was treated with an innovative approach using L-PRF in REPs associated with apical surgery. Follow-ups were performed at 6 months and 1 year later. They included periapical radiographs, cone-beam computed tomographic imaging, sensitivity, and vitality tests. The clinical evaluations performed at 6 months and 1 year revealed an absence of symptoms. The radiographic evaluations showed that the apical lesion was resolved. The cone-beam images indicated that the root length increased and the walls had thickened. The sensitivity tests were positive, and the laser Doppler flowmetry showed positive blood flow after 1 year. The success of the results in this case report indicate that L-PRF can be used as a complement in apical surgery and REPs and could provide an innovative alternative treatment strategy for complex clinical cases like these. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Multidisciplinary Management of Complicated Crown-Root Fracture of an Anterior Tooth Undergoing Apexification

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Merve Mese

2015-01-01

Full Text Available The purpose of this case report was to present the multidisciplinary management of a subgingival crown-root fracture of a patient undergoing apexification treatment. A 12-year-old male patient was referred to the pediatric dentistry clinic with an extensive tooth fracture of the right permanent maxillary lateral incisor. Clinical and radiographic examinations revealed the presence of a complicated crown-root fracture, which had elongated to the buccal subgingival area. The dental history disclosed that the apexification procedure had been started to be performed after his first trauma experience and he had neglected his appointment. The coronal fragment was gently extracted; endodontic treatment was performed; flap surgery was performed to make the fracture line visible. The coronal fragment was reattached to the root fragment with a dual-cure luting composite. A fiber post was stabilized and the access cavity of the tooth was restored with composite resin. At the end of the 24th month, the tooth was asymptomatic, functionally, esthetically acceptable and had no periapical pathology. It is important for the patients undergoing apexification treatment to keep their appointments because of the fracture risk. Restoration of the fractured tooth by preparing retention grooves and a bonding fiber-reinforced post are effective and necessary approaches for successful management.

Bacterial analysis of combined periodontal-endodontic lesions by polymerase chain reaction-denaturing gradient gel electrophoresis.

Science.gov (United States)

Xia, Minghui; Qi, Qingguo

2013-01-01

We used denaturing gradient gel electrophoresis (DGGE) to compare bacterial profiles in periodontium and root canals of teeth with combined periodontal-endodontic lesions. Samples of dental plaque and necrotic pulp were collected from thirteen extracted teeth with advanced periodontitis. Genomic DNA was extracted for polymerase chain reaction (PCR) analysis using universal bacterial primers. The PCR products were then loaded onto DGGE gels to obtain fractionated bands. Characteristic DGGE bands were excised and DNA was cloned and sequenced. The number of bands, which indicates the number of bacterial species, was compared between dental plaques and necrotic pulp tissues from the same tooth. Although the difference was statistically significant (P bacteria species were present in both the periodontal pockets and root canals of the same tooth; however, periodontal bacteria did not always invade the root canals, and some bacteria in root canals were not present in periodontal pockets of the same tooth. In some teeth, unique bacteria in root canals had not passed from periodontal pockets. A basic local alignment search tool (BLAST) sequence search in Genbank indicated that new bacteria species were present in periodontal pockets and root canals. Their characteristics must thus be further analyzed.

Endodontic management of C-shaped root canal system of mandibular first molar by using a modified technique of self-adjusting file system.

Science.gov (United States)

Helvacioglu-Yigit, Dilek

2015-01-01

C-shaped canal system is a seldom-found root canal anatomy which displays a challenge in all stages of endodontic treatment. According to the literature, this type of canal morphology is not a common finding in the mandibular first molar teeth. This case report presents endodontic management of a mandibular first molar with a C-shaped canal system. Root canal system was cleaned and shaped by nickel-titanium (NiTi) rotary instruments combined with self-adjusting file (SAF). Obturation was performed using warm, vertical condensation combined with the injection of warm gutta-percha. Follow-up examination 12 months later showed that the tooth was asymptomatic. The radiological findings presented no signs of periapical pathology. The clinician must be aware of the occurence and complexity of C-shaped canals in mandibular first molar teeth to perform a successful root canal treatment. The supplementary use of SAF after application of rotary instruments in C-shaped root canals might be a promising approach in endodontic treatment of this type of canal morphology.

Three-dimensional imaging modalities in endodontics

Science.gov (United States)

Mao, Teresa

2014-01-01

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome. PMID:25279337

Three-dimensional imaging modalities in endodontics

Energy Technology Data Exchange (ETDEWEB)

Mao, Teresa; Neelakantan, Prasanna [Dept. of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai (India)

2014-09-15

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome.

Three-dimensional imaging modalities in endodontics

International Nuclear Information System (INIS)

Mao, Teresa; Neelakantan, Prasanna

2014-01-01

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of peri-radicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome

[Discussion on combined periodontic-endodontic lesion type].

Science.gov (United States)

Wang, Kai; Zhou, Li

2008-02-01

Combined the elaboration on periodontic-endodontic lesion in the textbook Periodontics with the deficiencies existed in the clinical and teaching work and demonstrated the understanding on the type of the combined periodontic-endodontic lesion, and suggested the viewpoint of no sub-type of combined periodontic-endodontic lesion. Only regard the type of pulp disease that induced by periodontal disease as genuine combined periodontic-endodontic lesion.

Lung abscess

International Nuclear Information System (INIS)

Ha, H.K.; Kang, M.W.; Park, J.M.; Yang, W.J.; Shinn, K.S.; Bahk, Y.W.

1993-01-01

Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologicall impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess. (orig.)

Regenerative endodontics--Creating new horizons.

Science.gov (United States)

Dhillon, Harnoor; Kaushik, Mamta; Sharma, Roshni

2016-05-01

Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and exciting with the ability to shape the future of endodontics. This article highlights the fundamental concepts, protocol for treatment, and possible avenues for research in regenerative endodontics. © 2015 Wiley Periodicals, Inc.

Long-term prognosis of endodontically treated teeth: a retrospective analysis of preoperative factors in molars.

Science.gov (United States)

Setzer, Frank C; Boyer, Keith R; Jeppson, Joshua R; Karabucak, Bekir; Kim, Syngcuk

2011-01-01

Long-term predictability of restored endodontically treated teeth is important for the decision of tooth retention versus extraction and implant placement. The purpose of this study was to validate the hypothesis that preoperative factors can predict the long-term prognosis of molars requiring endodontic and restorative treatment for future prognostic investigations. A clinical database was searched for molar endodontic treatments with crown placement and a minimum of 4-year follow-up. Charts of 42 patients with 50 individual treatments were randomly selected. Information concerning crown lengthening; periodontal diagnosis; attachment loss; furcation involvement; mobility; and internal, external, or periradicular resorption was recorded. Radiographs from treatment initiation and follow-up were digitalized. The presence of apical periodontitis was evaluated. Available ferrule was calculated from bitewing radiographs using CAD software (AutoCAD; Autodesk, Cupertino, CA). The resulting data, age, sex, and times of restoration and follow-up were analyzed for correlation with the presence of apical radiolucency at follow-up and the following four possible outcome scenarios: "no event," "nonsurgical retreatment," "surgical retreatment," or "extraction" using Spearman rank order correlation analysis. Patients' ages ranged from 19 to 87 years, 22 were male and 20 female, and 48 teeth (96.0%) were retained at follow-up. Of those, 44 (88.0%) were without intervention ("no event"), and four (8.0%) underwent surgical or nonsurgical retreatment. Two teeth (4.0%) had been extracted. Significant positive correlations existed between "untoward events" (any form of retreatment or extraction) and "prognostic value according to periodontal status" (p = 0.047) and "attachment loss" (p = 0.042). The only preoperative factors significant for the prognosis of restored endodontically treated molars were related to periodontal prognostic value and attachment loss. It can be concluded that

Regenerative endodontics: A way forward.

Science.gov (United States)

Diogenes, Anibal; Ruparel, Nikita B; Shiloah, Yoav; Hargreaves, Kenneth M

2016-05-01

Immature teeth are susceptible to infections due to trauma, anatomic anomalies, and caries. Traditional endodontic therapies for immature teeth, such as apexification procedures, promote resolution of the disease and prevent future infections. However, these procedures fail to promote continued root development, leaving teeth susceptible to fractures. Regenerative endodontic procedures (REPs) have evolved in the past decade, being incorporated into endodontic practice and becoming a viable treatment alternative for immature teeth. The authors have summarized the status of regenerative endodontics on the basis of the available published studies and provide insight into the different levels of clinical outcomes expected from these procedures. Substantial advances in regenerative endodontics are allowing a better understanding of a multitude of factors that govern stem cell-mediated regeneration and repair of the damaged pulp-dentin complex. REPs promote healing of apical periodontitis, continued radiographic root development, and, in certain cases, vitality responses. Despite the clinical success of these procedures, they appear to promote a guided endodontic repair process rather than a true regeneration of physiological-like tissue. Immature teeth with pulpal necrosis with otherwise poor prognosis can be treated with REPs. These procedures do not preclude the possibility of apexification procedures if attempts are unsuccessful. Therefore, REPs may be considered first treatment options for immature teeth with pulpal necrosis. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Curricular Guidelines for Endodontics.

Science.gov (United States)

Journal of Dental Education, 1981

1981-01-01

Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

Endodontic treatment of a tiger

DEFF Research Database (Denmark)

Qvist, J.; Kortegaard, H.; Grøndahl, C.

The 84th Annual Meeting of NoF 2001, veterinary dentistry, endodontics, dental materials, animal case report......The 84th Annual Meeting of NoF 2001, veterinary dentistry, endodontics, dental materials, animal case report...

Amebic liver abscess

Science.gov (United States)

Hepatic amebiasis; Extraintestinal amebiasis; Abscess - amebic liver ... Amebic liver abscess is caused by Entamoeba histolytica. This parasite causes amebiasis , an intestinal infection that is also called ...

CT findings of renal abscess

International Nuclear Information System (INIS)

Lee, Myung Jun; Kim, Mi Young; Woo, Jung Ju; Kim, Ho Kyun; Kim, Won Hong; Jeon, Jeong Dong; Jeon, Woo Ki; Han, Chang Yul

1996-01-01

The purpose of this study is to determine characteristic CT findings in renal abscess. Twenty cases of renal abscess were retrospectively analyzed for CT findings relating to the shape and extent of the abscess, change of nephrogram, peripheral rim enhancement, wedge-shaped enhancement on delayed scans, enlargement of the kidney involved and associated findings. Seven patients had a renal abscess at the right kidney, nine at the lift kidney and two bilaterally. The abscesses were round in 18 cases and finger-like in two. Rim enhancement around renal abscess was seen in four cases (20%). Changes in the nephrogram around the abscess were seen in 12 cases (60%). In all six patients who had undergone delayed postcontrast scans, wedge-shaped enhancement was shown around the abscess (100%). In the observation of the extent of renal abscesses, 14 cases were within the kidney, six cases extended the beyond renal capsule, and two were loculated in the renal fascia itself. Renal enlargement was seen in nine cases (45%). These results suggest that CT findings such as delayed wedge-shaped enhancement, change of nephrogram, peripheral rim enhancement, renal enlargement, and associated findings are valuable for diagnosis, and that CT also gives information concerning the extent, evolution and complication of a renal abscess

Fracture resistance of endodontically-treated teeth: effect of combination bleaching and an antioxidant.

Science.gov (United States)

Khoroushi, Maryam; Feiz, Atieh; Khodamoradi, Roghayeh

2010-01-01

This in vitro study assessed the fracture resistance of endodontically-treated teeth undergoing combination bleaching with 38% and 9.5% hydrogen peroxide gels as in-office and at-home bleaching techniques, respectively. In addition, the effect of an antioxidizing agent, sodium ascorbate, was investigated. Sixty maxillary premolars were endodontically-treated, received a glass ionomer barrier as a mechanical seal and were embedded in acrylic resin up to the cemento-enamel junction. The specimens were divided into four groups (n = 15) as follows: G I: no bleaching, access cavity restored with resin composite (negative control); G II: bleached for three weeks daily using 9.5% hydrogen peroxide for two hours and three sessions of in-office bleaching using 38% hydrogen peroxide every seven days, then restored (positive control); G III: bleached similar to G II and restored after one week; G IV: bleached similar to G II, along with the use of an antioxidizing agent for 24 hours, then restored. In each in-office and at-home bleaching session, the whitening gels were applied to the buccal surface of the tooth and placed inside the pulp chamber (inside/outside bleaching technique). Finally, the specimens underwent fracture resistance testing; the data were analyzed using ANOVA and Scheffé's test (alpha = 0.05). Significant differences were observed among the study groups (p 0.05). Within the limitations of the current study, it can be concluded that the fracture resistance of endodontically-treated teeth decreases after combination bleaching. The use of sodium ascorbate can reverse decreased fracture resistance.

Post-menopausal breast abscess.

OpenAIRE

Raju, G. C.; Naraynsingh, V.; Jankey, N.

1986-01-01

Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma. Although the usual treatment of an abscess is incision and drainage, in post-menopausal women, excision of the lesion is helpful for accurate histological diagnosis.

Post-menopausal breast abscess.

Science.gov (United States)

Raju, G. C.; Naraynsingh, V.; Jankey, N.

1986-01-01

Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma. Although the usual treatment of an abscess is incision and drainage, in post-menopausal women, excision of the lesion is helpful for accurate histological diagnosis. PMID:3628144

Acute bacterial prostatitis and abscess formation.

Science.gov (United States)

Lee, Dong Sup; Choe, Hyun-Sop; Kim, Hee Youn; Kim, Sun Wook; Bae, Sang Rak; Yoon, Byung Il; Lee, Seung-Ju

2016-07-07

The purpose of this study was to identify risk factors for abscess formation in acute bacterial prostatitis, and to compare treatment outcomes between abscess group and non-abscess group. This is a multicenter, retrospective cohort study. All patients suspected of having an acute prostatic infection underwent computed tomography or transrectal ultrasonography to discriminate acute prostatic abscesses from acute prostatitis without abscess formation. A total of 31 prostate abscesses were reviewed among 142 patients with acute prostatitis. Univariate analysis revealed that symptom duration, diabetes mellitus and voiding disturbance were predisposing factors for abscess formation in acute prostatitis. However, diabetes mellitus was not related to prostate abscess in multivariate analysis. Patients with abscesses 20 mm who underwent transurethral resection had a shorter duration of antibiotic treatment than did those who did not have surgery. Regardless of surgical treatment, both the length of hospital stay and antibiotic treatment were longer in patients with prostatic abscesses than they were in those without abscesses. However, the incidence of septic shock was not different between the two groups. A wide spectrum of microorganisms was responsible for prostate abscesses. In contrast, Escherichia coli was the predominant organism responsible for acute prostatitis without abscess. Imaging studies should be considered when patients with acute prostatitis have delayed treatment and signs of voiding disturbance. Early diagnosis is beneficial because prostatic abscesses require prolonged treatment protocols, or even require surgical drainage. Surgical drainage procedures such as transurethral resection of the prostate were not necessary in all patients with prostate abscesses. However, surgical intervention may have potential merits that reduce the antibiotic exposure period and enhance voiding function in patients with prostatic abscess.

Nonsurgical drainage of splenic abscess

International Nuclear Information System (INIS)

Berkman, W.A.; Harris, S.A. Jr.; Bernardino, M.E.

1983-01-01

The mortality associated with intraabdominal abscess remains high despite modern surgical methods and antibiotics. Draingae of abscesses of the abdomen, retroperitoneum, pelvis, pancreatic pseudocyst, mediastinum, and lung may be treated effectively by percutaneous catheter placement. In several reports of percutaneous abdominal abscess drainage, only three cases of splenic abscess drainage have been reported. The authors have recently drained two splenic abscesses with the aid of computed tomography (CT) and emphasize several advantages of the percutaneous guided approach

Endo-periodontal lesion – endodontic approach

Science.gov (United States)

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system. PMID:25713618

Endodontic flare-ups: a prospective study.

Science.gov (United States)

Alves, Vanessa de Oliveira

2010-11-01

The objective of this prospective clinical study was to evaluate the incidence of flare-ups (pain and/or swelling requiring endodontic interappointment and emergency treatment) and identify the risk factors associated with their occurrence in patients who received endodontic treatment from June 2006 to June 2007 at the endodontics clinic of the São Paulo Dental Association (APCD), Jardim Paulista branch, São Paulo, Brazil. The incidence of flare-ups was 1.71% out of 408 teeth that had received endodontic therapy. Statistical analysis using the chi-squared test (P flare-up rate and the presence of a periradicular radiolucency. Copyright © 2010 Mosby, Inc. All rights reserved.

Microbiology of liver abscesses and the predictive value of abscess gram stain and associated blood cultures.

Science.gov (United States)

Chemaly, Roy F; Hall, Gerri S; Keys, Thomas F; Procop, Gary W

2003-08-01

Although rare, pyogenic liver abscesses are potentially fatal. We evaluated the predictive value of Gram stain of liver abscess aspirates and temporally associated blood cultures. Gram stains detected bacteria in 79% of the liver abscesses tested. The sensitivity and specificity of Gram stain of the liver abscesses were 90% and 100% for Gram-positive cocci (GPC) and 52% and 94% for Gram-negative bacilli (GNB). The sensitivities of the blood cultures for any GPC and GNB present in the liver abscess were 30% and 39%, respectively. Although, Gram stains and blood cultures offer incomplete detection of the microbial contents of pyogenic liver abscesses, both tests should always accompany liver abscess cultures.

Multiple splenic abscesses

Directory of Open Access Journals (Sweden)

Harish Kumar

2015-01-01

Full Text Available Splenic abscess is a rare clinical entity with poor prognosis. But owing to imaging technique, diagnosis and prognosis have improved nowadays. Most patients who are presented with splenic abscess are immunocompromised due to predisposing risk factors like diabetes mellitus, intravenous drug abuse, trauma, bacterial endocarditis, human immunodeficiency virus (HIV, chemotherapy, or steroids. Here, we are presenting a rarer case of multiple splenic abscesses with its complication in an immunocompetent healthy adult male without any risk factor.

Isolated Amoebic Abscess of Spleen

Directory of Open Access Journals (Sweden)

Kaushik M

2013-04-01

Full Text Available Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis. Extrahepatic amoebic abscesses have occasionally been described in the lung, brain, and skin and presumably result from hematogenous spread. Isolated amoebic abscess of spleen has been reported scarcely in literature. We report here a case of isolated amoebic abscess of spleen.

Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation.

Science.gov (United States)

Duncan, Christopher; Nadolski, Gregory J; Gade, Terence; Hunt, Stephen

2017-06-01

Lung parenchymal abscesses represent an uncommon pathology with high mortality if untreated. Although most respond well to antibiotics, the optimal therapy for persistent abscesses is unknown. The purpose of this study was to review the outcomes of percutaneous lung parenchymal abscess catheter drainage after broad-spectrum antibiotic therapy failure and correlate with patient microbiologic samples. Retrospective review of patients who underwent percutaneous lung abscess drainage at a tertiary hospital system from 2005 to 2015 was performed. In total, 19 procedures were identified on 16 different patients; six females and ten males. Mean patient age was 55 years (range 22-81). Median follow-up time was 7 months (range abscess cavity in 58% (11/19) or with non-draining abscess cavities in 21% (4/19) for a clinical success rate of 79%. Blood cultures demonstrated no growth in all cases, while 21% (4/19) of sputum or bronchoscopic cultures demonstrated growth. In comparison, the specimens from initial catheter placement isolated a causative organism in 95% (18/19) of case (p lung abscess after broad-spectrum antibiotics, percutaneous abscess drainage is highly sensitive for microbiologic sampling compared to sputum/bronchoscopic or blood cultures. Additionally, percutaneous drainage of lung parenchymal abscess cavities may promote resolution of the abscess with high rates of therapeutic success and low complications.

Neonatal orbital abscess

Directory of Open Access Journals (Sweden)

Khalil M Al-Salem

2014-01-01

Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

[Management of Lung Abscess].

Science.gov (United States)

Marra, A; Hillejan, L; Ukena, D

2015-10-01

A lung abscess is an infectious pulmonary disease characterised by the presence of a pus-filled cavity within the lung parenchyma. The content of an abscess often drains into the airways spontaneously, leading to an air-fluid level visible on chest X-rays and CT scans. Primary lung abscesses occur in patients who are prone to aspiration or in otherwise healthy individuals; secondary lung abscesses typically develop in association with a stenosing lung neoplasm or a systemic disease that compromises immune defences, such as AIDS, or after organ transplantation. The organisms found in abscesses caused by aspiration pneumonia reflect the resident flora of the oropharynx. The most commonly isolated organisms are anaerobic bacteria (Prevotella, Bacteroides, Fusobacterium, Peptostreptococcus) or streptococci; in alcoholics with poor oral hygiene, the spectrum of pathogens includes Staphylococcus aureus, Streptococcus pyogenes and Actinomyces. Chest radiography and computed tomography (CT) are mandatory procedures in the diagnostic algorithm. Standard treatment for a lung abscess consists of systemic antibiotic therapy, which is based on the anticipated or proven bacterial spectrum of the abscess. In most cases, primary abscesses are successfully treated by calculated empiric antibiotic therapy, with an estimated lethality rate of less than 10 %. Secondary abscesses, despite targeted antimicrobial therapy, are associated with a poor prognosis, which depends on the patient's general condition and underlying disease; lethality is as high as 75 %. Negative prognostic factors are old age, severe comorbidities, immunosuppression, bronchial obstruction, and neoplasms. Surgical intervention due to failure of conservative treatment is required in only 10 % of patients, with a success rate of up to 90 % and postoperative mortality rates ranging between 0 and 33 %. Treatment success after endoscopic or percutaneous drainage is achieved in 73 to 100 % of cases, with an

Cone Beam Computed Tomography Evaluation of the Periapical Status of Nonvital Tooth with Open Apex Obturated with Mineral Trioxide Aggregate: A Case Report

Directory of Open Access Journals (Sweden)

Vijay Shekhar

2013-01-01

Full Text Available Management of a tooth with open apex is a challenge to the dental practitioners. Evaluation of the periapical healing is required in such cases by radiographic techniques. The objective of this paper was to assess the healing of a periapical lesion in a non-vital tooth with open apex treated with mineral trioxide aggregate (MTA obturation using cone beam computed tomography (CBCT. The endodontic treatment of a fractured non-vital discolored maxillary left lateral incisor with an open apex was done with MTA obturation. The clinical and radiographic followup done regularly showed that the tooth was clinically asymptomatic and that the size of the periapical lesion observed by intraoral periapical (IOPA radiographs and CBCT was decreased remarkably after two years. CBCT and IOPA radiographs were found to be useful radiographic tools to assess the healing of a large periapical lesion in a non-vital tooth with open apex managed by MTA obturation.

Partial pulp necrosis caused by excessive orthodontic force

Directory of Open Access Journals (Sweden)

Min-Young Kim

2011-03-01

Full Text Available As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.

An Immature Type II Dens Invaginatus in a Mandibular Lateral Incisor with Talon’s Cusp: A Clinical Dilemma to Confront

Directory of Open Access Journals (Sweden)

Anshul Gangwar

2014-01-01

Full Text Available Dens invaginatus (DI is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. DI is classified as type I, II, and III by Oehlers depending on the severity of malformation. The maxillary lateral incisor is the most commonly affected tooth. Structural defects do exist in the depth of the invagination pits, and as a consequence, the early development of caries and the subsequent necrosis of the dental pulp, as well as abscess and cyst formation are clinical implications associated with DI. Occasionally, we can see more than one developmental anomaly occurring in a single tooth. In such cases it becomes important to identify the anomalies and initiate a proper treatment plan for good prognosis. In this paper, an unusual case of DI which clinically presented as a huge talons cusp affecting a mandibular lateral incisor tooth is described. This case report illustrates grinding of the talons cusp followed by nonsurgical endodontic management of dens invaginatus type II with an immature apex and periapical lesions, in which Mineral Trioxide Aggregate (MTA shows a complete periapical healing with bone formation at the site of the lesions.

Autologus Platelet Rich Fibrin aided Revascularization of an immature, non-vital permanent tooth with apical periodontitis: A case report.

Science.gov (United States)

Jadhav, Ganesh Ranganath; Shah, Dipali; Raghvendra, Srinidhi Surya

2015-01-01

Caries or trauma induced non-vital immature permanent tooth with blunderbuss, thin root which are very common among childrens are corrected using regenerative endodontic (revascularization) procedures. In the presented case, a 16-year-old boy reported with chief complaint of pain in maxillary left central incisor (Tooth #21). Tooth #21 showed grade III mobility, draining labial sinus, and short blunderbuss root with diffuse periapical radiolucency. Patient was explained the treatment plan and written informed consent was taken. Platelet rich fibrin (PRF) was prepared according to standard protocol. Autologous PRF was carried to the apical portion of the root canal after inducing revascularization. Access opening was double sealed with MTA and resin modified glass ionomer cement (RMGI). Baseline, 12 month and 18 month follow-up intraoral radiographs were taken. Clinically case was asymptomatic with complete resolution of intraoral sinus. Periapical healing, apical closure, root lengthening and dentinal wall thickening were uneventful. Thus PRF supplementation hastens the predictability and rate of revascularization in non-vital immature permanent teeth.

Peregrination of endodontic tools-past to present

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Ashwini Tumkur Shivakumar

2016-01-01

Full Text Available The clinical practice of yesterday′s endodontics becomes the heresy of today, and today′s endodontic practice becomes the heresy of tomorrow. The history of endodontics begins in the 17 th century. Since then, there have been numerous advances and developments, and research has proceeded continuously without pause. The manufacture of the first instruments for endodontic use dates back to 1875. These early instruments were made by hand from thin steel wires, and they performed the function of modern barbed broaches. In 1955, Ingle was the first to express the need for standardization of canal instruments. In 1965, the American Association of Endodontists adopted the terminology and nomenclature of the proposed standardized system. For many years, the standard cutting instruments have been the reamer, the K-type file, and the Hedstroem file. Recent changes in both metallurgy and endodontic concepts have led to the introduction of a wide range of new instruments. An effort has been made here to present the journey of endodontic instruments from the past to the present.

Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics

Science.gov (United States)

Kato, A; Ziegler, A; Higuchi, N; Nakata, K; Nakamura, H; Ohno, N

2014-01-01

The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts. PMID:24483229

One-appointment endodontic therapy: biological considerations.

Science.gov (United States)

Lin, Louis M; Lin, Jarshen; Rosenberg, Paul A

2007-11-01

The authors conducted a literature review to present the best available biological evidence concerning one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. Because of recent advances in technology, such as rotary engines and nickel-titanium instruments, some practitioners are performing one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. The authors reviewed the literature, which revealed only a small number of randomized, controlled clinical trials that have been conducted on one-appointment versus multiple-appointment endodontic therapy. As the apical canal preparation is enlarged, a greater percentage of bacteria is eradicated from infected root canals. In addition, sufficiently large apical root canal enlargement facilitates the delivery of antimicrobial irrigant to the apical portion of the canal. However, an association between positive or negative preobturation root canal culture results and the outcome of endodontic treatment has not been well-established. The best available evidence, based on a systematic literature review, indicates that one-appointment endodontic therapy may be feasible in selected cases of apical periodontitis in asymptomatic teeth. However, additional randomized, controlled clinical trials are required.

A review of the regenerative endodontic treatment procedure

Directory of Open Access Journals (Sweden)

Bin-Na Lee,

2015-08-01

Full Text Available Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

Establishing Apical Patency and its Effect on Endodontic Outcomes

Science.gov (United States)

2012-06-01

Endodontic  Outcomes   by Jason  S...Allen,  LT, DC, USN A thesis submitted to the Faculty of the Endodontics Graduate Program Naval Postgraduate Dental...Assistant Program Director, Endodontics Dept. Terry D. Webb, DDS, MS CAPT, DC, USN Chairman, Endodontics Dept. Glen M. Imamura, S, MS CAPT, DC,

Pediatric Pulmonary Abscess

Directory of Open Access Journals (Sweden)

Kyle Barbour

2018-04-01

Full Text Available History of present illness: A 6-year-old previously healthy male presented to the emergency department with three days of left upper quadrant abdominal pain. Family endorsed one week of fevers, cough productive of yellow sputum, and non-bilious, non-bloody emesis. He denied shortness of breath and chest pain. On exam, the patient was febrile with otherwise normal vital signs. He had diffuse tenderness to his abdomen but clear lungs. Laboratory studies revealed leukocytosis to 25,000/mm3 with a left shift. Significant findings: Upright posterior-anterior plain chest films show a left lower lobe consolidation with an air-fluid level and a single septation consistent with a pulmonary abscess (white arrows. A small left pleural effusion was also present, seen as blunting of the left costophrenic angle and obscuration of the left hemidiaphragm (black arrows. Discussion: Pediatric pulmonary abscesses are rare, most commonly caused by aspiration, and the majority consequently arise in dependent portions of the lung.1 The most common pathogens in children are Streptococcus pneumoniaeand Staphylococcus aureus.1 Immunocompromised patients and those with existing pulmonary disease more commonly contract Pseudomonas aeruginosaor Bacteroides, and fungal pathogens are possible.1 Common symptoms include tachypnea, fever, and cough. Imaging is necessary to distinguish pulmonary abscesses from pneumonia, empyema, pneumatocele, and other etiologies. Plain film radiography may miss up to 18% of pulmonary abscesses yet is often the first modality to visualize an intrathoracic abnormality.2 If seen, pulmonary abscesses most often appear as consolidations with air-fluid levels. Generally, pulmonary abscesses are round with irregular, thick walls, whereas empyemas are elliptical with smooth, thin walls.3 However, these characteristics cannot definitively distinguish these processes.2 Advantages of plain films include being low cost and easily obtained. Computed

Analysis of the rate of maturogenesis of a traumatized Cvek's stage 3 anterior tooth treated with platelet-rich fibrin as a regenerative tool using three-dimensional cone-beam computed tomography: an original case report.

Science.gov (United States)

Solomon, Raji Viola; Faizuddin, Umrana; Guniganti, Sushma Shravani; Waghray, Shefali

2015-01-01

Regenerative endodontic procedures are biologically based procedures which deal with the regeneration of pulp-like tissue, more idealistically the pulp-dentin complex. The regeneration of this pulp-dentin complex in an infected necrotic tooth with an open apex is possible only when the canal is effectively disinfected. Though there are various procedures for treating open apex ranging from Ca(OH) 2 apexification, mineral trioxide aggregate apexification and surgical approach, regeneration of tissues has always taken superior hand over the repair of tissues. The mechanics behind the regenerative endodontic procedures is that despite the tooth being necrotic, some pulp tissue can survive apically which under favorable conditions proliferate to aid in the process of regeneration. In the past 2 decades, an increased understanding of the physiological roles of platelets in wound healing and after tissue injury has led to the idea of using platelets as therapeutic tools in the field regenerative endodontics. In the present case report with an open apex, high sterilization protocol is followed using triple antibiotic paste as intra-canal medicament, followed which platelet rich fibrin is used as the regenerative material of choice. Over an 18-month follow-up period, clinically patient is asymptomatic and radiographically there is complete regression of the periapical lesion and initiation of the root end closure.

Interaction between endodontics and periodontics.

Science.gov (United States)

Rotstein, Ilan

2017-06-01

Endodontic-periodontal lesions present challenges to the clinician regarding diagnosis, treatment planning and prognosis. Etiologic factors, such as bacteria and viruses, as well as contributing factors, such as trauma, root resorptions, perforations, cracks and dental malformations, play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic-periodontal lesions vary, depending on the etiology, pathogenesis and correct diagnosis of each specific condition. This chapter will appraise the interrelationship between endodontic and periodontal lesions and provide biological and clinical evidence for diagnosis, prognosis and decision-making in the treatment of these conditions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation

International Nuclear Information System (INIS)

Duncan, Christopher; Nadolski, Gregory J.; Gade, Terence; Hunt, Stephen

2017-01-01

IntroductionLung parenchymal abscesses represent an uncommon pathology with high mortality if untreated. Although most respond well to antibiotics, the optimal therapy for persistent abscesses is unknown. The purpose of this study was to review the outcomes of percutaneous lung parenchymal abscess catheter drainage after broad-spectrum antibiotic therapy failure and correlate with patient microbiologic samples.Materials and MethodsRetrospective review of patients who underwent percutaneous lung abscess drainage at a tertiary hospital system from 2005 to 2015 was performed. In total, 19 procedures were identified on 16 different patients; six females and ten males. Mean patient age was 55 years (range 22–81). Median follow-up time was 7 months (range <1–78).ResultsTechnical success was 100%. There was one major complication, a pneumothorax. Follow-up was until tube removal or death in 100% of patients. Catheters were removed with resolution of the abscess cavity in 58% (11/19) or with non-draining abscess cavities in 21% (4/19) for a clinical success rate of 79%. Blood cultures demonstrated no growth in all cases, while 21% (4/19) of sputum or bronchoscopic cultures demonstrated growth. In comparison, the specimens from initial catheter placement isolated a causative organism in 95% (18/19) of case (p < 0.0001).ConclusionIn cases of persistent lung abscess after broad-spectrum antibiotics, percutaneous abscess drainage is highly sensitive for microbiologic sampling compared to sputum/bronchoscopic or blood cultures. Additionally, percutaneous drainage of lung parenchymal abscess cavities may promote resolution of the abscess with high rates of therapeutic success and low complications.

Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation

Energy Technology Data Exchange (ETDEWEB)

Duncan, Christopher; Nadolski, Gregory J.; Gade, Terence; Hunt, Stephen, E-mail: Stephen.hunt@uphs.upenn.edu [Hospital of the University of Pennsylvania, Perelman School of Medicine, Division of Interventional Radiology, Department of Radiology (United States)

2017-06-15

IntroductionLung parenchymal abscesses represent an uncommon pathology with high mortality if untreated. Although most respond well to antibiotics, the optimal therapy for persistent abscesses is unknown. The purpose of this study was to review the outcomes of percutaneous lung parenchymal abscess catheter drainage after broad-spectrum antibiotic therapy failure and correlate with patient microbiologic samples.Materials and MethodsRetrospective review of patients who underwent percutaneous lung abscess drainage at a tertiary hospital system from 2005 to 2015 was performed. In total, 19 procedures were identified on 16 different patients; six females and ten males. Mean patient age was 55 years (range 22–81). Median follow-up time was 7 months (range <1–78).ResultsTechnical success was 100%. There was one major complication, a pneumothorax. Follow-up was until tube removal or death in 100% of patients. Catheters were removed with resolution of the abscess cavity in 58% (11/19) or with non-draining abscess cavities in 21% (4/19) for a clinical success rate of 79%. Blood cultures demonstrated no growth in all cases, while 21% (4/19) of sputum or bronchoscopic cultures demonstrated growth. In comparison, the specimens from initial catheter placement isolated a causative organism in 95% (18/19) of case (p < 0.0001).ConclusionIn cases of persistent lung abscess after broad-spectrum antibiotics, percutaneous abscess drainage is highly sensitive for microbiologic sampling compared to sputum/bronchoscopic or blood cultures. Additionally, percutaneous drainage of lung parenchymal abscess cavities may promote resolution of the abscess with high rates of therapeutic success and low complications.

Taking the mystery out of endodontics, Part 6. Painless anesthesia for the "hot" tooth.

Science.gov (United States)

Weathers, A

1999-12-01

Much of what we were taught in dental school is no longer valid. In this article, I've examined some of the myths surrounding what I have dubbed the "inferior" inferior alveolar nerve block. Using the X-tip anesthesia system, it is now possible to achieve total, instant and profound anesthesia of the "hot" tooth, without the problems formerly associated with intraosseous injections.

stausartikel: behandling af subcutane abscesser

DEFF Research Database (Denmark)

Hardgrib, Nina; Petersen, Klaus Kjær

2017-01-01

Simple subcutaneous abscesses are common, and we have examined the literature concerning the ideal treatment of subcutaneous abscesses. We recommend radical debridement with removal of all pus, the abscess wall and any necrosis. If primary suture is chosen, preoperative antibiotics should be admi...

Abscess detection with radionuclides

International Nuclear Information System (INIS)

Alavi, J.B.

1988-01-01

Radionuclide studies may aid in the diagnosis and localization of intra-abdominal infections. Despite the introduction of new radiographic and ultrasound methods, there are several clinical situations in which radionuclide scans have proved useful. Those include detection of postoperative intra-abdominal abscess, evaluation of liver abscess, differentiation between pancreatic pseudocyst or abscess, evaluation of fever of unknown origin, and evaluation of inflammatory bowel disease. Each clinical situation is discussed separately here

Failure of endodontic treatment: The usual suspects.

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Tabassum, Sadia; Khan, Farhan Raza

2016-01-01

Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. With an ever increasing number of endodontic treatments being done each day, it has become imperative to avoid or minimize the most fundamental of reasons leading to endodontic failure. This paper reviews the most common causes of endodontic failure along with radiographic examples.

Essentials of Endodontic Microsurgery

Science.gov (United States)

2010-04-01

Holtzman DJ, et al. Quality of root-end preparations using ultrasonic and rotary instrumentation in cadavers. J Endod 2000;26:281. 39. Peters CI...00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Essentials of Endodontic Microsurgery 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT... Endodontic Program,Harvard School of Dental Medicine,Boston,MA 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND

Molecular diagnostics in endodontics

OpenAIRE

Rechenberg, Dan-Krister; Zehnder, Matthias

2014-01-01

Recent systematic reviews have substantiated the fact that current testing methods to assess the inflammatory state of the pulp and the periapical tissues are of limited value. Consequently, it may be time to search for alternative routes in endodontic diagnostics. Molecular assessment methods could be the future. However, in the field of endodontics, the research in that direction is only about to evolve. Because pulpal and periradicular diseases are related to opportunistic infections, diag...

Resistance to fracture of endodontically treated premolars restored with glass ionomer cement or acid etch composite resin: An in vitro study

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B Ranga

2010-01-01

Full Text Available Aim: Due to the weakness of endodontically treated posterior teeth requires more strengthened restoration to withstand occlusal forces. The purpose of the present study was to determine and compare the resistance to fracture of endodontically treated maxillary 1 st premolars restored with different materials in mesio-occluso-distal (MOD cavity preparations. Materials and Methods: MOD cavity preparations in 80 endodontically treated maxillary 1 st premolars were restored using four different methods. Fiber rings were filled with stone plaster and the teeth were placed into the plaster up to the level of cemento-enamel junction. The teeth were grouped according to restorative method, mounted in an Instrom T.T. machine, and the buccal walls subjected to a slowly increasing compressive force until fracture occurred. Result: The force of fracture of the walls of each tooth was recorded and the results in the various groups compared. All teeth fractured in a similar manner irrespective of the restorative method used. Conclusion: The resistance to the fracture of the teeth was the same when they were stored with glass ionomer cement as a base over which composite resin was placed. When the entire cavities were filled with glass ionomer cement, the resistance to fracture of the teeth decreased significantly compared with the acid etch resin technique.

Optimal mechanical design of anatomical post-systems for endodontic restoration.

Science.gov (United States)

Maceri, Franco; Martignoni, Marco; Vairo, Giuseppe

2009-02-01

This paper analyses the mechanical behaviour of a new reinforced anatomical post-systems (RAPS) for endodontic restoration. The composite restorative material (CRM) completely fills the root canal (as do the commonly used cast metal posts) and multiple prefabricated composite posts (PCPs) are employed as reinforcements. Numerical simulations based on 3D linearly elastic finite element models under parafunctional loads were performed in order to investigate the influence of the stiffness of the CRM and of the number of PCPs. Periodontal ligament effects were taken into account using a discretised anisotropic nonlinearly elastic spring system, and the full discrete model was validated by comparing the resulting stress fields with those obtained with conventional restorations (cast gold-alloy post, homogeneous anatomical post and cemented single PCP) and with the natural tooth. Analysis of the results shows that stresses at the cervical/middle region decrease as CRM stiffness increases and, for large and irregular root cavities that apical stress peaks disappear when multiple PCPs are used. Accordingly, from a mechanical point of view, an optimal RAPS will use multiple PCPs when CRM stiffness is equal to or at most twice that of the dentin. This restorative solution minimises stress differences with respect to the natural tooth, mechanical inhomogeneities, stress concentrations on healthy tissues, volumes subject to shrinkage phenomena, fatigue effects and risks of both root fracture and adhesive/cohesive interfacial failure.

Biofilm in endodontics: A review

Science.gov (United States)

Jhajharia, Kapil; Parolia, Abhishek; Shetty, K Vikram; Mehta, Lata Kiran

2015-01-01

Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms’ formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to

Neck deep abscesses: retropharyngeal abscess caused by a fish bone

International Nuclear Information System (INIS)

Caicedo, Julia; Toscano, Vinicio; Calle, Gilberto

2005-01-01

The neck deep abscesses are infections may threaten life, chiefly retropharyngeal; antibiotic proper use, surgical cleanings and early intensive care management have achieved the diminishing of morbi-mortality of these abscesses. We present the case of a 55 year old, diabetic woman with progressive odino-dysphagia, fever, soft palate, anterior pillars and posterior wall of pharynx swelling, left cervical mass, and jaundice, computer tomography CT reporting retropharyngeal abscess; during surgery a fistula in hypopharynx caused by a fish bone is found; the culture was polymicrobial: E. coli, citrobacter, staphylococcus and candida; to receive antibiotics according to culture, finally a direct suture and gastrectomy are performed, with suitable clinic and surgical evolution. (The author)

Percutaneous drainage treatment of primary liver abscesses

Energy Technology Data Exchange (ETDEWEB)

Berger, H.; Pratschke, E.; Berr, F.; Fink, U.

1989-02-01

28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess.

Management of foreign object in the root canal of central incisor tooth

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Mothanna Alrahabi

2014-01-01

Full Text Available There are several reports describing the impaction of foreign objects into the exposed pulp chambers and canals by patients, especially children as they often have the habit of inserting foreign objects in the oral cavity. These objects will become a potent source of infection.This case report describes the retrieval of a foreign object impacted into the root canal of a 12-year-old male patient who was referred to the endodontic specialty clinic at Taibah University College of Dentistry. The patient′s chief complaint was a pain in the upper left central tooth. Clinical examination revealed a complicated enamel-dentin fracture with a large caries cavity. A periapical radiographic image showed a radiopaque object in the root canal system. Stainless steel Hedstrom files were used to retrieve the object from the canal. Following a proper cleaning and shaping of the root canal system, an intra-canal calcium hydroxide dressing was placed for 1 week. The root canal system was then filled with sealer and gutta-percha using the lateral compaction technique and the tooth received an aesthetic restoration.

Percutaneous drainage treatment of primary liver abscesses

International Nuclear Information System (INIS)

Berger, H.; Pratschke, E.; Berr, F.; Fink, U.; Klinikum Grosshadern, Muenchen; Klinikum Grosshadern, Muenchen

1989-01-01

28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess. (orig.) [de

Splenic abscesses from Salmonella infection

International Nuclear Information System (INIS)

Gomez, Carmen Cecilia; Zuniga Eduardo

2005-01-01

Spleen abscesses are uncommon. We describe the case of a 56 year-old man who presented with diarrhea, fever, vomiting and weight loss. On physical examination, the main findings included jaundice, hepatomegaly and ascites. Diagnostic imaging showed the presence of spleen abscesses, due to Salmonella species. Considering the type of abscess, medical treatment was given without the need for interventional treatment, resulting in a satisfactory outcome. No other risk factor was found, other than the gastrointestinal focus as the precursor of the splenic abscess.

The effect of fiber dowel heights in resin composite cores on restoration failures of endodontically treated teeth.

Science.gov (United States)

Mekayarajjananonth, Trakol; Chitcharus, Nattinee; Winkler, Sheldon; Bogert, Meredith C

2009-01-01

In vitro and in vivo testing suggest that fiber posts may reduce the incidence of root fractures of endodontically treated teeth. The purpose of this in vitro study was to compare the effect of fiber post height in resin composite cores on the fracture resistance of endodontically treated teeth. Forty maxillary central incisors were randomly divided into 2 control groups (Groups 1 and 2) of 5 teeth each, and 3 experimental groups (Groups 3, 4, and 5) of 10 teeth each. The teeth in Group 1 had their opening restored with composite resin, the teeth in Group 2 were restored with quartz fiber posts without resin composite cores, and the teeth in Groups 3, 4, and 5 were restored with quartz fiber posts of 2, 4, and 6 mm high, respectively, in 6-mm resin composite cores. Ceramic crowns were fabricated for the specimens. Specimens were positioned in a mounting device and aligned at a 130-degree angle to the long axis of each tooth. A universal testing machine was used to apply constant load at a crosshead speed of 0.5 mm/min until failure occurred. The highest fracture load and mode of failure of each specimen was recorded. The highest fracture resistance force was observed in Group 2 (290.38 +/- 48.45 N) and decreased, respectively, in Group 1 (238.98 +/-26.26 N), Group 5 (228.35 +/-58.79 N), Group 4 (221.43 +/-38.74 N), and Group 3 (199.05 +/-58.00 N). According to one-way analysis of variance (ANOVA) and Duncan's test (P teeth should be restored with the longest possible post height while preserving maximum tooth structure.

Immunopathogenesis of brain abscess

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Kielian Tammy

2004-08-01

Full Text Available Abstract Brain abscess represents a significant medical problem despite recent advances made in detection and therapy. Due to the emergence of multi-drug resistant strains and the ubiquitous nature of bacteria, the occurrence of brain abscess is likely to persist. Our laboratory has developed a mouse experimental brain abscess model allowing for the identification of key mediators in the CNS anti-bacterial immune response through the use of cytokine and chemokine knockout mice. Studies of primary microglia and astrocytes from neonatal mice have revealed that S. aureus, one of the main etiologic agents of brain abscess in humans, is a potent stimulus for proinflammatory mediator production. Recent evidence from our laboratory indicates that Toll-like receptor 2 plays a pivotal role in the recognition of S. aureus and its cell wall product peptidoglycan by glia, although other receptors also participate in the recognition event. This review will summarize the consequences of S. aureus on CNS glial activation and the resultant neuroinflammatory response in the experimental brain abscess model.

Use of photoactivated disinfection and platelet-rich fibrin in regenerative Endodontics

Science.gov (United States)

Johns, Dexton Antony; Shivashankar, Vasundara Yayathi; Krishnamma, Shoba; Johns, Manu

2014-01-01

Aim: Photoactivated disinfection has been used as an adjunct to conventional endodontic treatment. Its use in regenerative endodontics is not reported in literature. The aim of this case report was to describe a new proposal for pulp revascularization with disinfection of pulp canal space using a unique combination of a photosensitizer solution and low-power laser light. Materials and Methods: A 9-year-old boy came with the chief complaint of discolored upper central incisors (#8, #9). A diagnosis of pulp necrosis was made on the basis of clinical and radiographic findings. The canal was irrigated with 5.25% sodium hypochlorite solution and dried with paper points. Photodynamic therapy was used to disinfect the root canal and platelet-rich fibrin was used to revitalize the pulp. Three millimeters of gray mineral trioxide aggregate was placed directly over the platelet-rich plasma clot. Three days later, the tooth was double-sealed with permanent filling materials. Results: Clinical examination revealed no sensitivity to percussion or palpation tests. Radiograph revealed continued thickening of the dentinal walls, root lengthening, regression of the peri-apical lesion and apical closure. Both the roots showed complete apical closure at the 10-month follow-up. However, the teeth were not responsive to electric pulp test. Conclusion: This report of pulp revascularization shows that disinfection with photodynamic therapy combined with platelet-rich fibrin leads to satisfactory root development in necrotic immature teeth. PMID:25298655

Ultrasonographic diagnosis of amebic liver abscess

Energy Technology Data Exchange (ETDEWEB)

Jeon, Hae Jeong; Suh, Won Hyuck; Park, Ung Chae [Korea University College of Medicine, Seoul (Korea, Republic of)

1988-10-15

Amebric liver abscess is the most common extraintestinal complication of amoebiasis. Radionuclide scan, computed tomography have helped ultrasound in making diagnosis of a amebic liver abscess, but sonography have made a remarkable contribution in the diagnosis and management. Sonographic features of proven amebic abscess of 17 cases in 16 patients were retrospectively analyzed. The abscess lesions were located in right lobe of the liver (14 cases), single in number (15 cases). There were 9 cases of pleural effusion. In one patient, colitis was present as a complication. Sonographic findings of amebic abscess were round inhomogeneous hypoechoic lesion; absence of definite wall echoes; posterior wall enhancement; progressive echolucent change with maturation. Ultrasound guided aspiration can make the microbiological diagnosis of amebic abscess.

Relationship between IL-1β production and endodontic status of human periapical lesions

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Popovska Lidija

2017-01-01

Full Text Available Background/Aim. Apical periodontitis is mainly caused by bacterial infection within the root canal and periapical bone destruction which are prominent features of this lesion. The aim of this study was to determine the quantity of interleukin-1β in the tissues of periapical lesions and to analyze its relationships with: lesion size, previous treatments and pathohistological finding of involved teeth. Methods. Periapical tissues were obtained from patients undergoing periapical surgery. Out of all 80 cases included in the study, 24 had no previous endodontic treatment (open lesions, 37 were with endodontic failure (closed lesion and in 15 cases root canal retreatment was performed few months before the surgery. By excluding four samples, the total of 76 samples, consisted of periapical lesions and the apical part of the tooth root, was collected. Each periapical tissue sample was divided into two equal parts. The one half of each lesion was used for quantification of interleukin-1β in tissue homogenates by the enzyme-linked immunosorbent assay (ELISA method. The other part of each lesion was used for histopathological evaluation. Results. For each of the tissue homogenates, the quantity of interleukin-1β was measured, and it ranged from 0.6 pg/mg up to 74 pg/mg. There was no significant difference between the symptomatology and amount of interleukin-1β. Statistical data analysis showed a moderate correlation between lesion size and interleukin-1β measured values. The highest levels of interleukin-1β corresponded with chronic lesions in the stages of acute exacerbation and granulomas in early developing stages. Persistant granulomas, scar tissues, non-inflamed cysts and teeth with recently finished endodontic treatments showed a significantly lower level of interleukin-1β. Conclusion. The study results suggest that the differences in quantity of interleukin-1β correlate to lesion progression and phases of development.

Recurrent periodontal abscess associated with "teeth as a tool".

Science.gov (United States)

Bhat, G Subraya; Singh, Vishal; Bhat, K Mahalinga

2012-01-01

We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology.

Recurrent periodontal abscess associated with "teeth as a tool"

Directory of Open Access Journals (Sweden)

G Subraya Bhat

2012-01-01

Full Text Available We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology.

A radiographic study on the conventional endodontic treatment

International Nuclear Information System (INIS)

Kang, Byung Cheol; Kwon, Hyuck Choon; You, Dong Soo

1985-01-01

The purpose of this study was to evaluate the initial and postoperative radiographic features of the endodontic treated teeth. The author examined the radiographs which comprise 114 teeth with 155 canals of 64 persons. The following factors were considered; Age, sex, tooth location, number of root canal, postoperative periods, initial diagnosis, and radiographic findings, postoperative radiographic findings. The apical levels of the root fillings were 76.8% to apex, 19.0% underfilling, 3.9% overfilling. The following results were obtained. 1. Of the 93 teeth which revealed initial periapical rarefaction, 66 teeth(71.0%) had showed complete bone healing, 19 teeth (20.4%) decreased rarefaction, 6 teeth (6.5%) no change, 2 teeth (2.2%) increased rarefaction after 20.0 months mean healing time. 2. 21 teeth which had on initial periapical rarefaction showed no occurrence of new periapical rarefaction. 3. Of the 66 teeth completely healed, 53 teeth (80.3%) had showed reappearance of laminadura, 64 teeth (97.0%) reappearance of periodontal ligament space after 23.4 months mean healing time.

Evaluation of fracture resistance of endodontically treated teeth restored with prefabricated posts and composites with varying quantities of remaining coronal tooth structure Avaliação da resistência à fratura de dentes tratados endodonticamente restaurados com pinos pré-fabricados e resinas compostas variando o remanescente dentário coronal

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Murilo Pereira de Melo

2005-06-01

Full Text Available OBJECTIVES: The aim of this study was to evaluate the influence of remaining coronal tooth structure on endodontically treated teeth restored with prefabricated posts and two different composites for core build-up: dual-cured resin (Enforce Core and light-cured resin (Z-250. METHODS: Fourty freshly extracted canines were endodontically treated and divided into four groups: Group I - teeth with 3mm remaining coronal structure, restored with Enforce Core; Group II - teeth with 3mm remaining coronal structure, restored with Z-250; Group III - teeth with no remaining coronal structure, restored with Enforce; Group IV - teeth with no remaining coronal structure, restored with Z-250. After restoration, the teeth were embedded in acrylic resin and the fracture resistance was measured on a universal testing machine at 45 degrees to the long axis of the tooth until failure. RESULTS: Data were analyzed by two-way analysis of variance, which showed significant differences between groups (p=0.00. The Tukey test did not show significant differences between specimens with and without remaining coronal structure. Conversely, significant difference was observed between groups with different core build-up. The highest values of fracture resistance were found in the group restored with light-cured resin. SIGNIFICANCE: The remaining coronal tooth structure did not influence the resistance of endodontically treated teeth; however, the change of core build-up was able to modify this resistence.O objetivo desta pesquisa foi avaliar a influência do remanescente dentário coronal de dentes tratados endodonticamente, restaurados com pinos pré-fabricados e duas resinas como núcleos de preenchimento, uma de presa dual (Enforce Core e outra fotopolimerizável (Z-250. Foram utilizados 40 caninos superiores humanos extraídos, divididos em quatro grupos de 10 espécimes: Grupo l - com remanescente dentário coronal de 3mm e restaurados com Enforce Core; Grupo ll - com

EFFICACY OF DIFFERENT ENDODONTIC IRRIGATION PROTOCOLS IN CALCIUM HYDROXIDE REMOVAL

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Elka N. Radeva

2016-10-01

Full Text Available Introduction: Calcium hydroxide is widely used in the field of endodontics as a temporary root canal filling. This medicament significantly increases pH and optimizes the treatment outcome. Its total removal before final obturation is very important. Otherwise it could affect the hermetic filling and respectively the endodontic success. Aim: To evaluate the most effective irrigation protocol of calcium hydroxide removal from root canals. Materials and methods: In this study 36 single root canal teeth were observed. They were randomly divided into three groups (n=10 each group according to the technique applied for calcium hydroxide removal - manual irrigation, irrigation and Revo-S rotary instrumentation; and passive ultrasonic irrigation, and a control group (n=6 – irrigation with distilled water only. After calcium hydroxide removals following the procedures above, teeth were separated longitudinally in a buccal-lingual direction and remnants of medicaments were observed in the apical, middle and coronal part of each tooth. Then all of the specimens were observed using scanning electron microscopy and evaluated by a specified scale. The results have undergone statistical analysis. Results: In the case of calcium hydroxide in the apex and in the middle with highest average is Revo-S, followed by Ultrasonic and irrigation. In the coronal part the highest average belongs to Revo-S, irrigation and Ultrasonic. In all groups the highest average is represented by control group. Conclusion: There is not a universal technique for removal of intracanal medicaments and applying more than one protocol is required.

Effects of the Ratio between Pigment and Bleaching Gel on the Fracture Resistance and Dentin Microhardness of endodontically treated Teeth.

Science.gov (United States)

Galloza, Marina Og; Jordão-Basso, Keren Cf; Bandeca, Matheus C; Costa, Samuel O; Borges, Alvaro H; Tonetto, Mateus R; Tirintan, Fabio C; Keine, Kátia C; Kuga, Milton C

2017-11-01

The aim of this study was to evaluate the effects of bleaching gel using 35% hydrogen peroxide (HP), associated with red carmine pigment (RC), in the 3:1 or 1:1 ratio, on fracture resistance and dentin microhardness of endodontically treated teeth. A total of 40 lower incisors were endodontically treated and divided into four groups (n = 10), according to the bleaching protocol: G1 (HP3), 35% HP + RC (3:1); G2 (HP1), 35% HP + RC (1:1); G3 (positive), 38% HP; and G4 (negative), unbleached. Four dental bleaching sessions were performed. The dental crowns were restored after the last session and submitted to the fracture resistance test. Totally, 60 specimens from the endodontically treated lower incisor crowns were prepared to evaluate the effects on dentin microhardness. The analysis was measured (in Knoop) prior to and after the last dental bleaching session using similar bleaching protocols. G2 presented the lowest fracture resistance (p 0.05). No difference was observed in the reduction of dentin microhardness among the groups (p > 0.05). A 1:1 ratio (bleaching gel:pigment) caused a significant fracture resistance reduction in relation to the other protocols. No effect on the dentin microhardness reduction was observed. The pigment addition to the bleaching agent accelerates the bleaching chemical reaction. However, no studies have evaluated the ideal proportion to optimize tooth bleaching.

Equine corneal stromal abscesses

DEFF Research Database (Denmark)

Henriksen, M. D. L.; Andersen, P. H.; Plummer, C. E.

2013-01-01

The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal....... Medical and surgical treatments are now directed towards elimination of fungal and bacterial infections, reduction and replacement of diseased corneal stroma, and suppression of iridocyclitis. If the abscess and anterior uveitis do not respond satisfactorily to medical therapy, full thickness or split...

Ultrasonographic Findings of Periappendiceal Abscess

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Woo, Seong Ku; Sung, Dong Wook; Ko, Young Tae; Lim, Jae Hoon; Kim, Soon Yong [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1983-09-15

Although the ultrasonography has been regarded as a important procedure in the diagnosis of intra-abdominal abscess, there were relatively few papers concerning the ultrasonographic findings of perpendicular abscess. Nineteen cases of surgically proven perpendicular abscess caused by perforated appendicitis were studied by ultrasonography at the Kyung Hee University Hospital during last 34 months. The results were as follows: 1. Diagnostic accuracy of the real-time ultrasonography was 94.7% (18/19). There were only one false positive and one false negative. 2. The location of abscesses were; perpendicular 68.4% (13/19), pelvic 21.0% (4/19), sub hepatic 5.3% (1/19) and sub phrenic 5.3% (1/19) in order of frequency. 3. Variable echo-patterns of abscesses was encounted. But irregular, thick walled, posteriorly reinforcing, echo-free or mixed echo-patterns were most common.

[A lung abscess caused by bad teeth].

Science.gov (United States)

van Brummelen, S E; Melles, D; van der Eerden, M

2017-01-01

An odontogenic cause of a lung abscess can easily be overlooked. A 61-year-old man presented at the emergency department with a productive cough and dyspnoea. He was admitted to the pulmonary ward with a suspected odontogenic lung abscess. A thorax CT scan confirmed the diagnosis 'lung abscess', following which the dental surgeon confirmed that the lung abscess probably had an odontogenic cause. The patient made a full recovery following a 6-week course of antibiotics, and he received extensive dental treatment. Poor oral hygiene can be a cause of a lung abscess. A patient with a lung abscess can be treated successfully with a 6-week course of antibiotics; however, if the odontogenic cause is not recognised the abscess can recur.

Predictors of Primary Breast Abscesses and Recurrence

Science.gov (United States)

Bharat, Ankit; Gao, Feng; Aft, Rebecca L.; Gillanders, William E.; Eberlein, Timothy J.

2014-01-01

Background We investigated the patients and microbiological risk factors that predispose to the development of primary breast abscesses and subsequent recurrence. Methods Patients with a primary breast abscess requiring surgical therapy between January 1, 2000 and December 31, 2006 were reviewed. Recurrent breast abscess was defined by the need for repeated drainage within 6 months. Patient characteristics were compared to the general population and between groups. Results A total of 89 patients with a primary breast abscess were identified; 12 (14%) were lactational and 77 (86%) were nonlactational. None of the lactational abscesses recurred, whereas 43 (57%) of the nonlactational abscesses did so (P breast abscess were predominantly African American (64% vs. 12%), had higher rates of obesity (body mass index > 30: 43% vs. 22%), and were tobacco smokers (45% vs, 23%) (P breast abscesses had a higher incidence of mixed bacteria (20.5% vs. 8.9%), anaerobes (4.5% vs. 0%), and Proteus (9.1% vs. 4.4%) but lower incidence of Staphylococcus (4.6% vs. 24.4%) (P breast abscess include African American race, obesity, and tobacco smoking. Patients with recurrent breast abscesses are more likely to be smokers and have mixed bacterial and anaerobic infections. Broader antibiotic coverage should be considered for the higher risk groups. PMID:19669231

Bioactive Polymeric Composites for Tooth Mineral Regeneration: Physicochemical and Cellular Aspects

Science.gov (United States)

Skrtic, Drago; Antonucci, Joseph M.

2011-01-01

Our studies of amorphous calcium phosphate (ACP)-based dental materials are focused on the design of bioactive, non-degradable, biocompatible, polymeric composites derived from acrylic monomer systems and ACP by photochemical or chemically activated polymerization. Their intended uses include remineralizing bases/liners, orthodontic adhesives and/or endodontic sealers. The bioactivity of these materials originates from the propensity of ACP, once exposed to oral fluids, to release Ca and PO4 ions (building blocks of tooth and bone mineral) in a sustained manner while spontaneously converting to thermodynamically stable apatite. As a result of ACP's bioactivity, local Ca- and PO4-enriched environments are created with supersaturation conditions favorable for the regeneration of tooth mineral lost to decay or wear. Besides its applicative purpose, our research also seeks to expand the fundamental knowledge base of structure-composition-property relationships existing in these complex systems and identify the mechanisms that govern filler/polymer and composite/tooth interfacial phenomena. In addition to an extensive physicochemical evaluation, we also assess the leachability of the unreacted monomers and in vitro cellular responses to these types of dental materials. The systematic physicochemical and cellular assessments presented in this study typically provide model materials suitable for further animal and/or clinical testing. In addition to their potential dental clinical value, these studies suggest the future development of calcium phosphate-based biomaterials based on composite materials derived from biodegradable polymers and ACP, and designed primarily for general bone tissue regeneration. PMID:22102967

Tubercular breast abscess

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Pradeep S Jadhav

2013-01-01

Full Text Available Tubercular breast abscess is a rare clinical entity and affects women from mainly the Indian subcontinent. It often mimics breast carcinoma and pyogenic breast abscess clinically. Routine laboratory investigations are not helpful in the diagnosis. Fine needle aspiration cytology (FNAC or biopsy is essential for diagnosis, and tuberculous culture when positive may be very useful to start antitubercular treatment.

Evolving Trends in Endodontic Research: An Assessment of Published Articles in 2 Leading Endodontic Journals.

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Tzanetakis, Giorgos N; Stefopoulos, Spyridon; Loizides, Alexios L; Kakavetsos, Vasileios D; Kontakiotis, Evangelos G

2015-12-01

The aim of this study was to evaluate and analyze the evolving trends in endodontic research in 2 leading endodontic journals (ie, Journal of Endodontics and International Endodontic Journal) in articles published from January 2009 to December 2013. The differences in content between this period and a 10-year earlier period from January 1999 to December 2003 were also evaluated. Each journal's content was accessed through the web edition. For each article, the following parameters were recorded: number of authors, article type, number of affiliations, field of study, source of article, and geographic origin. The recorded data were analyzed using both descriptive and analytic statistics. During 2009-2013 (second period), the mean number of authors per article increased significantly compared with 1999-2003 (first period). The main volume of the literature in both periods and journals was original research articles. The number of published reviews increased significantly from the first to the second study period in contrast to case reports/clinical articles, which presented a significant decrease. "Endodontic materials" was the most prevalent thematic category in both study periods. The number of published articles related to "biology" and "chemical preparation and disinfection" increased significantly from the first to the second study period. On the contrary, the number of articles regarding "obturation and microleakage" presented a considerable decrease at the same time. The United States was the leading country in the number of publications in the first period followed by Brazil. In the second period, this rank was reversed with Brazil becoming the leading country followed by the United States. In the last 15 years, the progress of the specialty of endodontology was apparent as shown through the trends and shifts in research orientation in published articles in the 2 leading endodontic journals. The results of the present reviewing process encourage both journals

Thyroid abscess following traumatic intubation

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Marc A. Polacco, MD

2017-09-01

Full Text Available Thyroid abscess is a rare condition, and consequently diagnosis is often delayed. Causes include 3rd and 4th branchial cleft anomalies, hematogenous spread of infection, trauma from esophageal foreign body, and fine needle aspiration. Thyroid abscesses carry potential morbidity with thyroid and parathyroid gland destruction, tracheal compression, tracheal or esophageal fistula, internal jugular vein thrombophlebitis, and sepsis. The authors report a case of a 33-year old woman with a thyroid abscess following traumatic intubation. Thyroid abscess should be considered in patients presenting with anterior neck pain and swelling with a recent history of traumatic intubation, ultrasound or CT with contrast being the ideal diagnostic modalities.

Brain Abscess after Esophageal Dilatation

DEFF Research Database (Denmark)

Gaïni, S; Grand, M; Michelsen, J

2007-01-01

Brain abscess formation is a serious disease often seen as a complication to other diseases and to procedures. A rare predisposing condition is dilatation therapy of esophageal strictures. A case of brain abscess formation after esophageal dilatations is presented. A 59-year-old woman was admitted...... with malaise, progressive lethargy, fever, aphasia and hemiparesis. Six days before she had been treated with esophageal dilatation for a stricture caused by accidental ingestion of caustic soda. The brain abscess was treated with surgery and antibiotics. She recovered completely. This clinical case...... illustrates the possible association between therapeutic esophageal dilatation and the risk of brain abscess formation....

Regenerative endodontics: barriers and strategies for clinical translation.

Science.gov (United States)

Mao, Jeremy J; Kim, Sahng G; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y; Yang, Rujing; Zhou, Xuedong

2012-07-01

Regenerative endodontics has encountered substantial challenges toward clinical translation. The adoption by the American Dental Association of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for most endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other organ systems has not led to clinical translation in regeneration endodontics. Recent work using novel biomaterial scaffolds and growth factors that orchestrate the homing of host endogenous cells represents a departure from traditional cell transplantation approaches and may accelerate clinical translation. Copyright © 2012 Elsevier Inc. All rights reserved.

Advances in endodontics: Potential applications in clinical practice

Science.gov (United States)

Kishen, Anil; Peters, Ove A.; Zehnder, Matthias; Diogenes, Anibal R.; Nair, Madhu K.

2016-01-01

Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

Analysis of the rate of maturogenesis of a traumatized Cvek′s stage 3 anterior tooth treated with platelet-rich fibrin as a regenerative tool using three-dimensional cone-beam computed tomography: An original case report

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Raji Viola Solomon

2015-01-01

Full Text Available Regenerative endodontic procedures are biologically based procedures which deal with the regeneration of pulp-like tissue, more idealistically the pulp-dentin complex. The regeneration of this pulp-dentin complex in an infected necrotic tooth with an open apex is possible only when the canal is effectively disinfected. Though there are various procedures for treating open apex ranging from Ca(OH 2 apexification, mineral trioxide aggregate apexification and surgical approach, regeneration of tissues has always taken superior hand over the repair of tissues. The mechanics behind the regenerative endodontic procedures is that despite the tooth being necrotic, some pulp tissue can survive apically which under favorable conditions proliferate to aid in the process of regeneration. In the past 2 decades, an increased understanding of the physiological roles of platelets in wound healing and after tissue injury has led to the idea of using platelets as therapeutic tools in the field regenerative endodontics. In the present case report with an open apex, high sterilization protocol is followed using triple antibiotic paste as intra-canal medicament, followed which platelet rich fibrin is used as the regenerative material of choice. Over an 18-month follow-up period, clinically patient is asymptomatic and radiographically there is complete regression of the periapical lesion and initiation of the root end closure.

Persistent extraradicular infection in root-filled asymptomatic human tooth: scanning electron microscopic analysis and microbial investigation after apical microsurgery.

Science.gov (United States)

Signoretti, Fernanda G C; Endo, Marcos S; Gomes, Brenda P F A; Montagner, Francisco; Tosello, Fernanda B; Jacinto, Rogério C

2011-12-01

Procedural accidents have a negative effect on healing and might contribute to the persistence of infections in inaccessible apical areas, requiring surgical intervention. This report describes a case of persistent apical periodontitis of a lower left first molar associated with the sinus tract and a periapical lesion that required nonsurgical endodontic retreatment and apical surgery for resolution. The tooth had received endodontic treatment 3 years ago and had to be retreated using the crown-down technique with chemical auxiliary substance (2% chlorhexidine gel), foramen patency, and enlargement and was filled in a single appointment. The occlusal access cavity was immediately restored with composite resin. After 1 month, it could be observed that the sinus tract persisted and, radiographically, the lesion remained unaltered. Therefore, endodontic microsurgery was indicated. Apical microsurgery was performed under magnification with the use of a dental operating microscope including apicectomy, root end with ultrasound, and sealing with mineral trioxide aggregate. A microbiological sample was collected from the apical lesion. The resected distal root apex was observed by scanning electron microscopy. The following species were detected: Actinomyces naeslundii and Actinomyces meyeri, Propionibacterium propionicum, Clostridium botullinum, Parvimonas micra, and Bacteroides ureolyticus; scanning electron microscopic analysis revealed bacterial biofilm surrounding the apical foramen and external radicular surface. Gutta-percha overfilling at the apex because of a zip caused during initial endodontic treatment could be observed. A 6-month follow-up showed apparent radiographic periapical healing, which progressed after 24 months. Gram-positive anaerobic bacteria and extraradicular biofilm seem to participate in the maintenance of persistent periapical pathology, and endodontic retreatment followed by periapical microsurgery proved to be a successful alternative in the

Imaging Techniques in Endodontics: An Overview

Science.gov (United States)

Deepak, B. S.; Subash, T. S.; Narmatha, V. J.; Anamika, T.; Snehil, T. K.; Nandini, D. B.

2012-01-01

This review provides an overview of the relevance of imaging techniques such as, computed tomography, cone beam computed tomography, and ultrasound, to endodontic practice. Many limitations of the conventional radiographic techniques have been overcome by the newer methods. Advantages and disadvantages of various imaging techniques in endodontic practice are also discussed. PMID:22530184

One step pulp revascularization treatment of an immature permanent tooth with chronic apical abscess: a case report.

Science.gov (United States)

Shin, S Y; Albert, J S; Mortman, R E

2009-12-01

To describe a case in which a mandibular right second premolar with a necrotic pulp, sinus tract, periradicular radiolucency and an immature apex underwent revascularization via a single treatment approach. Revascularization procedures have the potential to heal a partially necrotic pulp, which can be beneficial for the continued root development of immature teeth. However, it is not clear which revascularization protocols are the most effective. This case report details the outcome of a successful revascularization procedure on tooth 45 (FDI) in a 12-year-old patient, eliminating the associated periapical pathosis within 19 months. The tooth was treated using coronal root irrigation with 6% NaOCl and 2% chlorhexidine without instrumentation in a single visit. The successful outcome of this case report suggests that this conservative revascularization treatment approach can preserve the vitality of the dental pulp stem cells and create a suitable environment for pulp regeneration, resulting in the completion of root maturation. The noninstrumentation procedure using 6% NaOCl and 2% chlorhexidine coronal irrigation may help preserve the remaining vital dental pulp stem cells believed to be critical for pulp revascularization. A single visit pulp revascularization protocol can be a favourable treatment option for an immature permanent tooth with a partially necrotic pulp.

Percutaneous transhepatic drainage of lung abscess through a diaphragmatic fistula caused by a penetrating liver abscess.

Science.gov (United States)

Taniguchi, Masako; Morita, Satoru; Ueno, Eiko; Hayashi, Mitsutoshi; Ishikawa, Motonao; Mae, Masahiro

2011-11-01

Liver abscesses occurring just below the diaphragm can penetrate or perforate the thoracic cavity, resulting in lung abscess or pyothorax. Although surgical or percutaneous transpleural drainage is often required in such cases, the latter approach has some risks, including hemothorax and bronchopleural fistula formation when the cavity is surrounded by normal lung parenchyma. The present report describes a treatment technique of percutaneous transhepatic drainage through the diaphragmatic fistula to avoid the risks of a transpulmonary approach in a case of lung abscess caused by a penetrating liver abscess.

The interventional therapy of lung abscess

International Nuclear Information System (INIS)

Huang Changcen

2000-01-01

Objective: To observe the therapeutic effect of chronic lung abscess by interventional therapy under CT guidance. Methods: The group consisted of 12 patients. Firstly, the positions of abscess were localized by CT, secondly under CT guidance puncturing into the abscess with a needle and then thirdly, drain aging through the abscess and injecting some antibiotics through the needle. The treatment consisted by 16 times with an average drawing volume out 10-100 ml, during 18-28 days as a course. All patients were cured. Conclusion: The interventional therapy under CT guidance for chronic lung abscess can increase the therapeutic effect, decrease the course of treatment and avoid the operation. Therefore, it is a safe, simple and convenient method

ULTRASONOGRAPHIC EVALUATION OF AMOEBIC LIVER ABSCESS

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Nagesh

2016-04-01

Full Text Available AIMS To study the role of ultrasonography in the diagnosis, followup, resolution and percutaneous interventions of amoebic liver abscesses. METHODOLOGY 25 patients with 38 amoebic liver abscesses were included in this study. The diagnostic criteria being compatible history, tender and enlarged liver, radiological and ultrasound findings and response to metronidazole therapy. Confirmed cases of amoebic liver abscesses were followed up by ultrasonography till complete resolution. RESULTS The highest incidence of age was seen between 3 rd and 5 th decades (84% with a male sex incidence of 92%, disease preponderance in people belonging to low socioeconomic group and a high incidence among alcoholics. The radiological findings were: Elevation of right dome of diaphragm (56%, restricted diaphragmatic movements (88%, right basal lung changes (48%, right pleural effusion (12%, and indistinct hazy diaphragmatic contour (40%. The ultrasonographic findings were: 87% of the abscesses were located in right lobe, 11% in left lobe and 2% in both lobes. Among the 25 patients, 76% showed solitary and 24% showed multiple abscesses. Of the 38 amoebic abscesses, 79% were hypoechoic, 13% were hyperechoic and 8% were anechoic. 11 patients were subjected for ultrasound-guided aspiration. CONCLUSION Ultrasound is a safe, reliable and non-invasive imaging modality for the diagnosis, followup and percutaneous interventions of amoebic liver abscesses. The sonographic resolution time of amoebic liver abscesses varies from 28 to 286 days.

Ultrasonographic Findings of Breast Abscess

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Shin, Hyeong Cheol; Oh, Ki Keun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1995-06-15

Breast abscess cannot be differentiated from breast malignancy by film mammography. Pain and spread of infection can be developed during film mammography procedure due to compression. However, ultrasonography is known to be an adequate procedure for diagnosis of breast abscesses. Therefore, we performed the present study to document the ultrasonographic findings of breast abscess. We analyzed ultrasonograms of ninexases with surgically proven breast abscesses. All patients were female and their ages ranged from l2 to 56 years(average, 35 years). The lesion was located in the right breast in four cases, and in the left in five cases. On ultrasonography, all lesions were anechoic or low echoic. The lesion showed mixed echogenicityin five cases. Posterior acoustic enhancement was noted in seven cases. Lateral shadowing was seen in four cases.There were skin thickening in five cases and subcutaneous fat obliteration in all cases. Ultrasonography is useful in the diagnosis of breast abscess

Ultrasonographic Findings of Breast Abscess

International Nuclear Information System (INIS)

Shin, Hyeong Cheol; Oh, Ki Keun

1995-01-01

Breast abscess cannot be differentiated from breast malignancy by film mammography. Pain and spread of infection can be developed during film mammography procedure due to compression. However, ultrasonography is known to be an adequate procedure for diagnosis of breast abscesses. Therefore, we performed the present study to document the ultrasonographic findings of breast abscess. We analyzed ultrasonograms of ninexases with surgically proven breast abscesses. All patients were female and their ages ranged from l2 to 56 years(average, 35 years). The lesion was located in the right breast in four cases, and in the left in five cases. On ultrasonography, all lesions were anechoic or low echoic. The lesion showed mixed echogenicityin five cases. Posterior acoustic enhancement was noted in seven cases. Lateral shadowing was seen in four cases.There were skin thickening in five cases and subcutaneous fat obliteration in all cases. Ultrasonography is useful in the diagnosis of breast abscess

Dental abscess: A microbiological review

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Shweta

2013-01-01

Full Text Available Dental abscess is a frequently occurring infectious process known to the health practice. The fate of the infection depends on the virulence of the bacteria, host resistance factors, and regional anatomy. Serious consequences arising from the spread of a dental abscess lead to significant morbidity and mortality. Acute dental abscess is polymicrobial, comprising of strict anaerobes, such as anaerobic cocci, Prevotella, Fusobacterium species, and facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group. Numerous novel, uncultivable and fastidious organisms have been identified as potential pathogens with the use of non-culture techniques. The majority of localized dental abscesses respond to surgical treatment while the use of antimicrobials is limited to severe spreading infections. There is a need for good-quality clinical trials of sufficient size to identify the ideal treatment. The microbiology of the acute dentoalveolar abscess and its treatment in the light of improved culture and diagnostic methods are reviewed.

Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

Science.gov (United States)

Kitagawa, Yoshimasa; Sano, Kazuo; Nakamura, Mikiko; Ogasawara, Toshiyuki

2003-04-01

This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. Root resorption did not occur, and good functional results were obtained without any complications. Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.

Regenerative Endodontics: Barriers and Strategies for Clinical Translation

OpenAIRE

Kim, Sahng G.; Zhou, Jian; Ye, Ling; Cho, Shoko; Suzuki, Takahiro; Fu, Susan Y.; Yang, Rujing; Zhou, Xuedong; Mao, Jeremy J.

2012-01-01

Despite a great deal of enthusiasm and effort, regenerative endodontics has encountered substantial challenges towards clinical translation. Recent adoption by the American Dental Association (ADA) of evoked pulp bleeding in immature permanent teeth is an important step for regenerative endodontics. However, there is no regenerative therapy for the majority of endodontic diseases. Simple recapitulation of cell therapy and tissue engineering strategies that are under development for other orga...

Brain abscess: surgical experiences of 162 cases

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Forhad Hossain Chowdhury

2015-01-01

Full Text Available Aim: Brain abscess still poses a public health challenge in spite of the advent of modern neurosurgical techniques and antibiotics. Here, we present our surgical experiences and ultimate outcome in the management of brain abscess. Methods: Totally, 162 patients with proved brain abscess who underwent surgical treatment were included in this study. The prospectively recorded data of surgical management of brain abscess and the ultimate outcome (by Glasgow outcome scale were studied retrospectively. Results: Total number of cases was 162, of which 113 were acute pyogenic abscess while 49 were chronic abscess. Among the chronic abscess, 29 were chronic pyogenic abscess, 14 were tubercular, 3 aspergillus, and 3 abscesses were in malignant brain metastases. In acute cases, common clinical features were headache, fever, vomiting, focal deficit and seizure. In chronic abscesses, common clinical features were mild to moderate headache and progressive focal deficit. Seventy-three (45.06% patients had adjacent localized sinus, middle ear or cranial infection. The common predisposing factors included postneurosurgery, postpenetrating injury to brain, chronic suppurative otitis media, and congenital heart disease, infective endocarditis, sinusitis and sub optimum immuno-status. Frontal lobe involved in 30.2% cases, temporal lobe is next to involved. Single time burr hole aspiration in 111 (68.5% cases, two or more times burr hole aspiration were done in 34 (21% cases. Pus culture was negative in 129 (79.62% cases. Total number of death was 22 (13.58% cases. Complete resolution of abscess with complete recovery of preoperative neuro-deficit was seen in 80.86% cases and recovery with major neuro-deficit was observed in 5.55% cases. There is a significant association between Glasgow coma scale (GCS on admission and mortality in brain abscess. Conclusion: In most of the cases, pus culture did not yield growth of any causative organism. Mortality was not

The effect of post material on the characteristic strength of fatigued endodontically treated teeth.

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Pereira, Jefferson Ricardo; do Valle, Accácio Lins; Shiratori, Fabio Kenji; Ghizoni, Janaina Salomon; Bonfante, Estevam Augusto

2014-11-01

The biomechanical properties of post systems may become more important as the amount of remaining tooth structure decreases, thus different materials may influence the characteristic strength of fatigued endodontically treated teeth. The purpose of this study was to assess the characteristic strength and probability of survival of endodontically treated teeth restored with different intraradicular post systems. Forty human maxillary canines with similar root lengths were randomly divided into 4 groups (n=10): cast post and core, stainless-steel prefabricated post, carbon-fiber post, and glass-fiber post. Cores and metallic crowns were fabricated for all specimens. Restored teeth were exposed to mechanical fatigue (250,000 cycles) in a controlled chewing simulator. Each intact specimen was mounted in a special device and aligned at a 45-degree angle to the long axis of the tooth. A universal testing machine was used to apply a static load at a crosshead speed of 0.5 mm/min until specimen failure. The maximum value was recorded in newtons (N). Probability Weibull curves (2-sided 90% confidence bounds) were calculated for each group, and a probability of survival as a function of load at failure was plotted for the groups. A significantly higher characteristic strength was observed for groups carbon-fiber post (755.82 N) and cast post and core (750.6 N) (P<.05) compared with glass-fiber post (461.35 N) and stainless-steel prefabricated post (524.78 N) groups. All the roots in the cast post and core group demonstrated catastrophic fracture, whereas the remaining groups had no root fractures. Prefabricated posts made of glass fiber and stainless steel showed significantly lower characteristic strength and probability of survival than cast post and core, whereas crowns with carbon-fiber posts presented a single load similar to the fracture values of cast posts. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All

A systematic review of nonsurgical single-visit versus multiple-visit endodontic treatment

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Wong AWY

2014-05-01

Full Text Available Amy WY Wong, Chengfei Zhang, Chun-hung Chu Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China Abstract: Conventional endodontic treatment used to require multiple visits, but some clinicians have suggested that single-visit treatment is superior. Single-visit endodontic treatment and multiple-visit endodontic treatment both have their advantages and disadvantages. This paper is a literature review of the research on nonsurgical single-visit versus multiple-visit endodontic treatment. The PubMed database was searched using the keywords (endodontic treatment OR endodontic therapy OR root canal treatment OR root canal therapy AND (single-visit OR one-visit OR 1-visit. Review papers, case reports, data studies, and irrelevant reports were excluded, and 47 papers on clinical trials were reviewed. The studies generally had small sample sizes, and the endodontic procedures varied among the studies. Meta-analysis on the selected studies was performed, and the results showed that the postoperative complications of the single-visit and multiple-visit endodontic treatment were similar. Furthermore, neither single-visit endodontic treatment nor multiple-visit treatment had superior results over the other in terms of healing or success rate. Results of limited studies on disinfection of the root canals using low-energy laser photodynamic therapy is inconclusive, and further studies are necessary to show whether laser should be used in endodontic treatment. This review also found that that neither single-visit endodontic treatment nor multiple-visit treatment could guarantee the absence of postoperative pain. Since the study design of many studies displayed significant limitation and the materials and equipment used in endodontic treatment have dramatically changed in recent years, prospective randomized clinical trials are needed to further verify the postoperative pain and success rates of

Endodontic microsurgery, presentation of a clinical case

International Nuclear Information System (INIS)

Zeledon Mayorga, Rodolfo

2009-01-01

A literature review is conducted on endodontic surgery. The report of a clinical case is facilitated. The technique chosen according to the clinical and radiographic examination was endodontic microsurgery, the case has presented a positive evolution of four years [es

The flare-up phenomenon in endodontics: a clinical perspective and review.

Science.gov (United States)

Matusow, R J

1988-06-01

The acute endodontic cellulitis exacerbation, which can be potentially fatal, is a definitive entity in endodontic flare-ups. Aerobic microbes, particularly streptococci, are the predominant causative microbes isolated. There was a noticeable absence of obligate anaerobes. This is significant for the selection of an antibiotic for therapy. Treatment parameters were presented. An endodontic cellulitis exacerbation is most unlikely with obligate anaerobes. An endodontic flare-up perspective was attempted with some clinical parameters. The proponents of routine one-visit endodontic treatment with prophylactic drugs to prevent cellulitis exacerbations do not appear to offer any advantage to the more traditional approaches to endodontic treatment of the patient, which may be more beneficial.

Recurrent periodontal abscess associated with “teeth as a tool”

Science.gov (United States)

Bhat, G. Subraya; Singh, Vishal; Bhat, K. Mahalinga

2012-01-01

We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology. PMID:22628975

Hepatic abscess versus peripheral cholangiocarcinoma: Sonographic differentiation

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Chung, Hwan Hoon; Kim, Yun Hwan; Kang, Chang Ho; Chung, Kyoo Byung; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of); Lee, Chang Hee [Kunkuk University College of Medicine, Chung-Ju Hospital, Chung-Ju (Korea, Republic of)

2000-12-15

To find out the sonographic findings that are useful to differentiate hepatic abscess from peripheral cholangiocarcinoma. Twenty-two hepatic abscesses and 22 peripheral cholangiocarcinomas which had been confirmed histologically were included in this study. Objective points were echo characteristics of the lesion, internal septation, presence of peripheral low echoic rim, demarcation from normal liver(well or poorly defined), posterior enhancement, multiplicity, dilatation of bile duct(obstructive or non-obstructive), intrahepatic duct stone, pleural effusion, and intra-abdominal fluid collection. Echo characteristics of the lesion were classified in-to four types. Type I; Predominantly echogenic with hypoechoic portion, type II; Echogenic without hypoechoic portion, type III; Predominantly hypoechoic with echogenic portion, type IV; Hypoechoic without echogenic portion. 1)Nine abscesses and 2 peripheral cholangiocarcinomas were type I(p=0.037), 2)One abscess and 18 peripheral cholangiocarcinomas were type II(p=0.001), 3)Seven abscesses and none of peripheral cholangiocarcinomas were type III(p=0.001), 4)Five abscesses and 2 peripheral cholangiocarcinomas were type IV(p=0.410). Only 7 abscesses showed internal septations(p=0.013). One abscess and 9 peripheral cholangiocarcinomas showed peripheral hypoechoic halos(p=0.012). Only 9 peripheral cholangiocarcinomas showed obstructive bile duct dilatation (p=0.001). There were no statistically significant differences between abscess and peripheral cholangiocarcinoma on other objective points. Predominantly echogenic with hypoechoic portion, predominantly hypoechoic with echogenic portion, and internal septation are the features suggestive of hepatic abscess, and echogenic without hypoechoic portion, peripheral hypoechoic halo, obstructive bile duct dilatation are suggestive of peripheral cholangiocarcinoma. Therefore these sonographic findings are helpful to differentiate hepatic abscess from peripheral

Problems associated with the diagnosis and treatment of endodontic disease

International Nuclear Information System (INIS)

Emily, P.

1990-01-01

The diagnosis of endodontic lesions in animal dentistry is complicated and restricted by the use of objective diagnostic procedures. Human endodontics uses subjective symptoms to a large degree, as well as objective symptoms. Subjective symptoms include patient pain; sensitivity to hot or cold; percussion; and foul taste or odor. Veterinary dentists must receive input from clients, as well as using their own clinical and radiographic evaluation. Many endodontic lesions remain undetected because the client fails to notice broken or discolored teeth, facial swelling, drooling, difficulty in chewing, chewing only on one side, and general malaise. An increased awareness of the endodontic problems that can occur in animals increases the level of veterinary care. Numerous techniques, including apexogenesis, apexification, direct and indirect pulp capping, and conventional and surgical endodontic therapy, can be used to treat various endodontic problems successfully

Management of peritonsillar abscess

African Journals Online (AJOL)

Management of peritonsillar abscess at Harare. The optimal management of PTA is still a. Central Hospital Central Afr J Med 1990; 36: 187-90. controversial subject in otolaryngology. 8 Stronger SP, Schaefer SD, Close IS. A randomized trial for outpatient management of peritonsillar abscess. The generally accepted classic ...

Percutaneous drainage of chest abscesses in children

International Nuclear Information System (INIS)

Ball, W.S. Jr.; Towbin, R.B.; Bisset, G.S. III.

1987-01-01

Similar techniques for draining abdominal abscesses are now being applied to abscesses within the chest. This report describes the authors' experience in percutaneous drainage of seven chest abscesses in six children aged 3-13 years (mean, 7.3 years). Four pleural/extrapleural loculations were drained in three patients. Abscess location included right apex (one), right minor fissure (one), and left supradiaphragmatic (two). Collections resulted from esophageal perforation (two) or esophageal anastomotic leak (two). Three lung abscesses were drained in three patients. Abscess location included right lower, left lower, and right middle lobes. All lay adjacent to a pleural surface and were localized by CT or US before drainage. There were no complications. Complete resolution occurred in all six patients without the need for surgical intervention

Endodontics and the ageing patient.

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Johnstone, M; Parashos, P

2015-03-01

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. © 2015 Australian Dental Association.

Splenic abscess: a rare presentation

Directory of Open Access Journals (Sweden)

Mohit Bhatia

2015-01-01

Full Text Available Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies. When untreated, splenic abscess is associated with nearly 100% mortality; in treated patients, the mortality rate is 16.6% during the first 90 days. It mostly occurs in patients with neoplasia, immunodeficiency, trauma, diabetes or splenic infarct. The incidence of splenic abscess is thought to be growing because of the increase in the number of immunocompromised patients who are particularly at risk for this disease and also because of the widespread use of diagnostic modalities. However, the optimal treatment for this remains unclear. We present a case of a 42-year-old man diagnosed with multiloculated splenic abscess and was subjected to splenectomy.

Pulmonary abscess

International Nuclear Information System (INIS)

Valencia Chavez, Maria de la Cruz

2000-01-01

Pulmonary abscess is defined as a suppurative process and bounded, caused by piogens organisms that it progresses to central necrosis and it commits an or more areas of the pulmonary parenchyma. Initially it is impossible to differ of a located pneumonia, but when the lesion communicates with a bronchus, part of the neurotic tissue is replaced by air, producing the classic image radiological fluid-air. The presence of multiple lesions smaller than 2 cms of diameter cm is defined arbitrarily as necrotizing pneumonia it is indistinguishable of an abscess. The paper includes the pathogenesis and etiology, clinical course, diagnostic and treatment

[Bacterial brain abscess--experiences with 67 patients].

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Berlit, P; Fedel, C; Tornow, K; Schmiedek, P

1996-08-01

Sixty-seven patients with brain abscess were managed over 19 years (1975-1993). Our series had a 2.5 to 1 male predominance; the age distribution was from 3 days to 81 years. The underlying conditions of hematogenic brain abscesses (n = 33; 49%) included lung infections (n = 16), heart disease (n = 4), sepsis (n = 10), and other foci (n = 3). Otolaryngologic infections led to the abscess in 10 cases; there were 9 traumatic abscesses. The causes remained unknown in 15 cases. There were 47 solitary abscesses (70%) and 20 multiple abscesses. The most frequent presenting signs and symptoms were neurologic deficits (n = 17), disturbances of consciousness (n = 14), seizures (n = 6), and headaches, meningism and vomiting (n = 13). Causative organisms were isolated in 39 cases (58%) and included staphylococci (n = 6), streptococci (n = 6), enterobacteriae (n = 2), and anaerobic pathogens (n = 9). The most reliable laboratory sign of inflammation was an elevated ESR (52/59 patients). With the advent of computed tomography, burr hole aspiration of the abscess with or without drainage was possible in 30 cases; the mortality in this subgroup was 9%. All 4 patients with surgical excision in the pre CT-era died. The mortality of patients treated with antibiotics only was 62% (18/29). Overall mortality was 37% (25/67), including 5 cases with post mortem-diagnosis of brain abscess. Good recovery was achieved in 29/42 survivors. Predictors of a poor outcome were the patient's age, the level of consciousness, multiple abscesses, polybacterial cultures, and a hematogenic etiology, but not the size of the abscess.

Cone beam computed tomography in endodontic

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Durack, Conor; Patel, Shanon [Unit of Endodontology, Department of Conservative Dentistry, King' s College London, London (United Kingdom)

2012-07-01

Cone beam computed tomography (CBCT) is a contemporary, radiological imaging system designed specifically for use on the maxillofacial skeleton. The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontic. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The purpose of this paper is to review the current literature relating to the limitations and potential applications of CBCT in endodontic practice. (author)

Cone beam computed tomography in endodontic

International Nuclear Information System (INIS)

Durack, Conor; Patel, Shanon

2012-01-01

Cone beam computed tomography (CBCT) is a contemporary, radiological imaging system designed specifically for use on the maxillofacial skeleton. The system overcomes many of the limitations of conventional radiography by producing undistorted, three-dimensional images of the area under examination. These properties make this form of imaging particularly suitable for use in endodontic. The clinician can obtain an enhanced appreciation of the anatomy being assessed, leading to an improvement in the detection of endodontic disease and resulting in more effective treatment planning. In addition, CBCT operates with a significantly lower effective radiation dose when compared with conventional computed tomography (CT). The purpose of this paper is to review the current literature relating to the limitations and potential applications of CBCT in endodontic practice. (author)

Regeneration and Repair in Endodontics—A Special Issue of the Regenerative Endodontics—A New Era in Clinical Endodontics

Science.gov (United States)

Saoud, Tarek Mohamed A.; Ricucci, Domenico; Lin, Louis M.; Gaengler, Peter

2016-01-01

Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former

Regeneration and Repair in Endodontics—A Special Issue of the Regenerative Endodontics—A New Era in Clinical Endodontics

Directory of Open Access Journals (Sweden)

Tarek Mohamed A. Saoud

2016-02-01

Full Text Available Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals

Bisphosphonates and their clinical implications in endodontic therapy.

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Moinzadeh, A-T; Shemesh, H; Neirynck, N A M; Aubert, C; Wesselink, P R

2013-05-01

This review gives an overview of the factors that may play a role in the development of osteonecrosis of the jaw in patients treated with bisphosphonates (BPs) and undergoing nonsurgical endodontic treatment as well as some recommendations for its prevention. BPs are a widely prescribed group of drugs for diverse bone diseases. The occasional but devastating adverse effect of these drugs has been described as bisphosphonate-related osteonecrosis of the jaw (BRONJ). As this condition is debilitating and difficult to treat, all efforts should be made to prevent its occurence in patients at risk. The main triggering event is considered to be dental extraction. Even though nonsurgical endodontic treatment appears to be a relatively safe procedure, care remains essential. After an overview of this class of drugs, the clinical presentation, epidemiology and pathogenesis of BRONJ, as well as the possible risk factors associated with its development after nonsurgical endodontic treatment will be described. Finally, several strategies will be proposed for the prevention of BRONJ during nonsurgical endodontic treatment. © 2012 International Endodontic Journal. Published by Blackwell Publishing Ltd.

3D Computer aided treatment planning in endodontics.

Science.gov (United States)

van der Meer, Wicher J; Vissink, Arjan; Ng, Yuan Ling; Gulabivala, Kishor

2016-02-01

Obliteration of the root canal system due to accelerated dentinogenesis and dystrophic calcification can challenge the achievement of root canal treatment goals. This paper describes the application of 3D digital mapping technology for predictable navigation of obliterated canal systems during root canal treatment to avoid iatrogenic damage of the root. Digital endodontic treatment planning for anterior teeth with severely obliterated root canal systems was accomplished with the aid of computer software, based on cone beam computer tomography (CBCT) scans and intra-oral scans of the dentition. On the basis of these scans, endodontic guides were created for the planned treatment through digital designing and rapid prototyping fabrication. The custom-made guides allowed for an uncomplicated and predictable canal location and management. The method of digital designing and rapid prototyping of endodontic guides allows for reliable and predictable location of root canals of teeth with calcifically metamorphosed root canal systems. The endodontic directional guide facilitates difficult endodontic treatments at little additional cost. Copyright © 2016. Published by Elsevier Ltd.

Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens in endodontic lesions detected by culture and by PCR.

Science.gov (United States)

Gomes, B P F A; Jacinto, R C; Pinheiro, E T; Sousa, E L R; Zaia, A A; Ferraz, C C R; Souza-Filho, F J

2005-08-01

he aim of this study was to investigate the presence of four black-pigmented bacteria, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia and Prevotella nigrescens, in endodontic infections by culture and polymerase chain reaction (PCR) analyses. Microbial samples were obtained from 50 teeth with untreated necrotic pulps (primary infection) and from 50 teeth with failing endodontic treatment (secondary infection). Microbiological strict anaerobic techniques were used for serial dilution, plating, incubation, and identification. For PCR detection, the samples were analyzed using species-specific primers of 16S rDNA and the downstream intergenic spacer region. Culture and PCR detected the test species in 13/100 and 50/100 of the study teeth, respectively. The organisms were cultured from 11/50 (22%) of primarily infected root canal samples and from 2/50 (4%) of secondary root canal samples. PCR detection identified the target species in 32/50 (64%) and 18/50 (36%) of primary and secondary infections, respectively. P. gingivalis was rarely isolated by culture methods (1%), but was the most frequently identified test species by PCR (38%). Similarly, P. endodontalis was not recovered by culture from any tooth studied, but was detected by PCR in 25% of the sampled teeth. PCR-based identification also showed higher detection rates of P. intermedia (33%) and P. nigrescens (22%) than culture (13%). In conclusion, P. gingivalis, P. endodontalis, P. intermedia, and P. nigrescens were identified more frequently in teeth with necrotic pulp than in teeth with failing endodontic treatment. Also, a higher frequency of black-pigmented species was detected by PCR than by culture.

Computed tomography in epidural abscess, subdural empyema, meningitis, and brain abscess

International Nuclear Information System (INIS)

Schadel, A.; Boettcher, H.D.; Haverkamp, U.; Wagner, W.; Schmilowski, G.M.; Muenster Univ.

1983-01-01

Computerised tomography cannot be of great help in diagnosing meningitis. Examination of the cerebrospinal fluid remains essential. After the inflammation of the meninges has progressed to some stage of encephalitis, the formation of an abscess can be located via computed tomography. It is characterised by the ring-type abscess capsule. Computed tomography for diagnostic purposes is superior to cerebral scanning, which demonstrates enhanced activity, but does not show the formation of a membrane, so essential for differential diagnosis. Furthermore, computed tomography shows the adjacent anatomical structures and answers the questions of displacements and threatening invasion of the ventricle system. Epidural and subdural abscesses can also be located by computed tomography. Therapy can begin directly after computerised tomography, whereas in scintigraphy only a non-specific enhanced activity is present, which often does not allow differentiation between epidural and subdural location. (orig.) [de

Photodynamic therapy in endodontics: a literature review.

Science.gov (United States)

Trindade, Alessandra Cesar; De Figueiredo, José Antônio Poli; Steier, Liviu; Weber, João Batista Blessmann

2015-03-01

Recently, several in vitro and in vivo studies demonstrated promising results about the use of photodynamic therapy during root canal system disinfection. However, there is no consensus on a standard protocol for its incorporation during root canal treatment. The purpose of this study was to summarize the results of research on photodynamic therapy in endodontics published in peer-reviewed journals. A review of pertinent literature was conducted using the PubMed database, and data obtained were categorized into sections in terms of relevant topics. Studies conducted in recent years highlighted the antimicrobial potential of photodynamic therapy in endodontics. However, most of these studies were not able to confirm a significant improvement in root canal disinfection for photodynamic therapy as a substitute for current disinfection methods. Its indication as an excellent adjunct to conventional endodontic therapy is well documented, however. Data suggest the need for protocol adjustments or new photosensitizer formulations to enhance photodynamic therapy predictability in endodontics.

CT manifestations of liver abscess

International Nuclear Information System (INIS)

Yan Jianfeng; Peng Yongjun

2006-01-01

Objective: To study CT findings of hepatic abscess. Methods: CT findings and clinical materials of 38 patients with liver abscess verified by aspiration were retrospectively viewed. All patients were examined by non-enhanced and contrast enhanced CT. Results: In 25 cases, inhomogeneous hypodense lesions with unclear demarcation were found on non-enhanced CT. On contrast enhanced CT scan, target or cluster enhancement was found Additionally, air was found within some lesions. In the rest 13 cases with early stage liver abscess, no typical sign was found on non-enhanced CT, while rosette sign and continued enhancement sign were demonstrated after the contrast agent was given. Conclusion: Various CT findings are found in different stages of liver abscess. The diagnosis and differential diagnosis should be based on CT manifestations and clinical history as well. (authors)

[Colonization of Porphyromonas endodontalis in primary and secondary endodontic infections].

Science.gov (United States)

Hong, Li; Hai, Ji; Yan-Yan, He; Shenghui, Yang; Benxiang, Hou

2015-02-01

This study aims to assess and compare the prevalence of Porphyromonas endodontalis (P. endodontalis) in root canals associated with primary and secondary endodontic infections by using 16s rDNA PCR and real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR). A total of 120 adult patients with one radiographically documented periapical lesion were included. Sixty teeth presented with primary endodontic infections and 60 with secondary endodontic infections requiring retreatment. P. endodontalis was identified by using 16s rDNA PCR techniques. The positive DNA expression of P. endodontalis in two types of infected root canals were quantitatively compared by using SYBR GREEN I RTFQ-PCR. The prevalence of P. endodontalis in the root canals with primary endodontic infections was significantly higher than that in root canals with secondary endodontic infections (P = 0.001). However, RTFQ-PCR results showed no significant difference in DNA expression quantities between the primary and secondary endodontic infections root canals (P = 0.303). P. endodontalis is more highly associated with root canals having primary endodontic infections, although P. endodontalis colonize in both root canals with primary and secondary chronic apical periodontitis.

Cone beam computed tomography in Endodontics - a review.

Science.gov (United States)

Patel, S; Durack, C; Abella, F; Shemesh, H; Roig, M; Lemberg, K

2015-01-01

Cone beam computed tomography (CBCT) produces undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a lower effective radiation dose than computed tomography. The aim of this paper is to: (i) review the current literature on the applications and limitations of CBCT; (ii) make recommendations for the use of CBCT in Endodontics; (iii) highlight areas of further research of CBCT in Endodontics. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Clinical and CT findings of Klebsiella liver abscess: comparison with non-Klebsiella liver abscess

International Nuclear Information System (INIS)

Woo, Young Geun; Kim, Man Deuk; Yoon, Sang Wook; Kim, Hee Jin; Kim, Hyun; Lee, Kang Mun; Lee, Eun Ja

2003-01-01

To analyse the clinical features and CT findings of pyogenic liver abscess due to Klebsiella pneumoniae, and to compare the findings with those of cases in which abscesses were caused by other pathogens. Twenty-one cases of pyogenic liver abscess were assigned to either the Klebsiella or the non-Klebsiella group, and the patients' past medical history and intra-abdominal abnormalities such as calculus or malignancy were reviewed. Laboratory data such as alkaline phosphatase (ALT), SGOT and SGPT levels were analyzed, and on the basis of the CT findings, decisions were reached as to (a) whether abscesses were single or multiple contiguous or discontiguous, uniloculated or multiloculated; and (b) the presence or absence of gas, hepatic parenchymal enhancement, peripheral rim enhancement, and extrahepatic abnormality. For statistical analysis, fisher's exact test was used. Among 21 abscesses, Klebsiella pneumoniae was the most common pathogen (n=11). The others were Pseudomonas (n=3), E.coli (n=2), Enterococcus (n=2), G. (+) cocci (n=2) and polymicrobial (n=1). Diabetes mellitus was more common among patients in the Klebsiella group, among whom a multiloculated single cavity was a frequent finding. Five patients in the non-Klebsiella group experienced biliary tract obstruction, which was not demonstrated in the Klebsiella group. Hepatic parenchymal enhancement was more common in the non-Klebsiella group. In case of pyogenic liver disease, especially where diabates mellitus is involved, Klebsiella pneumoniae is a major pathogen. Significant CT findings of Klebsiella liver abscess included a multiloculated single cavity, rare biliary tract obstruction, and little hepatic parenchymal enhancement

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report

Directory of Open Access Journals (Sweden)

Bhrugesh J Panseriya

2011-01-01

Full Text Available A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male.

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report.

Science.gov (United States)

Panseriya, Bhrugesh J; Hungund, Shital

2011-07-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male.

Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization.

Science.gov (United States)

Becerra, Patricia; Ricucci, Domenico; Loghin, Simona; Gibbs, Jennifer L; Lin, Louis M

2014-01-01

Histologic studies of teeth from animal models of revascularization/revitalization are available; however, specimens from human studies are lacking. The nature of tissues formed in the canal of human revascularized/revitalized teeth was not well established. An immature mandibular premolar with infected necrotic pulp and a chronic apical abscess was treated with revascularization/revitalization procedures. At both the 18-month and 2-year follow-up visits, radiographic examination showed complete resolution of the periapical lesion, narrowing of the root apex without root lengthening, and minimal thickening of the canal walls. The revascularized/revitalized tooth was removed because of orthodontic treatment and processed for histologic examination. The large canal space of revascularized/revitalized tooth was not empty and filled with fibrous connective tissue. The apical closure was caused by cementum deposition without dentin. Some cementum-like tissue was formed on the canal dentin walls. Inflammatory cells were observed in the coronal and middle third of revascularized/revitalized tissue. In the present case, the tissue formed in the canal of a human revascularized/revitalized tooth was soft connective tissue similar to that in the periodontal ligament and cementum-like or bone-like hard tissue, which is comparable with the histology observed in the canals of teeth from animal models of revascularization/revitalization. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Splenic abscesses: From diagnosis to therapy].

Science.gov (United States)

Davido, B; Dinh, A; Rouveix, E; Crenn, P; Hanslik, T; Salomon, J

2017-09-01

Splenic abscess is septic collection which occurs after haematogenous spread or local dissemination. Splenic abscess is an uncommon and rare condition, more frequently affecting male and immunocompromised patients. There are no guidelines regarding its diagnosis and management. Computed tomography (CT) scan is highly sensitive and specific (95% and 92%, respectively) in the diagnosis of splenic abscess. Diagnosis is based on blood cultures which are positive in 24 to 80% of cases. Bacterial growth culture of abscess after drainage is more efficient (50-80%) and can be performed after surgery or percutaneous drainage under imaging, including CT scan. Microorganisms involved are frequently enterobacteriaceae, gram-positive cocci and anaerobes. This particular ecology leads to an empiric broad-spectrum antibiotic therapy, with a variable duration, from 10days to more than one month. Management remains very close to the one applied in case of liver abscesses. The role of splenectomy in the prevention of recurrence remains controversial. We reviewed the literature regarding splenic abscesses, from diagnosis to therapy. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Breast abscess: evidence based management recommendations.

Science.gov (United States)

Lam, Elaine; Chan, Tiffany; Wiseman, Sam M

2014-07-01

Literature review was carried out and studies reporting on treatment of breast abscesses were critically appraised for quality and their level of evidence using the Strength of Recommendation Taxonomy guidelines, and key recommendations were summarized. Needle aspiration either with or without ultrasound guidance should be employed as first line treatment of breast abscesses. This approach has the potential benefits of: superior cosmesis, shorter healing time, and avoidance of general anaesthesia. Multiple aspiration sessions may be required for cure. Ultrasound-guided percutaneous catheter placement may be considered as an alternative approach for treatment of larger abscesses (>3 cm). Surgical incision and drainage should be considered for first line therapy in large (>5 cm), multiloculated, or long standing abscesses, or if percutaneous drainage is unsuccessful. All patients should be treated concurrently with antibiotics. Patients with recurrent subareolar abscesses and fistulas should be referred for consideration of surgical treatment.

Abscess of the spleen

Directory of Open Access Journals (Sweden)

Grubor Nikica

2005-01-01

Full Text Available Splenic abscess is a rare disease but with increasing frequency. The authors present 9 patients with splenic abscess treated at the Institute of Digestive System Diseases, Clinical Centre of Serbia, in a period from January 1, 1986 to May 15, 2004. Splenic abscess was the complication of septic endocarditis in 4, trauma in 2, dental infection in 1, while in 2 cases it was the complication of chemotherapy in myeloproliferative disorders. All 9 patients had fever, 7 - abdominal pain, 4 - left shoulder pain, and 1 patient had nausea and vomiting. Higher white blood count was found in 6 patients, pleural effusion in 4, elevated left hemidiaphragm in 1 and basal pneumonia in 1 patient as well. Ultrasonography and CT were the most reliable diagnostic procedures. CT was superior in diagnosis of multiple small abscesses. Culture of the pus recovered the Enterococcus in 3 cases, Streptococcus a hemolyticus in 1, Staphylococcus epidermidis and Candida albicans in 1, Staphylococcus aureus, E. Coli and Candida albicans in 1, Staphylococcus aureus and Salmonella enteritidis in 1 case. Eight patients underwent splenectomy and 1 was cured by combined antibiotics in high doses. One patient died postoperatively due to septic endocarditis that had been present before surgery. The authors believe that splenectomy and antibiotics administered according to drug susceptibility test as well as management of underlying disease are the method of choice for splenic abscess treatment. Conservative antibiotic treatment is indicated in selected cases only.

Cerebral Abscess Potentially of Odontogenic Origin

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Marouene Ben Hadj Hassine

2015-01-01

Full Text Available Odontogenic origins are rarely implicated in the formation of brain abscesses. The relative paucity of this kind of infection and the difficulty in matching the causative microorganisms of a brain abscess to an odontogenic source can explain the late management of patients. We herein describe a case of a 46-year-old man with a cerebellar abscess that was probably due to an odontogenic infection. The diagnosis supported by imaging and microscopic identification, mini craniectomy for abscess drainage followed by eradication of all potential dental infectious foci, and an antibiotic regimen based on cephalosporins, metronidazole, and vancomycine contributed to a successful outcome.

The periodontal abscess (II). Short-term clinical and microbiological efficacy of 2 systemic antibiotic regimes.

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Herrera, D; Roldán, S; O'Connor, A; Sanz, M

2000-06-01

The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute periodontal abscesses. After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3-5 days, 10-12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10-12 days). Blood and urine samples were collected at baseline and after 10-12 days. Microbiological samples were processed by anaerobic culturing, and isolated periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (pperiodontal abscesses in periodontitis patients.

Three cases of liver abscess

International Nuclear Information System (INIS)

Maeyama, Toyoaki; Imamoto, Shoichiro; Hirai, Kenji; Nagasaki, Yoshikazu; Abe, Hirohiko

1980-01-01

Three patients with liver abscess were presented with special reference to the diagnostic evaluation of computed tomography (CT). CT findings were specific for liver abscess and valuable for its correct diagnosis and accurately defined the extent of involvement. (author)

Recurrent Bilateral Breast Abscesses after Sternotomy

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Hamza Cinar

2012-01-01

Full Text Available Median sternotomy is the most commonly used incision in cardiothoracic procedures. Development of breast abscess after sternotomy is a very rare situation. We present a case of sternal wound infection with recurrent bilateral breast abscess after sternotomy. Our case is the first and only case in the literature due to the presence of sternal wound infection with recurrent bilateral breast abscess after sternotomy.

Methodological Quality Assessment of Meta-analyses in Endodontics.

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Kattan, Sereen; Lee, Su-Min; Kohli, Meetu R; Setzer, Frank C; Karabucak, Bekir

2018-01-01

The objectives of this review were to assess the methodological quality of published meta-analyses related to endodontics using the assessment of multiple systematic reviews (AMSTAR) tool and to provide a follow-up to previously published reviews. Three electronic databases were searched for eligible studies according to the inclusion and exclusion criteria: Embase via Ovid, The Cochrane Library, and Scopus. The electronic search was amended by a hand search of 6 dental journals (International Endodontic Journal; Journal of Endodontics; Australian Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology; Endodontics and Dental Traumatology; and Journal of Dental Research). The searches were conducted to include articles published after July 2009, and the deadline for inclusion of the meta-analyses was November 30, 2016. The AMSTAR assessment tool was used to evaluate the methodological quality of all included studies. A total of 36 reports of meta-analyses were included. The overall quality of the meta-analyses reports was found to be medium, with an estimated mean overall AMSTAR score of 7.25 (95% confidence interval, 6.59-7.90). The most poorly assessed areas were providing an a priori design, the assessment of the status of publication, and publication bias. In recent publications in the field of endodontics, the overall quality of the reported meta-analyses is medium according to AMSTAR. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Computed tomographic evaluation of empyema and lung abscess

International Nuclear Information System (INIS)

Lee, Soo Dong; Kwon, Kwi Ryun; Kim, Ok Bae; Zeon, Suck Kil; Suh, Soo Jhi

1986-01-01

The differentiation between lung abscess and empyema can be difficult, but has important therapeutic consequences. Thoracotomy tube drainage is essential therapy for an empyema, whereas prolonged antibiotic therapy and postural drainage often suffice for a lung abscess. Conventional radiographic findings are usually relied on to help make correct differentiation between empyema and lung abscess, but overlying lung disease or unfavorable location of lesion often results in ambiguous findings. Although ultrasound has proved useful in differentiating empyema from lung abscess, CT is best accurate diagnostic method. Authors reviewed chest CT of 50 cases (41 empyema, 9 lung abscesses) which were diagnosed by surgery or clinical background during the period from May 1980 to June 1985 at Dongsan Medical Center, Keimyung University. The results were as follows: 1) Age and sex distribution a) Empyema: The incidence was most common in the 6th and 7th decades. Male to female ratio was 3:1. b) Lung abscess: The incidence was most common in the 5th, 6th and 7th decades. Male to female ratio was 2:1. 2) Wall characteristics (empyema 32 cases, lung abscess 9 cases): The 9 cases of 41 empyema had not defined their walls. a) Empyema had at least a part of their wall that was thin (81%), unform width (84%), and smooth on both margins (more than 96%). b) The wall of lung abscess was thick (89%), irregular width (89%), and irregular margins (100%). 3) Separation of uniformly thickened visceral pleura from parietal pleura ('split pleura' sign) was seen only in 68% of all empyemas. 4) Adjacent lung compression was seen only in 88% of all empyemas. 5) Chest wall angle: In 78% of all empyemas had obtuse or mixed angles, whereas in 85% of all lung abscesses had acute angle. 6) Shape of lesion: Empyema had variant shapes from round to crescent, however all lung abscesses had round or ovoid shape. 7) Size of lesion: In 85% of all empyemas had medium (41%) of large (44%) size, but the lung

Computed tomographic evaluation of empyema and lung abscess

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Lee, Soo Dong; Kwon, Kwi Ryun; Kim, Ok Bae; Zeon, Suck Kil; Suh, Soo Jhi [Keimyung University School of medicine, Taegu (Korea, Republic of)

1986-06-15

The differentiation between lung abscess and empyema can be difficult, but has important therapeutic consequences. Thoracotomy tube drainage is essential therapy for an empyema, whereas prolonged antibiotic therapy and postural drainage often suffice for a lung abscess. Conventional radiographic findings are usually relied on to help make correct differentiation between empyema and lung abscess, but overlying lung disease or unfavorable location of lesion often results in ambiguous findings. Although ultrasound has proved useful in differentiating empyema from lung abscess, CT is best accurate diagnostic method. Authors reviewed chest CT of 50 cases (41 empyema, 9 lung abscesses) which were diagnosed by surgery or clinical background during the period from May 1980 to June 1985 at Dongsan Medical Center, Keimyung University. The results were as follows: 1) Age and sex distribution a) Empyema: The incidence was most common in the 6th and 7th decades. Male to female ratio was 3:1. b) Lung abscess: The incidence was most common in the 5th, 6th and 7th decades. Male to female ratio was 2:1. 2) Wall characteristics (empyema 32 cases, lung abscess 9 cases): The 9 cases of 41 empyema had not defined their walls. a) Empyema had at least a part of their wall that was thin (81%), unform width (84%), and smooth on both margins (more than 96%). b) The wall of lung abscess was thick (89%), irregular width (89%), and irregular margins (100%). 3) Separation of uniformly thickened visceral pleura from parietal pleura ('split pleura' sign) was seen only in 68% of all empyemas. 4) Adjacent lung compression was seen only in 88% of all empyemas. 5) Chest wall angle: In 78% of all empyemas had obtuse or mixed angles, whereas in 85% of all lung abscesses had acute angle. 6) Shape of lesion: Empyema had variant shapes from round to crescent, however all lung abscesses had round or ovoid shape. 7) Size of lesion: In 85% of all empyemas had medium (41%) of large (44%) size, but

Metalloproteinases 2 and 9 Immunoexpression in Periapical Lesions from Primary Endodontic Infection: Possible Relationship with the Histopathological Diagnosis and the Presence of Pain.

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Pereira Faustino, Isabel Schausltz; Azevedo, Rebeca Souza; Takahama, Ademar

2016-04-01

The aim of this study was to evaluate the possible associations among the histopathological diagnosis, the inflammatory infiltrate profile, the presence of pain, and the immunoexpression of matrix metalloproteinases MMP-2 and MMP-9 in periapical lesions from primary endodontic infection. Fifty-one primary periapical lesions obtained from extracted teeth were selected for this study. Patients were previously evaluated for the presence of pain and sinus tract related to the tooth to be extracted. Tissues were processed for microscopic examination and MMP-2 and MMP-9 immunoexpression. Microscopically, samples were classified as periapical granulomas or periapical cysts and the inflammatory infiltrate as chronic or mixed. The percentage of immunopositive cells for MMP-2 and MMP-9 of each case was performed based on 10 consecutive microscopic fields. The Student t or chi-square tests were used in the statistical analysis. Of the total, 28 cases were classified as periapical granulomas (54.90%) and 23 cases as periapical cysts (45.10%). Seventeen patients (33.33%) reported pain associated with the extracted tooth, with 12 cases of periapical granulomas (70.58%) and 5 cases of periapical cysts (29.42%). All cases showed immunopositivity for MMP-2 and MMP-9 in a high percentage of cells, mainly in the cytoplasm of the leukocytes. MMP-2 was expressed more in periapical granulomas than periapical cysts (P periapical lesions from a primary endodontic infection. Moreover, we may suggest MMP-2 is expressed more in periapical granuloma and in cases associated with pain. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Argon laser application to endodontics

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Blankenau, Richard J.; Ludlow, Marvin; Anderson, David

1993-07-01

The application of laser technology to endodontics has been studied for some time. At the present time several major problems are being investigated: (1) removal of infected tissues, (2) sterilization of canals, (3) obturation of canals, and (4) preservation of the vitality of supporting tissues. This list is not intended to imply other problems do not exist or have been solved, but it is a starting point. This paper reviews some of the literature that relates to laser applications to endodontics and concludes with some of the findings from our investigation.

Radiological aspects of bacterial lung abscess

International Nuclear Information System (INIS)

Groskin, S.A.; Panicek, D.; Ewing, D.; Rivera, F.; Math, K.; Teixeira, J.; Heitzman, E.R.

1987-01-01

Clinical, radiological, and pathological data derived from an analysis of over 70 cases of bacterial lung abscess are presented. Etiologic agents and risk factors are presented. Key radiographic findings are discussed, and those that are most useful in differentiating bacterial lung abscess from cavitated carcinoma, infected cyst, and emphysema are emphasized. Radiographic aspects of the complications of bacterial lung abscess are illustrated, and radiological approaches to their therapy are discussed

Avaliação do tratamento endodôntico em radiografias periapicais e panorâmicas Evaluation of endodontic treatment with periapical and panoramic radiography

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Cristina Maria Dumit SEWELL

1999-07-01

Full Text Available Radiografias periapicais e panorâmicas, com aparelho elipsopantomográfico, são comparadas na avaliação do tratamento endodôntico. Com este objetivo, radiografias realizadas nestas duas técnicas, num mesmo paciente, com pelo menos um dente com tratamento endodôntico, foram analisadas por três examinadores, levando-se em consideração as condições apicais (lesões periapicais, a obturação do canal radicular (tipo de material, preenchimento e limite apical, a restauração do dente e o preenchimento da câmara pulpar. Os resultados mostram que a radiografia periapical define melhor a presença de rarefação óssea periapical difusa, obturação do canal radicular com guta-percha, tratamento endodôntico inadequado, justaposição do material restaurador inadequada para a região anterior e a presença de restauração metálica fundida na região posterior. Para os demais itens avaliados, os resultados da análise estatística não são significantes. A concordância de diagnósticos entre examinadores se mostra superior nas radiografias periapicais.Periapical and panoramic radiography with a ellipsopantomograph device, are compared in the evaluation of endodontic treatment. With this objective, radiographies carried out under both techniques with the same patient having at least one tooth endodontically treated, were analysed by three observers, taking into consideration the apical conditions (periapical lesions, the root canal filling (material type, filling and apical level, tooth restoration and filling of the pulpar camera. The results demonstrated that periapical radiography is a better way to define the appearance of difuse periapical bone rarefaction, root canal filling with gutta-percha, insatisfactory endodontic treatment, an inadequate juxtaposition of the restoration material to the anterior region, and the presence of metallic casted restorations in the posterior region. Other result evaluations were not significant. The

A survey of Australian prosthodontists: The use of posts in endodontically treated teeth.

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Sambrook, Raelene; Burrow, Michael

2018-05-09

This study aimed to gain insight into common practices of Australian prosthodontists when placing a post in an endodontically treated tooth (ETT). A 17-question open- and closed- format questionnaire was sent to registered Australian prosthodontists. The response rate was 55% (n=95). The majority of respondents indicated the purpose of a post was to retain a core (n=94, 99%). The decision to place a post is affected by the quantity of remaining tooth structure (n=91, 96%) and the definitive restoration (n=68, 72%). The ideal post length is neither a short nor long post with the most frequent response (n=52, 34%) being 'as long as possible without disturbing the apical seal'. The apical seal requirements were defined as 4-5mm of Gutta Percha for 77% of respondents. The most preferred post type was a custom cast metal post (n=85, 49%). The most popular luting cement was resin composite (n=84, 39%). The results from this survey do not provide a definitive guide for restoring an ETT. However, it illustrates how Australian prosthodontists address this clinical challenge. The multiple responses received for a number of questions suggest that the material and technique employed in the Australian context is influenced by the individual clinical case. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Bone formation within a breast abscess.

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Mannu, Gurdeep Singh; Ahmed, Farid; Cunnick, Giles; Mungalsingh, Naren

2014-09-22

We present a rare case of osseous metaplasia in a poorly healing breast abscess. An 87-year-old woman was referred to the breast surgery clinic with a painful lump in her right breast. Initial imaging and core biopsy suggested a breast abscess. Despite several courses of antibiotics and repeated attempts at aspiration the painful lesion persisted. It was eventually surgically excised in its entirety and final histopathology showed the presence of bone formation within the abscess. The patient's symptoms subsequently resolved. To the best of our knowledge, this is the first case in the literature, of osseous metaplasia within a breast abscess in the absence of malignancy. 2014 BMJ Publishing Group Ltd.

Percutaneous drainage of 100 subphrenic abscesses

International Nuclear Information System (INIS)

Casola, G.; Sonnenberg, E. van; D'Agostino, H.; Kothari, R.; May, S.; Taggart, S.

1990-01-01

PURPOSE: Percutaneous drainage of subphrenic abscesses is technically more difficult because lung and pleura may be transgressed during catheter insertion. The purpose of this paper is to determine the incidence of thoracic complications secondary to subphrenic abscess drainage and to determine factors that may alter this. The authors' series consists of 100 subphrenic abscesses that were drained percutaneously. Patients range in age from 14 to 75 years. Abscesses were secondary to surgery (splenectomy, pancreatectomy, partial hepatectomy, gastrectomy), pancreatitis, and trauma. Catheters ranged in size from 8 to 14 F and were inserted via trocar or Seldinger technique. Thoracic complications of pneumothorax or empyema were determined from follow-up chest radiographs or CT scans

Brain abscess - diagnosis and management

International Nuclear Information System (INIS)

Bhand, A.K

2004-01-01

Objective: To evaluate the clinical presentation, diagnosis, and sources of infection, surgical management outcome and microorganisms involved in the brain abscess in our locality. Subjects and Methods: All patients who were confirmed cases of brain abscess were entered into the study. Data collected on proforma, contained categories of age, gender, clinical presentation, diagnostic laboratory findings, computed tomography scans reports, associated anomalies, surgical management, culture reports antibiotic therapy, microbiologic features and treatment out come. Results: Out of 82 patients, 58 were males and 24 females. Mean age was 18 years (range 05 months to 55 years). Headache with papilloedema was the commonest presentation (82%). Neurological deficit was present in 46%. A source of infection was present in 89%. Otogenic source was the commonest (63%). CT scan was diagnostic in all (100%) cases. Solitary abscess was found in 79% of the cases while in 21 % of the cases multiple abscesses were found. Temporal lobe he commonest site involved (55%). Cultures were found positive for microorganism in 82% of the cases. Bactericides (38%) and Streptococci (25%) were the commonest isolates. Burr hole aspiration was done in only 38% of the cases while excision of the capsule along with aspiration was carried out in 62% of the cases. Over all morality was 22% in this series; causes of death were septicemia, ventriculitis and pneumonia. Conclusion: Diagnosis with CT scan, appropriate antibiotic therapy and complete removal of abscess along with excision capsule could reduce the mortality and neurological deficits from brain abscess. (author)

Mechanism of /sup 67/Ga uptake by an experimental abscess. Permeability of plasma from blood vessel in abscess

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Nitta, Kazuo; Ogawa, Hiroshi; Ando, Atsushi; Ando, Itsuko; Hiraki, Tatsunosuke; Hisada, Kinichi

1985-06-01

In the previous paper, we reported that /sup 67/Ga was accumulated in abscess and uptake rate of /sup 67/Ga in abscess increased with time after the injection of /sup 67/Ga-citrate. The present study was undertaken to elucidate the influence of blood flow on the accumulation of /sup 67/Ga in abscess. Five days after subcutaneous injection of 0.2 ml of turpentine to the rats, /sup 131/I-human serum albumin (HSA) was injected intravenously to the rats. At an appropriate time after the injection (10 min to 6 days), uptake rates of /sup 131/I-HSA in abscess and normal tissues were measured. Similarly, /sup 51/Cr-red blood cells (RBC) were injected intravenously to the above rats and the uptake rates of /sup 51/Cr-RBC were also measured. One, three, and 24 hours after injection of /sup 131/I-HSA, the uptake rates of /sup 131/I-HSA in abscess were 1.32 %dose/g, 1.84 %dose/g, and 0.82 %dose/g, respectively. However, the uptake rates of /sup 51/Cr-RBC in abscess was very small, and the value was 0.14 %dose/g at 24 hours after the injection. In the case of abscess, blood in the tissue fluid was very little, but the permeability of /sup 131/I-HSA from the blood vessel in the tissue was much larger than that of normal tissues. From these facts, it was deduced that the accelerated permeability caused the abscess accumulation of /sup 67/Ga.

CT studies of brain abscesses in cats

International Nuclear Information System (INIS)

Kretzschmar, K.; Wallenfang, T.; Bohl, J.

1981-01-01

Cerebral abscesses were produced in 56 cats by introducing staphylococcus aureus into the white matter of one cerebral hemisphere, using a stereotaxic apparatus. The cats were treated with antibiotics and/or steroids. The size and density of the inflammatory process and the abscess ring were measured on postcontrast CT scans. Differences were found depending on the stage of the abscess, but the deviation of values was too great for determining the age of the abscess from one measurement, to be able to apply proper treatment. The size and density of the abscesses were the same on CT whether the animals were treated or not. This was contrary to the clinical picture, the measurements of edema, and the histopathological studies. (orig.)

[Lung abscess: changes in treatment?].

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Clottu, E; Nicod, L P

2015-11-18

Lung abscess occurs in very pleomorphic according to germs initially involved. The mechanism commonly found is an aspiration of the oropharyngeal flora in patients with disorders of consciousness or swallowing. The infection is polymicrobial, with presence of anaerobic germs in 2/3 of the cases. The support consists of a prolonged antibiotic treatment, as well as anaerobic until resolution or stability of the radiological image. In case of prolonged toxic state, drainage of the abscess is to be discussed especially if there is no airways drainage. Surgical sanctions is rarely needed regardless of the size of the abscess, unless underlying carcinoma is present.

Lung abscess; Percutaneous catheter therapy

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Ha, H.K. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Kang, M.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Park, J.M. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Yang, W.J. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Shinn, K.S. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of)); Bahk, Y.W. (Depts. of Radiology and Internal Medicine, Catholic Univ. Medical Coll., Seoul (Korea, Republic of))

1993-07-01

Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologicall impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess. (orig.).

CT findings of perihepatic tuberculous abscess

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Ryu, Jeong Ah; Lee, Jong Tae; Chung, Jae Joon; Park, Su Mi; Kim, Myeong Jin; Yoo, Hyung Sik [Yonsei Univ. College of Medicine, Research Institute of Radiological Science, Yonsei Univ., Seoul (Korea, Republic of)

1999-12-01

To evaluate the CT findings of perihepatic tuberculous abscesses. The CT scans of 11 patients (6 females and 5 males) with 14 pathologically proven perihepatic tuberculous abscess were retrospectively evaluated in terms of the morphological characteristics of the abscesses and changes in other abdominal organs and at other sites. A total of 14 absceses were noted in 11 patients. Six (43%) were in the right subphrenic space, three (21%) in the right perihepatic space, three (21%) in the left subphrenic space, and two (14%) in the left perihepatic space. The right side was predominant. The abscesses ranged in size from 1 to 10 (mean, 5) cm in diameter, with a wall thickness of 2-7 (mean, 3) mm. Of the 14 abscesses, 13 were oval, and one spherical. CT findings were as follows : a smooth abscess margin with even wall thickness in seven of the eleven patients (64%); calcification of the wall in two (18%); internal septa in seven (64%); localized fluid collection in nine (82%); lymphadenopathy in five (45%); and peritoneal enhancement in seven (64%). Lesions suggesting tuberculous infection coexisted at other sites in eight patients. These included the lung in six patients (55%), the neck in three (27%), an axilla in two (18%), the liver in two (18%), the spleen in one (9%), and the gastroin-testinal tract in one (9%). CT scanning is useful for establishing the diagnosis of perihepatic tuberculous abscesses by evaluating the morphological characteristics of the mass and by observing changes in other abdominal organs and at other sites.

CT findings of perihepatic tuberculous abscess

International Nuclear Information System (INIS)

Ryu, Jeong Ah; Lee, Jong Tae; Chung, Jae Joon; Park, Su Mi; Kim, Myeong Jin; Yoo, Hyung Sik

1999-01-01

To evaluate the CT findings of perihepatic tuberculous abscesses. The CT scans of 11 patients (6 females and 5 males) with 14 pathologically proven perihepatic tuberculous abscess were retrospectively evaluated in terms of the morphological characteristics of the abscesses and changes in other abdominal organs and at other sites. A total of 14 absceses were noted in 11 patients. Six (43%) were in the right subphrenic space, three (21%) in the right perihepatic space, three (21%) in the left subphrenic space, and two (14%) in the left perihepatic space. The right side was predominant. The abscesses ranged in size from 1 to 10 (mean, 5) cm in diameter, with a wall thickness of 2-7 (mean, 3) mm. Of the 14 abscesses, 13 were oval, and one spherical. CT findings were as follows : a smooth abscess margin with even wall thickness in seven of the eleven patients (64%); calcification of the wall in two (18%); internal septa in seven (64%); localized fluid collection in nine (82%); lymphadenopathy in five (45%); and peritoneal enhancement in seven (64%). Lesions suggesting tuberculous infection coexisted at other sites in eight patients. These included the lung in six patients (55%), the neck in three (27%), an axilla in two (18%), the liver in two (18%), the spleen in one (9%), and the gastroin-testinal tract in one (9%). CT scanning is useful for establishing the diagnosis of perihepatic tuberculous abscesses by evaluating the morphological characteristics of the mass and by observing changes in other abdominal organs and at other sites

Current trends in endodontic practice: emergency treatments and technological armamentarium.

Science.gov (United States)

Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus

2009-01-01

The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

Lung abscess: update on microbiology and management.

Science.gov (United States)

Yazbeck, Moussa F; Dahdel, Maher; Kalra, Ankur; Browne, Alexander S; Pratter, Melvin R

2014-01-01

A lung abscess is a circumscribed collection of pus in the lung as a result of a microbial infection, which leads to cavity formation and often a radiographic finding of an air fluid level. Patients with lung abscesses commonly present to their primary care physician or to the emergency department with "nonresolving pneumonia." Although, the incidence of lung abscess has declined since the introduction of antibiotic treatment, it still carries a mortality of up to 10%-20%. This article discusses in detail the up-to-date microbiology and the management of lung abscesses.

Giant tubercular brainstem abscess: A case report

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Pragati Chigurupati

2014-01-01

Full Text Available Tubercular brain abscesses are uncommon and tubercular brainstem abscesses are rarely reported. Most of these cases occur in immunocompromised patients. We report a case of giant brainstem abscess in a 5-year-old human immunodeficiency virus-seronegative female child who presented with complaints of headache, diplopia and unsteadiness of gait since 6 months. Diagnosis was made by a magnetic resonance imaging scan of brain. The patient demonstrated a remarkable clinical recovery after microsurgery combined with a course of antituberculous therapy. Microbiological and histological findings confirmed the diagnosis of a tuberculous abscess.

Primary lung abscess caused by Staphylococcus lugdunensis.

Science.gov (United States)

Chou, Deng-Wei; Lee, Chao-Tai

2017-11-01

Staphylococcus lugdunensis, a strain of coagulase-negative staphylococci, is part of the normal flora of human skin but can cause multiple infections at various sites. This microorganism has emerged as a major human pathogen. However, no study has reported primary lung abscess caused by S. lugdunensis. A 54-year-old alcoholic man without relevant past medical history was admitted because of primary lung abscesses. Empirical amoxicillin/clavulanate therapy was initially administered; however, the patient had persistent pleuritic chest pain and fever. He subsequently underwent resection of the lung abscess and removal of exudative pleural effusion on the fourth hospital day. Histopathologic examination confirmed the diagnosis of lung abscess, and colonies of gram-positive bacteria were identified. The culture specimen from the abscess was positive for S. lugdunensis, which was susceptible to amoxicillin/clavulanate, cefazolin, ciprofloxacin, clindamycin, erythromycin, oxacillin, teicoplanin, tetracycline, and vancomycin. Following resection and 3 weeks of amoxicillin/clavulanate therapy, the patient eventually recovered well without relapse. This case report is the first to describe S. lugdunensis as a cause of primary lung abscess; this microorganism should be considered a potential monomicrobial pathogen in primary lung abscess. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Multiple lung abscesses caused by Streptococcus constellatus

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Vanina Rognoni

2018-02-01

Full Text Available Despite numerous descriptions of body abscesses produced by Streptococcus milleri group bacteria, lung abscesses caused by this group remain under-reported and the clinical and laboratory features have yet to be fully characterised. We present the case of a patient admitted with lung multiple abscesses produced by Streptococcus constellatus.

Rapid kill-novel endodontic sealer and Enterococcus faecalis.

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Nurit Beyth

Full Text Available With growing concern over bacterial resistance, the identification of new antimicrobial means is paramount. In the oral cavity microorganisms are essential to the development of periradicular diseases and are the major causative factors associated with endodontic treatment failure. As quaternary ammonium compounds have the ability to kill a wide array of bacteria through electrostatic interactions with multiple anionic targets on the bacterial surface, it is likely that they can overcome bacterial resistance. Melding these ideas, we investigated the potency of a novel endodontic sealer in limiting Enterococcus faecalis growth. We used a polyethyleneimine scaffold to synthesize nano-sized particles, optimized for incorporation into an epoxy-based endodontic sealer. The novel endodontic sealer was tested for its antimicrobial efficacy and evaluated for biocompatibility and physical eligibility. Our results show that the novel sealer foundation affixes the nanoparticles, achieving surface bactericidal properties, but at the same time impeding nanoparticle penetration into eukaryotic cells and thereby mitigating a possible toxic effect. Moreover, adequate physical properties are maintained. The nanosized quaternary amine particles interact within minutes with bacteria, triggering cell death across wide pH values. Throughout this study we demonstrate a new antibacterial perspective for endodontic sealers; a novel antibacterial, effective and safe antimicrobial means.

Pulp regeneration in a full-length human tooth root using a hierarchical nanofibrous microsphere system.

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Li, Xiangwei; Ma, Chi; Xie, Xiaohua; Sun, Hongchen; Liu, Xiaohua

2016-04-15

While pulp regeneration using tissue engineering strategy has been explored for over a decade, successful regeneration of pulp tissues in a full-length human root with a one-end seal that truly simulates clinical endodontic treatment has not been achieved. To address this challenge, we designed and synthesized a unique hierarchical growth factor-loaded nanofibrous microsphere scaffolding system. In this system, vascular endothelial growth factor (VEGF) binds with heparin and is encapsulated in heparin-conjugated gelatin nanospheres, which are further immobilized in the nanofibers of an injectable poly(l-lactic acid) (PLLA) microsphere. This hierarchical microsphere system not only protects the VEGF from denaturation and degradation, but also provides excellent control of its sustained release. In addition, the nanofibrous PLLA microsphere integrates the extracellular matrix-mimicking architecture with a highly porous injectable form, efficiently accommodating dental pulp stem cells (DPSCs) and supporting their proliferation and pulp tissue formation. Our in vivo study showed the successful regeneration of pulp-like tissues that fulfilled the entire apical and middle thirds and reached the coronal third of the full-length root canal. In addition, a large number of blood vessels were regenerated throughout the canal. For the first time, our work demonstrates the success of pulp tissue regeneration in a full-length root canal, making it a significant step toward regenerative endodontics. The regeneration of pulp tissues in a full-length tooth root canal has been one of the greatest challenges in the field of regenerative endodontics, and one of the biggest barriers for its clinical application. In this study, we developed a unique approach to tackle this challenge, and for the first time, we successfully regenerated living pulp tissues in a full-length root canal, making it a significant step toward regenerative endodontics. This study will make positive scientific

A comparative study between the efficacy of tramadol, celecoxib and ibuprofen in pain control after root canal therapy of tooth

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Eshagh A. Saberi

2011-01-01

Full Text Available Background: Root canal therapy of teeth can relief the endodontic pain, but post-endodontic pain and discomfort are its undesirable effects. There are many studies on various drugs for alleviation of post-endodontic pain. The aim of this study was to compare the analgesic effect of tramadol, celecoxib and ibuprofen in vital teeth.Materials & Method: In this double blind randomized clinical trial study, 104 patients with vital first mandibular molar tooth were selected. The patients were divided in to four groups, tramadol (A, celecoxib (B, ibuprofen (C and placebo (D. The similar capsules were filled with50mg tramadol HCL, 100mg celecoxib, 400mg ibuprofen and starch . Each patient received randomly one capsule one hour before treatment. If the pain persists, the patient received one tablet of 325 mg acetaminophen every 6 hours. The groups were controlled for 3 days. The data were collected one hour before and 6, 12, 24, 48, 72 hours after treatment. Results were analyzed using kruskal-wallis and Mann-Whitney U tests.Results: The results showed that after 12 (p=0.039 and 24(p=0.024 hours of treatment, tramadol was better in pain relief in comparison with other groups and there was one difference between tramadol and ibuprofen after treatment after 12 hours (p=0.013. But there was no significant deference between drug groups at 6, 48 and 72 hour after treatment.Conclusion: Tramadol prescription in comparison with celecoxib, ibuprofen and placebo has greater analgesic effect after root canal therapy in vital teeth. In addition tramadol may be a good medicine for post-endodontic pain control

Lung abscess caused by Mycoplasma pneumoniae.

Science.gov (United States)

Omae, Takashi; Matsubayashi, Tadashi

2015-08-01

A 10-year-old boy with West syndrome was referred to hospital because of high fever and cough. Chest X-ray and computed tomography showed consolidation with an abscess in the right upper lobe. Laboratory data indicated cytokine storm. Various antibacterial agents and additional corticosteroid were unable to control the hypercytokinemia, which was suppressed after cyclosporine A was started. The lung abscess remained, however, and right upper lobectomy was performed. Culture from the abscess showed no growth, while polymerase chain reaction assay indicated Mycoplasma pneumoniae DNA. Serum passive agglutinin titer for M. pneumoniae was significantly elevated in the convalescent phase. These findings are strong evidence that the lung abscess was caused by M. pneumoniae infection. © 2015 Japan Pediatric Society.

Treatment Plan and Clinical Management of a Geminated Maxillary Lateral Incisor: A Case Report

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Siavash Moushekhian

2014-06-01

Full Text Available The anatomic anomalies detection is important for an attentive clinician. Asuccessful treatment of an endodontically involved tooth should make itfunctional and aesthetically acceptable for the patient. The following articlepresented a case of gemination and the endodontic, prosthetic and periodontaltreatments which were done to keep a complicated tooth in aesthetic zone

Pulsed Nd-YAG laser in endodontics

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Ragot-Roy, Brigitte; Severin, Claude; Maquin, Michel

1994-12-01

The purpose of this study was to establish an operative method in endodontics. The effect of a pulsed Nd:YAG laser on root canal dentin has been examined with a scanning electron microscope. Our first experimentation was to observe the impacts carried out perpendicularly to root canal surface with a 200 micrometers fiber optic in the presence of dye. Secondarily, the optical fiber was used as an endodontic instrument with black dye. The irradiation was performed after root canal preparation (15/100 file or 40/100 file) or directly into the canal. Adverse effects are observed. The results show that laser irradiation on root canal dentin surfaces induces a nonhomogeneous modified dentin layer, melted and resolidified dentin closed partially dentinal tubules. The removal of debris is not efficient enough. The laser treatment seems to be indicated only for endodontic and periapical spaces sterilization after conventional root canal preparation.

Endodontic Treatment of Maxillary Premolar with Three Root Canals Using Optical Microscope and NiTi Rotatory Files System.

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Relvas, João Bosco Formiga; de Carvalho, Fredsom Marcio Acris; Marques, André Augusto Franco; Sponchiado, Emílio Carlos; Garcia, Lucas da Fonseca Roberti

2013-01-01

The aim of the study was to report a clinical case of endodontic treatment of a maxillary first premolar with three root canals using an optical microscope and rotary instrumentation technique. The main complaint of the patient, a 16-year-old girl, was pain in tooth 14. After clinical and radiographic examination, irreversible pulpitis was diagnosed. An alteration in the middle third of the pulp chamber radiographically observed suggested the presence of three root canals. Pulp chamber access and initial catheterization using size number 10 K-files were performed. The optical microscope and radiographic examination were used to confirm the presence of three root canals. PathFiles #13, #16, and #19 were used to perform catheterization and ProTaper files S1 and S2 for cervical preparation. Apical preparation was performed using F1 file in the buccal canals and F2 in the palatal canal up to the working length. The root canals were filled with Endofill sealer by thermal compaction technique using McSpadden #50. The case has been receiving follow-up for 12 months and no painful symptomatology or periapical lesions have been found. The use of technological tools was able to assist the endodontic treatment of teeth with complex internal anatomy, such as three-canal premolars.

Bone formation within a breast abscess

OpenAIRE

Mannu, Gurdeep Singh; Ahmed, Farid; Cunnick, Giles; Mungalsingh, Naren

2014-01-01

We present a rare case of osseous metaplasia in a poorly healing breast abscess. An 87-year-old woman was referred to the breast surgery clinic with a painful lump in her right breast. Initial imaging and core biopsy suggested a breast abscess. Despite several courses of antibiotics and repeated attempts at aspiration the painful lesion persisted. It was eventually surgically excised in its entirety and final histopathology showed the presence of bone formation within the abscess. The patient...

Uvula Abscess in a Newborn Infant.

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Tuncer, Erkun; Ors, Rahmi

2018-05-01

Abscesses can be found in several places in the oral cavity, most commonly occurring in peritonsillar and periodontal regions. In this report, the authors described a uvula abscess in a 1-month-old term newborn who was brought to the pediatric outpatient clinic with the complaints of difficulty in sucking-swallowing and refusal to suck at the breast. To the best of the authors' knowledge this is the first report of a uvula abscess in the literature.

Why intravenous moderate sedation should be taught in graduate endodontic programs.

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Montagnese, Thomas Anthony

2012-03-01

The purpose of this opinion article is to present reasons why intravenous moderate sedation should be taught in graduate endodontic programs. Access to oral health care is an area of much interest and concern, but some patients are unable to get endodontic care because they have special needs. Special needs can refer to patients who fear dentistry itself and other aspects of dental treatment. A variety of phobias and medical, developmental, and physical conditions can make it difficult for some patients to tolerate the endodontic care they need and want. Moderate sedation can help many of these patients. Endodontists in general are not trained to provide intravenous moderate sedation. By incorporating intravenous moderate sedation into endodontic practice, many of these patients can be treated. The first step in achieving this goal is to add intravenous moderate sedation training to graduate endodontic programs. The long-term effect will be to make specialty endodontic care available to more people.

Cutaneous sinus tracts (or emerging sinus tracts of odontogenic origin: a report of 3 cases

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Ronald S Brown

2010-07-01

Full Text Available Ronald S Brown1, Robert Jones2, Tawana Feimster3, Frances E Sam21Department of Oral Diagnostic Services, Howard University College of Dentistry, Washington, DC, USA; 2Department of Oral and Maxillofacial Surgery, Howard University College of Dentistry, Washington, DC, USA; 3Department of Endodontics, Howard University College of Dentistry, Washington, DC, USAAbstract: Three cases are presented in which patients presented with either cutaneous swelling or cutaneous sinus tracts of odontogenic origin. A cutaneous sinus tract of odontogenic origin is a pathway through the alveolar bone that typically begins at the apex of an infected tooth or of an infected portion of the dental alveolus and empties infected material (pus through the skin. Where as the more common finding of an oral fistula is a pathway from the apical periodontal area of a tooth to the surface of the oral mucous membrane, permitting the discharge of suppurative material. Diagnosis, etiology and treatment are discussed with reference to patient history, clinical examinations, imaging, and treatment perspectives.Keywords: dental abscess, fistula, cutaneous sinus tract, odotogenic infection

Endodontic complications of root canal therapy performed by dental students with stainless-steel K-files and nickel-titanium hand files.

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Pettiette, M T; Metzger, Z; Phillips, C; Trope, M

1999-04-01

Straightening of curved canals is one of the most common procedural errors in endodontic instrumentation. This problem is commonly encountered when dental students perform molar endodontics. The purpose of this study was to compare the effect of the type of instrument used by these students on the extent of straightening and on the incidence of other endodontic procedural errors. Nickel-titanium 0.02 taper hand files were compared with traditional stainless-steel 0.02 taper K-files. Sixty molar teeth comprised of maxillary and mandibular first and second molars were treated by senior dental students. Instrumentation was with either nickel-titanium hand files or stainless-steel K-files. Preoperative and postoperative radiographs of each tooth were taken using an XCP precision instrument with a customized bite block to ensure accurate reproduction of radiographic angulation. The radiographs were scanned and the images stored as TIFF files. By superimposing tracings from the preoperative over the postoperative radiographs, the degree of deviation of the apical third of the root canal filling from the original canal was measured. The presence of other errors, such as strip perforation and instrument breakage, was established by examining the radiographs. In curved canals instrumented by stainless-steel K-files, the average deviation of the apical third of the canals was 14.44 degrees (+/- 10.33 degrees). The deviation was significantly reduced when nickel-titanium hand files were used to an average of 4.39 degrees (+/- 4.53 degrees). The incidence of other procedural errors was also significantly reduced by the use of nickel-titanium hand files.

Iatrogenic psoas abscess. Case report

DEFF Research Database (Denmark)

Bernstein, Inge Thomsen; Hansen, B J

1991-01-01

A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago.......A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago....

Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite.

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Isufi, Almira; Plotino, Gianluca; Grande, Nicola Maria; Ioppolo, Pietro; Testarelli, Luca; Bedini, Rossella; Al-Sudani, Dina; Gambarini, Gianluca

2016-01-01

To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (Pcomposite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations.

Non-linear indices of heart rate variability during endodontic treatment.

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Santana, Milana Drumond Ramos; Pita Neto, Ivo Cavalcante; Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Ramos, José Lucas Souza; Garner, David M; Valenti, Vitor Engácia; Abreu, Luiz Carlos de

2016-01-01

Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of α1 in T2 compared to T1 and T4 (p endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation.

The Relation of Endodontic-Periodontal Lesion and Therapy

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Trijani Suwandi

2013-07-01

Full Text Available The correlation between endodontic-periodontal lesion has been documented well be researches. Endodontic lesion originates from pulp, while periodontal lesion originates from periodontal tissues. Anatomically they are connected by apical foramen, lateral canal and accessories, as well as dentin tubules. The correlation appeared as the endodontic defect can be from periodontal lesion, or a periodontal defect is from a pulp tissue. Together they can emerge and form a combination lesion. Endodontic infections have been highly correlated with deeper periodontal pockets and furcation involvement in mandibular, the causal relationship between the two pathoses has not yet been established. This consensus supports the influence of degenerated or inflamed pulp that can happen on the periodontium; but not all researchers agree about the effect of periodontal disease on the pulp. Conclusion: The mechanism of endo-perio lesion need to taken care in order to have appropriate diagnostic so that the right therapy would be able to keep the teeth in the oral cavity.

Chlorhexidine in endodontics.

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Gomes, Brenda P F A; Vianna, Morgana E; Zaia, Alexandre A; Almeida, José Flávio A; Souza-Filho, Francisco J; Ferraz, Caio C R

2013-01-01

Chemical auxiliary substances (CAS) are essential for a successful disinfection and cleanness of the root canals, being used during the instrumentation and if necessary, as antimicrobial intracanal medicaments. Different CAS have been proposed and used, among which sodium hypochlorite (NaOCl), chlorhexidine (CHX), 17% EDTA, citric acid, MTAD and 37% phosphoric acid solution. CHX has been used in Endodontics as an irrigating substance or intracanal medicament, as it possesses a wide range of antimicrobial activity, substantivity (residual antimicrobial activity), lower cytotoxicity than NaOCl whilst demonstrating efficient clinical performance, lubricating properties, rheological action (present in the gel presentation, keeping the debris in suspension); it inhibits metalloproteinase, is chemically stable, does not stain cloths, it is odorless, water soluble, among other properties. CHX has been recommended as an alternative to NaOCl, especially in cases of open apex, root resorption, foramen enlargement and root perforation, due to its biocompatibility, or in cases of allergy related to bleaching solutions. The aim of this paper is to review CHX's general use in the medical field and in dentistry; its chemical structure, presentation form and storage; mechanism of action; antimicrobial activity including substantivity, effects on biofilms and endotoxins, effects on coronal and apical microbial microleakage; tissue dissolution ability; interaction with endodontic irrigants; effects on dentin bonding, metalloproteinases and collagen fibrils; its use as intracanal medicament and diffusion into the dentinal tubules; its use as disinfectant agent of obturation cones; other uses in the endodontic therapy; and possible adverse effects, cytotoxicity and genotoxicity.

Short-term vs long-term calcium hydroxide therapy after immediate tooth replantation: a histomorphometric study in monkey's teeth.

Science.gov (United States)

Panzarini, Sônia Regina; Gulinelli, Jéssica Lemos; Saito, Célia T M H; Poi, Wilson Roberto; Sonoda, Celso Koogi; Américo de Oliveira, José; Melo, Moriel Evangelista; de Souza Gomes, Weglis Dyanne

2012-06-01

Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy. © 2011 John Wiley & Sons A/S.

Iliacus abscess with radiculopathy mimicking herniated nucleus ...

African Journals Online (AJOL)

An iliacus abscess is an extremely rare cause of low back pain. With an iliacus abscess, the classical signs seen with a psoas abscess are frequently absent. Therefore, a timely diagnosis at the initial visit is difficult and inadequate treatment usually results in high mortality. Here, we report the case of 19-year-old man who ...

Cross-sectional evaluation of post-operative pain and flare-ups in endodontic treatments using a type of rotary instruments.

Science.gov (United States)

Tanalp, Jale; Sunay, Hakki; Bayirli, Gündüz

2013-01-01

The purpose of this clinical study was to evaluate the general incidence of post-operative pain and flare-ups in patients who were endodontically treated by two endodontics specialists using rotary instruments (Hero 642, Micro Mega, France) with the same treatment protocol. Records of 382 teeth belonging to 268 patients treated by two endodontics specialists during a 6-month period were kept and evaluated. Post-operative pain between treatment visits was categorized using a pre-established scoring system. Ninety-five patients were males, whereas 173 were females. Pulpal necrosis without periapical pathosis was determined as the most common indication for endodontic treatment (21.7%) followed by irreversible pulpitis and re-treatment without periapical lesions (18.3%, 18.3%, respectively). The general prevalence of post-operative pain and flare-ups was determined as 8.1%, whereas cases that could be classified as real flare-ups which were severe and required an unscheduled visit (scores 2 and 3) comprised 3.4% of the cases. No statistically significant correlation was determined between gender and post-operative pain and flare-up (p = 0.05). There was a significant correlation between number of appointments and the presence of pain and flare-ups. Teeth undergoing multiple visits had a higher risk of developing post-operative pain and flare-ups compared to those with single appointments with a statistical significance (p = 0.03). Teeth with pre-operative pain were more prone to developing post-operative pain and discomfort with a statistically significant difference (p = 0.02). While no significant correlation was determined between tooth vitality and pain and flare-ups (p = 0.5), a statistically significant relationship existed between the presence of a periapical pathosis and post-operative pain and flare-ups. Cases with a periapical lesion had a higher risk of developing pain and flare-ups compared to those with no periapical involvement (p = 0.0001). Future

Bilateral Tubercular Lung Abscess in a Diabetic Female

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N.S Neki

2017-07-01

Full Text Available Liquefactive necrosis of the lung tissue caused by microbial infection, lung abscess is characterised by formation of cavities containing necrotic debris. In the vast majority of cases of lung abscess, polymicrobial bacteria can be found with predominance of anaerobes. Mycobacterium has been described as a very rare causative agent of community acquired lung abscess. We are presenting a case of middle aged diabetic female, who had bilateral lung abscesses, aetiology of which was established to be tubercular. Astonishing it may sound; based upon extensive web and library search, it's the first case report on tubercular lung abscess in a diabetic from India, and perhaps from the world itself.

[Complex treatment of patients with cholangiogenic hepatic abscess].

Science.gov (United States)

Nychytaĭlo, M Iu; Skums, A V; Medvets'kyĭ, Ie B; Ohorodnyk, P V; Mashkovs'kyĭ, H Iu; Shkarban, V P; Shkarban, P O; Farzolakh, Mekhraban Jafarlu

2005-07-01

Results of treatment of 47 patients with cholangiogenic hepatic abscess were analyzed. Clinical, laboratory and special methods of investigation were applied for diagnosis. The authors consider ultrasound investigation (USI), computer tomography and the abscess puncture under the USI control with subsequent cytological and bacterial control the decisive methods in diagnosis of hepatic abscess. In complex of treatment of patients miniinvasive technologies were applied--the abscess puncture, its cavity drainage under USI control transcutaneus transhepatic cholangiostomy, endoscopic papillosphincterotomy with lithotripsy and nasobiliary drainage, according to indications. Efficacy of the abscess cavity sanation, using miramistinum and decasan, was proved. In general therapy the directed transport of medicines was applied.

Endodontic cellulitis 'flare-up'. Case report.

Science.gov (United States)

Matusow, R J

1995-02-01

Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.

Endodontic-related facial paresthesia: systematic review.

Science.gov (United States)

Alves, Flávio R; Coutinho, Mariana S; Gonçalves, Lucio S

2014-01-01

Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is characterized by a burning or twinging sensation or by partial loss of local sensitivity. Paresthesia related to endodontic treatment can occur because of extravasation of filling material or the intracanal dressing, as a consequence of periapical surgery or because of periapical infection. A literature review of paresthesia in endodontics was undertaken, with a view to identifying and discussing the most commonly affected nerves, the diagnostic process and the treatment options. Among reported cases, the most commonly affected nerves were those passing through the jaw: the inferior alveolar nerve, the mental nerve and the lingual nerve. To diagnose paresthesia, the endodontist must carry out a complete medical history, panoramic and periapical radiography, and (in some cases) computed tomography, as well as mechanoceptive and nociceptive tests. To date, no specific treatment for endodontic-related paresthesia has been described in the literature, since the problem may be related to a variety of causes.

Accuracy of Digital Radiography and Cone Beam Computed Tomography on Periapical Radiolucency Detection in Endodontically Treated Teeth

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Tadas Venskutonis

2014-07-01

Full Text Available Objectives: The aim of the present study was to compare the accuracy of intraoral digital periapical radiography and cone beam computed tomography in the detection of periapical radiolucencies in endodontically treated teeth. Material and Methods: Radiographic images (cone beam computed tomography [CBCT] scans and digital periapical radiography [PR] images from 60 patients, achieved from September 2008 to July 2013, were retrieved from databases of the Department of Oral Diseases, Lithuanian University of Health Sciences. Twenty patients met inclusion criteria and were selected for further evaluation. Results: In 20 patients (42.4 [SD 12.1] years, 65% men and 35% women a total of 35 endodontically treated teeth (1.75 [SD 0.91]; 27 in maxilla and 8 in mandible were evaluated. Overall, it was observed a statistical significant difference between the number of periapical lesions observed in the CBCT (n = 42 and radiographic (n = 24 examinations (P < 0.05. In molar teeth, CBCT identify a significantly higher amount of periapical lesions than with the radiographic method (P < 0.05. There were significant differences between CBCT and PR in the mean number of lesions identified per tooth (1.2 vs 0.66, P = 0.03, number of teeth with lesions (0.71 vs 0.46, P = 0.03 and number of lesions identified per canal (0.57 vs 0.33, P = 0.005. Considering CBCT as “gold standard” in lesion detection with the sensitivity, specificity and accuracy considering as score 1, then the same parameters of PR were 0.57, 1 and 0.76 respectively. Conclusions: Within the limitations of the present study, it can be concluded that cone beam computed tomography scans were more accurate compared to digital periapical radiographs for detecting periapical radiolucencies in endodontically treated teeth. The difference was more pronounced in molar teeth.

[Use of Cone Beam Computed Tomography in endodontics: rational case selection criteria].

Science.gov (United States)

Rosen, E; Tsesis, I

2016-01-01

To present rational case selection criteria for the use of CBCT (Cone Beam Computed Tomography) in endodontics. This article reviews the literature concerning the benefits of CBCT in endodontics, alongside its radiation risks, and present case selection criteria for referral of endodontic patients to CBCT. Up to date, the expected ultimate benefit of CBCT to the endodontic patient is yet uncertain, and the current literature is mainly restricted to its technical efficacy. In addition, the potential radiation risks of CBCT scan are stochastic in nature and uncertain, and are worrying especially in pediatric patients. Both the efficacy of CBCT in supporting the endodontic practitioner decision making and in affecting treatment outcomes, and its long term potential radiation risks are yet uncertain. Therefore, a cautious rational decision making is essential when a CBCT scan is considered in endodontics. Risk-benefit considerations are presented.

Computed tomographic diagnosis of abdominal abscess in childhood

International Nuclear Information System (INIS)

Kuhn, J.P.; Berger, P.E.

1980-01-01

Twenty-eight children suspected clinically of having an abdominal abscess were examined by CT. Eighteen had gallium 67 citrate scans and 22 had ultrasound studies. Computed tomography was found to be the most accurate test for diagnosis and evaluation of an abscess and the computed tomographic appearance of abscess is illustrated. However, because of cost factors, radiation dose, and clinical considerations, computed tomography is not always the first modality of choice in evaluating a suspected abdominal abscess [fr

Bioactive Materials in Endodontics: An Evolving Component of Clinical Dentistry.

Science.gov (United States)

Mohapatra, Satyajit; Patro, Swadheena; Mishra, Sumita

2016-06-01

Achieving biocompatibility in a material requires an interdisciplinary approach that involves a sound knowledge of materials science, bioengineering, and biotechnology. The host microbial-material response is also critical. Endodontic treatment is a delicate procedure that must be planned and executed properly. Despite major advances in endodontic therapy in recent decades, clinicians are confronted with a complex root canal anatomy and a wide selection of endodontic filling materials that, in turn, may not be well tolerated by the periapical tissues and may evoke an immune reaction. This article discusses published reports of various bioactive materials that are used in endodontic therapy, including calcium hydroxide, mineral trioxide aggregate, a bioactive dentin substrate, calcium phosphate ceramics, and calcium phosphate cements.

Percutaneous catheter drainage of tuberculous psoas abscesses

International Nuclear Information System (INIS)

Pombo, F.; Martin-Egana, R.; Cela, A.; Diaz, J.L.; Linares-Mondejar, P.; Freire, M.

1993-01-01

Six patients with 7 tuberculous psoas or ilio-psoas abscesses were treated by CT-guided catheter drainage and chemotherapy. The abscesses (5 unilateral and 1 bilateral) were completely drained using a posterior or lateral approach. The abscess volume was 70 to 700 ml (mean 300 ml) and the duration of drainage 5 to 11 days (mean 7 days). Immediate local symptomatic improvement was achieved in all patients, and there were no procedural complications. CT follow-up at 3 to 9 months showed normalization in 5 patients, 2 of whom are still in medical therapy. One patient, who did not take the medication regularly, had a recurrent abscess requiring new catheter drainage after which the fluid collection disappeared. Percutaneous drainage represents an efficient and attractive alternative to surgical drainage as a supplement to medical therapy in the management of patients with large tuberculous psoas abscesses. (orig.)

Application of forensic luminol for blood detection in endodontic files

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Rodrigo ARRUDA-VASCONCELOS

Full Text Available Abstract Introduction Blood is a biological material with high potential of infectious transmission in dental environments, including herpes simplex, hepatitis and AIDS. Aim To investigate the efficacy of luminol in detecting blood in endodontic files before and after the sterilization process. Material and method Luminol was used to investigate the presence or absence of traces of blood tissue in 50 endodontic files, visible to naked eye or not, after performing endodontic treatment and after the cleaning/sterilization process. The results obtained were tabulated and statistically analyzed by using the Friedman’s test at a significance level of 5% (p<0.05. Result By naked eye, it was found that 31/50 files showed no trace of blood, 8/50 showed a slight presence of blood and 11/50 showed a considerable presence of blood after endodontic treatment. After the use of luminol, however, 16/50 endodontic files showed no trace of blood, 19/50 showed a slight presence of blood and 15/50 showed a considerable presence of blood. After the cleaning and sterilization process, no blood was detected in the files. Conclusion It was concluded that the luminol solution is effective in detecting blood tissue in endodontic files as well as in validating the cleaning/sterilization process.

Percutaneous drainage of lung abscesses

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