An in vivo study evaluating lesion sterilization and tissue repair 3 MIX-MP noninstrumentation endodontic treatment as an alternative to conventional endodontic retreatment

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Vaishnavi Dasari

2016-01-01

Full Text Available Aim: To alleviate the patient's symptoms and promote periapical healing in teeth with failure of root canal treatment, without the removal of previous obturating material using lesion sterilization and tissue repair (LSTR 3 MIX-MP noninstrumentation endodontic treatment (NIET. Materials and Methods: Fifteen single-rooted teeth with a history of root canal treatment 1–2 years previously, requiring retreatment, with pain, sinus tract, swelling and periapical lesions, and having acceptable obturation were included in the study. The previous coronal restoration was removed, and a medication cavity was prepared for placement of 3MIX MP; this was followed by lining with Glass ionomer cement and a coronal restoration with composite resin. Results: At 8 weeks, all patients did not have either pain, tenderness on vertical percussion, pain on biting, or swelling (asymptomatic. Radiographically, the periapical lesions had reduced by 1 mm in five cases. In six patients, the lesion size remained unchanged. Conclusion: LSTR NIET is an excellent, inexpensive, less traumatic, and least time-consuming alternative to treat symptomatic teeth requiring endodontic retreatment.

The solutions to your problems in endodontic retreatment and microsurgery

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Leslie Ang

2016-06-01

How to find the 4th canal in the upper Second molars in 60% of your patients, How to find the 4th canal in the upper First molars in 90% of your patients, How to retreat canals root filled with metal posts, fiber posts, gutta percha, hard canal cement & thermafils, How to remove fractured posts and posts cemented with resin cements. Understand why and how to perform Endodontic Surgery: How to treat large periapical lesions microsurgically, How to use the latest Ultrasonic technology under the Surgical Operating Microscope in all forms of microsurgery, Learn about the modern concepts in transplants, apicoectomies and intentional replantations.

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.

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.

Postoperative pain after endodontic retreatment: single- versus two-visit treatment.

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Yoldas, Oguz; Topuz, Aysin; Isçi, A Sehnaz; Oztunc, Haluk

2004-10-01

The purpose of this clinical study was to determine the effect of 1- or 2-visit root canal treatment on the postoperative pain in the retreatment cases. Two hundred eighteen cases that required retreatment were included in the study. Obturated and unfilled canal space and the status of periapical tissues were evaluated according to the PAI index. The patients were subcategorized in regard to the presence or the absence of preoperative pain. Approximately half of each category was treated in 1 appointment. After removing the previous root canal obturation materials and biomechanic preparation of root canals, the teeth in the 1-visit group were obturated at the first appointment by using AH 26 sealer and laterally compacted gutta-percha, and those in the 2-visit group were medicated with calcium hydroxide-chlorhexidine combination and then closed with a temporary filling material. One week after the initial appointment, patients were asked about the occurrence of postoperative pain. The level of discomfort was rated as no pain, mild pain, moderate pain, or severe pain (flare-up). Data were statistically analyzed using the chi-squared and Fischer exact tests. Eight patients from the 1-visit group and 2 patients from the 2-visit group had flare-ups. There was a statistical difference between the groups (P endodontic treatment with intracanal medication was found to be effective in reducing postoperative pain of previously symptomatic teeth and decreased the number of flare-ups in all retreatment cases.

Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study.

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Maity, Ipsita; Meena, N; Kumari, R Anitha

2014-04-01

The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.

[Test your decision-making. When to do endodontic retreatment? Results of a study].

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Aryanpour, S; D'Hoore, W; Van Nieuwenhuysen, J P

2000-01-01

The goals of this survey were to determine the most frequent therapeutic option and to evaluate the consensus among a sample of Belgian practitioners managing the same simulated cases of root treated teeth. On average, conservative options (nonsurgical retreatment 35.27% and no retreatment 29.61%) are the most selected alternatives. Surgical options and extraction respectively constitute 21.18% and 13% of the treatment propositions. As expected, the presence of radiographic and/or clinical signs resulted in a more aggressive attitude, but the presence of symptoms does not seem to be a valid reason for reintervention. The results of the study demonstrate considerable interindividual variations in clinical management of root treated teeth, regardless of personal factors, such as gender, years of experience and graduation institution. Even if a consensus appears within a group of professionals, it is not necessarily applied by a majority of practitioners; this contributes certainly to the explanation of the geographical or institutional variations noted in the medical practices.

Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study

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Ipsita Maity

2014-01-01

Full Text Available Aims: The aim of this study was to assess the outcome of single sitting root canal treatment (RCT of asymptomatic teeth with periapical cysts. Materials and Methods: Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. Results: Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. Conclusions: It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.

Effect of Intracanal Medication with Calcium Hydroxide and 1% Chlorhexidine in Endodontic Retreatment Cases with Periapical Lesions: An In Vivo Study

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Ertugrul Ercan

2007-01-01

Conclusion: Our results suggest that a combination of Ca(OH2 and 1% CHX can be successfully used as intracanal medicament for disinfection in endodontic retreatment cases with periapical lesions. [J Formos Med Assoc 2007;106(3:217-224

Incidence of flare-ups and evaluation of quality after retreatment of resorcinol-formaldehyde resin ("Russian Red Cement") endodontic therapy.

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Gound, Tom G; Marx, David; Schwandt, Nathan A

2003-10-01

The purpose of this retrospective study was to evaluate the quality of treatment and incidence of flare-ups when teeth with resorcinol-formaldehyde resin are retreated in a postgraduate endodontic clinic. Fifty-eight cases were included in this study. Obturated and unfilled canal space was measured on radiographs. Forty-eight percent of the total canal space was filled before retreatment; 90% was filled after retreatment. After retreatment, obturations were rated as optimal in 59%, improved in 33%, unchanged in 6%, and worse in 2%. Seven patients (12%) had postretreatment flare-ups. Data were statistically analyzed using the Cochran-Armitage Test for Discrete Variables. No statistical difference in the incidence of flare-ups was found in teeth that before treatment had more than half the canal space filled compared to teeth with less than half, cases with pre-existing periradicular radiolucencies compared to cases with normal periradicular appearance, symptomatic cases compared to asymptomatic cases, or cases with optimal fillings after retreatment compared to less than optimal cases. It was concluded that teeth with resorcinol-formaldehyde fillings might be retreated with a good prognosis for improving the radiographic quality, but a higher than normal incidence of flare-ups may occur.

Nonsurgical management of a periapical cyst: a case report.

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Dandotikar, Deepakraj; Peddi, Ravigna; Lakhani, Bharvi; Lata, Kamini; Mathur, Aditi; Chowdary, Uday Kumar

2013-06-01

Large periapical lesions, regardless of whether they are granulomas, abscesses or cysts, are primarily caused by root canal infection. Thus the treatment protocol should be elimination of etiological factors in the root canal system rather than their product, apical true cyst. A 10 year old female patient reported to the Department of Pedodontics and Preventive Dentistry, Dr R Ahmed Dental College & Hospital, Kolkata, with the chief complaint of pain and swelling in relation to upper front fractured teeth. Clinical and radiological findings were suggestive of periapical radicular cyst. Non-surgical endodontic therapy was performed using 1% sodium hypochlorite solution irrigant and Calcium hydroxide intra canal medicament. A 12 months follow-up radiographic examination revealed progressive involution of periapical radiolucency without any clinical symptoms. Periapical cysts respond favorably to non-surgical endodontic treatment and should be considered as primary treatment modality. How to cite this article: Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary U K. Nonsurgical Management of a Periapical Cyst: A Case Report. J Int Oral Health 2013; 5(3):79-84.

[Nonsurgical retreatment in a case of a radiolucent apical lesion].

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Vicente Gómez, A; Rodríguez Ponce, A

1989-01-01

We present a case of failure that was helpful solved without surgical endodontic treatment. We don't achieve clinical success besides endodontic treatment was twice remade. Finally we decided to put a temporary filling with calcium hydroxide and wait until apical radiolucency disappear and complete our treatment with gutta-percha, sealer and lateral condensation.

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.

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

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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

Regenerative endodontics--Creating new horizons.

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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.

[Nonsurgical retreatment of lateral radiopacity after surgical treatment].

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Arias de Luxan, A

1990-01-01

A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months.

Endodontic applications of 3D printing.

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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.

The efficacy of ProTaper Universal rotary retreatment instrumentation to remove single gutta-percha cones cemented with several endodontic sealers.

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Ersev, H; Yilmaz, B; Dinçol, M E; Dağlaroğlu, R

2012-08-01

To evaluate residual root filling material following removal of three newly developed root canal sealers used with a matched-taper single-cone root filling technique and to compare the efficacy of ProTaper Universal rotary retreatment instruments with that of a conventional manual technique. The canals of 120 palatal roots in maxillary molar teeth were instrumented with EndoWave nickel-titanium rotary instruments and filled using Hybrid Root SEAL, EndoSequence BC Sealer, Activ GP system or AH Plus with matched-taper single gutta-percha cones. The root fillings were then removed with ProTaper Universal retreatment rotary instruments or a manual technique. Buccolingual and proximal digital radiographs of the roots were exposed to determine the area of remaining filling material in the coronal, middle and apical thirds. The area percentages of remaining filling material in each third and total canal area were calculated. Data were analysed statistically with Kruskal-Wallis and Mann-Whitney U-tests. The level of significance was set at PProTaper groups. When using gross radiographic criteria, the Activ GP was more effectively removed from root canals than AH Plus with hand instrumentation. Hybrid Root SEAL, EndoSequence BC Sealer and AH Plus were removed to a similar extent. ProTaper Universal retreatment instruments were as safe and effective as hand instruments in reaching the working length. © 2012 International Endodontic Journal.

Efficacy of Different Methods for Removing Root Canal Filling Material in Retreatment - An In-vitro Study.

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Kasam, Swetha; Mariswamy, Annapoorna Ballagere

2016-06-01

Although success of endodontic therapy has significantly improved in the last few decades due to the introduction of novel materials and techniques, failures of endodontic therapy requiring re-treatment still comprise a significant percentage of patients requiring root canal treatment. To evaluate and compare the effective removal of gutta percha and sealer, amount of apical debris extrusion and time required for gutta percha removal using various endodontic files. Total 48 extracted mandibular premolars were mounted on acrylic blocks and endodontic procedure was carried out using size 40 K file and obturated using guttapercha and zinc oxide eugenol sealer. After one month storage, samples were decoronated, mounted on screw capped vials and subjected to removal of obturated material by four instruments: H files, safe sided H files, protaper universal retreatment rotary system and ultrasonic retreatment tip, grouped as 1, 2, 3, and 4 respectively. Only 2mm of obturated material from the coronal part was removed using no. 3 Gates Glidden drill, guttapercha was softened with a drop of xylene for 2 mins for each canal and retreatment was performed. The retreatment procedure was said to be complete when no visible debris were observed on the instrument flutes. The samples split into two halves and examined under stereomicroscope, photographed, assessed using AUTOCAD software and percentage of remaining filling material in coronal, middle, apical thirds of the canal was calculated in mm(2). Retreatment time was recorded in seconds and apically extruded debris was assessed by microbalance in grams for each tooth. The data was analyzed by using descriptive statistics, ANOVA and Scheffe's post hoc test through SPSS for windows (v 16.0). The ultrasonic retreatment tip had less percentage of residual guttapercha/sealer, shorter mean operating time and little apical extrusion with a significant difference (p<0.05) between the other groups. All techniques retained guttapercha

Endodontic Treatment of a Maxillary Second Molar with Developmental Anomaly: A Case Report

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Asgary, Saeed

2007-01-01

Fusion is a rare occurrence in molar teeth. The purpose of this rare case presentation is to describe the nonsurgical endodontic treatment of maxillary molar. A 28-year-old patient was referred for endodontic treatment of her chronic apical abscess of right maxillary second molar. In the clinical examination, a sinus tract adjacent to involved tooth and a small crown of supernumerary tooth fused to the buccal surface of the molar at gingival margin was observed. Endodontic treatment was decid...

Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite.

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Tenore, Gianluca; Palaia, Gaspare; Ciolfi, Chiara; Mohsen, Mohamed; Battisti, Andrea; Romeo, Umberto

2017-01-01

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva manoeuvre. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. Presented here is a case of subcutaneous emphysema that occurred after sodium hypochlorite irrigation during endodontic treatment, and the description of its etiologies and prevention during nonsurgical endodontic treatment. Endodontic success can be essentially achieved via good debridement of a root canal, and an ideal endodontic irrigant is effective in removing the smear layer, opening the dentinal tubules, and producing a clean surface for closer obturation. A 60-years-old woman had an abnormal swelling and pain during an endodontic treatment accompanied by her dentist to the emergency room and was referred to our observation for complaining of severe pain, ecchymosis and severe swelling on the left side of her face. The aforementioned symptoms appeared after sodium hypochlorite irrigation and aggressive use of air spray for drying the root canal during the endodontic treatment of the upper left lateral incisor. An extrusion during an inappropriate endodontic treatment may occasionally be reported and can cause tissue damage. NaOCl is one of the best and most commonly used irrigating solutions because of its efficacy, but it can also negatively affect the periapical tissues. Determining the correct working length, even when performing an intraoperative periapical radiograph and confirming the root canal integrity, could help avoid these kinds of accidents.

Predictors, prevention, and management of postoperative pain associated with nonsurgical root canal treatment: A systematic review

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Mothanna K. AlRahabi, PhD

2017-10-01

Full Text Available Postoperative pain after root canal treatment can be reduced by applying recent advances in endodontic techniques and equipment. This systematic review includes current knowledge about pain after nonsurgical root canal treatment, including predictors, related factors, effects of recent advances, and management. A literature search was performed using the PubMed, ScienceDirect, and Cochrane Library databases for articles published between 1990 and 2016. Search keywords included postoperative pain, nonsurgical treatment, single visit, recent advances in endodontics, and management of postoperative pain with endodontic treatment. Only original research studies were included; editorials, reviews, brief notes, conference proceedings, and letters to the editor were excluded. The initial search yielded 4941 articles, which were assessed and filtered using the selection criteria. Sixty-five studies met the inclusion criteria and were included in the review. The findings showed that pain after nonsurgical root canal treatment occurred in 3–69.3% of patients. Microorganisms were identified as the primary contributors to postoperative pain, and there was no significant difference in postoperative pain between single- and multiple-visit treatments. Postoperative pain after root canal treatment ranges from mild to moderate and occurs even after optimally performed procedures. Furthermore, adequate management of postoperative pain is often considered an indicator of clinical excellence. Application of recently developed endodontic techniques and devices will reduce postoperative pain. Furthermore, a flexible, severity-based drug administration plan can be used to control and manage pain after root canal treatment. Application of the current research findings will reduce pain following root canal treatment and improve patient outcomes.

Endodontic treatment of a maxillary second molar with developmental anomaly: a case report.

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Asgary, Saeed

2007-01-01

Fusion is a rare occurrence in molar teeth. The purpose of this rare case presentation is to describe the nonsurgical endodontic treatment of maxillary molar. A 28-year-old patient was referred for endodontic treatment of her chronic apical abscess of right maxillary second molar. In the clinical examination, a sinus tract adjacent to involved tooth and a small crown of supernumerary tooth fused to the buccal surface of the molar at gingival margin was observed. Endodontic treatment was decided for the involved molar for functional reason. Recall examination, a year after completion of endodontic and restorative treatments, showed the tooth was clinically asymptomatic and there was no radiographic lucency around the apical region.

A comparative evaluation of efficacy of protaper universal rotary retreatment system for gutta-percha removal with or without a solvent.

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Kumar, M Sita Ram; Sajjan, Girija S; Satish, Kalyan; Varma, K Madhu

2012-09-01

The aim was to evaluate and compare the efficacy of ProTaper Universal rotary retreatment system with or without solvent and stainless steel hand files for endodontic filling removal from root canals and also to compare retreatment time for each system. Thirty extracted mandibular premolars with single straight canals were endodontically treated. Teeth were divided into three major groups, having 10 specimens each. Removal of obturating material in group 1 by stainless steel hand files with RC Solve, group 2 by ProTaper Universal retreatment instruments and group 3 by ProTaper Universal retreatment instruments along with RC solve was done. Retreatment was considered complete for all groups when no filling material was observed on the instruments. The retreatment time was recorded for each tooth. All specimens were grooved longitudinally in a buccolingual direction. The split halves were examined under a stereomicroscope and images were captured and analyzed. The remaining filling debris area ratios were considered for statistical analysis. With ANOVA test, statistical analysis showed that there was statistically no significant difference regarding the amount of filling remnants between the groups (P ProTaper Universal retreatment system files alone proved to be faster than the other experimental groups.

Management of a large radicular cyst: A non-surgical endodontic approach

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Shweta Dwivedi

2014-01-01

Full Text Available A radicular cyst arises from epithelial remnants stimulated to proliferate by an inflammatory process originating from pulpal necrosis of a non-vital tooth. Radiographically, the classical description of the lesion is a round or oval, well-circumscribed radiolucent image involving the apex of the tooth. A radicular cyst is usually sterile unless it is secondarily infected. This paper presents a case report of conservative non-surgical management of a radicular cyst associated with permanent maxillary right central incisor, right lateral incisor and right canine in a 24-year-old female patient. Root canal treatment was done together with cystic aspiration of the lesion. The lesion was periodically followed up and significant bone formation was seen at the periapical region of affected teeth and at the palate at about 9 months. Thus, nonsurgical healing of a large radicular cyst with palatal swelling provided favorable clinical and radiographic response.

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.

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

Inferior alveolar nerve paresthesia after overfilling of endodontic sealer into the mandibular canal.

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González-Martín, Maribel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José Luis; Segura-Egea, Juan José

2010-08-01

The present study describes a case of endodontic sealer (AH Plus) penetration within and along the mandibular canal from the periapical zone of a lower second molar after endodontic treatment. The clinical manifestations comprised anesthesia of the left side of the lower lip, paresthesia and anesthesia of the gums in the third quadrant, and paresthesia and anesthesia of the left mental nerve, appearing immediately after endodontic treatment. The paresthesia and anesthesia of the lip and gums were seen to decrease, but the mental nerve paresthesia and anesthesia persisted after 3.5 years. This case illustrates the need to expend great care with all endodontic techniques when performing nonsurgical root canal therapy, especially when the root apices are in close proximity to vital anatomic structures such as the inferior alveolar canal. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

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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.

In vitro evaluation of the effectiveness of ProTaper universal rotary retreatment system for gutta-percha removal with or without a solvent.

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Takahashi, Cristiane Midori; Cunha, Rodrigo Sanches; de Martin, Alexandre Sigrist; Fontana, Carlos Eduardo; Silveira, Cláudia Fernandes M; da Silveira Bueno, Carlos Eduardo

2009-11-01

Effective removal of gutta-percha in endodontic retreatment is a significant factor to ensure a favorable outcome from failed procedures. The purpose of this study was to evaluate the efficacy of a nickel-titanium rotary instrument system with or without a solvent versus stainless steel hand files for gutta-percha removal. Forty extracted human maxillary anterior teeth were prepared and filled. They were divided into 4 groups: Gates-Glidden and K-files, Gates-Glidden and K-files with chloroform, ProTaper Universal rotary retreatment system, and ProTaper Universal rotary retreatment system with chloroform. The operating time was recorded. The teeth were longitudinally sectioned and photographed. The images were analyzed and the filling remnants were quantified by using the IMAGE TOOL software. With Kruskall-Wallis test, statistical analysis showed that there was no significant difference between the techniques in regard to the amount of the endodontic filling remnants (P ProTaper Universal rotary retreatment system was faster than the hand files (P ProTaper Universal rotary retreatment system without chloroform was faster.

Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material.

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Marques da Silva, B; Baratto-Filho, F; Leonardi, D P; Henrique Borges, A; Volpato, L; Branco Barletta, F

2012-10-01

To assess the efficacy of different retreatment rotary files in removing gutta-percha and endodontic sealer from canals. Ninety straight single-rooted premolars were prepared up to a size 30 and filled with gutta-percha and sealer and then randomly assigned to six retreatment groups (n = 15). Groups I, III, and V were retreated using rotary systems ProTaper Universal Retreatment (PTUR), D-RaCe, and Mtwo Retreatment, respectively. Groups II, IV, and VI were retreated using the additional instruments F4, size 40, .04 taper RaCe, and size 40, .04 taper Mtwo, respectively. The roots were split vertically, and images of the halves were obtained using a high-resolution scanner and evaluated with AutoCAD software to calculate the percentage of residual material. Data were analyzed with Kruskal-Wallis and Student-Newman-Keuls tests using a 5% significance cutoff (P 0.05) between groups when additional instruments were used. The percentage of residual material was lowest in the PTUR group and was statistically significant only when compared to the D-RaCe system (P = 0.0038). All root canals had residual filling material after retreatment even when additional instruments were used. © 2012 International Endodontic Journal.

Root Canal Retreatment menggunakan Kombinasi Kalsium Hidroksida dan Chlorhexidine sebagai Medikamen Intra Kanal Insisivus Sentral Kiri Maksila

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Andina Novita Sari

2014-12-01

retreatment dengan cleaning dan shaping ulang yang baik dengan menggunakan medikasi intrakanal berupa kombinasi kalsium hidroksida dan chlorhexidine 2% diharapkan mempunyai efek antimikroba yang sinergis untuk mencapai kesuksesan root canal retreatment.   Root Canal Retreatment Using Calcium Hydroxide as Intra Canal Medicament On The Maxillary Left Incisor. Enterococcus faecalis bacteria is most abundant in the root canal infection treated endodontically. Chlorhexidine has a broad antibacterial spectrum and has been used as an endodontic irrigant and intracanal medication. Chlorhexidine has a bactericidal and fungicidal effect as chlorhexidine absorbed into the bacterial cell surface and cause damage to the integrity of the cell membrane. Calcium hydroxide is a biocompatible, antimicrobial agents with high pH effects and stimulates hard tissue formation. A mixture of calcium hydroxide and chlorhexidine is used to control bacteria Enterococcus faecalis alternative. The purpose of this case report is to report on the success of root canal treatment in the left maxillary central incisor with acute periapical periodontitis using a combination of calcium hydroxide and chlorhexidine as intracanal A 24 years old female patient presents with left upper central incisor tooth ache since 4 years ago. The tooth was hurt to percussion, but normal to pulpation as well as the mobility. The tooth has a history of previous trauma and broken 6 years ago and has performed endodontic treatment. Radiographic examination showed obturation teeth 21 are not hermetic with periapical radiolucency in diffuse boundaries, widening of the periodontal ligament and the dissolution of the lamina dura. Root canal re-treatment using a combination of calcium hydroxide and chlorhexidine as intracanal medicaments were performed. In conclussion, the root canal cleaning and shaping retreatment can be performed using a combination of calcium hydroxide and chlorhexidine as intracanal

A comparative evaluation of efficacy of protaper universal rotary retreatment system for gutta-percha removal with or without a solvent

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M Sita Ram Kumar

2012-01-01

Full Text Available Aim: The aim was to evaluate and compare the efficacy of ProTaper Universal rotary retreatment system with or without solvent and stainless steel hand files for endodontic filling removal from root canals and also to compare retreatment time for each system. Materials and Methods: Thirty extracted mandibular premolars with single straight canals were endodontically treated. Teeth were divided into three major groups, having 10 specimens each. Removal of obturating material in group 1 by stainless steel hand files with RC Solve, group 2 by ProTaper Universal retreatment instruments and group 3 by ProTaper Universal retreatment instruments along with RC solve was done. Retreatment was considered complete for all groups when no filling material was observed on the instruments. The retreatment time was recorded for each tooth. All specimens were grooved longitudinally in a buccolingual direction. The split halves were examined under a stereomicroscope and images were captured and analyzed. The remaining filling debris area ratios were considered for statistical analysis. Results: With ANOVA test, statistical analysis showed that there was statistically no significant difference regarding the amount of filling remnants between the groups (P < 0.05. Differences between the means of groups are statistically significant regarding the retreatment time. Conclusion: Irrespective of the technique used, all the specimens had some remnants on the root canal wall. ProTaper Universal retreatment system files alone proved to be faster than the other experimental groups.

The Efficacy of the WaveOne Reciprocating File System versus the ProTaper Retreatment System in Endodontic Retreatment of Two Different Obturating Techniques.

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Jorgensen, Ben; Williamson, Anne; Chu, Rene; Qian, Fang

2017-06-01

This ex vivo study aimed to evaluate the efficacy of retreating GuttaCore (Dentsply Tulsa Dental Specialties, Tulsa, OK) and warm vertically condensed gutta-percha in moderately curved canals with 2 different systems: ProTaper Universal Retreatment (Dentsply Tulsa Dental) and WaveOne (Dentsply Tulsa Dental). Eighty mesial roots of mandibular molars were used in this study. The mesiobuccal canals in each sample were prepared to length with the WaveOne Primary file (Dentsply Tulsa Dental). The canals were obturated with either a warm vertical approach or with GuttaCore and divided into 4 retreatment groups with the same mean root curvature: warm vertical retreated with ProTaper, warm vertical retreated with WaveOne, GuttaCore retreated with ProTaper, and GuttaCore retreated with WaveOne. The warm vertical groups were obturated using a continuous-wave technique of gutta-percha compaction, and the GuttaCore groups were obturated according to the manufacturer's instructions. After allowing sealer to set, each specimen was retreated with either the ProTaper Universal Retreatment files D1, D2, or D3 or with the WaveOne Primary file to the predetermined working length. The time taken to reach the working length was recorded. Instrument fatigue and failure were also evaluated. The post hoc 2-sample t tests showed that the overall mean total time taken to reach the working length for the warm vertical groups was significantly greater than that observed for the GuttaCore groups (mean = 87.11 vs 60.16 seconds, respectively), and the overall mean total time taken to reach the working length for WaveOne was significantly greater than that observed for ProTaper (99.09 vs 48.18 seconds, respectively). Two-way analysis of variance showed a significant main effect for both the type of experiment groups (F 1,76  = 15.32, P = .0002) and the type of retreatments (F 1,76  = 54.67, P file underwent more separations than the ProTaper files. The WaveOne Primary file underwent

3D imaging, 3D printing and 3D virtual planning in endodontics.

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Shah, Pratik; Chong, B S

2018-03-01

The adoption and adaptation of recent advances in digital technology, such as three-dimensional (3D) printed objects and haptic simulators, in dentistry have influenced teaching and/or management of cases involving implant, craniofacial, maxillofacial, orthognathic and periodontal treatments. 3D printed models and guides may help operators plan and tackle complicated non-surgical and surgical endodontic treatment and may aid skill acquisition. Haptic simulators may assist in the development of competency in endodontic procedures through the acquisition of psycho-motor skills. This review explores and discusses the potential applications of 3D printed models and guides, and haptic simulators in the teaching and management of endodontic procedures. An understanding of the pertinent technology related to the production of 3D printed objects and the operation of haptic simulators are also presented.

Saving Single-rooted Teeth with Combined Endodontic-periodontal Lesions.

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Pico-Blanco, Alexandre; Castelo-Baz, Pablo; Caneiro-Queija, Leticia; Liñares-González, Antonio; Martin-Lancharro, Pablo; Blanco-Carrión, Juan

2016-12-01

Teeth affected by combined endodontic-periodontal lesions are usually considered by all prognosis classifications as hopeless teeth. The development of new biomaterials combined with modern endodontic and periodontal regeneration techniques may improve dental prognosis and maintain the affected teeth. Moreover, 1 of the replacement options for those teeth, dental implants, has shown an increasing number of biological and technical complications. Five patients were included in this case series study. Full periodontal and radiographic examination revealed generalized chronic periodontitis. Moreover, endodontic-periodontal lesions affecting single-rooted teeth were detected in those patients with tissue destruction beyond the apex. After splinting those teeth, conventional endodontic and nonsurgical periodontal treatment was performed. Three months later, periodontal regeneration was applied at those teeth in order to reconstruct supporting tissues and to improve dental prognosis. After a follow-up period ranging from 14 months to 17 years, it was observed that all teeth remain asymptomatic and in normal function. No signs of apical pathosis were observed, and the periodontium was stable. All patients were included in a strict maintenance program to check the periodontal and apical status. This case series shows that it is possible to change the prognosis of teeth affected by combined endodontic-periodontal lesions, even if the periodontal support is destroyed beyond the apex. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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.

Clinical decision making in restorative dentistry, endodontics, and antibiotic prescription.

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Zadik, Yehuda; Levin, Liran

2008-01-01

The purpose of this study was to evaluate the influence of geographic location of graduation (Israel, Eastern Europe, Latin America) on decision making regarding management of dental caries, periapical lesions, and antibiotic prescribing routines. A questionnaire was given to ninety-eight general practitioners regarding demographic and work habits. Photographs of lesions were shown on a screen. Participants reported recommended treatment and whether they would routinely prescribe antibiotics following regular endodontic treatment, retreatment, and impacted third molar surgical extraction in healthy patients. There was a 94 percent (n=92) response rate, of which eighty-five responses were used in the data analysis. Surgical treatment of asymptomatic enamel caries lesions was not recommended by most of the subjects, and surgery was recommended for DEJ caries lesions in low or moderate caries risk patients, both without significant differences between geographic regions of dental school graduation. Israelis had a lower frequency of retreatment in asymptomatic teeth that demonstrated periapical radiolucency with post restoration (without crown) compared to Latin Americans and East Europeans. Most of the participants would not retreat asymptomatic teeth that demonstrated periapical radiolucency with post and crown. After third molar surgery, 46 percent of participants routinely prescribed antibiotics. Significantly more Latin American graduates prescribed antibiotics following endodontic treatment, retreatment, and third molar extractions (pantibiotics) and overtreatment (caries) among young practitioners reflect failure of undergraduate education in proper use of antibiotics and management of the carious lesions according to the patient's clinical presentation and caries risk assessment rather than routinely undertaking surgical caries treatment.

Interference of partial visual analysis of root filling quality and apical status on retreatment decisions

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Renata Dornelles Morgental

2012-04-01

Full Text Available OBJECTIVE: The presence of periapical radiolucency has been used as a criterion for endodontic treatment failure. However, in addition to the inherent limitations of radiographic examinations, radiographic interpretations are extremely subjective. Thus, this study investigated the effect of partial analysis of root filling quality and periapical status on retreatment decisions by general dentists. MATERIAL AND METHODS: Twelve digitalized periapical radiographs were analyzed by 10 observers. The study was conducted at three time points at 1-week intervals. Radiographs edited with the Adobe Photoshop CS4 software were analyzed at three time points: first, only root filling quality was analyzed; second, only the periapical areas of the teeth under study were visualized; finally, observers analyzed the unedited radiographic image. Spearman ’s coefficient was used to analyze the correlations between the scores assigned when the periapical area was not visible and when the unedited radiograph was analyzed, as well as between the scores assigned when root fillings where not visible and when the unedited radiograph was analyzed. Sensitivity, specificity, positive and negative predictive values between partial images and unedited radiographs were also used to analyze retreatment decisions. The level of significance was set at 5%. RESULTS: The visualization of the root filling on the unedited radiograph affected the interpretation of the periapical status and the technical quality of the fillings has a greater influence on the general dentist’s decision to prescribe endodontic retreatment than the periapical condition. CONCLUSION: In order to make endodontic diagnosis, radiographic interpretation process should not only emphasize technical aspects, but also consider biological factors.

Comparative evaluation of debris extruded apically by using, Protaper retreatment file, K3 file and H-file with solvent in endodontic retreatment

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Chetna Arora

2012-01-01

Full Text Available Aim: The aim of this study was to evaluate the apical extrusion of debris comparing 2 engine driven systems and hand instrumentation technique during root canal retreatment. Materials and Methods: Forty five human permanent mandibular premolars were prepared using the step-back technique, obturated with gutta-percha/zinc oxide eugenol sealer and cold lateral condensation technique. The teeth were divided into three groups: Group A: Protaper retreatment file, Group B: K3, file Group C: H-file with tetrachloroethylene. All the canals were irrigated with 20ml distilled water during instrumentation. Debris extruded along with the irrigating solution during retreatment procedure was carefully collected in preweighed Eppendorf tubes. The tubes were stored in an incubator for 5 days, placed in a desiccator and then re-weighed. Weight of dry debris was calculated by subtracting the weight of the tube before instrumentation and from the weight of the tube after instrumentation. Data was analyzed using Two Way ANOVA and Post Hoc test. Results : There was statistically significant difference in the apical extrusion of debris between hand instrumentation and protaper retreatment file and K3 file. The amount of extruded debris caused by protaper retreatment file and K3 file instrumentation technique was not statistically significant. All the three instrumentation techniques produced apically extruded debris and irrigant. Conclusion: The best way to minimize the extrusion of debris is by adapting crown down technique therefore the use of rotary technique (Protaper retreatment file, K3 file is recommended.

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.

Saving Natural Teeth: Intentional Replantation-Protocol and Case Series.

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Grzanich, Derek; Rizzo, Gabriella; Silva, Renato Menezes

2017-12-01

Intentional replantation is a reliable and predictable treatment for cases in which nonsurgical endodontic retreatment failed or is impractical and endodontic surgery is hampered because of anatomic limitations. This article presents a protocol for intentional replantation illustrated with some interesting cases. The cases presented here are from patients (average age, 61 years) with no contributing medical history. The cases are molars with previous failed endodontic treatment/retreatment and diagnosed with apical periodontitis. Treatment procedures included atraumatic extractions with minimal manipulations of the periodontal ligament, followed by root-end resection, root-end preparation with ultrasonic tips, root-end fill with bioceramic cement, and rapid tooth replacement into the socket. Granulomatous tissue was gently curetted when applicable. All procedures were performed under the microscope. Intentional replantation with careful case selection may be considered as a last option for preserving hopeless teeth. Atraumatic extraction by using state-of-the-art equipment, instruments, and materials, minimal extra-alveolar time, and maintaining an aseptic technique are key factors for success. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Use of second-generation platelet concentrate (platelet-rich fibrin and hydroxyapatite in the management of large periapical inflammatory lesion: A computed tomography scan analysis

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Hemalatha Hiremath

2014-01-01

Full Text Available Periapical surgery is required when periradicular pathosis associated with endodontically treated teeth cannot be resolved by nonsurgical root canal therapy (retreatment, or when retreatment was unsuccessful, not feasible or contraindicated. Endodontic failures can occur when irritants remain within the confines of the root canal, or when an extraradicular infection cannot be eradicated by orthograde root canal treatment. Foreign-body responses toward filling materials, toward cholesterol crystals or radicular cysts, might prevent complete periapical healing. We present here a case report wherein, combination of platelet-rich fibrin (PRF and the hydroxyapatite graft was used to achieve faster healing of the large periapical lesion. Healing was observed within 8 months, which were confirmed by computed tomography, following improved bone density. PRF has many advantages over platelet-rich plasma. It provides a physiologic architecture that is very favorable to the healing process, which is obtained due to the slow polymerization process.

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".

Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: A comparative in vitro study.

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Bhagavaldas, Moushmi Chalakkarayil; Diwan, Abhinav; Kusumvalli, S; Pasha, Shiraz; Devale, Madhuri; Chava, Deepak Chowdary

2017-01-01

The aim of this in vitro study was to compare the efficacy of two retreatment rotary systems in the removal of Gutta-percha (GP) and sealer from the root canal walls with or without solvent. Forty-eight extracted human mandibular first premolars were prepared and obturated with GP and AH Plus sealer. Samples were then randomly divided into four groups. Group I was retreated with MtwoR rotary system without solvent, Group II was retreated with MtwoR rotary system with Endosolv R as the solvent, Group III with D-RaCe rotary system without solvent, and Group IV with D-RaCe rotary system and Endosolv R solvent. The cleanliness of canal walls was determined by stereomicroscope (×20) and AutoCAD software. Kruskal-Wallis test and Mann-Whitney U-test were used to compare the data. Results showed that none of the retreatment systems used in this study was able to completely remove the root canal filling material. D-RaCe with or without solvent showed significantly ( P > 0.05) less filling material at all levels compared to MtwoR with/without solvent. Within the limitation of the current study, D-RaCe rotary retreatment system is more effective in removing filling material from root canal walls when compared to MtwoR rotary retreatment system.

Knowledge regarding technical aspects of non-surgical root canal treatment in Al-Madinah Al-Munawarah private dental centers

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Mothanna Alrahabi

2015-01-01

Full Text Available Objective: We evaluated knowledge of technical aspects of non-surgical root canal treatment among general dentists in private dental clinics in Al-Madinah Al-Munawarah, Saudi Arabia. Materials and Methods: A questionnaire was distributed randomly to 70 general dental practitioners who were working in private dental centers. The response rate was 88.6%. Results: The results showed that only 3% of dentists were using rubber dams for isolation during endodontic treatment. The majority (59.7% were using radiographs to determine the length. Also, 37% were using nickel-titanium (NiTi rotary instruments to prepare the root canal. The lateral condensation technique with gutta percha points to fill the root canal was used by most respondents (77.5%. Conclusions: This study provides important data on endodontic treatment by general dental practitioners in Al-Madinah Al-Munawarah private dental centers. It shows a general lack of knowledge regarding the importance of using rubber dams as well as the new endodontic materials and methods. Continuing education programs to update their knowledge in the field of endodontics are essential.

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.

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.

Assessment of Apical Extrusion of Debris during Endodontic Retreatment with 3 Rotary Nickel-Titanium Retreatment Systems and Hand Files

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Gkampesi S.

2016-03-01

Full Text Available Aim: to evaluate the amount of debris extruded apically as well as the time needed for removal of root canal filling material using ProTaper, MTwo, REndo NiTi rotary retreatment systems and hand files.

Endodontic periapical lesion-induced mental nerve paresthesia

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Shadmehr, Elham; Shekarchizade, Neda

2015-01-01

Paresthesia is a burning or prickling sensation or partial numbness, resulting from neural injury. The symptoms can vary from mild neurosensory dysfunction to total loss of sensation in the innervated area. Only a few cases have described apical periodontitis to be the etiological factor of impaired sensation in the area innervated by the inferior alveolar and mental nerves. The aim of the present paper is to report a case of periapical lesion-induced paresthesia in the innervation area of the mental nerve, which was successfully treated with endodontic retreatment. PMID:25878687

[Test your decision-making. When to do endodontic retreatment? Some therapeutic alternatives].

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Aryanpour, S; D'Hoore, W; Van Nieuwenhuysen, J P

2000-01-01

The aim of the present article was to propose examples of treatment alternatives for the management of 14 clinical cases. All these cases involved endodontically treated teeth and have been managed by the same practitioner. In this paper, the authors tried to show the variety of treatment alternatives as well as the complexity of the decision-making process and, not to consider that proposed alternatives were the most adequate.

Nonsurgical healing of large periradicular lesions using a triple antibiotic paste: A case series

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Sonali Taneja

2010-01-01

Full Text Available The infection of the root canal system is considered to be a polymicrobial infection, consisting of both aerobic and anaerobic bacteria. Because of the complexity of the root canal infection, it is unlikely that any single antibiotic could result in effective sterilization of the canal. A combination of antibiotic drugs (metronidazole, ciprofloxacin, and minocycline is used to eliminate target bacteria, which are possible sources of endodontic lesions. Three case reports describe the nonsurgical endodontic treatment of teeth with large periradicular lesions. A triple antibiotic paste was used for 3 months. After 3 months, teeth were asymptomatic and were obturated. The follow-up radiograph of all the three cases showed progressive healing of periradicular lesions. The results of these cases show that when most commonly used medicaments fail in eliminating the symptoms then a triple antibiotic paste can be used clinically in the treatment of teeth with large periradicular lesions.

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

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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

Double palatal roots in maxillary second molars: A case report and literature review

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Mohammed S Alenazy

2015-01-01

Full Text Available A thorough understanding of internal and external anatomy of various teeth is critical for a successful outcome of endodontic therapy. The aims of this paper were (1 to describe the clinical retreatment of a maxillary second molar with two palatal roots and (2 to review the available literature regarding this anatomical variation. A 45-year-old Saudi female presented for non-surgical retreatment of maxillary left second molar. Careful radiographic and clinical examinations revealed the presence of two buccal and two palatal roots each with a single root canal. Anatomical variations can occur in any tooth; therefore, the clinicians should always anticipate the occurrence of these variations and utilize all the available tools to diagnose and manage them

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

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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

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

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

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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

Endodontic management of a haemophilic patient- a clinical perspective.

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Dudeja, Pooja Gupta; Dudeja, Krishan Kumar; Lakhanpal, Manisha; Ali, Sartaj

2014-07-01

Haemophilia and other bleeding disorders remain an enigma to the dentists world over. They not only challenge the skills of dental specialists but also raise the question of how these individuals should be managed emotionally as well as psychologically. The high incidence of dental problems in haemophiliacs is most likely caused by the fear and apprehension not only on the part of the patients but also dentists of inducing bleeding during treatment which can even be life threatening in certain cases. With proper care, diligence and meticulous treatment planning, there is no dental treatment that cannot be performed in such patients. Mild haemophiliacs can be easily managed and can effectively undergo even surgical endodontics without factor replacement therapies. However, severe haemophilia can pose significant health hazard and needs thorough preparation to meet any exigencies arising during the treatment. This case report describes how one such severely haemophilic patient with pain and swelling in the left submandibular region was managed with nonsurgical endodontic treatment in mandibular molar teeth and also discusses the importance of correct methods of diagnosis and various treatment considerations in such patients.

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.

Flare-up rate of single-visit endodontics.

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Trope, M

1991-01-01

The purpose of the study was to compare the flare-up rate for single-visit endodontics among teeth without radiographic or clinical signs of apical periodontitis, those with radiographic or clinical signs of apical periodontitis not previously root-treated, and those with apical periodontitis where retreatment was performed. All teeth were instrumented to a predetermined minimum size with a 0.5 per cent solution of sodium hypochlorite being used as the irrigant. The root canal was obturated without regard to the presence or absence of symptoms or diagnosis of the apical condition. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed, the patient was instructed to telephone immediately and was considered to have had a flare-up. Teeth without signs of apical periodontitis did not have any flare-ups. One flare-up occurred in 69 teeth with signs of apical periodontitis not previously root-treated. The majority of the flare-ups (3 of 22 teeth) occurred in teeth with signs of apical periodontitis requiring retreatment.

Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT.

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Rödig, T; Reicherts, P; Konietschke, F; Dullin, C; Hahn, W; Hülsmann, M

2014-10-01

To compare the efficacy of reciprocating and rotary NiTi-instruments in removing filling material from curved root canals using micro-computed tomography. Sixty curved root canals were prepared and filled with gutta-percha and sealer. After determination of root canal curvatures and radii in two directions as well as volumes of filling material, the teeth were assigned to three comparable groups (n = 20). Retreatment was performed using Reciproc, ProTaper Universal Retreatment or Hedström files. Percentages of residual filling material and dentine removal were assessed using micro-CT imaging. Working time and procedural errors were recorded. Statistical analysis was performed by variance procedures. No significant differences amongst the three retreatment techniques concerning residual filling material were detected (P > 0.05). Hedström files removed significantly more dentine than ProTaper Universal Retreatment (P  0.05). Reciproc and ProTaper Universal Retreatment were significantly faster than Hedström files (P = 0.0001). No procedural errors such as instrument fracture, blockage, ledging or perforation were detected for Hedström files. Three perforations were recorded for ProTaper Universal Retreatment, and in both NiTi groups, one instrument fracture occured. Remnants of filling material were observed in all samples with no significant differences between the three techniques. Hedström files removed significantly more dentine than ProTaper Universal Retreatment, but no significant differences between both NiTi systems were detected. Procedural errors were observed with ProTaper Universal Retreatment and Reciproc. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Dissolution of root canal sealers in EDTA and NaOCl solutions.

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Keleş, Ali; Köseoğlu, Mustafa

2009-01-01

Solutions of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) have been used as canal irrigants in endodontic treatment. The authors conducted a study to compare the ability of these solutions to dissolve sealers. The authors assessed the solubility of six sealers-calcium hydroxide, polyketone, zinc oxide-eugenol, silicone and two epoxy resins-in EDTA and two concentrations of NaOCl (2.5 percent and 5.0 percent). They immersed standardized samples (n = 5) of each sealer for two minutes and 10 minutes. They obtained the mean values of sealer dissolution in solutions by calculating the difference between the original preimmersion and postimmersion weights to determine the amount of sealer removed. They compared the values via factorial analysis of variance. They analyzed differences between the six sealers with respect to their solubility in EDTA or NaOCl solutions at two minutes and 10 minutes by using a one-way analysis of variance (P Polyketone and calcium hydroxide-based sealers were the most soluble sealers (P < .05). The results of this study indicate that during nonsurgical endodontic re-treatment, EDTA and NaOCl solutions used for removing smear layer aided in the retreatment by dissolving some root canal sealers.

Current trends in endodontic treatment by general dental practitioners: report of a United States national survey.

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Savani, Gina M; Sabbah, Wael; Sedgley, Christine M; Whitten, Brian

2014-05-01

In the United States almost 70% of root canal treatment (RCT) is performed by general dentists (GPs), yet little is known about their treatment protocols. A paper survey was mailed to 2000 United States GPs with questions about the types of endodontic cases treated, routine treatment protocols, use of newer technologies, and endodontic continuing education (CE). Completed surveys were returned by 479 respondents (24%). GPs who perform RCT (84%) reported providing anterior (99%), bicuspid (95%), and molar (62%) RCT and retreatment (18%). Rubber dam was used always (60%), usually (16%), sometimes (13%), and never (11%). Newer technologies used by GPs included digital radiography (72%), magnification (80%), electronic apex locator (70%), and nickel-titanium rotary instrumentation (74%). Compared with GPs with >20 years of experience, those in practice for ≤10 years were more likely to use rubber dam (P 20 years were more likely to perform retreatments (P 5 hours of CE were more likely to use rotary instrumentation (P irrigant activation devices (P 20 years. More experienced GPs were more likely to take on complicated cases than those with fewer years of practice. There was no association between hours of CE and compliance with rubber dam usage. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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.

Effect of photodynamic therapy (PDT) on Enterococcus faecalis biofilm in experimental primary and secondary endodontic infections.

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Tennert, Christian; Feldmann, Katharina; Haamann, Edwina; Al-Ahmad, Ali; Follo, Marie; Wrbas, Karl-Thomas; Hellwig, Elmar; Altenburger, Markus J

2014-11-04

To determine the antibacterial effect of photodynamic Therapy on Enterococcus faecalis (E. faecalis) biofilms in experimentally infected human root canals in primary infections and endodontic retreatments. One hundred and sixty single-rooted extracted teeth with one root canal were prepared using ProTaper instruments. Seventy specimens were left without root canal filling and autoclaved. The root canals of another 70 specimens were filled with Thermafil and AH Plus and the root canal fillings were removed after 24 hours using ProTaper D files and plasma sterilized. The specimens were infected with a clinical isolate of E. faecalis for 72 hours. Samples were taken using sterile paper points to determine the presence of E. faecalis in the root canals. The specimens were randomly divided into groups according to their treatment with 20 teeth each and a control. In the PDT group the teeth were treated using PDT, consisting of the photosensitizer toluidine blue and the PDT light source at 635 nm. In the NaOCl (sodium hypochlorite) group the root canals were rinsed with 10 mL of 3% NaOCl. In the NaOCl-PDT group the root canals were rinsed with 10 mL of 3% of sodium hypochlorite and then treated with PDT. Samples were taken after treatments using sterile paper points. Additionally, remaining root canal filling material was recovered from the root canal walls. Survival fractions of the samples were calculated by counting colony-forming units. A one-way analysis of variance (ANOVA) was applied to the data to assess the effect of different treatment techniques. Antimicrobial treatment of root canals caused a significant reduction of bacterial load in all groups. NaOCl irrigation eliminated E. faecalis most effectively. PDT alone was less effective compared to NaOCl irrigation and the combination of NaOCl irrigation and PDT. CFU levels recovered from the filling material after NaOCl irrigation of the root canals were 10fold higher compared to PDT and the combination of Na

Orthograde retreatment failure with extruded MTA apical plug in a large periradicular lesion followed by surgical intervention: case report.

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Brito-Junior, Manoel; Faria-e-Silva, Andre Luis; Quintino, Alex Carvalho; Moreira-Junior, Gil; Geber, Mauro; Camilo, Carla Cristina; Soares, Janir Alves

2012-01-01

Absence of periapical healing after orthograde retreatment using an apical plug with mineral trioxide aggregate (MTA) can require surgical intervention. A patient with a root-filled maxillary central incisor with chronic apical periodontitis and sinus tract was referred for endodontic retreatment. Excessive apical enlargement was verified, indicating an MTA apical plug placement; however, an unintentional extrusion of MTA occurred during this step. The root canal was filled with gutta-percha and sealer, and periodic recalls were scheduled. The sinus tract was observed after six months and the lesion remained unaltered, although the extruded MTA had resorbed; therefore, an apicoectomy and retrograde root-end filling with MTA were performed. Absence of sinus tract, normal clinical aspect, and complete repair of the lesion were observed at the two-year follow-up.

RETRATAMENTO ENDODÔNTICO: ESTUDO COMPARATIVO ENTRE TÉCNICA MANUAL, ULTRA-SOM E CANAL FINDER ENDODONTIC RETREATMENT: COMPARATIVE STUDY BETWEEN MANUAL TECHNIQUE, ULTRASONIC SCALER, AND CANAL FINDER

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Clovis Monteiro BRAMANTE

1998-01-01

Full Text Available Instrumentações manual, ultra-sônica e com Canal Finder foram utilizadas para retratamento de 30 dentes com canais obturados com guta-percha e óxido de zinco e eugenol. Avaliaram-se: 1. tempo gasto para a penetração inicial até o ápice; 2. tempo para completar a limpeza; 3. extrusão de material e 4. limpeza dos canais. O Canal Finder foi a técnica que propiciou melhor limpeza, seguida da manual e da ultra-sônica. A parede palatina do canal foi constantemente mais limpa do que a vestibular. Quanto à extrusão, a técnica de ultra-som foi a que propiciou mais extravasamento de material obturador.Endodontic retreatment of 30 teeth filled with guta percha and zinc oxide-eugenol was carried out using manual instrumentation, ultrasonic scaler, and the Canal Finder System. The following variables were evaluated: time spent to reach the apex; time spent to complete cleaning of the canal; apical extrusion of material; and cleanliness of the canals. Results showed the Canal Finder System as providing the highest level of cleanliness of the canal system; lingual walls were constantly cleaner than buccal walls; ultrasonic technique presented a greater degree of apical extrusion of filling material.

Evaluation of apically extruded debris during root canal retreatment with several NiTi systems.

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Dincer, A N; Er, O; Canakci, B C

2015-12-01

To compare the amount of debris extruded apically during root canal retreatment using ProTaper, Mtwo and Reciproc instruments with hand H-files. In total, 60 freshly extracted human mandibular incisor teeth were used. All root canals were prepared with a Reciproc R25 file than filled with Gutta-percha and AH Plus sealer using cold lateral condensation before being assigned randomly to four groups (n = 15 each). In group 1, root fillings were removed with the Protaper Universal retreatment system; ProTaper Universal F3 and F4 instruments were used for the final preparation. In group 2, root fillings were removed with the Mtwo retreatment system; Mtwo size 30, .06 taper, size 35, .06 taper and size 40, .06 taper files were used for the final preparation. In group 3, root fillings were removed with Reciproc R25 instruments; Reciproc R40 instruments were used for the final preparation. In group 4, the root fillings were removed with Gates Glidden burs and sizes 35, 30 and 25 H-files; for final preparation, a size 40 H-file was used. Glass vials were used for debris collection. The vials were weighed before and after Gutta-percha removal. Additionally, the times required for the retreatment procedures were recorded. Data were analysed statistically using one-way analysis of variance. The Reciproc system produced significantly smaller amounts of apical extruded debris than the other groups (P ProTaper groups. The ProTaper and Reciproc groups required significantly less time than the Mtwo and H-file groups (P hand filing. Use of the ProTaper and Reciproc instruments required less time for retreatment procedures than use of the Mtwo or H-file. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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...

Nonsurgical periodontal therapy: A review

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Jyotsana Tanwar

2016-01-01

Full Text Available Nonsurgical therapy aims to eliminate both living bacteria in the microbial biofilm and calcified biofilm microorganisms from the tooth surface and adjacent soft tissues. Complete elimination of such pathogenic microorganisms is perhaps over-ambitious. However, a reduction in inflammation of the periodontium due to a lesser bacterial load leads to beneficial clinical changes. In addition, nonsurgical therapy aims to create an environment in which the host can more effectively prevent pathogenic microbial recolonization using personal oral hygiene methods. The concept of critical probing depth was consistently found to be greater for the surgical approach than for the nonsurgical treatment. The various methods used in nonsurgical therapy, such as hand instrumentation, ultrasonic and sonic scalers, and ablative laser therapy.

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

Evaluation of Dentin Defect Formation during Retreatment with Hand and Rotary Instruments: A Micro-CT Study.

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Yilmaz, Ayca; Helvacioglu-Yigit, Dilek; Gur, Cansu; Ersev, Handan; Kiziltas Sendur, Gullu; Avcu, Egemen; Baydemir, Canan; Abbott, Paul Vincent

2017-01-01

The purpose of this study was to compare the incidence and longitudinal propagation of dentin defects after gutta-percha removal with hand and rotary instruments using microcomputed tomography. Twenty mandibular incisors were prepared using the balanced-force technique and scanned in a 19.9  μ m resolution. Following filling with the lateral compaction technique, gutta-percha was removed with ProTaper Universal Retreatment (PTUR) or hand instruments. After rescanning, a total of 24,120 cross-sectional images were analyzed. The numbers, types, and longitudinal length changes of defects were recorded. Defects were observed in 36.90% of the cross sections. A total of 73 defects were comprised of 87.67% craze lines, 2.73% partial cracks, and 9.58% fractures. No significant difference in terms of new defect formation was detected between the retreatment groups. The apical and middle portions of the roots had more dentin defects than the coronal portions. Defects in three roots of the PTUR instrument group increased in length. Under the conditions of this in vitro study, gutta-percha removal seemed to not increase the incidence of dentin defect formation, but the longitudinal defect propagation finding suggests possible cumulative dentinal damage due to additional endodontic procedures. Hand and rotary instrumentation techniques caused similar dentin defect formation during root canal retreatment.

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.

Comparison of debris extruded apically and working time used by ProTaper Universal rotary and ProTaper retreatment system during gutta-percha removal

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Mary Kinue Nakamune Uezu

2010-12-01

Full Text Available OBJECTIVE: The aim of this study was to evaluate the in vitro action of ProTaper retreatment files and ProTaper Universal in the retreatment of mandibular premolars. MATERIAL AND METHODS: The amount of debris extruded apically was measured and the time to reach the working length and to complete the removal of gutta-percha was observed. Thirty teeth had their canals prepared using ProTaper Universal files and were obturated by the single cone technique. The teeth were then stored at 37ºC in a humid environment for 7 days. During the use of the rotary instruments for root canal filling removal, the apical portions of the teeth were attached to the open end of a resin tube to collect the apically extruded debris. RESULTS: ProTaper Universal files were significantly faster (p=0.0011 than the ProTaper retreatment files to perform gutta-percha removal, but no significant difference was found between the files regarding the time to reach the working length or the amount of apical extrusion. CONCLUSIONS: ProTaper Universal rotary had better results for endodontic retreatment, and both techniques promote similar apical extrusion of debris.

Impact of cone beam computed tomography (CBCT) on diagnostic thinking in endodontics of posterior teeth: A before- after study.

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Al-Salehi, S K; Horner, K

2016-10-01

The aim of this study was to evaluate the impact of limited volume CBCT upon diagnosis as part of endodontic management of posterior teeth. The null hypothesis that CBCT does not make any difference in endodontic diagnosis was tested. A single-centre "before-after" study was conducted in a secondary healthcare establishment. Eligible patients were all adults aged 18 years or over who were referred to a specialist endodontic unit. Further inclusion criteria were that the cases were either re-treatment or de novo root canal treatment where the anatomy was judged to be complex. Exclusion criteria included vulnerable groups and de novo endodontic treatment with uncomplicated root canal anatomy. As well as a full history and clinical examination, a high quality colour photographic intraoral image, two paralleling technique periapical radiographs and limited volume CBCT examination were carried out for each patient. All components, except the CBCT dataset, were combined into a Powerpoint presentation and assessed by 4 observers. A questionnaire was designed for the observers as part of the study. CBCT information only changed the radiological findings and the final diagnosis in a minority of cases. There was no clear evidence that CBCT increases the confidence of observers or that CBCT was helpful in making a diagnosis. Routine use of CBCT cannot not be justified on the basis of a change in diagnosis and carefully selected use is appropriate. CBCT is being increasingly used in the field of endodontics. The benefits gained from the use of CBCT must be carefully balanced against the increased radiation dosage. Determination of selection criteria for the use of CBCT in endodontics is, therefore, essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of dental students' perception and self-confidence levels regarding endodontic treatment.

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Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-04-01

The aim of this study was to obtain information about senior dental students' perceptions and self-confidence levels regarding endodontic practice. Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). The results showing students' lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment.

Evaluation of dental students’ perception and self-confidence levels regarding endodontic treatment

Science.gov (United States)

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-01-01

Objectives: The aim of this study was to obtain information about senior dental students’ perceptions and self-confidence levels regarding endodontic practice. Materials and Methods: Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. Results: The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). Conclusions: The results showing students’ lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment. PMID:24883030

Comparative evaluation of cyclic fatigue resistance of D-RaCe and ProTaper retreatment instruments in curved artificial canals.

Science.gov (United States)

Topçuoğlu, H S; Topçuoğlu, G; Aktı, A

2016-06-01

To compare the cyclic fatigue resistance of D-RaCe and ProTaper rotary nickel-titanium (NiTi) retreatment files when used in curved artificial canals. A total of 120 new D-RaCe DR2 and ProTaper D3 retreatment files were tested in stainless steel artificial canals having 45° and 60° angles of curvature. Thirty instruments of each of the file systems were tested in both angles of curvature (n = 30). The retreatment instruments were rotated until fracture to calculate the number of cycles to failure. The length of each fractured fragment was recorded. Data were analysed by independent sample t-test. Fractured surfaces of the instruments were analysed by scanning electron microscopy. In the canal with 45° angle of curvature, no significant difference was observed between the retreatment systems (P > 0.05); on the other hand, in the canal with 60° angle of curvature, D-RaCe DR2 instruments had greater cyclic fatigue resistance than ProTaper D3 (P  0.05). The fracture surfaces of the instruments had morphologic characteristics of ductile fracture. D-RaCe DR2 instrument exhibited greater cyclic fatigue resistance than ProTaper D3 only in root canals with 60° angle of curvature. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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

Science.gov (United States)

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

To Cut or not to Cut: Can Large Periapical Cysts be Treated by Endodontic Treatment only?

Directory of Open Access Journals (Sweden)

MHK Motamedi

2010-05-01

Full Text Available Introduction: The periapical cyst originates from the epithe-lium in a granuloma and is frequently associated with an inflammatory response to a necrotic pulp. This condition is clinically asymptomatic but can result in a slow-growth, bone resorption and swelling in the affected region.The hypothesis: Some authors support that if the endodontic infection is eliminated, the immune system is able to promote lesion repair, while others believe that surgical intervention is invariably nec-essary to remove cyst epithelium. This hypothesis indicates that large periapical cysts may be treated by only nonsurgical endodontic treatment.Evaluation of the hypothesis: Radicular cysts exist in two structurally distinct classes namely, those containing cavities completely enclosed in epithelial lining (periapical true cysts and those containing epithelium-lined cavities that are open to the root canals (periapical pocket cysts. From a clinical point of view a periapical pocket cyst may heal after conventional root canal therapy whereas an apical true cyst is less likely to be resolved without surgical intervention. During the endodontic therapy of teeth associated with periapi-cal cysts, root canal instrumentation could be done slightly beyond the apical foramen. This will produce a transitory acute inflammation and destruction of the protective epithelial layer of the cyst, converting it into a granulated tissue, which has better resolution. Instru-mentation beyond the apical foramen could be carried out because it would help in cyst resolution through the relief of the intra-cystic pressure.

Evaluation of Dentin Defect Formation during Retreatment with Hand and Rotary Instruments: A Micro-CT Study

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Ayca Yilmaz

2017-01-01

Full Text Available The purpose of this study was to compare the incidence and longitudinal propagation of dentin defects after gutta-percha removal with hand and rotary instruments using microcomputed tomography. Twenty mandibular incisors were prepared using the balanced-force technique and scanned in a 19.9 μm resolution. Following filling with the lateral compaction technique, gutta-percha was removed with ProTaper Universal Retreatment (PTUR or hand instruments. After rescanning, a total of 24,120 cross-sectional images were analyzed. The numbers, types, and longitudinal length changes of defects were recorded. Defects were observed in 36.90% of the cross sections. A total of 73 defects were comprised of 87.67% craze lines, 2.73% partial cracks, and 9.58% fractures. No significant difference in terms of new defect formation was detected between the retreatment groups. The apical and middle portions of the roots had more dentin defects than the coronal portions. Defects in three roots of the PTUR instrument group increased in length. Under the conditions of this in vitro study, gutta-percha removal seemed to not increase the incidence of dentin defect formation, but the longitudinal defect propagation finding suggests possible cumulative dentinal damage due to additional endodontic procedures. Hand and rotary instrumentation techniques caused similar dentin defect formation during root canal retreatment.

Efficacy of ProTaper retreatment system in root canals filled with gutta-percha and two endodontic sealers.

Science.gov (United States)

Só, Marcus Vinícius Reis; Saran, Caroline; Magro, Miriam Lago; Vier-Pelisser, Fabiana Vieira; Munhoz, Marcelo

2008-10-01

This study evaluated the efficacy of ProTaper Universal rotary retreatment system and hand files for filling material removal during retreatment and the influence of sealer type on the presence of filling debris in the reinstrumented canals. The canals of 60 palatal roots of first molars were obturated with gutta-percha and either a zinc oxide-eugenol-based or a resin-based sealer and reinstrumented: G1, EndoFill/hand files; G2, AH Plus/hand files; G3, EndoFill/ProTaper; G4, AH Plus/ProTaper. Roots were cleaved and examined with an optical microscope, and the amount of filling debris on canal walls was analyzed on digitized images. There was no significant difference (P > .05) among the root canal thirds within each group. G3 presented significantly more filling debris than G1 in the cervical third (P = .04). In the middle third, G2/G3/G4 showed more debris than G1 (P = .03). The techniques were similar (P = .64) in the apical third. All groups presented filling debris in the 3 canal thirds after reinstrumentation.

Effectiveness of ProTaper Universal retreatment instruments used with rotary or reciprocating adaptive motion in the removal of root canal filling material.

Science.gov (United States)

Capar, I D; Arslan, H; Ertas, H; Gök, T; Saygılı, G

2015-01-01

To compare the effectiveness of ProTaper Universal retreatment instruments with continuous rotation and adaptive motion (AM; a modified reciprocating motion that combines rotational and reciprocating motion) in the removal of filling material. Mesiobuccal root canals in 36 mandibular first molars were instrumented up to size F2 with the ProTaper Universal instrument (Dentsply Maillefer, Ballaigues, Switzerland) and filled using sealer and ProTaper Universal F2 gutta-percha cones. Gutta-percha was then down-packed and the root canal backfilled using the extruder hand-piece of the Elements Obturation System (SybronEndo, Orange, CA, USA). The teeth were assigned to two groups (n = 18), and removal of the root fillings was performed using one of the following techniques: group 1) ProTaper Universal retreatment files used with rotational motion (RM) and group 2) ProTaper Universal retreatment files used with adaptive motion (AM) (600° clockwise/0° counter-clockwise to 370° clockwise/50° counter-clockwise). The teeth were sectioned, and both halves were analysed at 8 × magnification. The percentage of remaining filling material was recorded. The data were analysed statistically using the Student's t-test at a 95% confidence level (P ProTaper Universal retreatment files with adaptive motion removed more filling materials from root canals than the rotational movement. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Regenerative endodontics: a comprehensive review.

Science.gov (United States)

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

Non-surgical therapy of Peyronie's disease.

Science.gov (United States)

Taylor, Frederick L; Levine, Laurence A

2008-01-01

The present paper provides a review of the available non-surgical treatments for Peyronie's disease (PD). A review of published literature on oral, intralesional, external energy and iontophoresis therapies for PD was performed, and the published results of available treatment options reviewed. The authors recommendations for appropriate non-surgical management of PD are provided. Although there are many published reports that show the efficacy of non-surgical therapies for PD, there is a lack of large scale, multicenter controlled clinical trials, which makes treatment recommendations difficult. Careful review of the literature does suggest that there are treatment options that make scientific sense and appear to stabilize the disease process, reduce deformity, and improve function. Offering no treatment at all will encourage our patients to pursue alternative treatments, which might do harm, and misses the opportunity to do some good. Clearly further work is necessary to develop safe and effective non-surgical treatments for PD.

[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.

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.

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...

Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals - a micro-computed tomography study.

Science.gov (United States)

Rödig, T; Hausdörfer, T; Konietschke, F; Dullin, C; Hahn, W; Hülsmann, M

2012-06-01

To compare the efficacy of two rotary NiTi retreatment systems and Hedström files in removing filling material from curved root canals. Curved root canals of 57 extracted teeth were prepared using FlexMaster instruments and filled with gutta-percha and AH Plus. After determination of root canal curvatures and radii in two directions, the teeth were assigned to three identical groups (n = 19). The root fillings were removed with D-RaCe instruments, ProTaper Universal Retreatment instruments or Hedström files. Pre- and postoperative micro-CT imaging was used to assess the percentage of residual filling material as well as the amount of dentine removal. Working time and procedural errors were recorded. Data were analysed using analysis of covariance and analysis of variance procedures. D-RaCe instruments were significantly more effective than ProTaper Universal Retreatment instruments and Hedström files (P ProTaper group, four instrument fractures and one lateral perforation were observed. Five instrument fractures were recorded for D-RaCe. D-RaCe instruments were associated with significantly less residual filling material than ProTaper Universal Retreatment instruments and hand files. Hedström files removed significantly less dentine than both rotary NiTi systems. Retreatment with rotary NiTi systems resulted in a high incidence of procedural errors. © 2012 International Endodontic Journal.

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.

Total knee replacement and non-surgical treatment of knee osteoarthritis

DEFF Research Database (Denmark)

Skou, Søren T; Roos, Ewa M; Laursen, Mogens B

2018-01-01

OBJECTIVES: To compare 2-year outcomes of total knee replacement (TKR) followed by non-surgical treatment to that of non-surgical treatment alone and outcomes of the same non-surgical treatment to that of written advice. DESIGN: In two randomized trials, 200 (mean age 66) adults with moderate...... to severe knee osteoarthritis (OA), 100 eligible for TKR and 100 not eligible for TKR, were randomized to TKR followed by non-surgical treatment, non-surgical treatment alone, or written advice. Non-surgical treatment consisted of 12 weeks of supervised exercise, education, dietary advice, use of insoles......, and pain medication. The primary outcome was the mean score of the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, covering pain, symptoms, activities of daily living (ADL), and quality of life (QOL). RESULTS: Patients randomized to TKR had greater improvements than patients randomized...

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...

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

Directory of Open Access Journals (Sweden)

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.

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

Science.gov (United States)

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.

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

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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

Relationship of intracanal medicaments to endodontic flare-ups.

Science.gov (United States)

Trope, M

1990-10-01

The purpose of the study was to compare the effect of three intracanal medicaments on the incidence of post-instrumentation flare-ups. All teeth were instrumented to a predetermined minimum size using a 0.5% solution of sodium hypochlorite as the irrigant. Formocresol, Ledermix, and calcium hydroxide were placed in strict sequence irrespective of the presence or absence of symptoms or radiographic signs of apical periodontitis. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed the patient was instructed to call the office immediately and was considered to have had a flare-up. Twelve flare-ups occurred in teeth with radiographic signs of apical periodontitis; none in teeth without periapical radiolucencies. Six of the twelve flare-ups occurred in retreatment cases and the other six occurred in teeth without previous endodontic treatment. No significant difference was found in the flare-up rate among the three intracanal medicaments.

[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.

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)

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

Directory of Open Access Journals (Sweden)

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.

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...

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.

The 'E' factor -- evolving endodontics.

Science.gov (United States)

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.

Persistent infection by Staphylococcus epidermidis in endodontic flare-up: a case report.

Science.gov (United States)

Gonçalves, Simone Helena Ferreira; de Vasconcelos, Rafaela Andrade; Cavalcanti, Bruno das Neves; Camargo, Carlos Henrique Ribeiro

2016-01-01

Endodontic flare-ups are challenging situations and may result from selective growth of specific bacterial species; microbial cultures and antibiograms should be used to allow faster, successful management of refractory lesions. A 47-year-old man reported pain on percussion after uncomplicated retreatment of the maxillary left canine for prosthetic purposes. In the following days, pain dramatically increased, leading to removal of the filling and use of intracanal medication. After many unsuccessful attempts to resolve the problem, a microbial culture of the root canal detected the presence of Staphylococcus epidermidis. An antibiogram determined the best drug combination to control this infection: tetracycline (oxytetracycline hydrochloride, 500 mg orally) plus third-generation cephalosporin (ceftriaxone, 1 g intramuscularly). Once the infection was controlled, the root canal was obturated. There was a reduction in the area of radiolucency, and the patient reported no pain at a 2-year follow-up.

Retreatments after multifocal intraocular lens implantation: an analysis

Directory of Open Access Journals (Sweden)

Gundersen KG

2016-03-01

Full Text Available Kjell Gunnar Gundersen,1 Sarah Makari,2 Steffen Ostenstad,1 Rick Potvin2 1Ifocus Eye Clinic, Haugesund, Norway; 2Science in Vision, Akron, NY, USA Purpose: To determine the incidence and etiology of required retreatment after multifocal intraocular lens (IOL implantation and to evaluate the methods and clinical outcomes of retreatment.Patients and methods: A retrospective chart review of 416 eyes of 209 patients from one site that underwent uncomplicated cataract surgery with multifocal IOL implantation. Biometry, the IOL, and refractive data were recorded after the original implantation, with the same data recorded after retreatment. Comments related to vision were obtained both before and after retreatment for retreated patients.Results: The multifocal retreatment rate was 10.8% (45/416 eyes. The eyes that required retreatment had significantly higher residual refractive astigmatism compared with those who did not require retreatment (1.21±0.51 D vs 0.51±0.39 D, P<0.01. The retreatment rate for the two most commonly implanted primary IOLs, blended bifocal (10.5%, 16/152 and bilateral trifocal (6.9%, 14/202 IOLs, was not statistically significantly different (P=0.12. In those requiring retreatment, refractive-related complaints were most common. Retreatment with refractive corneal surgery, in 11% of the eyes, and piggyback IOLs, in 89% of the eyes, was similarly successful, improving patient complaints 78% of the time.Conclusion: Complaints related to ametropia were the main reasons for retreatment. Residual astigmatism appears to be an important determinant of retreatment rate after multifocal IOL implantation. Retreatment can improve symptoms for a high percentage of patients; a piggyback IOL is a viable retreatment option. Keywords: piggyback IOL, Sulcoflex, toric, STAAR, symptoms, astigmatism

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.

Incidence and factors related to flare-ups in a graduate endodontic programme.

Science.gov (United States)

Iqbal, M; Kurtz, E; Kohli, M

2009-02-01

To investigate the incidence and factors related to endodontic flare-ups in nonsurgical root canal treatment (NSRCT) cases completed by graduate endodontic residents at University of Pennsylvania, USA. Residents at University of Pennsylvania enter all clinical patient records into an electronic database called PennEndo database. Analysis of records of 6580 patients treated from September 2000 to July 2005 revealed a total of 26 patients with flare-ups (0.39%). Patients were categorized to have undergone flare-up when they attended for an unscheduled visit and active treatment, and when they suffered from severe pain and or swelling after initiation or continuation of NSRCT. SAS software was used to develop a logistic regression model with flare-up as a dependent variable. Independent variables included in the model were: history of previous pain, one vs. two visit NSRCT, periapical diagnosis, tooth type, rotary versus hand instrumentation, and lateral versus vertical compaction of gutta-percha. The odds for developing a flare-up in teeth with a periapical radiolucency were 9.64 times greater than teeth without a periapical radiolucency (P = 0.0090). There was no statistically significant difference in flare-ups between one and two visits NSRCT. The odds of developing a flare-up increased 40 fold when NSRCT was completed in three or more visits. However, this result may have been confounded by addition of an unscheduled visit in patients suffering from flare-ups. Other independent variables did not have any statistically significant correlations. A low percentage of patients experienced flare-ups during NSRCT procedures. The presence of a periapical lesion was the single most important predictor of flare-ups during NSRCT.

One-appointment endodontic therapy: biological considerations.

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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

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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,

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.

[Non-surgical management after blunt traumatic liver injuries: A review article].

Science.gov (United States)

Noyola-Villalobos, Héctor Faustino; Loera-Torres, Marco Antonio; Jiménez-Chavarría, Enrique; Núñez-Cantú, Olliver; García-Núñez, Luis Manuel; Arcaute-Velázquez, Fernando Federico

2016-01-01

Hepatic trauma is a common cause for admissions in the Emergency Room. Currently, non-surgical management is the standard treatment in haemodynamically stable patients with a success rate of around 85 to 98%. This haemodynamic stability is the most important factor in selecting the appropriate patient. Adjuncts in non-surgical management are angioembolisation, image-guided drainage and endoscopic retrograde cholangiopancreatography. Failure in non-surgical management is relatively rare but potentially fatal, and needs to be recognised and aggressively treated as early as possible. The main cause of failure in non-surgical management is persistent haemorrhage. The aim of this paper is to describe current evidence and guidelines that support non-surgical management of liver injuries in blunt trauma. Copyright © 2016 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

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.

New approaches to non-surgical sterilization for dogs and cats: Opportunities and challenges.

Science.gov (United States)

Rhodes, Linda

2017-04-01

Over the last 40 years, researchers have explored methods to non-surgically suppress fertility in animals. Immunocontraception has been used to control wildlife populations but does not confer long-term immunity. The gonadotropin-releasing hormone (GnRH) agonist deslorelin, formulated as an implant to provide 6-month to 1-year suppression of fertility in male dogs, is available commercially in some countries. Neither of these approaches provide permanent sterility. A single-dose, permanent treatment would be a valuable tool in dog and cat population control. The Michelson Prize and Grants (MPG) programme was initiated "to eliminate shelter euthanasia of healthy, adoptable companion animals and reduce populations of feral and free-roaming cats and dogs" offering a $25 million US prize for a non-surgical sterilant that is effective as a single treatment in both male and female dogs and cats. Michelson Prize and Grants programme has offered US $50 million in grant money for research and has attracted scientists worldwide. Approaches under study include gene therapy, small interfering RNA to inhibit reproductive targets and delivery of cytotoxins to pituitary gonadotrophs or GnRH producing neurons in the hypothalamus. Research in implant technology that could deliver compounds over an animal's lifetime is also underway. Details of funded grants and results to date can be found at: http://www.michelsonprizeandgrants.org/michelson-grants/research-findings. The next steps are translating the most promising research into products. The Alliance for Contraception of Cats and Dogs (ACC&D) is helping to research practical methods of marking sterilized animals to avoid costly retreatment and population modelling that will help guide field workers in use of resources for sterilization programmes. © 2016 Blackwell Verlag GmbH.

Shoulder morbidity after non-surgical treatment of the neck

International Nuclear Information System (INIS)

Wouwe, Merian van; Bree, Remco de; Kuik, Dirk J.; Goede, Cees J.T. de; Verdonck-de Leeuw, Irma M.; Doornaert, Patricia; Rene Leemans, C.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides were treated by surgery (n = 51) or (chemo)radiation (n = 123). Abduction, anteflexion, endorotation and exorotation were assessed. Subjective measurements were performed using the Visual Analogue Scale for pain, the Shoulder Disability Questionnaire (SDQ) and stiffness reporting. Results: Predictive factors for SDQ-score > 0 (n = 54) were VAS pain score, stiffness, abduction, anteflexion, physiotherapy, low shoulder position and surgical treatment. The SDQ, stiffness and pain scores were significantly higher in the surgically treated group than in the non-surgical group (p < 0.01). Anteflexion, abduction and exorotation were less impaired in the non-surgically treated group than in the surgically treated group (p < 0.01). No differences between neck dissection and neck dissection with post-operative radiotherapy, and radiotherapy and chemoradiation were found for these movements. Conclusions: Shoulder morbidity is often present after non-surgical treatment of the neck, but to a lesser extent compared to surgical treatment. Radiotherapy adds no morbidity to neck dissection and chemotherapy does not add extra morbidity to primary radiation

Worldwide pattern of antibiotic prescription in endodontic infections.

Science.gov (United States)

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.

The Comparative Efficacy of Different Files in The Removal of Different Sealers in Simulated Root Canal Retreatment- An In-vitro Study.

Science.gov (United States)

Kanaparthy, Aruna; Kanaparthy, Rosaiah

2016-05-01

Root canal treatment enjoys a high success rate all over the world and has saved billions of teeth from extraction. However, there are instances of failure, the main causes being insufficient cleaning and inadequate obturation. In such cases the most conservative treatment option would be non-surgical retreatment. It requires regaining access to the entire root canal system through removal of the original root canal filling thus permitting further cleaning and re- obturation. Removal of gutta-percha and sealer becomes a critical step to gain access to the root canal system, remove necrotic tissue debris, bacteria and infected dentin. To compare and evaluate the efficacy of manual hand Hedstrom files and two rotary retreatment file systems ProTaper Universal retreatment files and Mtwo(R) (retreatment) files in the removal of root canal filling material during root canal retreatment and the influence of the type of sealers zinc oxide eugenol and AH plus on the presence of remaining debris in the reinstrumented canals in the apical, middle and coronal third. Sixty single rooted human premolar teeth were divided into 3 Groups of 20 teeth each Group I (20 Teeth): prepared using hand K Files, Group II (20 Teeth): prepared using ProTaper rotary system and Group III (20 Teeth): prepared using Mtwo rotary system. In Groups- IA, IIA, IIIA: (10 teeth each) Obturation was done using Zinc Oxide Eugenol sealer and gutta percha. In Groups- IB, IIB, IIIB: (10 teeth each) obturation was done with AH Plus sealer and gutta percha. All the teeth were subjected to retreatment. Groups IA and IB with Hedstrom files, Groups IIA and IIB with ProTaper retreatment files and for Groups IIIA and IIIB with Mtwo retreatment Files. The roots were longitudinally split and were observed under a stereomicroscope for remaining amount of filling material on the canal walls. Statistical analysis was done using One-way ANOVA (Analysis of variance) test and Tukey HSD Test. Mtwo(R) files showed

Failure of endodontic treatment: The usual suspects.

Science.gov (United States)

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.

Shoulder morbidity after non-surgical treatment of the neck.

NARCIS (Netherlands)

van Wouwe, V.; de Bree, R.; Kuik, D.J.; de Goede, C.J.T.; de Leeuw, I.M.; Leemans, C.R.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides

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...

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

Mandibular second premolar with three canals: Re-treatment of a case with unusual root canal anatomy

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Niranjan Desai

2011-01-01

Full Text Available A thorough knowledge of root canal anatomy along with the anatomical variations that may be present is essential for success of endodontic therapy. Unusual presentations in the number of the roots or the canals should be expected in every tooth. Mandibular second premolars are thought of as having a single root and canal. Studies have stated that the prevalence of three canals with three orifices in this tooth is 0.4%. The mandibular second premolar is particularly difficult to treat owing to the fact that a wide variation in the number, location and curvature of the roots and canals exist. Added to this is the fact that the access opening is restricted and location of the lingually placed orifices is difficult. This case report details the re-treatment of a mandibular second premolar with three canals and three separate orifices using the surgical microscope.

[Theory and practice of minimally invasive endodontics].

Science.gov (United States)

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.

Ceramic onlay for endodontically treated mandibular molar

Directory of Open Access Journals (Sweden)

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.

Modulation of Sea Ice Melt Onset and Retreat in the Laptev Sea by the Timing of Snow Retreat in the West Siberian Plain

Science.gov (United States)

Crawford, A. D.; Stroeve, J.; Serreze, M. C.; Rajagopalan, B.; Horvath, S.

2017-12-01

As much of the Arctic Ocean transitions to ice-free conditions in summer, efforts have increased to improve seasonal forecasts of not only sea ice extent, but also the timing of melt onset and retreat. This research investigates the potential of regional terrestrial snow retreat in spring as a predictor for subsequent sea ice melt onset and retreat in Arctic seas. One pathway involves earlier snow retreat enhancing atmospheric moisture content, which increases downwelling longwave radiation over sea ice cover downstream. Another pathway involves manipulation of jet stream behavior, which may affect the sea ice pack via both dynamic and thermodynamic processes. Although several possible connections between snow and sea ice regions are identified using a mutual information criterion, the physical mechanisms linking snow retreat and sea ice phenology are most clearly exemplified by variability of snow retreat in the West Siberian Plain impacting melt onset and sea ice retreat in the Laptev Sea. The detrended time series of snow retreat in the West Siberian Plain explains 26% of the detrended variance in Laptev Sea melt onset (29% for sea ice retreat). With modest predictive skill and an average time lag of 53 (88) days between snow retreat and sea ice melt onset (retreat), West Siberian Plains snow retreat is useful for refining seasonal sea ice predictions in the Laptev Sea.

Endodontic therapy for a fused mandibular molar.

Science.gov (United States)

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.

Decadal-scale coastal cliff retreat in southern and central California

Science.gov (United States)

Young, Adam P.

2018-01-01

Airborne LiDAR data collected in 1998 and 2009-2010 were used to measure coastal cliff erosion and retreat between the Mexico/California border and Bodega Head, California. Cliff erosion was detected along 44% of the 595 km of shoreline evaluated, while the remaining cliffs were relatively stable. The mean cliff top retreat rate was 0.12 m/yr, while mean retreat averaged over the entire cliff face was 0.04 m/yr. The maximum cliff top and face retreat rates were 4.2 and 3.8 m/yr, respectively. Historical ( 1930s to 1998) and recent retreat rates were significantly inversely correlated for areas with large historical or recent cliff retreat, such that locations with elevated historical retreat had low levels of recent retreat and locations with elevated recent retreat were preceded by low rates of historical retreat. The strength of this inverse correlation increased with cliff change magnitudes up to r2 of 0.91 for cliff top retreat rates > 2.9 m/yr. Mean recent retreat rates were 52-83% lower than mean historical retreat rates. Although beaches can protect cliffs against wave-driven erosion, cliffs fronted by beaches retreated 49% more than cliffs without beaches. On average, unarmored cliff faces retreated 0.05 m/yr between 1998 and 2009-2010, about three times faster than artificially armored cliffs. Alongshore metrics of wave-cliff impact, precipitation, and cliff hardness were generally not well correlated with recent cliff changes. A cliff hazard metric is used to detect cliff steepening and areas prone to future cliff top failures.

Technology Retreats and the Politics of Social Media

Directory of Open Access Journals (Sweden)

Adam Fish

2017-04-01

Full Text Available This essay examines weeklong technology retreats in Silicon Valley. These retreats embody digital healthism, which I define as the discourse that promotes the self-regulation of digital consumption for personal health. I argue that the self-regulation advanced by digital healthism insufficiently addresses the politics of media refusal. Technology retreats channel frustrations about social media use into opportunities for personal and corporate growth instead of political activism. I consider how technology retreats might participate in a dialogue about the regulation of social media platforms and companies by states. Evidence for these claims come from ethnographic research with the founders of a technology retreat in Silicon Valley.

Regenerative endodontics.

Science.gov (United States)

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.

Endodontic and Prosthetic Management of a Mid-Root and Crown Fracture of a Maxillary Central Incisor

Directory of Open Access Journals (Sweden)

Koidou Vasiliki P.

2014-11-01

Full Text Available Root fractures are relatively uncommon among other dental traumas and mostly affect the anterior dentition. This case report presents the endodontic and prosthodontic management of a maxillary central incisor with a combined fracture in the middle third of the root and the crown, as well as the 7-year follow up of the case. The healing potential of a horizontal root fracture in the middle third of the root is highlighted when appropriate treatment is applied. MTA used for obturation of the coronal fragment, induced hard tissue formation apically and promoted healing in the area, while the 2mm MTA left as apical barrier at the second stage of re-treatment and obturation with gutta-percha prevented its extrusion. The multidisciplinary approach in the management of such cases ensures a long term survival.

Endodontic decision making for asymptomatic root-filled teeth with apical periodontitis - A radiographic survey.

Science.gov (United States)

Taha, Nessrin A; Albashaireh, Zakereyya S; Alfied, Rmdan G

2018-03-23

The aim of the study was to compare decision making for asymptomatic root-filled teeth among dentists with differing educational backgrounds. Case scenarios based on 14 radiographs were created and 150 participants were asked to choose from five alternative treatment decisions and to state the rationale. Demographic data of the participants were recorded. Frequency distribution and cross-tabulation were performed; chi square testing was used for comparisons and logistic regression was performed to detect significant differences. The overall response rate was 87.3%. The practitioners chose intervention predominantly with non-surgical retreatment a common choice. Poor technical quality was a driving factor, while the existing poor coronal restoration and the need for a crown were generally not taken into account by general dentists. Speciality and experience were significant factors. Practitioners were more inclined to retain rather than extract teeth. It is concluded that clear guidelines listing factors to consider for intervention are required. © 2018 Australian Society of Endodontology Inc.

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

Science.gov (United States)

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

Patterns of retreatment with radiotherapy in a large academic centre

International Nuclear Information System (INIS)

Khor, Richard; Ball, David; Duchesne, Gillian; Bressel, Mathias; Tai, Keen Hun; Tedesco, Jo; Gill, Suki; Fitzpatrick, Claire; Foroudi, Farshad; Rose, William

2013-01-01

To characterise retreatment rates with radiotherapy at a large multifacility academic radiotherapy centre and assess the effect of distance on retreatment rate. Electronic administrative records were reviewed for patients receiving radiotherapy between 1998 and 2010 at regional and metropolitan facilities. Course-level data were reconstructed from electronic administrative databases. Intent of therapy, treatment dates and diagnosis were available for analysis. Retreatment characteristics were derived, including proportion of patients receiving retreatment, proportion of total radiotherapy prescriptions dedicated to retreatment and retreatment per treating facility. Travel distance for each patient to their treatment centre was estimated, and retreatment rates were reported as a function of increasing distance. A total of 48,200 patients were treated with 66,277 treatment courses during the study period. Retreatment courses constituted 25.2% of all courses prescribed. During the study period, 20.4% of all patients received at least one treatment course. Of these, the average number of retreatment courses prescribed was 1.84. Patients treated with radical intent had a retreatment rate of 13% compared with 45% for those treated initially with palliative intent. Retreatment rates in individual tumour sites ranged from 1.3 to 44.4%. The retreatment rate for those living less than 100km from treatment facility was 24.8%, and 20.5% for those living more than 100km from treatment centre (P<0.001) Retreatment accounted for over one quarter of radiotherapy courses, with the rate influenced by casemix and follow-up duration. With increasing distance from treatment centre, a decrease in retreatment rate was observed.

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.

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

Nonsurgical Interventions for Peyronie’s Disease: Update as of 2016

Directory of Open Access Journals (Sweden)

Gregory A Joice

2016-08-01

Full Text Available Peyronie’s disease (PD is a debilitating condition of the penis that leads to significant pain, erectile dysfunction, and emotional distress in men. PD is likely underreported due to lack of knowledge of the disease and the absence of well-established available treatments. Surgical treatment can lead to sustained improvements, but is often associated with penile shortening and places the patient at risk for perioperative morbidity. Nonsurgical management has been studied for several years as an alternative to surgery for men with PD. Currently, much of the data on nonsurgical management is conflicting, with only one treatment that has been recently approved by the US Food and Drug Administration. Significant effort has been devoted to advancing non-surgical treatments for PD that can be implemented outside of the operating room. This review aims to describe the research behind current nonsurgical therapies for PD and to highlight the recent advances that have been made within the last three years.

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

Imaging Techniques in Endodontics: An Overview

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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

Nonsurgical Treatment Options for Basal Cell Carcinoma

International Nuclear Information System (INIS)

Lien, M. H.; Sondak, V. K.; Sondak, V. K.

2011-01-01

Basal cell carcinoma (BCC) remains the most common form of non melanoma skin cancer (NMSC) in Caucasians, with perhaps as many as 2 million new cases expected to occur in the United States in 2010. Many treatment options, including surgical interventions and nonsurgical alternatives, have been utilized to treat BCC. In this paper, two non-surgical options, imiquimod therapy and photodynamic therapy (PDT), will be discussed. Both modalities have demonstrated acceptable disease control rates, cosmetically superior outcomes, and short-term cost-effectiveness. Further studies evaluating long-term cure rates and long-term cost effectiveness of imiquimod therapy and PDT are needed.

Discoloration Potential of Endodontic Sealers: A Brief Review

Science.gov (United States)

Tour Savadkouhi, Sohrab; Fazlyab, Mahta

2016-01-01

Tooth discoloration induced by endodontic sealers, is a common finding that impairs aesthetic outcome of endodontic treatment. The aim of the present mini literature review, was to summarize the existing data on discoloration potential of different endodontic sealers. The research covered the article published in PubMed and Google Scholar from 2000 to 2015. The searched keywords included ‘tooth discoloration AND endodontic’, ‘tooth discoloration AND sealer, ‘tooth discoloration AND zinc-oxide eugenol sealer’, ‘tooth discoloration AND Calcium Hydroxide Sealer’, ‘tooth discoloration AND Glass Ionomer Sealer’, ‘tooth discoloration AND epoxy-resin Sealer’, ‘tooth discoloration AND Silicon Based Sealer’, ‘tooth discoloration AND Bioceramic Sealer’ and ‘Spectrophotometry’. Conclusion: A total number of 44 articles were gained which reduced to 11 after excluding the repetitive items. The available evidence for discoloration potential of endodontic sealers currently available on the market is scarce. However, it can be concluded that all endodontic sealers can potentially stain the tooth structure to different degrees. PMID:27790251

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...

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.

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

Evaluation of apically extruded debris during removal of gutta-percha and ResilonTM using different instrumentation techniques

Directory of Open Access Journals (Sweden)

Pešić Dragana

2018-01-01

Full Text Available Background/Aim. Apical extrusion of material is considered as one of the very important factor for endodontic treatment success. Microorganisms, necrotic tissue, filling material and irrigants, which can be extruded apically during endodontic retreatment, may jeopardize the success of the therapy. The aim of this in vitro study was to quantitatively evaluate the amount of apically extruded debris during endodontic retreatment of teeth obturated with two different materials, using one hand and three rotary instrumentation techniques. Methods. Ninety-six extracted single-rooted teeth were endodontically treated and enlarged to size 40 using BioRaCe system, and then randomly divided into 8 groups of 12 specimens each. Half of the specimens were obturated with gutta-percha and AH Plus® sealer and another half with RealSeal SE system, using lateral condensation technique. Retreatment was performed using: Hedström files; ProFile rotary files; ProTaper Retreatment system and D-RaCe system. Apically extruded debris was collected in pre-weighed Eppendorf tubes and evaluated using an electronic microbalance. Data were analyzed statistically using t-test and analysis of variance. Results. In the AH Plus/gutta-percha group, all tested rotary instruments gave significantly less extruded debris compared with Hedström files (p < 0.05. In theRealSeal group, there was significant difference between DRaCe and Hedström instruments (p < 0.05. Conclusion. All retreatment techniques resulted in apical extrusion. DRaCe system produced significantly less extruded debris compared to hand files. No significant difference was found when comparing two instruments specially designed for retreatment: D-RaCe and ProTaper systems.

Endodontics and the ageing patient.

Science.gov (United States)

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.

Current overview on challenges in regenerative endodontics

Science.gov (United States)

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

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)

Retreatment Rates Among Endometriosis Patients Undergoing Hysterectomy or Laparoscopy.

Science.gov (United States)

Soliman, Ahmed M; Du, Ella Xiaoyan; Yang, Hongbo; Wu, Eric Q; Haley, Jane C

2017-06-01

Hysterectomy and laparoscopy are the two most common surgical options used to treat women with endometriosis, yet the disease may still recur. This study aimed to determine the long-term retreatment rates among endometriosis patients in the United States who received either hysterectomy or laparoscopy. Patients aged 18-49 years with endometriosis who underwent hysterectomy or laparoscopy were identified in the Truven Health MarketScan claims database (2004-2013). The retreatment rate up to 8 years after the initial surgery was estimated using Kaplan-Meier survival analysis. The relative risk of retreatment among patients with hysterectomy versus laparoscopy was assessed using a Cox proportional hazard model. A total of 24,915 patients with endometriosis who underwent hysterectomy and 37,308 patients with endometriosis who underwent laparoscopy were identified. The estimated retreatment rates were 3.3%, 4.7%, and 5.4% in the 2nd, 5th, and 8th year following hysterectomy, respectively, while the rates following laparoscopy were 15.8%, 27.5%, and 35.2%, respectively. The hazard ratio of retreatment was 0.157 (95% confidence interval [CI]: 0.146-0.169) comparing hysterectomy to laparoscopy. In the sensitivity analysis, which expanded the definition of retreatment by including medical treatments, the retreatment rate increased by a factor of 11-14 for the hysterectomy cohort and by a factor of 2-4 for the laparoscopy cohort, and the hazard ratio of retreatment rate for hysterectomy versus laparoscopy was 0.490 (95% CI: 0.477-0.502). Our study results indicated that the disease retreatment rate after laparoscopy is high among patients with endometriosis; even hysterectomy does not guarantee freedom from retreatment.

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.

Cooperative Spatial Retreat for Resilient Drone Networks.

Science.gov (United States)

Kang, Jin-Hyeok; Kwon, Young-Min; Park, Kyung-Joon

2017-05-03

Drones are broadening their scope to various applications such as networking, package delivery, agriculture, rescue, and many more. For proper operation of drones, reliable communication should be guaranteed because drones are remotely controlled. When drones experience communication failure due to bad channel condition, interference, or jamming in a certain area, one existing solution is to exploit mobility or so-called spatial retreat to evacuate them from the communication failure area. However, the conventional spatial retreat scheme moves drones in random directions, which results in inefficient movement with significant evacuation time and waste of battery lifetime. In this paper, we propose a novel spatial retreat technique that takes advantage of cooperation between drones for resilient networking, which is called cooperative spatial retreat (CSR). Our performance evaluation shows that the proposed CSR significantly outperforms existing schemes.

Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment.

Science.gov (United States)

Giuliani, Valentina; Cocchetti, Roberto; Pagavino, Gabriella

2008-11-01

The aim of this study was to evaluate the efficacy of the ProTaper Universal System rotary retreatment system and of Profile 0.06 and hand instruments (K-file) in the removal of root filling materials. Forty-two extracted single-rooted anterior teeth were selected. The root canals were enlarged with nickel-titanium (NiTi) rotary files, filled with gutta-percha and sealer, and randomly divided into 3 experimental groups. The filling materials were removed with solvent in conjunction with one of the following devices and techniques: the ProTaper Universal System for retreatment, ProFile 0.06, and hand instruments (K-file). The roots were longitudinally sectioned, and the image of the root surface was photographed. The images were captured in JPEG format; the areas of the remaining filling materials and the time required for removing the gutta-percha and sealer were calculated by using the nonparametric one-way Kruskal-Wallis test and Tukey-Kramer tests, respectively. The group that showed better results for removing filling materials was the ProTaper Universal System for retreatment files, whereas the group of ProFile rotary instruments yielded better root canal cleanliness than the hand instruments, even though there was no statistically significant difference. The ProTaper Universal System for retreatment and ProFile rotary instruments worked significantly faster than the K-file. The ProTaper Universal System for retreatment files left cleaner root canal walls than the K-file hand instruments and the ProFile Rotary instruments, although none of the devices used guaranteed complete removal of the filling materials. The rotary NiTi system proved to be faster than hand instruments in removing root filling materials.

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.

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.

Pregnancy following nonsurgical donor ovum transfer to a functionally agonadal woman

International Nuclear Information System (INIS)

Sauer, M.V.; Macaso, T.M.; Ishida, E.H.; Giudice, L.; Marshall, J.R.; Buster, J.E.

1987-01-01

We report this country's first nonsurgical donor ovum transfer pregnancy in a functionally agonadal woman who had received chemotherapy and radiation for Hodgkin's lymphoma. For women with ovarian failure, nonsurgical uterine lavage and ovum transfer may provide an opportunity for motherhood that was not possible previously

Effects of Dissolving Solutions on the Accuracy of an Electronic Apex Locator-Integrated Endodontic Handpiece

Directory of Open Access Journals (Sweden)

Yakup Ustun

2013-01-01

Full Text Available The effects of three dissolving agents on the accuracy of an electronic apex locator- (EAL- integrated endodontic handpiece during retreatment procedures were evaluated. The true lengths (TLs of 56 extracted incisor teeth were determined visually. Twenty teeth were filled with gutta-percha and a resin-based sealer (group A, 20 with gutta-percha and a zinc oxide/eugenol-based sealer (group B, and 16 roots were used as the control group (group C. All roots were prepared to TL. Guttasolv, Resosolv, and Endosolv E were used as the dissolving solutions. Two evaluations of the handpiece were performed: the apical accuracy during the auto reverse function (ARL and the apex locator function (EL alone. The ARL function of the handpiece gave acceptable results. There were significant differences between the EL mode measurements and the TL (P<0.05. In these comparisons, Tri Auto ZX EL mode measurements were significantly shorter than those of the TL.

Comparative Evaluation of Advanced and Conventional Diagnostic Aids for Endodontic Management of Periapical Lesions, An in Vivo Study

Science.gov (United States)

Singh, Smita; Arora, Saurabh; Sandhu, Amneet Kaur; Dhingra, Ravneet

2015-01-01

Aim: To evaluate efficacy of Colour Doppler ultrasonography (CDUSG), direct digital radiography (DDR) and conventional radiography (CR) in diagnosis of periapical lesions and to clinically correlate treatment plan of periapical diseases. Materials and Methods: Thirty patients which were diagnosed with periapical lesions in anterior region by using both conventional and digital radiography were examined using colour doppler ultrasound imaging at the site of lesion. The images of each lesion were analysed by two endodontists and by an expert oral radiologist. A tentative differential diagnosis was agreed upon, based on certain principles discussed in article, then a diagnosis between cyst, granuloma and mixed lesions was made. Periapical lesions diagnosed as mixed lesions by colour doppler ultrasonography (CDUSG) were treated non-surgically whereas other periapical lesions were treated surgically. Tissues obtained during endodontic surgery were processed and examined for histopathological findings, and compared with the diagnosis made by ultrasound images. Statistical analysis was done with Chi-Square test and using one-way-Anova. Results: The periapical lesions which were diagnosed as granuloma by ultrasonographic findings, was confirmed by the results of histopathological examination in all 16 surgically treated cases. The lesions in rest of the 14 cases which showed vascularity and were diagnosed as mixed lesions by ultrasonography, were treated non-surgically and had a favourable prognosis. Conclusion: CR and DDR facilitate diagnosis of the presence of periapical disease, but do not provide and information of its nature. CDUSG imaging facilitates accurate information on the pathological nature of the lesion and hence can lead to predictable treatment planning. PMID:25738075

Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort

DEFF Research Database (Denmark)

Chatzidionysiou, Katerina; Lie, Elisabeth; Lukina, Galina

2017-01-01

of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6-4.1 vs 4.6, 95% CI 4.......5-4.7, p leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment....

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.

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.

Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures.

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Aguiar, Arthur Almeida; Lima, Luciana Cavalvanti; Araújo, Cláudia Corrêa de; Gallindo, Rodrigo Melo

2017-12-29

To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56). The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001). Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease. Copyright © 2017. Published by Elsevier Editora Ltda.

Clinical results of nonsurgical treatment for spinal metastases

International Nuclear Information System (INIS)

Katagiri, Hirohisa; Takahashi, Mitsuru; Inagaki, Jiro; Kobayashi, Hidetoshi; Sugiura, Hideshi; Yamamura, Shigeki; Iwata, Hisashi

1998-01-01

Purpose: In contrast with many analyses of surgical treatment for spinal metastases, there have been only a few recent well-documented publications assessing nonsurgical treatment. This paper is a study of the outcome of nonsurgical therapy for metastatic tumors of the spine. Methods and Materials: One hundred and one patients with spinal metastases were treated with radiation therapy and/or chemotherapy without surgical intervention between 1990 and 1995, in prospective analysis, and had follow-up for more than 24 months. This study included 59 men and 42 women with a mean age of 61 years (range: 14 to 81). Mean follow-up periods were 11 months for patients dying of the disease and 53 months for the survivors. Neurological status, pain relief, functional improvement, and cumulative survival rate were assessed. Results: Of the total treated, 67 patients (66%) were evaluated as being neurologically stable or improved after treatment. Pain relief was achieved in 67%, and 64% showed functional improvement. Primary lesion responsiveness to nonsurgical therapy influenced the survival, neurological recovery, pain control, and function. Neurological findings before therapy were useful in predicting ambulatory status after treatment. Conclusion: Nonsurgical treatment was often successful when primary tumors had responsiveness to radiation therapy and/or chemotherapy. We found this to be evident even when neurological deficits were found, particularly in lumbar spines. Spinal metastases of tumors with less responsiveness, unless patients were neurologically intact, responded poorly to therapy. Most of the patients who were successfully treated enjoyed relief lasting nearly until death. Their functional ability was limited by general debility, rather than by local tumor regeneration

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.

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.

Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases

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Min Chen

2017-01-01

Full Text Available Objective. To assess the effectiveness and identify vocal fold leukoplakia types appropriate for nonsurgical treatment. Methods. The vocal fold leukoplakia in 178 patients was divided by gross appearance into three subtypes: flat and smooth, elevated and smooth, and rough. All patients received nonsurgical treatment including smoking and drinking cessation, voice rest, omeprazole, and Chinese medication therapy. The clinical response of three subtypes was assessed after a 6-month follow-up. Results. Vocal fold leukoplakia subtypes included flat and smooth (n=66; 37.1%, elevated and smooth (n=103; 57.9%, and rough (n=9; 5.0%. The rate of complete response was 80.3%, 66.0%, and 0.0% for the 3 lesion types, respectively (rough versus flat and smooth, P<0.001; rough versus elevated and smooth, P<0.001, Fisher’s exact test. The incidence of carcinoma in rough leukoplakia was significantly higher than that in smooth leukoplakia (44.4% versus 2.4%, P=0.002, Fisher’s exact test. Clinical type was the only significant factor for clinical response of nonsurgical treatment (P=0.005, ordinal logistic regression. Conclusions. The effectiveness of nonsurgical treatment for smooth vocal fold leukoplakia is better in comparison to rough vocal fold leukoplakia. Smooth leukoplakia could be managed with nonsurgical treatment; more aggressive treatments should be considered for rough leukoplakia.

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.

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 ...

Current trends in endodontic practice: emergency treatments and technological armamentarium.

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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.

Use of cone-beam computed tomography in diagnosing and treating endodontic treatment failure: A case study

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Gloria Lee

2017-01-01

Full Text Available The use of cone-beam computed tomography (CBCT as a complementary imaging modality applies to various clinical situations that with conventional two-dimensional radiographs alone may pose diagnostic challenges. These challenges include but are not limited to locating missed canals in endodontic retreatment and diagnosing the presence of lesions such as resorption, periapical bone defects, root fractures, and perforations. In this study, we present a case of an asymptomatic apical periodontitis that was incidentally found on a panoramic radiograph. Analyses based on panoramic and periapical radiographs and clinical examinations were insufficient for definitive diagnosis, which necessitated the use of CBCT. The CBCT scan allowed identification of the cause of the apical disease, an unfilled mesiolingual canal in previously root canal treated left mandibular second molar, as well as the extent of the lesion. We also explore the diagnostic challenges in using traditional two-dimensional radiographs only, the challenges in locating root canals in mandibular second molars, and risks and benefits in using CBCT.

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.

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.

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.

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.

Endodontic cellulitis 'flare-up'. Case report.

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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.

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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.

[Use of Cone Beam Computed Tomography in endodontics: rational case selection criteria].

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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.

Cooperative Spatial Retreat for Resilient Drone Networks †

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Kang, Jin-Hyeok; Kwon, Young-Min; Park, Kyung-Joon

2017-01-01

Drones are broadening their scope to various applications such as networking, package delivery, agriculture, rescue, and many more. For proper operation of drones, reliable communication should be guaranteed because drones are remotely controlled. When drones experience communication failure due to bad channel condition, interference, or jamming in a certain area, one existing solution is to exploit mobility or so-called spatial retreat to evacuate them from the communication failure area. However, the conventional spatial retreat scheme moves drones in random directions, which results in inefficient movement with significant evacuation time and waste of battery lifetime. In this paper, we propose a novel spatial retreat technique that takes advantage of cooperation between drones for resilient networking, which is called cooperative spatial retreat (CSR). Our performance evaluation shows that the proposed CSR significantly outperforms existing schemes. PMID:28467390

Comparison of the amount of apical debris extrusion associated with different retreatment systems and supplementary file application during retreatment process.

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Çiçek, Ersan; Koçak, Mustafa Murat; Koçak, Sibel; Sağlam, Baran Can

2016-01-01

The type of instrument affects the amount of debris extruded. The aim of this study was to compare the effect of retreatment systems and supplementary file application on the amount of apical debris extrusion. Forty-eight extracted mandibular premolars with a single canal and similar length were selected. The root canals were prepared with the ProTaper Universal system with a torque-controlled engine. The root canals were dried and were obturated using Gutta-percha and sealer. The specimens were randomly divided into four equal groups according to the retreatment procedures (Group 1, Mtwo retreatment files; Group 2, Mtwo retreatment files + Mtwo rotary file #30 supplementary file; Group 3, ProTaper Universal retreatment (PTUR) files; and Group 4, PTUR files + ProTaper F3 supplementary file). The extruded debris during instrumentation were collected into preweighed Eppendorf tubes. The amount of apically extruded debris was calculated by subtracting the initial weight of the tube from the final weight. Three consecutive weights were obtained for each tube. No statistically significant difference was found in the amount of apically extruded debris between Groups 1 and 3 (P = 0.590). A significant difference was observed between Groups 1 and 2 (P file significantly increased the amount of apically extruded debris.

Bioactive Materials in Endodontics: An Evolving Component of Clinical Dentistry.

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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.

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.

Restoration of Endodontically Treated Molars Using All Ceramic Endocrowns

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Roopak Bose Carlos

2013-01-01

Full Text Available Clinical success of endodontically treated posterior teeth is determined by the postendodontic restoration. Several options have been proposed to restore endodontically treated teeth. Endocrowns represent a conservative and esthetic restorative alternative to full coverage crowns. The preparation consists of a circular equigingival butt-joint margin and central retention cavity into the entire pulp chamber constructing both the crown and the core as a single unit. The case reports discussed here are moderately damaged endodontically treated molars restored using all ceramic endocrowns fabricated using two different systems, namely, CAD/CAM and pressed ceramic.

Assessment of patients' awareness and factors influencing patients' demands for sedation in endodontics.

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Huh, Yoo Kyeom; Montagnese, Thomas A; Harding, Jarrod; Aminoshariae, Anita; Mickel, Andre

2015-02-01

Endodontic therapy is perceived by many as a procedure to be feared. Many studies have reported that fear and anxiety are major deterrents to seeking dental care in general, but only a few deal with the use of sedation in endodontic therapies. The purpose of this study was to assess patients' awareness of and factors influencing the potential demand for sedation in endodontics. We hypothesized that there is an association between demographic factors and the demand for sedation in endodontics. A survey consisting of 24 questions was given to patients 18 years and older who presented to the graduate endodontic clinic. Results were collected and statistically analyzed. Thirty-six percent of patients reported that their perception of sedation was being put to sleep, and 27% perceived it as related to or reducing pain. Concerns associated with endodontic therapy were the fear of pain (35%), fear of needles (16%), difficulty getting numb (10%), and anxiety (7%). The 2 major demographic factors that influenced the demand for sedation were cost and the level of anxiety (P endodontic therapy if the option of sedation was available. The demand for sedation in endodontics is high. Patients' understanding of sedation varies. More patients would consider having endodontic procedures if sedation was available. The provision of sedation by endodontists could result in more patients accepting endodontic therapies. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

[Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

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Zabalegui, B; Gil, J; Zabalegui, I

1989-01-01

Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion.

Endodontic management of patients with systemic complications

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Kalaiselvam Rajeswari

2016-01-01

Full Text Available Successful endodontic practice requires complete knowledge about the various medical conditions and appropriateness in planning treatment as per the need with effective safety measures. This review focuses on a number of systemic complications encountered in endodontic practice and directions to be followed for avoiding potential complications. A detailed PubMed search was carried out using specific keywords, and 25 articles were referred for finalizing the content.

Non-invasive endodontic treatment of large periapical lesions

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Harry Huiz Peeters

2008-09-01

Full Text Available Background: In most cases of large periapical radiolucent lesions of pulpal origin, we often encounter a dilemmatic situation, such as whether to either treat these cases endodontically or surgically. Development of techniques, instruments and root medicaments as well as the tendency toward minimally invasive treatment, all support dentists to treat those cases using the minimal invasive principle (i.e. endodontically instead of surgically. Purpose: The purpose of this paper is to report and discuss the managing of periapical lesions by endodontic no invasive treatment. Case management: The patient with large periapical lesions were treated with noninvasive endodontic treatment. After 6 months, patients in this report were asymptomatic and radiolucencies had disappeared. When the root canal treatment is done according to accepted clinical principles and under aseptic condition, including cleaning, shaping, abturating as well as proper diagnosis, the healing process of the infected area will occur. Conclusion: Some lesions, however, may not be treated conservatively and may require surgical treatment for total elimination of the lesions.

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

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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.

Clinical considerations for regenerative endodontic procedures.

Science.gov (United States)

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.

Antimicrobial Activity of Calcium Hydroxide in Endodontics: A Review

Science.gov (United States)

Shalavi, S; Yazdizadeh, M

2012-01-01

The purpose of endodontic therapy is to preserve the patient's natural teeth without compromising the patient's local or systemic health. Calcium hydroxide has been included in several materials and antimicrobial formulations that are used in several treatment modalities in endodontics, such as inter-appointment intracanal medicaments. The purpose of this article was to review the antimicrobial properties of calcium hydroxide in endodontics. Calcium hydroxide has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. Calcium hydroxide has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also a valuable anti-endotoxin agent. However, its effect on microbial biofilms is controversial. PMID:23323217

Association between Systemic Diseases and Endodontic Outcome: A Systematic Review.

Science.gov (United States)

Aminoshariae, Anita; Kulild, James C; Mickel, Andre; Fouad, Ashraf F

2017-04-01

To date, the relationships between systemic diseases and endodontic treatment outcomes remain poorly studied. Thus, the purpose of this systematic review was to evaluate the relationship between host-modifying factors and their association with endodontic outcomes. Two reviewers independently conducted a comprehensive literature search. The MEDLINE, Embase, Cochrane, and PubMed databases were searched. In addition, the bibliographies and gray literature of all relevant articles and textbooks were manually searched. There was no disagreement between the 2 reviewers. Sixteen articles met the inclusion criteria with moderate to high risk of bias. There was no article with low risk of bias. Available scientific evidence remains inconclusive as to whether diabetes and/or cardiovascular disease(s) may be associated with endodontic outcomes. Human immunodeficiency virus and oral bisphosphonate did not appear to be associated with endodontic outcomes. Although additional well-designed longitudinal clinical studies are needed, the results of this systematic review suggest that some systemic diseases may be correlated with endodontic outcomes. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Summary of: Regenerative endodontics.

Science.gov (United States)

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.

Patient Choice of Nonsurgical Treatment Contributes to Disparities in Head and Neck Squamous Cell Carcinoma.

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Parhar, Harman S; Anderson, Donald W; Janjua, Arif S; Durham, J Scott; Prisman, Eitan

2018-06-01

Objectives There are well-established outcome disparities among different demographic groups with head and neck squamous cell carcinoma (HNSCC). We aimed to investigate the potential contribution of patient choice of nonsurgical treatment to these disparities by estimating the rate of this phenomenon, identifying its predictors, and estimating the effect on cancer-specific survival. Study Design Retrospective nationwide analysis. Settings Surveillance, Epidemiology, and End Results Database (2004-2014). Subjects and Methods Patients with HNSCC, who were recommended for primary surgery, were included. Multivariable logistic regression was used to identify demographic and clinical factors associated with patient choice of nonsurgical treatment, and Kaplan Meier/Cox regression was used to analyze survival. Results Of 114,506 patients with HNSCC, 58,816 (51.4%) were recommended for primary surgery, and of those, 1550 (2.7%) chose nonsurgical treatment. Those who chose nonsurgical treatment were more likely to be older (67.1 ± 12.6 vs 63.6 ± 13.1, P unmarried (OR married, 0.50; 95% CI, 0.44-0.58), had an advanced tumor, and had a hypopharyngeal or laryngeal primary. Choice of nonsurgical treatment imparted a 2.16-fold (95% CI, 2.02-2.30) increased risk of cancer-specific death. Conclusion Of the patients, 2.7% chose nonsurgical treatment despite a provider recommendation that impairs survival. Choice of nonsurgical treatment is associated with older age, having Black or Asian ethnicity, being unmarried, having an advanced stage tumor, and having a primary site in the hypopharynx or larynx. Knowledge of these disparities may help providers counsel patients and help patients make informed decisions.

Pulse oximetry: a potential aid in endodontic diagnosis?

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Caplan, Dan

2010-06-01

Pulse oximetry: review of a potential aid in endodontic diagnosis. Jafarzadeh H, Rosenberg PA. J Endod 2009;35(3):329-33. Dan Caplan, DDS, PhD. This article provided a description of pulse oximetry, its use in patient care settings, and its potential for use in endodontic diagnosis. Information not available. Comprehensive literature review. Level 3: Other evidence. Not applicable.

Dentists with enhanced skills (Special Interest) in Endodontics: gatekeepers views in London.

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Ghotane, Swapnil G; Al-Haboubi, Mustafa; Kendall, Nick; Robertson, Claire; Gallagher, Jennifer E

2015-09-21

Dentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity. The aim of this study was to explore primary dental care practitioners' views of dentists with a special interest (DwSIs) in Endodontics in London, with reference to an educational and service initiative established by (the former) London Deanery in conjunction with the NHS. A cross-sectional postal survey of primary care dentists working across different models of care within London was conducted, with a target to achieve views of at least 5 % of London's dentists. The questionnaire instrument was informed by qualitative research and the dental literature and piloted prior to distribution; data were analysed using SPSS v19 and STATA v12.0. Six per cent of London's primary care dentists (n = 243) responded to the survey; 53 % were male. Just over one third (37 %; n = 90) were aware of the DwSI service being provided. Most practitioners reported that having access to a DwSI in Endodontics would support the care of their patients (89 %; n = 215), would carry out more endodontic treatment in the NHS primary dental care if adequately reimbursed (93 %; n = 220), and had more time (76 %; n = 180). Female respondents appeared to be less confident in doing endodontic treatment (p = 0.001). More recently qualified respondents reported greater need for training/support for performing more endodontic treatment in the NHS primary dental care (p = 0.001), were more dissatisfied with access to endodontic service in the NHS primary dental care (p = 0.007) and more interested to train as a DwSI in endodontics (p = 0.001) compared with respondents having a greater number of years of clinical experience since qualification. The findings lend support to the concept of developing dentists with enhanced skills as well as ensuring additional funding, time and support to facilitate more routine endodontics through the NHS primary care to meet

Formation and interpretation of eskers beneath retreating ice sheets

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Creyts, T. T.; Hewitt, I.

2017-12-01

The retreat of the ice sheets during the Pleistocene left large and spectacular subglacial features exposed. Understanding these features gives us insight into how the ice sheets retreated, how meltwater influenced retreat, and can help inform our understanding of potential future rates of ice sheet retreat. Among these features, eskers, long sinuous ridges primarily composed of clastic sediments, lack a detailed explanation of how surface melt rates and ice sheet retreat rates influence their growth and spatial distribution. Here, we develop a theory for esker formation based on the initial work of Rothlisberger modified for sediment transport and inclusion of surface meltwater forcing. The primary subglacial ingredients include water flow through subglacial tunnels with the addition of mass balances for sediment transport. We show how eskers when water flow slows below a critical stress for sediment motion. This implies that eskers are deposited in a localized region near the snout of the ice sheet. Our findings suggest that very long eskers form sequentially as the ice front retreats. The position of the esker follows the path of the channel mouth through time, which does not necessarily coincide with the instantaneous route of the feeding channel. However, in most cases, we expect those locations to be similar. The role of surface meltwater and the climatology associated with the forcing is crucial to the lateral spacing of the eskers. We predict that high surface melt rates lead to narrower catchments but that the greater extent of the ablation area means that channels are likely larger. At the same time, for a given channel size (and hence sediment flux), the size of a deposited esker depends on a margin retreat rate. Hence, the size of the eskers is related delicately to the balance between surface melt rates and margin retreat rates. We discuss how our theory can be combined with observed esker distributions to infer the relationship between these two rates

Analysis of endodontic therapy in patients irradiated for head and neck cancer

International Nuclear Information System (INIS)

Seto, B.G.; Beumer, J. III; Kagawa, T.; Klokkevold, P.; Wolinsky, L.

1985-01-01

The outcome of endodontic therapy in 16 patients irradiated for head and neck cancer was studied. Thirty-five postradiation endodontically treated teeth (54 roots) were included in the study. The follow-up period ranged from 6 months to 54 months. At the time of last follow-up, 46 of 54 roots were being maintained. No osteoradionecroses were seen in association with teeth that had been endodontically treated. From this review, it is clear that endodontic therapy is a viable method of treating diseased teeth in patients irradiated for oral neoplasms

2017 Rapid Retreat Of Thwaites Glacier

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Milillo, P.; Rignot, E. J.; Mouginot, J.; Scheuchl, B.

2017-12-01

We employ data from the second generation of SAR systems e.g. the Italian COSMO- SkyMed (CSK) constellation and the German TanDEM-X (TDX) formation to monitor grounding line retreat using short repeat-time interferometry and accurate InSAR DEM on Thwaites glacier in the Amundsen Sea Embayment (ASE), West Antarctica. The ASE is a marine-based ice sheet with a retrograde bed containing enough ice to raise global sea level by 120 cm. Several studies have inferred the mechanical properties of portions of ASE using observationally constrained numerical models, but these studies offer only temporal snapshots of basal mechanics owing to a dearth of observational time series. Prior attempts of grounding lines mapping have been limited because few space-borne SAR missions offer the short-term repeat pass capability required to map the differential vertical displacement of floating ice at tidal frequencies with sufficient detail to resolve grounding line boundaries in areas of fast ice deformation. Using 1-day CSK repeat pass data and TDX DEMs, we collected frequent, high-resolution grounding line measurements of Thwaites glaciers spanning 2015-2017. We compare the results with ERS data spanning 1996-2011, and Sentinel-1a 2014-2015 data. Between 2011 and 2017 we observe a maximum retreat of 5-7 km across the main Thwaites glacier tongue and Thwaites Eastern ice shelf (TEIS) corresponding to an increased retreat rate of 0.5 km/yr. Grounding line retreat has been fueled by the enhanced intrusion of warm, salty, subsurface ocean water of circumpolar deep water origin onto the continental shelf, beneath the floating ice shelf, to reach the glacier grounding zone and melt it from below at rates varying from 50 to 150 m/yr. The retreat rate varies depending on the magnitude of ice melt by the ocean, the rate of ice thinning and the shape of the glacier surface and bed topography.

Novel surface coating materials for endodontic dental implant

International Nuclear Information System (INIS)

Fathi, M.H.; Mortazavi, V.; Moosavi, S.B.

2003-01-01

The aim of this study was to design and produce novel coating materials in order to obtain two goals including; improvement of the corrosion behavior of metallic dental endodontic implant and the bone osteointegration simultaneously. Stainless steel 316L (SS) was used as a metallic substrate and a novel Hydroxyapatite/Titanium (HA/Ti) composite coating was prepared on it. Structural characterization techniques including XRD, SEM and EDX were utilized to investigate the microstructure and morphology of the coating. Electrochemical tests were performed in physiological solutions in order to determine and compare the corrosion behavior of the coated and uncoated specimens as an indication of biocompatibility. Two types of endodontic implants including; SS with and without (HA/Ti) composite coating were prepared and subsequently implanted in the mandibular canine of 20 cats after completion of root canal treatment and osseous preparation. After a healing period of 4 months, osteointegration evaluation and histopathological interpretation was carried out using SEM and optical microscopy. Results indicate that the novel HA/Ti composite coating improves the corrosion behavior and biocompatibility of SS endodontic dental implant. The clinical evaluation (in vivo test) results showed that there was significant difference in osteointegration between coated and uncoated endodontic dental implants and average bone osteointegration of coated implants were more than uncoated implants. The histopathological results and bone tissue response to the coated implants was acceptable and it was concluded that HA/Ti composite coated SS could be used as well as an endodontic dental implant. (author)

Improving the quality of endodontic record keeping through clinical audit.

Science.gov (United States)

King, E; Shekaran, L; Muthukrishnan, A

2017-03-10

Introduction Record keeping is an essential part of day-to-day practice and plays an important role in treatment, audit and dento-legal procedures. Creating effective endodontic records is challenging due to the scope of information required for comprehensive notes. Two audits were performed to assess the standards of endodontic record keeping by dentists in a restorative dentistry department and students on an endodontic MSc course.Methods Fifty sets of departmental records and 10 sets of student records were retrospectively evaluated against the European Society of Endodontology 2006 guidelines. Results of the first cycle of both audits were presented to departmental staff and MSc students, alongside an educational session. Additionally, departmental guidelines, consent leaflets and endodontic record keeping forms were developed. Both audits were repeated using the same number of records, thus completing both audit cycles.Results The most commonly absent records included consent, anaesthetic details, rubber dam method, working length reference point, irrigation details and obturation technique. Almost all areas of record keeping improved following the second audit cycle, with some areas reaching 100% compliance when record keeping forms were used. Statistically significant improvements were seen in 24 of the 29 areas in the departmental audit and 14 of the 29 areas in the MSc audit (P = 0.05).Conclusions Significant improvements in endodontic record keeping can be achieved through the provision of education, departmental guidelines, consent leaflets and endodontic record keeping forms.

Endodontic management of mandibular first molars with mid mesial canal: A case series

OpenAIRE

Pradnya Sunil Nagmode; Ankit Vasant Patel; Archana Bhaskar Satpute; Pooja L Gupta

2017-01-01

The purpose of this study is to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main cause of endodontic therapy failure. Dental operating microscope plays a key role in the identification of canal and success of endodontic treatment. This case series describes the endodontic treatment of mandibular fir...

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.

Activation of Alkaline Irrigation Fluids in Endodontics

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Laurence J. Walsh

2017-10-01

Full Text Available In conventional endodontic treatment, alkaline solutions of sodium hypochlorite (NaOCl and ethylenediaminetetraacetic acid (EDTA are used in combination to disinfect the root canal system and to eliminate debris and smear layers. An important concept that has emerged over recent years is the use of active physical methods for agitating these fluids to improve their penetration within areas that are not reached by endodontic instruments and to accelerate the chemical actions of these alkaline fluids against planktonic microorganisms, biofilms, soft tissue remnants and smear layers. Ultrasonic agitation and more recently pulsed lasers have emerged as two promising methods for activating endodontic irrigation fluids. Ultrasonic agitation with piezoelectric devices employs a moving tip, while laser agitation uses a stationary tip. Both methods cause cavitation, followed by implosions and shear forces which assist with debridement. Fluid streaming further enhances the activity of the fluids. While agitation enhances performance of irrigants, extrusion of fluids from the root canal during activation is a hazard that must be controlled.

Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

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Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S. (Pennsylvania State University College of Medicine, Hershey (United States))

1992-09-01

One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years.

Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

International Nuclear Information System (INIS)

Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S.

1992-01-01

One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years

Bioactive endodontic materials for everyday use: a review.

Science.gov (United States)

Walsh, Ryan M; He, Jianing; Schweitzer, Jordan; Opperman, Lynne A; Woodmansey, Karl F

2018-01-01

Bioceramic materials are at the forefront of modern dentistry. Bioactive bioceramic endodontic materials promote pulpal and periapical tissue healing and are easy to use. Dentists can choose among many endodontic materials, depending on their needs. This article highlights the major differences among commercially available bioactive tricalcium silicate bioceramics, commonly known as mineral trioxide aggregate materials, to enable dentists to make appropriate decisions in the selection of these materials.

A Review of Antibacterial Agents in Endodontic Treatment

OpenAIRE

Rahimi, Saeed; Janani, Maryam; Lotfi, Mehrdad; Shahi, Shahriar; Aghbali, Amirala; Vahid Pakdel, Mahdi; Salem Milani, Amin; Ghasemi, Negin

2014-01-01

Microorganisms play a major role in initiation and perpetuation of pulpal and periapical diseases. Therefore, elimination of the microorganisms present in the root canal system is the fundamental objective of endodontic treatment. The use of mechanical debridement, chemical irrigation or other antimicrobial protocols and intra-canal medicaments are critical to attain this goal. The aim of this article was to review the antimicrobial agents and their properties in endodontics.

Association of Endodontic Lesions with Coronary Artery Disease

OpenAIRE

Liljestrand, J. M.; Mäntylä, P.; Paju, S.; Buhlin, K.; Kopra, K. A. E.; Persson, G. R.; Hernandez, M.; Nieminen, M. S.; Sinisalo, J.; Tjäderhane, L.; Pussinen, P. J.

2016-01-01

An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finn...

The health impact of residential retreats: a systematic review.

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Naidoo, Dhevaksha; Schembri, Adrian; Cohen, Marc

2018-01-10

Unhealthy lifestyles are a major factor in the development and exacerbation of many chronic diseases. Improving lifestyles though immersive residential experiences that promote healthy behaviours is a focus of the health retreat industry. This systematic review aims to identify and explore published studies on the health, wellbeing and economic impact of retreat experiences. MEDLINE, CINAHL and PsychINFO databases were searched for residential retreat studies in English published prior to February 2017. Studies were included if they were written in English, involved an intervention program in a residential setting of one or more nights, and included before-and-after data related to the health of participants. Studies that did not meet the above criteria or contained only descriptive data from interviews or case studies were excluded. A total of 23 studies including eight randomised controlled trials, six non-randomised controlled trials and nine longitudinal cohort studies met the inclusion criteria. These studies included a total of 2592 participants from diverse geographical and demographic populations and a great heterogeneity of outcome measures, with seven studies examining objective outcomes such as blood pressure or biological makers of disease, and 16 studies examining subjective outcomes that mostly involved self-reported questionnaires on psychological and spiritual measures. All studies reported post-retreat health benefits ranging from immediately after to five-years post-retreat. Study populations varied widely and most studies had small sample sizes, poorly described methodology and little follow-up data, and no studies reported on health economic outcomes or adverse effects, making it difficult to make definite conclusions about specific conditions, safety or return on investment. Health retreat experiences appear to have health benefits that include benefits for people with chronic diseases such as multiple sclerosis, various cancers, HIV

Effect of non-surgical periodontal treatment on chronic kidney disease patients

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Hilana Paula Carillo Artese

2010-12-01

Full Text Available Chronic kidney disease (CKD is a debilitating systemic condition. Our working hypothesis is that CKD predialysis patients with periodontitis would respond poorly to periodontal treatment owing to immunologic compromise. Twenty-one predialysis patients (group 1 and 19 individuals without clinical evidence of kidney disease (group 2 with chronic periodontitis were subjected to non-surgical periodontal treatment with no antibiotics. Clinical periodontal and systemic parameters were evaluated at baseline and 3 months after treatment. Both groups showed significant and similar post-treatment improvements in all periodontal parameters examined. Most interestingly, periodontal treatment had a statistically significant positive effect on the glomerular filtration rate of each individual (group 1, p = 0.04; group 2, p = 0.002. Our results indicate that chronic periodontitis in predialysis kidney disease patients improved similarly in patients with chronic periodontitis and no history of CKD after receiving non-surgical periodontal therapy. This study demonstrates that CKD predialysis patients show a good response to non-surgical periodontal treatment.

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.

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

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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.

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

Directory of Open Access Journals (Sweden)

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.

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.

An overview of the endodontic curriculum in Fiji from 2009 to 2013.

Science.gov (United States)

Devi, Arpana A; Abbott, Paul V

2015-12-01

This paper seeks to provide the reader with an overview of the endodontic curriculum in Fiji from 2009 to 2013. It also intends to inform readers of the changes in endodontic teaching, the learning methods utilised, curriculum development, the transition from block teaching to partial block teaching combined with longitudinal teaching, and the future plans for the endodontic module. © 2015 Australian Society of Endodontology.

Definition and endodontic treatment of dilacerated canals: a survey of Diplomates of the American Board of Endodontics.

Science.gov (United States)

Dastmalchi, Nafiseh; Kazemi, Zeinab; Hashemi, Siroos; Peters, Ove A; Jafarzadeh, Hamid

2011-01-01

To gather data from Diplomates of the American Board of Endodontics regarding treatment of dilacerated canals. A questionnaire addressing definition, endodontic treatment procedures and prognosis was constructed and distributed via e-mail to 708 Diplomates of the American Board of Endodontics. Data from 150 respondents, a 21% response rate, were collected by using a Web-based interface. For statistical analysis, Chi-square tests were used. More than 25% of respondents believed that a dilacerated root should have a curvature > 40°. One-visit treatment is the best therapeutic approach and transportation is the most likely complication in preparation of these canals. A crown-down technique, watch-winding motion and a master apical file # 25 are the best choices for preparation of these canals. Any warm obturation technique is preferred over lateral compaction by most respondents. A crown-down technique for root canal preparation and a thermoplastic obturation technique are recommended for canals whose curvature is more than 40°. The prognosis of the treatment of these canals is judged not lower than normal canals. Crown-down technique and thermoplastic obturation are recommended for dilacerated canals.

What are estimated reimbursements for lower extremity prostheses capable of surgical and nonsurgical lengthening?

Science.gov (United States)

Henderson, Eric R; Pepper, Andrew M; Letson, G Douglas

2012-04-01

Growing prostheses accommodate skeletally immature patients with bone tumors undergoing limb-preserving surgery. Early devices required surgical procedures for lengthening; recent devices lengthen without surgery. Expenses for newer expandable devices that lengthen without surgery are more than for their predecessors but overall reimbursement amounts are not known. We sought to determine reimbursement amounts associated with lengthening of growing prostheses requiring surgical and nonsurgical lengthening. We retrospectively reviewed 17 patients with growing prostheses requiring surgical expansion and eight patients with prostheses capable of nonsurgical expansion. Insurance documents were reviewed to determine the reimbursement for implantation, lengthening, and complications. Growth data were obtained from the literature. Mean reimbursement amounts of surgical and nonsurgical lengthenings were $9950 and $272, respectively. Estimated reimbursements associated with implantation of a growing prosthesis varied depending on age, sex, and location. The largest difference was found for 4-year-old boys with distal femoral replacement where reimbursement for expansion to maturity for surgical and nonsurgical lengthening prostheses would be $379,000 and $208,000, respectively. For children requiring more than one surgical expansion, net reimbursements were lower when a noninvasive lengthening device was used. Annual per-prosthesis maintenance reimbursements to address complications for surgical and nonsurgical lengthening prostheses were $3386 and $1856, respectively. This study showed that reimbursements for lengthening of growing endoprostheses capable of nonsurgical expansion may be less expensive in younger patients, particularly male patients undergoing distal femur replacement, than endoprostheses requiring surgical lengthening. Longer outcomes studies are required to see if reimbursements for complications differ between devices. Level III, economic and decision

Use of Cone Beam Computed Tomography in Endodontics

Science.gov (United States)

Scarfe, William C.; Levin, Martin D.; Gane, David; Farman, Allan G.

2009-01-01

Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics. PMID:20379362

Role of herbs in endodontics

Directory of Open Access Journals (Sweden)

Rajendra Kumar Tewari

2016-01-01

Full Text Available Medicinal plants and herbs have attracted a lot of attention since the past few years. The market for drugs extracted from these plants and made from herbal extracts has seen a significant rise. India is known for its rich stock of medicinal plants. Among many, some herbs are rich in phytochemical content. These phytochemicals are useful in generating phytomedicines which have effects on the human body. In the field of endodontics, phytomedicines are a boon. They have been popularly used as analgesic, anti-inflammatory, sedatives, and antibiotics. They are most significantly used as endodontic irrigants. Phytotherapy has been a grand entrant in the drug market. The reason why herbal extracts have the potential to be highly popular is due to the side effects of synthetic medicines which alter microbiota.

Pyrosequencing Analysis of Cryogenically Ground Samples from Primary and Secondary/Persistent Endodontic Infections.

Science.gov (United States)

Keskin, Cangül; Demiryürek, Ebru Özsezer; Onuk, Ertan Emek

2017-08-01

This study aimed to characterize the microbial communities of primary and secondary/persistent endodontic infections using high-throughput pyrosequencing from the pulverized samples. The roots of 20 extracted human teeth with primary endodontic infection and 20 teeth with secondary/persistent endodontic infection were collected. The outer surfaces of the roots were disinfected, and whole roots were cryopulverized. 16S amplicon pyrosequencing data from the DNA extracted from the pulverized root powders were obtained, and microorganism abundance and diversity were calculated. Data were analyzed using statistical and bioinformatic methods. Pyrosequencing analysis resulted a total of 2,606,128 sequences from 40 samples. A total of 15 phyla, 160 genera, and 368 species were detected. No significant difference between primary and secondary/persistent endodontic infections was found regarding the diversity and richness of operational taxonomic units at the phyla, genera, and species levels (P > .005). The present study revealed that the microbial diversity of secondary/persistent endodontic infections did not differ than those of primary endodontic infections. A new archaeal species, Candidatus Nitrosoarchaeum limnia, was detected in root canals of 1 patient with primary endodontic infection for the first time. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Spiral computed tomography assessment of the efficacy of different rotary versus hand retreatment system.

Science.gov (United States)

Mittal, Neelam; Jain, Jyoti

2014-01-01

The purpose of this study was to evaluate the efficacy of nickel-titanium rotary retreatment systems versus stainless steel hand retreatment system with or without solvent for gutta-percha removal during retreatment. Sixty extracted human mandibular molar teeth with single canal in a distal root was prepared with ProTaper rotary nickel-titanium files and obturated with gutta-percha and sealer. The teeth were randomly divided into six groups of 10 specimens in each groups. The volume of filling material before and after retreatment were evaluated in cm(3) using the computed tomography (CT) scanner proprietary software. Maximum amount of filling material removed during retreatment with ProTaper retreatment system with solvent and minimum with hand retreatment system with solvent. None of the technique was 100% effective in removing the filling materials, but the ProTaper retreatment system with solvent was better.

Non-surgical treatment of esophageal achalasia

OpenAIRE

Annese, Vito; Bassotti, Gabrio

2006-01-01

Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration, weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia.

The results of surgical and nonsurgical treatment of mallet finger

Directory of Open Access Journals (Sweden)

Starčević Branislav

2006-01-01

Full Text Available Introduction: The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer finger. Objective Our paper had several research Objectives: presentation of the existing Results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors’ Results. Method: The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months. An average follow up was 28.7 months. The Objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by χ2-test and Student’s t-test. The confidence interval was p=0.05. Results: A total range of motion was 51.9±6.6 for nonsurgically treated patients, and 48.2±4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5±3.3 for nonsurgical and 10.0±3.2 for operated patients. Conclusion: The Results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical Method of treating the same deformity.

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.

Pain and senzitisation after total knee replacement or nonsurgical treatment in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Arendt-Nielsen, Lars; Simonsen, Ole; Laursen, Mogens Berg

2018-01-01

BACKGROUND: This study is a secondary analysis of 12-month follow-ups from two parallel, randomised controlled trials (RCT) in painful knee osteoarthritis patients. RCT1: Total knee replacement (TKR) followed by non-surgical treatment compared with non-surgical treatment. RCT2: Non...

Use of Cone Beam Computed Tomography in Endodontics

Directory of Open Access Journals (Sweden)

William C. Scarfe

2009-01-01

Full Text Available Cone Beam Computed Tomography (CBCT is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics.

Endodontic management of mandibular first molars with mid mesial canal: A case series.

Science.gov (United States)

Nagmode, Pradnya Sunil; Patel, Ankit Vasant; Satpute, Archana Bhaskar; Gupta, Pooja L

2017-01-01

The purpose of this study is to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main cause of endodontic therapy failure. Dental operating microscope plays a key role in the identification of canal and success of endodontic treatment. This case series describes the endodontic treatment of mandibular first molars with extra root canals, evaluate the occurrence of this extra canal, and discuss the importance of their identification and treatment.

Possibilities and limits of imaging endodontic structures with CBCT.

Science.gov (United States)

Weber, Marie-Theres; Stratz, Nadja; Fleiner, Jonathan; Schulze, Dirk; Hannig, Christian

2015-01-01

An adequate portrayal of the root canal anatomy by diagnostic imaging is a prerequisite for a successful diagnosis and therapy in endodontics. The introduction of dental cone beam computed tomography (CBCT) has considerably expanded the scope of imaging diagnostics. The aim of the following study was to evaluate the imaging of endodontic structures with CBCT. One hundred and twenty teeth were examined with a CBCT device (ProMax 3D). Subsequently, the findings of the three-dimensional images were evaluated and compared to those of dental radiographs and tangential section preparations of the examined teeth. Results with high prevalence, such as existing roots and root canals, as well as results with low prevalence, e.g., extremely fine anatomical structures of the endodontic tissue, could be visualized precisely by dental CBCT; side canals, ramifications, communications, pulp stones, and obliterations could also be detected. Additionally, the length of curved root canals could be determined accurately. Likewise, root fractures were visualized reliably with CBCT. However, carious lesions could not be diagnosed adequately, and the evaluation of fillings and prosthetic restorations was complicated due to scattered X-ray artifacts. CBCT datasets qualify to visualize and diagnose small anatomical structures of the endodontic tissue.

Endodontic, surgical and periodontal treatment of dens invaginatus. Case report.

Science.gov (United States)

Castellarin, M; Demitri, V; Politi, M

2001-01-01

The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.

Prognostic indicators for failed nonsurgical reduction of intussusception

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Khorana J

2016-08-01

Full Text Available Jiraporn Khorana,1 Jesda Singhavejsakul,1 Nuthapong Ukarapol,2 Mongkol Laohapensang,3 Jakraphan Siriwongmongkol,1 Jayanton Patumanond4 1Division of Pediatric Surgery, Department of Surgery, 2Division of Gastroenterology, Department of Pediatrics, Chiang Mai University Hospital, Chiang Mai, 3Division of Pediatric Surgery, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, 4Center of Excellence in Applied Epidemiology, Thammasat University Hospital, Pathumthani, Thailand Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 were collected. Patients aged 0–15 years and without contraindications (peritonitis, abdominal X-ray signs of perforation, and/or hemodynamic instability were included for nonsurgical reduction. The success and failure groups were divided according to the results of the reduction. Prognostic indicators for failed reduction were identified by using generalized linear model for exponential risk regression. The risk ratio (RR was used to report each factor. Results: One hundred and ninety cases of intussusception were enrolled. Twenty cases were excluded due to contraindications. A total of 170 cases of intussusception were included for the final analysis. The significant risk factors for reduction failure clustered by an age of 3 years were weight <12 kg (RR =1.48, P=0.004, symptom duration >3 days (RR =1.26, P<0.001, vomiting (RR =1.63, P<0.001, rectal bleeding (RR =1.50, P<0.001, abdominal distension (RR =1.60, P=0.003, temperature >37.8°C (RR =1.51, P<0.001, palpable abdominal mass (RR =1.26, P<0.001, location of mass (left over right side (RR =1.48, P<0.001, poor prognostic signs on ultrasound scans (RR =1.35, P<0.001, and method of reduction (hydrostatic over pneumatic (RR =1

Aspergillus in endodontic infection near the maxillary sinus

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Cinthya Cristina Gomes

2015-10-01

Full Text Available ABSTRACT INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%:Aspergillus niger (6.7%, Aspergillus versicolor (1.6%, and Aspergillus fumigatus(1.6%. CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

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.

Endodontics and the irradiated patient

International Nuclear Information System (INIS)

Cox, F.L.

1976-01-01

With increasingly larger numbers of irradiated patients in our population, it seems likely that all dentists will eventually be called upon to manage the difficult problems that these patients present. Of utmost concern should be the patient's home care program and the avoidance of osteroradionecrosis. Endodontics and periodontics are the primary areas for preventing or eliminating the infection that threatens osteoradionecrosis. Endodontic treatment must be accomplished with the utmost care and maximum regard for the fragility of the periapical tissues. Pulpally involved teeth should never be left open in an irradiated patient, and extreme care must be taken with the between-visits seal. If one is called upon for preradiation evaluation, routine removal of all molar as well as other compromised teeth should be considered. Attention should be directed to the literature for further advances in the management of irradiated patients

Non-surgical treatment of esophageal achalasia

Science.gov (United States)

Annese, Vito; Bassotti, Gabrio

2006-01-01

Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration, weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia. PMID:17007039

Natural Therapeutic Options in Endodontics - A Review

Science.gov (United States)

Venkateshbabu, Nagendrababu; Anand, Suresh; Abarajithan, Mohan; Sheriff, Sultan O.; Jacob, Pulikkotil S.; Sonia, Nath

2016-01-01

Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer. PMID:27386007

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.

Science.gov (United States)

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.

Periapical and endodontic status of permanent teeth in patients with hypophosphatemic rickets

DEFF Research Database (Denmark)

Andersen, Mette Guldbæk; Beck-Nielsen, Signe; Haubek, Dorte

2012-01-01

panoramic radiograph, which was scored for endodontically affected teeth (i.e. teeth with periapical radiolucencies and/or endodontically treated teeth). A total of 52 patients (age range: 5·7-74·5 years; 17 males and 35 females) were included. HR patients were characterised by a high number...... genetically. The aim of the present study was to describe the periapical and endodontic status of permanent teeth in patients with genetically and/or biochemically confirmed HR. The patients were recruited from a medical study on HR patients. The patients underwent a dental examination including a digital...... of endodontically affected teeth (mean: 4·2; s.d.: 5·0). The number of affected teeth rose significantly with age (P ...

CALCIUM HYDROXIDE IN ENDODONTIC TREATMENT OF PERIAPICALLY INFECTED TEETH

Directory of Open Access Journals (Sweden)

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.

Removal of root filling materials.

LENUS (Irish Health Repository)

Duncan, H.F. Chong, B.S.

2011-05-01

Safe, successful and effective removal of root filling materials is an integral component of non-surgical root canal re-treatment. Access to the root canal system must be achieved in order to negotiate to the canal terminus so that deficiencies in the original treatment can be rectified. Since a range of materials have been advocated for filling root canals, different techniques are required for their removal. The management of commonly encountered root filling materials during non-surgical re-treatment, including the clinical procedures necessary for removal and the associated risks, are reviewed. As gutta-percha is the most widely used and accepted root filling material, there is a greater emphasis on its removal in this review.

Non-surgical radiofrequency facelift.

Science.gov (United States)

Narins, David J; Narins, Rhoda S

2003-10-01

There has been considerable interest in using non-ablative methods to rejuvenate the skin. The ThermaCool TC (Thermage Inc.) is a radiofrequency (RF) device that has been introduced to induce tightening of the address the problem of skin via a uniform volumetric heating into the deep dermis tightening, resulting in a 'non-surgical facelift'. Radiofrequency produces a uniform volumetric heating into the deep dermis. Twenty treatment areas in 17 patients were treated to evaluate the efficacy and safety of RF treatment to the brow and jowls. The technique was found to produce gradual tightening in most patients, and there were no adverse effects.

Treatment philosophy and retreatment rates following piezoelectric lithotripsy.

Science.gov (United States)

Fegan, J; Camp, L A; Wilson, W T; Miller, G L; Preminger, G M

1993-01-01

Second generation lithotriptors offer the advantage of anesthesia-free fragmentation of renal and ureteral calculi but they frequently require multiple treatments to attain a stone-free status. However, excessive single lithotripsy sessions or multiple treatments may be associated with significant damage to the kidney. For some clinicians a common treatment philosophy involves evaluation of serial plain abdominal films every 24 hours after lithotripsy and immediate retreatment of all patients with incomplete fragmentation. To avoid unnecessary retreatments and, thus, minimize potential renal damage, we prospectively evaluated 100 patients undergoing lithotripsy on a Wolf Piezolith 2300 device. Patients were routinely treated with 4,000 shocks at 1,100 bar. Serial plain abdominal films were obtained at 1 day and 2 weeks after lithotripsy. The need for retreatment was determined by the plain abdominal film results. Additional therapy was considered necessary if there was no stone fragmentation or if residual fragments measured greater than 4 mm. Of the patients whose plain abdominal film at 24 hours indicated the need for a repeat treatment 43% were stone-free on the 2-week film. Thus, these patients were spared an unnecessary treatment by allowing adequate time for the stone fragments to pass spontaneously. Our data suggest that repeat treatments on second generation lithotriptors should not be performed within 24 hours. Rather, the patient should be reevaluated at least 1 to 2 weeks later to avoid unnecessary retreatment with the attendant potential for renal injury. In addition, when comparing the retreatment rates of various lithotriptors, one should also consider the treatment philosophy used at the particular institution and the timing of the radiographic studies used to determine the stone-free status.

Applications of piezoelectric surgery in endodontic surgery: a literature review.

Science.gov (United States)

Abella, Francesc; de Ribot, Joan; Doria, Guillermo; Duran-Sindreu, Fernando; Roig, Miguel

2014-03-01

Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery. We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles. A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples. Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic treatment associated with photodynamic therapy: Case report.

Science.gov (United States)

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.

Exceptional retreat of Novaya Zemlya's marine-terminating outlet glaciers between 2000 and 2013

Directory of Open Access Journals (Sweden)

J. R. Carr

2017-09-01

Full Text Available Novaya Zemlya (NVZ has experienced rapid ice loss and accelerated marine-terminating glacier retreat during the past 2 decades. However, it is unknown whether this retreat is exceptional longer term and/or whether it has persisted since 2010. Investigating this is vital, as dynamic thinning may contribute substantially to ice loss from NVZ, but is not currently included in sea level rise predictions. Here, we use remotely sensed data to assess controls on NVZ glacier retreat between 1973/76 and 2015. Glaciers that terminate into lakes or the ocean receded 3.5 times faster than those that terminate on land. Between 2000 and 2013, retreat rates were significantly higher on marine-terminating outlet glaciers than during the previous 27 years, and we observe widespread slowdown in retreat, and even advance, between 2013 and 2015. There were some common patterns in the timing of glacier retreat, but the magnitude varied between individual glaciers. Rapid retreat between 2000 and 2013 corresponds to a period of significantly warmer air temperatures and reduced sea ice concentrations, and to changes in the North Atlantic Oscillation (NAO and Atlantic Multidecadal Oscillation (AMO. We need to assess the impact of this accelerated retreat on dynamic ice losses from NVZ to accurately quantify its future sea level rise contribution.

Irrigation in endodontic treatment.

Science.gov (United States)

Basrani, Bettina

2011-01-01

The primary endodontic treatment goal is to optimize root canal disinfection and to prevent reinfection. Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal system. In this review of the literature, various irrigants and the interactions between irrigants are discussed and new delivery systems are introduced.

X-Ray diagnostics and their relation to a successful endodontic treatment

International Nuclear Information System (INIS)

Cecetkova, A.; Ondrasovicova, J.

2008-01-01

Radiography plays very major rule in endodontic. One of the most used method is intraoral radiography ( intraoral diagnostic x-ray, x-ray with hand root instrument, recall, after call and follow up x-ray ). These radiographic pictures help us detect the morphology of the root canal system, endodontic complications and periapical lessions. X-ray radiographs have to be isometric in the ortoradial projection. Some cases we may use the ex-centric projection (mesial and distal projection). Endodontic complications as broken hand root instrument, via falsa, intra-canal step may be confirmed by intraoral x-ray radiographs. (authors)

Clinically Enhancing Local Anesthesia Techniques for Endodontic Treatment.

Science.gov (United States)

Bahcall, James; Xie, Qian

2017-02-01

Local anesthesia is one of the most important drugs given to patients who undergo endodontic treatment. Yet, clinicians often do not view local anesthetic agents as drugs and, therefore, struggle clinically to consistently achieve profound pulpal anesthesia. To improve the clinical effects of local anesthesia for endodontic treatment, in conjunction with selecting the correct type of local anesthesia, clinicians need to thoroughly understand how the local anesthetic process works and how to objectively test for clinical signs of pulpal anesthesia and integrate supplemental anesthesia when appropriate.

Murdoch Retreats from China

Institute of Scientific and Technical Information of China (English)

Jessy Zhang

2006-01-01

@@ News Corp's Asian flagship enterprise Star Group announced in early June it would sell a 19.9 percent stake in Phoenix Satellite Television to China Mobile. This move is widely interpreted as a signal that Rudolf Murdoch, the helmsman of News Corp,might have lost his patience and could eventually retreat from the Chinese media market.

Endodontic medicine: connections between apical periodontitis and systemic diseases.

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Segura-Egea, J J; Martín-González, J; Castellanos-Cosano, L

2015-10-01

The prevalence of apical periodontitis (AP) in Europe has been reported to affect 61% of individuals and 14% of teeth, and increase with age. Likewise, the prevalence of root canal treatment (RCT) in Europe is estimated to be around 30-50% of individuals and 2-9% of teeth with radiographic evidence of chronic persistent AP in 30-65% of root filled teeth (RFT). AP is not only a local phenomenon and for some time the medical and dental scientific community have analysed the possible connection between apical periodontits and systemic health. Endodontic medicine has developed, with increasing numbers of reports describing the association between periapical inflammation and systemic diseases. The results of studies carried out both in animal models and humans are not conclusive, but suggest an association between endodontic variables, that is AP and RCT, and diabetes mellitus (DM), tobacco smoking, coronary heart disease and other systemic diseases. Several studies have reported a higher prevalence of periapical lesions, delayed periapical repair, greater size of osteolityc lesions, greater likelihood of asymptomatic infections and poorer prognosis for RFT in diabetic patients. On the other hand, recent studies have found that a poorer periapical status correlates with higher HbA1c levels and poor glycaemic control in type 2 diabetic patients. However, there is no scientific evidence supporting a causal effect of periapical inflammation on diabetes metabolic control. The possible association between smoking habits and endodontic infection has also been investigated, with controversial results. The aim of this paper was to review the literature on the association between endodontic variables and systemic health (especially DM and smoking habits). © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

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.

Cleanliness of endodontic files after use and before sterilization

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Maria de Lourdes Portella

2008-01-01

Full Text Available Objectives: To evaluate the efficacy of two endodontic file cleaning methods: manual and with the use of ultrasonic vat Method: Sixty-six endodontic files were used for root canal preparations and afterwards divided into three groups: 1 manual cleaning; 2ultrasonic cleaning; 3 files used in patients, but were not cleaned (positive control.Results: Statistical analysis showed that in the case of manually cleaned files, the percentage of cleaning was 0.4% while in those that were dirty it was 99.6%. In the case of ultrasonic cleaning, the cleaning percentage was 49.21% while the percentage of dirt was 50.79%. Conclusion: The most satisfactory result was obtained with the use of ultrasound, and it is suggested that after ultrasound, brushing, the use of liquid soap and water, and drying should be performed for adequate cleaning of endodontic files.

Aspergillus in endodontic infection near the maxillary sinus.

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Gomes, Cinthya Cristina; Pinto, Larissa Christina Costa; Victor, Fernanda Loretti; Silva, Erlange Andrade Borges da; Ribeiro, Apoena de Aguiar; Sarquis, Maria Inês de Moura; Camões, Isabel Coelho Gomes

2015-01-01

Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

[Nonsurgical endodontic treatment of an invaginated canine].

Science.gov (United States)

Fernández Guerrero, F; Miñana Laliga, R; Bullon Fernandez, P

1989-01-01

We present a case of a maxillary canine with a dens invaginatus treated successfully. The patient had pain, swelling and a sinus tract coming from the inmature apex of the canine. The canals were enlarged and cleaned and the main canal was filled with Calcium Hydroxide to allow the root development. Seven months later, the patient was asymptomatic and the tooth was obturated with guttapercha. One year later it was confirm the success in the treatment.

Wastewater retreatment and reuse system for agricultural irrigation in rural villages.

Science.gov (United States)

Kim, Minyoung; Lee, Hyejin; Kim, Minkyeong; Kang, Donghyeon; Kim, Dongeok; Kim, YoungJin; Lee, Sangbong

2014-01-01

Climate changes and continuous population growth increase water demands that will not be met by traditional water resources, like surface and ground water. To handle increased water demand, treated municipal wastewater is offered to farmers for agricultural irrigation. This study aimed to enhance the effluent quality from worn-out sewage treatment facilities in rural villages, retreat effluent to meet water quality criteria for irrigation, and assess any health-related and environmental impacts from using retreated wastewater irrigation on crops and in soil. We developed the compact wastewater retreatment and reuse system (WRRS), equipped with filters, ultraviolet light, and bubble elements. A pilot greenhouse experiment was conducted to evaluate lettuce growth patterns and quantify the heavy metal concentration and pathogenic microorganisms on lettuce and in soil after irrigating with tap water, treated wastewater, and WRRS retreated wastewater. The purification performance of each WRRS component was also assessed. The study findings revealed that existing worn-out sewage treatment facilities in rural villages could meet the water quality criteria for treated effluent and also reuse retreated wastewater for crop growth and other miscellaneous agricultural purposes.

Endodontic Microbiology and Pathobiology: Current State of Knowledge.

Science.gov (United States)

Fouad, Ashraf F

2017-01-01

Newer research tools and basic science knowledge base have allowed the exploration of endodontic diseases in the pulp and periapical tissues in novel ways. The use of next generation sequencing, bioinformatics analyses, genome-wide association studies, to name just a few of these innovations, has allowed the identification of hundreds of microorganisms and of host response factors. This review addresses recent advances in endodontic microbiology and the host response and discusses the potential for future innovations in this area. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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.

Maxillary First Molars with 2 Distobuccal Canals: A Case Series.

Science.gov (United States)

Fogel, Howard M; Cunha, Rodrigo Sanches

2017-11-01

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Non-surgical treatment for eyelid retraction in thyroid eye disease (TED).

Science.gov (United States)

Grisolia, Ana Beatriz Diniz; Couso, Ricardo Christopher; Matayoshi, Suzana; Douglas, Raymond S; Briceño, César Augusto

2017-08-09

Thyroid eye disease (TED) is an autoimmune condition with an unpredictable course that may lead to permanent facial disfigurement. Eyelid retraction is one of the most common findings, and frequently demands attention due to ocular exposure and impaired cosmesis. Surgical treatment remains the most effective option, but there is a role for temporary corrections during the active phase of the disease, as well as in patients who are poor surgical candidates. The aim of this review is to describe the non-surgical modalities currently available for treatment of eyelid malposition in TED. The authors have focused on the use of hyaluronic acid, triamcinolone injections and botulinum toxin type A as non-surgical treatment alternatives, paying special attention to dosing, technique, efficacy and duration of effect. Non-surgical treatment modalities may represent viable in cases where surgical correction is not an option. Although temporary, these modalities appear to be beneficial for ocular exposure remediation, improving quality of life and broadening our therapeutic arsenal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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.

Clinical applications of cone beam computed tomography in endodontics: A comprehensive review.

Science.gov (United States)

Cohenca, Nestor; Shemesh, Hagay

2015-09-01

The use of cone beam computed tomography (CBCT) in endodontics has been extensively reported in the literature. Compared with the traditional spiral computed tomography, limited field of view (FOV) CBCT results in a fraction of the effective absorbed dose of radiation. The purpose of this manuscript is to review the application and advantages associated with advanced endodontic problems and complications, while reducing radiation exposure during complex endodontic procedures. The benefits of the added diagnostic information provided by intraoperative CBCT images in select cases justify the risk associated with the limited level of radiation exposure.

Patients' perceptions, treatment need, and complexity of orthodontic re-treatment

NARCIS (Netherlands)

Ren, Yijin; Boxum, Christo; Sandham, John

The aim of the present study was to investigate the subjective perception and objective treatment need and complexity of patients seeking orthodontic re-treatment. One hundred subjects (66 females, 34 males, age 26.7+/-8.2 years) seeking re-treatment were asked to complete a questionnaire which was

Absorbed radiation by various tissues during simulated endodontic radiography

International Nuclear Information System (INIS)

Torabinejad, M.; Danforth, R.; Andrews, K.; Chan, C.

1989-01-01

The amount of absorbed radiation by various organs was determined by placing lithium fluoride thermoluminescent chip dosimeters at selected anatomical sites in and on a human-like X-ray phantom and exposing them to radiation at 70- and 90-kV X-ray peaks during simulated endodontic radiography. The mean exposure dose was determined for each anatomical site. The results show that endodontic X-ray doses received by patients are low when compared with other radiographic procedures

The Sensitivity of Endodontic Enterococcus spp. Strains to Geranium Essential Oil.

Science.gov (United States)

Łysakowska, Monika E; Sienkiewicz, Monika; Banaszek, Katarzyna; Sokołowski, Jerzy

2015-12-21

Enterococci are able to survive endodontic procedures and contribute to the failure of endodontic therapy. Thus, it is essential to identify novel ways of eradicating them from infected root canals. One such approach may be the use of antimicrobials such as plant essential oils. Enterococcal strains were isolated from endodontically treated teeth by standard microbiological methods. Susceptibility to antibiotics was evaluated by the disc-diffusion method. The minimal inhibitory concentration (MIC) of geranium essential oil was investigated by microdilution in 96-well microplates in Mueller Hinton Broth II. Biofilm eradication concentrations were checked in dentin tests. Geranium essential oil inhibited enterococcal strains at concentrations ranging from 1.8-4.5 mg/mL. No correlation was shown between resistance to antibiotics and the MICs of the test antimicrobials. The MICs of the test oil were lower than those found to show cytotoxic effects on the HMEC-1 cell line. Geranium essential oil eradicated enterococcal biofilm at concentrations of 150 mg/mL. Geranium essential oil inhibits the growth of endodontic enterococcal species at lower concentrations than those required to reach IC50 against the HMEC-1 cell line, and is effective against bacteria protected in biofilm at higher concentrations. In addition, bacteria do not develop resistance to essential oils. Hence, geranium essential oil represents a possible alternative to other antimicrobials during endodontic procedures.

Comparative evaluation of four different sterilization methods on contaminated endodontic files

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Malathi Yenni

2017-01-01

Full Text Available Background: The reuse of instruments in the field of endodontics leads to cross infection due to contamination with microbes as the instruments come into direct contact with saliva, blood, and infected tissues. Since microbes are considered to be the major cause of endodontic failures, sterilization of endodontic instruments is mandatory for maintaining asepsis to prevent cross-contamination from one person to other. Hence, the present study was conducted to compare the effectiveness of four different methods of sterilizing contaminated endodontic files. Materials and Methods: A total of 48 stainless steel K files were divided into four groups based on the sterilization method followed – Group A: Autoclave, Group B: Glass bead sterilization, Group C: Glutaraldehyde, and Group D: Quitanet Plus (aldehyde-free solution. In all the tested groups, half of the files were contaminated with Escherichia coli and remaining with Enterococcus faecalis. Then, presterilization colony counts were recorded, followed by sterilization through respective methods. Later, the sterilized files were rinsed with distilled water and 100 ul of the diluted concentration was transferred and cultured onto the respective agar plates to determine the total microbial reduction. Results: Autoclave showed complete effectiveness in reducing the microbial count followed by Quitanet Plus, glass bead sterilizer, and glutaraldehyde. Conclusion: Autoclave is considered to be the best sterilization technique to prevent cross infection in endodontic therapy.

PCR methodology as a valuable tool for identification of endodontic pathogens.

Science.gov (United States)

Siqueira, José F; Rôças, Isabela N

2003-07-01

This paper reviews the principles of polymerase chain reaction (PCR) methodology, its application in identification of endodontic pathogens and the perspectives regarding the knowledge to be reached with the use of this highly sensitive, specific and accurate methodology as a microbial identification test. Studies published in the medical, dental and biological literature. Evaluation of published epidemiological studies examining the endodontic microbiota through PCR methodology. PCR technology has enabled the detection of bacterial species that are difficult or even impossible to culture as well as cultivable bacterial strains showing a phenotypically divergent or convergent behaviour. Moreover, PCR is more rapid, much more sensitive, and more accurate when compared with culture. Its use in endodontics to investigate the microbiota associated with infected root canals has expanded the knowledge on the bacteria involved in the pathogenesis of periradicular diseases. For instance, Tannerella forsythensis (formerly Bacteroides forsythus), Treponema denticola, other Treponema species, Dialister pneumosintes, and Prevotella tannerae were detected in infected root canals for the first time and in high prevalence when using PCR analysis. The diversity of endodontic microbiota has been demonstrated by studies using PCR amplification, cloning and sequencing of the PCR products. Moreover, other fastidious bacterial species, such as Porphyromonas endodontalis, Porphyromonas gingivalis and some Eubacterium spp., have been reported in endodontic infections at a higher prevalence than those reported by culture procedures.

Culture-dependent approaches to explore the prevalence of root canal pathogens from endodontic infections

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Maryam Pourhajibagher

2017-12-01

Full Text Available Abstract: Endodontic infections are considered to be caused by the presence of various microorganisms within the root canal system. Recognition of this microbiota contributes to the successful treatment of infected root canals. This study investigated the microorganisms associated with primary and secondary endodontic infections via culture methods, biochemical tests, and molecular approaches in an Iranian population. Microbial specimens were collected from 36 patients with primary endodontic infection and 14 patients with a history of root canal therapy. Advanced microbiological culture techniques were used to isolate microbiota; subsequently, biochemical tests and 16S ribosomal RNA gene sequencing were performed to identify the microorganisms. Within the total 218 cultivable isolates, Veillonella parvula (20.6% was found to occur with the highest frequency in primary endodontic infection, followed by Porphyromonas gingivalis (14.1%, and Aggregatibacter actinomycetemcomitans (9.2%. Enterococcus faecalis (36.6% was the most predominant microorganism in secondary endodontic infections, followed by Candida albicans, Propionibacterium acnes, and V. parvula with frequencies of 20%, 2%, and 2%, respectively. It was concluded that V. parvula and E. faecalis was most frequently found in primary and secondary endodontic infections, respectively.

Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco.

Science.gov (United States)

Dooley, Kelly E; Lahlou, Ouafae; Ghali, Iraqi; Knudsen, Janine; Elmessaoudi, My Driss; Cherkaoui, Imad; El Aouad, Rajae

2011-02-28

Patients with tuberculosis require retreatment if they fail or default from initial treatment or if they relapse following initial treatment success. Outcomes among patients receiving a standard World Health Organization Category II retreatment regimen are suboptimal, resulting in increased risk of morbidity, drug resistance, and transmission.. In this study, we evaluated the risk factors for initial treatment failure, default, or early relapse leading to the need for tuberculosis retreatment in Morocco. We also assessed retreatment outcomes and drug susceptibility testing use for retreatment patients in urban centers in Morocco, where tuberculosis incidence is stubbornly high. Patients with smear- or culture-positive pulmonary tuberculosis presenting for retreatment were identified using clinic registries in nine urban public clinics in Morocco. Demographic and outcomes data were collected from clinical charts and reference laboratories. To identify factors that had put these individuals at risk for failure, default, or early relapse in the first place, initial treatment records were also abstracted (if retreatment began within two years of initial treatment), and patient characteristics were compared with controls who successfully completed initial treatment without early relapse. 291 patients presenting for retreatment were included; 93% received a standard Category II regimen. Retreatment was successful in 74% of relapse patients, 48% of failure patients, and 41% of default patients. 25% of retreatment patients defaulted, higher than previous estimates. Retreatment failure was most common among patients who had failed initial treatment (24%), and default from retreatment was most frequent among patients with initial treatment default (57%). Drug susceptibility testing was performed in only 10% of retreatment patients. Independent risk factors for failure, default, or early relapse after initial treatment included male gender (aOR = 2.29, 95% CI 1

The etiology and symptoms of endodontic cases treated in a university clinic in Saudi Arabia

International Nuclear Information System (INIS)

AlYahya, A. S.; Selirn, H. A.; Guile, E. E.

1989-01-01

Endodontic patients treated at a University Dental Clinic over a two year period were studied. A total of 281 patients seen in a beginning endodontic course were analyzed to determine (1) the etiology of the pulpal disease presenting and (2) the signs and symptoms of pulpal disease. Results indicated that caries was the most prevalent reason for endodontic treatment. Most cases (40.6%) were asymptomatic. Lower molars were the most commonly affected and there was no significant difference in endodontic treatment distribution between males and females in the patient population studied. (author)

A survey of dental residents' expectations for regenerative endodontics.

Science.gov (United States)

Manguno, Christine; Murray, Peter E; Howard, Cameron; Madras, Jonathan; Mangan, Stephen; Namerow, Kenneth N

2012-02-01

The objective was to survey a group of dental residents regarding their expectations for using regenerative endodontic procedures as part of future dental treatments. After institutional review board approval, the opinions of 32 dentists who were having postgraduate residency training to become specialists in a dental school were surveyed. The survey had 40 questions about professional status, ethical beliefs, judgment, and clinical practice. It was found that 83.9% of dentists had no continuing education or training in stem cells or regenerative endodontic procedures. Results showed that 96.8% of dentists are willing to receive training to be able to provide regenerative endodontic procedures for their patients. Of the total group, 49.1% of dentists already use membranes, scaffolds, or bioactive materials to provide dental treatment. It was determined that 47.3% of dentists agree that the costs of regenerative procedures should be comparable with current treatments. It was also found that 55.1% of dentists were unsure whether regenerative procedures would be successful. Dentists are supportive of using regenerative endodontic procedures in their dental practice, and they are willing to undergo extra training and to buy new technology to provide new procedures. Nevertheless, dentists also need more evidence for the effectiveness and safety of regenerative treatments before they will be recommended for most patients. Copyright © 2012. Published by Elsevier Inc.

Retrospective review of voluntary reports of nonsurgical paresthesia in dentistry.

Science.gov (United States)

Gaffen, Andrew S; Haas, Daniel A

2009-10-01

Paresthesia is an adverse event that may be associated with the administration of local anesthetics in dentistry. The purpose of this retrospective study was to analyze cases of paresthesia associated with local anesthetic injection that were voluntarily reported to Ontario"s Professional Liability Program (PLP) from 1999 to 2008 inclusive, to see if the findings were consistent with those from 1973 to 1998 from this same source. All cases of nonsurgical paresthesia reported from 1999 to 2008 were reviewed; cases involving surgical procedures were excluded. Variables examined included patient age and gender, type and volume of local anesthetic, anatomic site of nerve injury, affected side and pain on injection or any other symptoms. During the study period, 182 PLP reports of paresthesia following nonsurgical procedures were made; all but 2 were associated with mandibular block injection. There was no significant gender predilection, but the lingual nerve was affected more than twice as frequently as the inferior alveolar nerve. During 2006-2008 alone, 64 cases of nonsurgical paresthesia were reported to PLP, a reported incidence of 1 in 609,000 injections. For the 2 local anesthetic drugs available in dental cartridges as 4% solutions, i.e., articaine and prilocaine, the frequencies of reporting of paresthesia were significantly greater than expected (chi2, exact binomial distribution; p paresthesia.

The Effect of Autoclaving on Torsional Moment of Two Nickel-Titanium Endodontic Files

Science.gov (United States)

2012-01-01

titanium endodontic files 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) J. B. King, H. W. Roberts, B. E... Endodontic Journal, doi:10.1111/j.1365- 2591.2011.01958.x 45, 156–161, 2012 doi:10.1111/j.1365-2591.2011.01958.x Wiley Blackwell Publishing, 111 River...autoclaving on torsional strength of two nickel–titanium (NiTi) rotary endodontic files: Twisted Files (SybronEndo, Orange, CA, USA) and GT Series X

Apical surgery vs apical surgery with simultaneous orthograde retreatment: A prospective cohort clinical study of teeth affected by persistent periapical lesion

Directory of Open Access Journals (Sweden)

Carlo Prati

2018-06-01

gruppo di chirurgia apicale con ritrattamento ortogrado simultaneo. Keywords: Apical surgery, Retreatment, Treatment, Endodontics, MTA, Parole chiave: Chirurgia apicale, Ritrattamento, Trattamento, Endodonzia, MTA

Nonsurgical reduction of the interventricular septum in patients with hypertrophic cardiomyopathy.

Science.gov (United States)

Shamim, Waqar; Yousufuddin, Mohammed; Wang, Duolao; Henein, Michael; Seggewiss, Hubert; Flather, Marcus; Coats, Andrew J S; Sigwart, Ulrich

2002-10-24

In patients with hypertrophic cardiomyopathy and obstruction of the left ventricular outflow tract, nonsurgical reduction of the septum is a treatment option when medical therapy has failed. We investigated the long-term effects of nonsurgical reduction of the septum on functional capacity and electrocardiographic and echocardiographic characteristics. Sixty-four consecutive patients with hypertrophic cardiomyopathy and a mean (+/-SD) age of 48.5+/-17.2 years underwent nonsurgical reduction of the septum by injection of ethanol into the septal perforator branch of the left anterior descending coronary artery. These patients were assessed by exercise testing, electrocardiography, and resting and dobutamine (stress-induced) echocardiography after a mean period of 3.0+/-1.3 years. At follow-up, patients had significant improvements in New York Heart Association class, peak oxygen consumption (from 18.4+/-5.8 to 30.0+/-4.4 ml per kilogram of body weight per minute, P<0.001), and left ventricular outflow tract gradients (resting gradient, from 64+/-36 to 16+/-15 mm Hg; P<0.001; stress-induced gradient, from 132+/-34 to 45+/-19 mm Hg; P<0.001). Procedure-related complications included right bundle-branch block in all patients, complete heart block in 31 patients (48 percent), and significant increases in QRS and corrected QT intervals. Seventeen patients (27 percent) required permanent pacing. R-wave amplitude was significantly decreased (from 32+/-8 to 17+/-7 mV, P<0.001). The dimensions of the left ventricular cavity increased, and the interventricular septal thickness was reduced. Nonsurgical septal reduction leads to sustained improvements in both subjective and objective measures of exercise capacity in association with a persistent reduction in resting and stress-induced left ventricular outflow tract gradients. It is also associated with a high incidence of procedure-related complete heart block, however, often requiring permanent pacing. Copyright 2002

Effect of nonsurgical periodontal treatment on C-reactive protein levels in maintenance hemodialysis patients.

Science.gov (United States)

Yazdi, Farin Kiany; Karimi, Noozhan; Rasouli, Manoochehr; Roozbeh, Jamshid

2013-01-01

C-reactive protein (CRP) has been implicated as a possible mediator of the association between periodontitis and several systemic diseases. This study evaluated the impact of nonsurgical periodontal treatment on the serum levels of CRP in chronic kidney disease (CKD) patients on hemodialysis. A total of 77 CKD patients on hemodialysis were included in this study. At baseline, periodontal examination was assessed for all the patients, and chronic periodontitis was defined through clinical attachment level and probing pocket depth, according to the American Association of Periodontology. Nonsurgical periodontal treatment was performed and serum levels of CRP were evaluated at baseline and 8 weeks after periodontal treatment. Periodontal treatment resulted in significant reductions in CRP levels (p periodontitis. Periodontitis is an important source of systemic inflammation in CKD patients. Nonsurgical periodontal treatment can effectively reduce the serum level of CRP in these patients.

Endodontic inter-appointment flare-ups: An example of chaos?

Directory of Open Access Journals (Sweden)

Poorya Jalali

2015-01-01

Full Text Available Introduction: Pain and/or swelling after instrumentation of a root canal constitute a significant complication during endodontic treatment. Despite a large number of articles discussing the causative factors behind endodontic flare-ups, the exact mechanism is still not understood. The Hypothesis: The seemingly irrational behavior of endodontic inter-appointment flare-ups may be due to sensitive dependence on initial conditions. A model based on Lorenz′ chaos theory is presented as a possible explanation for the sudden emergence and unpredictability of flare-ups. Evaluation of the Hypothesis: All studies agree on some common traits regarding inter-appointment flare-ups: Careful instrumentation can still cause flare-up; the host inflammatory response behaves as a complex nonlinear network; and also the poly-etiologic nature of this phenomenon all illustrate the sensitive dependence on initial conditions of the system. Integrating more variables (e.g., different species of bacteria into this already complex system will make it increasingly chaotic reflecting its unpredictable behavior.

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

Science.gov (United States)

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.

Endodontic applications of cone beam computed tomography: case series and literature review

Directory of Open Access Journals (Sweden)

Francesc Abella

2015-11-01

Full Text Available Cone beam computed tomography (CBCT is a relatively new method that produces three-dimensional (3D information of the maxillofacial skeleton, including the teeth and their surrounding tissue, with a lower effective radiation dose than traditional CT scans. Specific endodontic applications for CBCT are being identified as the use of this technology becomes more common. CBCT has great potential to become a valuable tool for diagnosing and managing endodontic problems, as well as for assessing root fractures, apical periodontitis, resorptions, perforations, root canal anatomy and the nature of the alveolar bone topography around teeth. This article aims to review cone beam technology and its advantages over CT scans and conventional radiography, to illustrate current and future clinical applications in endodontic practice, and to highlight areas of further research of CBCT in endodontics. Specific case examples illustrate how treatment planning has changed with the images obtained with CBCT technology compared with only periapical radiography.

The trend of quality of publications in endodontic surgery: a 10-year systematic survey of the literature.

Science.gov (United States)

Del Fabbro, Massimo; Corbella, Stefano; Tsesis, Igor; Taschieri, Silvio

2015-03-01

The aims of the present systematic literature analysis were to evaluate, over a 10-year period, the trend of the proportion of RCT, SR, MA published on endodontic surgery, and to investigate if the impact factor (IF) of the main endodontic Journals correlates with the proportion of RCT, SR, MA they publish. An electronic search of the RCT, SR and MA published on the topic "endodontic surgery" from 2001 to 2010 was performed on Medline and Cochrane CENTRAL database using specific search terms combined with Boolean operators. Endodontic Journals impact factor was retrieved by the Thomson Scientific database. The proportion of each study type over the total number of articles on endodontic surgery published per year was estimated. The correlation between the number of high-evidence level studies published on the main endodontic Journals and the IF of such Journals per year was estimated. From a total of 900 articles published in 2001-2010 on endodontic surgery, there were 114 studies of high evidence level. A significant increase of the proportion of either RCT, SR and MA over the years was found. A modest to unclear correlation was found between the Journal IF and the number of high-evidence articles published. There is a positive trend over the years among researchers in performing studies of good quality in endodontic surgery. The impact factor of endodontic Journals is not consistently influenced by publication of high-evidence level articles. Copyright © 2015 Elsevier Inc. All rights reserved.

Therapy: a new nonsurgical therapy option for benign thyroid nodules?

DEFF Research Database (Denmark)

Hegedüs, Laszlo

2009-01-01

Despite the increasing implementation of iodization programs, benign nodular thyroid disease will remain a prevalent therapeutic concern for decades. recent research suggests that nonsurgical therapy, including radioactive iodine, radiofrequency thermal ablation and percutaneous laser ablation, m...

Incidence, outcomes, and risk factors for retreatment after wavefront-optimized ablations with PRK and LASIK.

Science.gov (United States)

Randleman, J Bradley; White, Alfred J; Lynn, Michael J; Hu, Michelle H; Stulting, R Doyle

2009-03-01

To analyze and compare retreatment rates after wavefront-optimized photorefractive keratectomy (PRK) and LASIK and determine risk factors for retreatment. A retrospective chart review was performed to identify patients undergoing PRK or LASIK with the wavefront-optimized WaveLight platform from January 2005 through December 2006 targeted for a piano outcome and to determine the rate and risk factors for retreatment surgery in this population. Eight hundred fifty-five eyes were analyzed, including 70 (8.2%) eyes with hyperopic refractions and 785 (91.8%) eyes with myopic refractions. After initial treatment, 72% of eyes were 20/20 or better and 99.5% were 20/40 or better. To improve uncorrected visual acuity, 54 (6.3%) eyes had retreatments performed. No significant differences in retreatment rates were noted based on age (P = .15), sex (P = .8), eye (P = .3), PRK versus LASIK (P = 1.0), room temperature (P = .1) or humidity (P = .9), and no correlation between retreatment rate and month or season of primary surgery (P = .4). There was no correlation between degree of myopia and retreatment rate. Eyes were significantly more likely to undergo retreatment if they were hyperopic (12.8% vs 6.0%, P = .006) or had astigmatism > or = 1.00 diopter (D) (9.1% vs 5.3%, P = .04). Retreatment rate was 6.3% with the WaveLight ALLEGRETTO WAVE excimer laser. This rate was not influenced by age, sex, corneal characteristics, or environmental factors. Eyes with hyperopic refractions or astigmatism > or = 1.00 D were more likely to undergo retreatment.

Undergraduates’ opinion after 5-year experience with rotary endodontic instruments

OpenAIRE

Flávia Sens Fagundes Tomazinho; Gisele Aihara Haragushiku; Flares Baratto Filho; Denise Piotto Leonardi; Maria da Graça Kfouri Lopes; Alexandre Moro

2011-01-01

Introduction: Dentistry evolution in the past few years has revolutionized daily practice in some specialties. One of these revolutions has occurred in Endodontics due to the advancement of rotary techniques for root canal preparation and its subsequent incorporation into the teaching of Dentistry undergraduates. Objective: The aim of this study was to report a 5-year experience on the undergraduate laboratorial and clinical use of rotary endodontic preparation at a private university. Materi...

[Overall digitalization: leading innovation of endodontics in big data era].

Science.gov (United States)

Ling, J Q

2016-04-09

In big data era, digital technologies bring great challenges and opportunities to modern stomatology. The applications of digital technologies, such as cone-beam CT(CBCT), computer aided design,(CAD)and computer aided manufacture(CAM), 3D printing and digital approaches for education , provide new concepts and patterns to the treatment and study of endodontic diseases. This review provides an overview of the application and prospect of commonly used digital technologies in the development of endodontics.

A Naval Postgraduate Dental School Analysis of Initial Endodontic Treatment

Science.gov (United States)

2013-06-01

to prevent or heal disease , i.e. apical periodontitis . Accordingly, endodontic treatment outcomes can better be defined in reference to healing and...Janket S, Baird AE, Chuang S, Jones JA. Meta-analysis of periodontal disease risk and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral...appointment endodontic therapy in dogs ’ teeth with apical periodontitis . J Endod 2003;29:121-4. 27. Penesis VA, Fitzgerald PI, Fayad MI, Wenckus

Characterization of experimental cements with endodontic goal

International Nuclear Information System (INIS)

Dantas, A.M.X.; Sousa, W.J.B.; Oliveira, E.D.C.; Carrodeguas, R.G.; Fook, M.V. Lia; Universidade Estadual da Paraiba

2017-01-01

The present study aimed to characterize experimental endodontic cements using as comparative parameter MTA cement. Two experimental endodontic cements were assessed: one based on 95% tri-strontium aluminate and 5% gypsum (CE1) and another based on 50% Sr_3Al_2O_6 and 50% non-structural white cement (CE2). Experimental cements were manipulated and characterized by scanning electron microscopy (SEM), coupled to EDS mode, X-ray diffractometer (XRD) and Thermogravimetric (TG) analysis. Data analysis demonstrated that the particles of the materials used presented varied shapes and sizes, with similar elements and crystalline behavior. However, CE1 presented increased mass loss. Experimental cements presents similarities to MTA, nevertheless, further studies are encourage to determinate comparative properties with the commercially material. (author)

Oral microbiota species in acute apical endodontic abscesses

Directory of Open Access Journals (Sweden)

Noelle George

2016-03-01

Full Text Available Background and objectives: Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18 exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other regions. Design: Endodontic abscesses were sampled from patients at the Oregon Health & Science University (OHSU School of Dentistry. DNA from abscess specimens was subjected to polymerase chain reaction amplification using 16S rRNA gene-specific primers and Cy3-dCTP labeling. Labeled DNA was then applied to microbial microarrays (280 species generated by the Human Oral Microbial Identification Microarray Laboratory (Forsyth Institute, Cambridge, MA. Results: The most prevalent microorganisms, found across multiple abscess specimens, include Fusobacterium nucleatum, Parvimonas micra, Megasphaera species clone CS025, Prevotella multisaccharivorax, Atopobium rimae, and Porphyromonas endodontalis. The most abundant microorganisms, found in highest numbers within individual abscesses, include F. nucleatum, P. micra, Streptococcus Cluster III, Solobacterium moorei, Streptococcus constellatus, and Porphyromonas endodontalis. Strong bacterial associations were identified between Prevotella multisaccharivorax, Acidaminococcaceae species clone DM071, Megasphaera species clone CS025, Actinomyces species clone EP053, and Streptococcus cristatus (all with Spearman coefficients >0.9. Conclusions: Cultivable and uncultivable bacterial species have been identified in endodontic abscesses obtained from the Portland, Oregon demographic region, and taxa identifications correlated well with other published studies, with the exception of Treponema and Streptococcus cristae, which

Oral microbiota species in acute apical endodontic abscesses.

Science.gov (United States)

George, Noelle; Flamiatos, Erin; Kawasaki, Kellie; Kim, Namgu; Carriere, Charles; Phan, Brian; Joseph, Raphael; Strauss, Shay; Kohli, Richie; Choi, Dongseok; Baumgartner, J Craig; Sedgley, Christine; Maier, Tom; Machida, Curtis A

2016-01-01

Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18) exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other regions. Endodontic abscesses were sampled from patients at the Oregon Health & Science University (OHSU) School of Dentistry. DNA from abscess specimens was subjected to polymerase chain reaction amplification using 16S rRNA gene-specific primers and Cy3-dCTP labeling. Labeled DNA was then applied to microbial microarrays (280 species) generated by the Human Oral Microbial Identification Microarray Laboratory (Forsyth Institute, Cambridge, MA). The most prevalent microorganisms, found across multiple abscess specimens, include Fusobacterium nucleatum, Parvimonas micra, Megasphaera species clone CS025, Prevotella multisaccharivorax, Atopobium rimae, and Porphyromonas endodontalis. The most abundant microorganisms, found in highest numbers within individual abscesses, include F. nucleatum, P. micra, Streptococcus Cluster III, Solobacterium moorei, Streptococcus constellatus, and Porphyromonas endodontalis. Strong bacterial associations were identified between Prevotella multisaccharivorax, Acidaminococcaceae species clone DM071, Megasphaera species clone CS025, Actinomyces species clone EP053, and Streptococcus cristatus (all with Spearman coefficients >0.9). Cultivable and uncultivable bacterial species have been identified in endodontic abscesses obtained from the Portland, Oregon demographic region, and taxa identifications correlated well with other published studies, with the exception of Treponema and Streptococcus cristae, which were not commonly identified in endodontic abscesses between the

Endodontic-periodontic bifurcation lesions: a novel treatment option.

Science.gov (United States)

Lin, Shaul; Tillinger, Gabriel; Zuckerman, Offer

2008-05-01

The purpose of this preliminary clinical report is to suggest a novel treatment modality for periodontal bifurcation lesions of endodontic origin. The study consisted of 11 consecutive patients who presented with periodontal bifurcation lesions of endodontic origin (endo-perio lesions). All patients were followed-up for at least 12 months. Treatment included calcium hydroxide with iodine-potassium iodide placed in the root canals for 90 days followed by canal sealing with gutta-percha and cement during a second stage. Dentin bonding was used to seal the furcation floor to prevent the ingress of bacteria and their by-products to the furcation root area through the accessory canals. A radiographic examination showed complete healing of the periradicular lesion in all patients. Probing periodontal pocket depths decreased to 2 to 4 mm (mean 3.5 mm), and resolution of the furcation involvement was observed in post-operative clinical evaluations. The suggested treatment of endo-perio lesions may result in complete healing. Further studies are warranted. This treatment method improves both the disinfection of the bifurcation area and the healing process in endodontically treated teeth considered to be hopeless.

From stem to roots: Tissue engineering in endodontics

Science.gov (United States)

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

[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.

Modeling Antarctic Ice Sheet retreat in warm climates: a historical perspective.

Science.gov (United States)

Pollard, D.; Deconto, R. M.; Gasson, E.

2016-12-01

Early modeling of Antarctic Ice Sheet size vs. climate focused on asymmetry between retreat and growth, with much greater warming needed to cause retreat from full ice cover, due to Height Mass Balance Feedback and albedo feedback. This led to a long-standing model-data conflict, with models needing 1000 to2000 ppmv atmospheric CO2 to produce retreat from full size, vs. proxy data of large ice fluctuations despite much lower CO2 since the Miocene.Subsequent modeling with marine ice physics found that the West Antarctic Ice Sheet could undergo repeated warm-period collapses with realistic past forcing. However, that yields only 3 to 7 m equivalent sea-level rise above modern, compared to 10 to 20 m or more suggested by some geologic data. Large subglacial basins in East Antarctica could be vulnerable to the same processes,but did not retreat in most models due to narrower and shallower sills.After recent modifications, some ice sheet models were able to produce warm-period collapse of major East Antarctic basins, with sea-level rise of up to 15 m. The modifications are (i) hydrofracturing by surface melt, and structural failure of ice cliffs, or (ii) numerical treatment at the grounding line. In these models, large retreat occurs both for past warmintervals, and also for future business-as-usual scenarios.Some interpretations of data in the late Oligocene and Miocene suggest yet larger fluctuations, between 50 to 100% of modern Antarctic size. That would require surface-melt driven retreat of some terrestrial East Antarctic ice, despite the hysteresis issue raised above. A recent study using a coupled climate-ice sheet model found that with a finer climate gridand more frequent coupling exchange, substantial retreat of terrestrial Antarctica can occur with 500 to 840 ppmv CO2, much lower than in earlier models. This will allow meaningful interactions between modeling and deeper-time geologic interpretations since the late Oligocene.

A clarification on endodontic flare-ups.

Science.gov (United States)

Morse, D R; Esposito, J V

1990-09-01

In an article on endodontic flare-ups by Robert J. Matusow, our research and publications are discussed. Since we found what we consider to be distortions and misinterpretations of our work, it was decided to clarify the apparent discrepancies found in Matusow's article.

Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection.

Science.gov (United States)

Garcez, Aguinaldo S; Ribeiro, Martha S; Tegos, George P; Núñez, Silvia C; Jorge, Antonio O C; Hamblin, Michael R

2007-01-01

To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals. Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation. Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (Ptreatment. Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy. (c) 2006 Wiley-Liss, Inc.

Enhancing the research and publication efforts of health sciences librarians via an academic writing retreat.

Science.gov (United States)

Bullion, John W; Brower, Stewart M

2017-10-01

This case study describes the South Central Chapter of the Medical Library Association (SCC/MLA) initiative to develop an academic writing retreat for members who sought the necessary time and support to advance their research projects toward publication. SCC/MLA staged a dedicated writing retreat to coincide with the organization's 2012, 2013, and 2014 annual meetings. Each cohort met over two days to write and to workshop their peers' manuscripts. Organizers distributed an online survey one month after each retreat to evaluate attendees' perceptions. Three years' worth of writing retreats yielded fourteen peer-reviewed articles and one book chapter. Participants indicated that the retreat helped them meet or exceed their writing goals by offering protected time and a setting conducive to productivity. The format of the retreat is cost effective and easily adaptable for fellow professionals who wish to organize a formal event as a conference offering or simply support a writing group at their home institutions. In SCC/MLA, the retreat revitalized interest in writing and demystified the scholarly publication process.

EMG monitoring during functional non-surgical therapy of Achilles tendon rupture.

Science.gov (United States)

Hüfner, Tobias; Wohifarth, Kai; Fink, Matthias; Thermann, H; Rollnik, Jens D

2002-07-01

After surgical therapy of Achilles tendon rupture, neuromuscular changes may persist, even one year after surgery. We were interested whether these changes are also evident following a non-surgical functional therapy (Variostabil therapy boot/Adidas). Twenty-one patients with complete Achilles tendon rupture were enrolled in the study (mean age 38.5 years, range 24 to 60; 18 men, three women) and followed-up clinically and with surface EMG of the gastrocnemius muscles after four, eight, 12 weeks, and one year after rupture. EMG differences between the affected and non-affected side could only be observed at baseline and after four weeks following Achilles tendon rupture. The results from our study show that EMG changes are not found following non-surgical functional therapy.

Microbial causes of endodontic flare-ups.

Science.gov (United States)

Siqueira, Jose F

2003-07-01

Inter-appointment flare-up is characterized by the development of pain, swelling or both, following endodontic intervention. The causative factors of flare-ups encompass mechanical, chemical and/or microbial injury to the pulp or periradicular tissues. Of these factors, microorganisms are arguably the major causative agents of flare-ups. Even though the host is usually unable to eliminate the root canal infection, mobilization and further concentration of defence components at the periradicular tissues impede spreading of infection, and a balance between microbial aggression and host defences is commonly achieved. There are some situations during endodontic therapy in which such a balance may be disrupted in favour of microbial aggression, and an acute periradicular inflammation can ensue. Situations include apical extrusion of infected debris, changes in the root canal microbiota and/or in environmental conditions caused by incomplete chemo-mechanical preparation, secondary intraradicular infections and perhaps the increase in the oxidation-reduction potential within the root canal favouring the overgrowth of the facultative bacteria. Based on these situations, preventive measures against infective flare-ups are proposed, including selection of instrumentation techniques that extrude lesser amounts of debris apically; completion of the chemo-mechanical procedures in a single visit; use of an antimicrobial intracanal medicament between appointments in the treatment of infected cases; not leaving teeth open for drainage and maintenance of the aseptic chain throughout endodontic treatment. Knowledge about the microbial causes of flare-ups and adoption of appropriate preventive measures can significantly reduce the incidence of this highly distressing and undesirable clinical phenomenon.

Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain.

Science.gov (United States)

Alsomadi, Leena; Al Habahbeh, Riyad

2015-12-01

To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Peak postoperative pain occurred at 16 hours post-treatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients.

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

Science.gov (United States)

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.

Reliable Refuge: Two Sky Island Scorpion Species Select Larger, Thermally Stable Retreat Sites.

Science.gov (United States)

Becker, Jamie E; Brown, Christopher A

2016-01-01

Sky island scorpions shelter under rocks and other surface debris, but, as with other scorpions, it is unclear whether these species select retreat sites randomly. Furthermore, little is known about the thermal preferences of scorpions, and no research has been done to identify whether reproductive condition might influence retreat site selection. The objectives were to (1) identify physical or thermal characteristics for retreat sites occupied by two sky island scorpions (Vaejovis cashi Graham 2007 and V. electrum Hughes 2011) and those not occupied; (2) determine whether retreat site selection differs between the two study species; and (3) identify whether thermal selection differs between species and between gravid and non-gravid females of the same species. Within each scorpion's habitat, maximum dimensions of rocks along a transect line were measured and compared to occupied rocks to determine whether retreat site selection occurred randomly. Temperature loggers were placed under a subset of occupied and unoccupied rocks for 48 hours to compare the thermal characteristics of these rocks. Thermal gradient trials were conducted before parturition and after dispersal of young in order to identify whether gravidity influences thermal preference. Vaejovis cashi and V. electrum both selected larger retreat sites that had more stable thermal profiles. Neither species appeared to have thermal preferences influenced by reproductive condition. However, while thermal selection did not differ among non-gravid individuals, gravid V. electrum selected warmer temperatures than its gravid congener. Sky island scorpions appear to select large retreat sites to maintain thermal stability, although biotic factors (e.g., competition) could also be involved in this choice. Future studies should focus on identifying the various biotic or abiotic factors that could influence retreat site selection in scorpions, as well as determining whether reproductive condition affects thermal

Larynx preservation with primary non-surgical treatment for loco-regionally advanced larynx cancer

International Nuclear Information System (INIS)

Corry, June; Peters, Lester; D'Costa, Leta; Chua, Margaret; Peters, Lester J.; Vallance, Neil; Lyons, Bernard; Kleid, Stephen; Sizeland, Andrew

2011-01-01

Full text: The objective of this paper was to review the results of primary non-surgical treatment with the aim of larynx preservation for loco-regionally advanced larynx cancer (LALC). Methods: All patients with LALC presenti:lg between January 2002 and Decem ber 2006 who were selected for primary non-surgical treatment were included in this study. Results: There were 60 patients, 48% with stage III and 52% with stage IV disease. The median follow-up of living patients was 41 months. Larynx preservation with local disease control was achieved in 83% and 77% of patients at 3 and 5 years, respectively. Failure-free survival at 3 and 5 years was 66% and 59%, respectively, and overall survival was 67% and 45%, respectively. All patients with larynx preservation had a functional voice. Two patients became feeding tube dependant. Thirty-nine percent of all deaths were unrelated to LALC. Conclusions: Primary non-surgical treatment achieves high rates of larynx preservation with a low rate of severe complications but overall survival remains disappointing.

Scientific retreats with 'speed dating': networking to stimulate new interdisciplinary translational research collaborations and team science.

Science.gov (United States)

Ranwala, Damayanthi; Alberg, Anthony J; Brady, Kathleen T; Obeid, Jihad S; Davis, Randal; Halushka, Perry V

2017-02-01

To stimulate the formation of new interdisciplinary translational research teams and innovative pilot projects, the South Carolina Clinical and Translational Research (SCTR) Institute (South Carolina Clinical and Translational Science Award, CTSA) initiated biannual scientific retreats with 'speed dating' networking sessions. Retreat themes were prioritized based on the following criteria; cross-cutting topic, unmet medical need, generation of novel technologies and methodologies. Each retreat begins with an external keynote speaker followed by a series of brief research presentations by local researchers focused on the retreat theme, articulating potential areas for new collaborations. After each session of presentations, there is a 30 min scientific 'speed dating' period during which the presenters meet with interested attendees to exchange ideas and discuss collaborations. Retreat attendees are eligible to compete for pilot project funds on the topic of the retreat theme. The 10 retreats held have had a total of 1004 participants, resulted in 61 pilot projects with new interdisciplinary teams, and 14 funded projects. The retreat format has been a successful mechanism to stimulate novel interdisciplinary research teams and innovative translational research projects. Future retreats will continue to target topics of cross-cutting importance to biomedical and public health research. Copyright © 2016 American Federation for Medical Research.

A retrospective clinical and radiographic study on healing of periradicular lesions in patients taking oral bisphosphonates.

Science.gov (United States)

Hsiao, Angela; Glickman, Gerald; He, Jianing

2009-11-01

Bisphosphonates have been related to impaired bone remodeling. The impact of oral bisphosphonates on periradicular healing has not been studied. The purpose of this study was to evaluate the healing of periradicular lesions in patients taking oral bisphosphonates after root canal therapy. Thirty-four teeth with preoperative periradicular radiolucencies were identified in patients undergoing oral bisphosphonate therapy. These cases were examined clinically and radiographically to determine treatment outcome. Thirty-eight control teeth were selected from a pool of patients not taking bisphosphonates. Nonsurgical root canal treatment and retreatment was performed by endodontic residents and undergraduate dental students at Baylor College of Dentistry using nonstandardized protocols. In the bisphosphonate group, 73.5% of the lesions healed, whereas the control cases had a healing rate of 81.6%. There was no statistically significant difference between the groups (p > 0.05). The results of this preliminary short-term study suggest that patients taking long-term oral bisphosphonates can expect a satisfactory outcome with evidence of periradicular healing after conventional root canal treatment. Thus, root canal treatment may be considered a safe and realistic alternative to extraction in patients on bisphosphonate therapy.

Comparison of three digital radiographic imaging systems for the visibility of endodontic files

International Nuclear Information System (INIS)

Park, Jong Won; Kim, Eun Kyung; Han, Won Jeong

2004-01-01

To compare three digital radiographic imaging sensors by evaluating the visibility of endodontic file tips with interobserver reproducibility and assessing subjectively the clarity of images in comparison with the x-ray film images. Forty-five extracted sound premolars were used for this study. Fifteen plaster blocks were made with three premolars each and 8, 10, 15 K-flexofiles were inserted into the root canal of premolars. They were radiographically exposed using periapical x-ray films (Kodak Insight Dental film, Eastmann Kodak company, Rochester, USA), Digora imaging plates (Soredex-Orion Co., Helsinki, Finland), CDX 2000HQ sensors (Biomedisys Co., Seoul, Korea), and CDR sensors (Schick Inc., Long Island, USA). The visibility of endodontic files was evaluated with interobserver reproducibility, which was calculated as the standard deviations of X, Y coordinated of endodontic file tips measured on digital images by three oral and maxillofacial radiologists. The clarity of images was assessed subjectively using 3 grades, i.e, plus, equal, and minus in comparison with the conventional x-ray film images. Interobserver reproducibility of endodontic file tips was the highest in CDR sensor (p<0.05) only except at Y coordinates of 15 file. In the subjective assessment of the image clarity, the plus grade was the most frequent in CDR sensor at all size of endodontic file (p<0.05). CDR sensor was the most superior to the other sensors, CDX 2000HQ sensor and Digora imaging plate in the evaluation of interobserver reproducibility of endodontic file tip and subjective assessment of image clarity.

Little Ice Age advance and retreat of Glaciar Jorge Montt, Chilean Patagonia

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A. Rivera

2012-03-01

Full Text Available Glaciar Jorge Montt (48°20' S/73°30' W, one of the main tidewater glaciers of the Southern Patagonian Icefield (SPI, has experienced the greatest terminal retreat observed in Patagonia during the past century, with a recession of 19.5 km between 1898 and 2011. This retreat has revealed trees laying subglacially until 2003. These trees were dated using radiocarbon, yielding burial ages between 460 and 250 cal yrs BP. The presence of old growth forest during those dates indicates that Glaciar Jorge Montt was upvalley of its present position before the commonly recognized Little Ice Age (LIA period in Patagonia. The post-LIA retreat was most likely triggered by climatically induced changes during the 20th century; however, Glaciar Jorge Montt has responded more dramatically than its neighbours. The retreat of Jorge Montt opened a 19.5 km long fjord since 1898, which reaches depths in excess of 390 m. The bathymetry is well correlated with glacier retreat rates, suggesting that dynamic responses of the glacier are at least partially connected to near buoyancy conditions at the ice front, resulting in high calving fluxes, accelerating thinning rates and rapid ice velocities.

Effective exposure level and diagnostic performance in endodontic radiography

International Nuclear Information System (INIS)

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

Surgical versus non-surgical management for pleural empyema.

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Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

2017-03-17

Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

Treatment of a Developmental Groove and Supernumerary Root Using Guided Tissue Regeneration Technique

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Zahra Alizadeh Tabari

2016-01-01

Full Text Available Introduction. The radicular groove is a developmental groove which is usually found on the palatal or lateral aspects of the maxillary incisor teeth. The present case is a maxillary lateral incisor with a small second root and a deep radicular groove. The developmental groove caused a combined periodontal-endodontic lesion. Methods. Case was managed using a combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal treatment. After completion of root canal treatment, guided tissue regeneration (GTR was carried out using decalcified freeze dried bone allograft (DFDBA and a bioabsorbable collagenous membrane. Tooth also was splinted for two months. Results. After 12 months the tooth was asymptomatic. The periapical radiolucency disappeared and probing depth did not exceed 3 mm. Conclusion. Combined treatment procedure involving nonsurgical root canal therapy and surgical periodontal regenerative treatment can be a predictable technique in treating combined endodontic-periodontal lesions caused by radicular groove.

Antimicrobial activity and pH of a endodontic sealer containing MTA

DEFF Research Database (Denmark)

Maliza, Amanda GA; de Andrade, Flaviana Bombarda; Arias, Marcela C

Objective: To investigate the antimicrobial activity, calcium release, and pH of a new mineral trioxide aggregate endodontic sealer when compared to endodontic sealers containing calcium hydroxide and/or epoxy resin. Method: Specimens were fabricated from MTA Fillapex, Sealer 26, Sealapex, and AH...... Plus immediately, 24 or 48 hours prior to the tests. The antimicrobial activity against Enterococcus faecalis and Candida albicans was evaluated by the direct contact and the agar diffusion methods. Calcium release was determined by atomic absorption spectrometry. The pH from solutions containing...... in solution with an alkaline pH. Conclusion: The new mineral trioxide aggregate endodontic sealer presented higher antimicrobial activity when compared to the sealers containing calcium hydroxide and/or epoxy resin. As for pH and calcium release, the sealers containing calcium hydroxide resulted in presented...

The acceptance of dental operating microscope among advance education specialty programs in endodontics in the middle east

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Mansour Alrejaie

2012-01-01

Full Text Available Aim: To present the current situation of dental operating microscopy (DOM training in the available Advance Specialty Education Programs in Endodontics in Arab Middle-Eastern countries. Materials and Methods: A web-based survey was sent to the electronic mail address of Advance Specialty Education programs of 15 Arab and middle east countries. The questions were limited to those who have an advanced specialty education program in Endodontics at their University if they are using an operating microscope? Results: Out of 15 countries, only 4 countries have microscopic technology in their Advance Education Programs in Endodontics. Conclusion: Few Arab Middle-Eastern countries have DOM in their advance education programs in endodontics. The highest authority in advancing endodontic education in the Arab Middle-East should consider in the near future the importance of this technology as standard care in teaching advance endodontics. An advance workshops should be organized regularly to provide enough knowledge about this standard educational technology.

Comparison of the effect of two endodontic irrigation protocols on the elimination of bacteria from root canal system: a prospective, randomized clinical trial.

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Beus, Christopher; Safavi, Kamran; Stratton, Jeffrey; Kaufman, Blythe

2012-11-01

The purpose of this prospective, randomized clinical study was to compare the results of a nonactivated single-irrigation protocol (NAI) that used only 1% NaOCl with a passive ultrasonic multi-irrigation protocol (PUI) that used 1% NaOCl, 17% ethylenediaminetetraacetic acid, and 2% chlorhexidine in rendering canals bacteria free. In addition, the effect of a second-visit instrumentation after intra-appointment calcium hydroxide (CaOH(2)) was also evaluated in bacterial elimination. Fifty patients were recruited with a posterior tooth requiring primary endodontic treatment of apical periodontitis. Standard nonsurgical endodontic therapy was performed on both groups in a 2-visit approach by using calcium hydroxide intracanal medicament. Teeth were randomly treated with the NAI or PUI protocols in the first visit after complete instrumentation. Bacterial cultures were obtained at 4 periods during treatment from the canals: (1) before instrumentation, (2) after irrigation protocol, (3) after CaOH(2) medication, and (4) before obturation. Statistical analysis was performed on data by using the Fisher exact test and multivariate analysis. NAI and PUI rendered canals 80% and 84% bacteria free, respectively, at the end of the first visit. After CaOH(2) medication the total sample (NAI + PUI) had increased to 87% bacteria free, and the second-visit instrumentation resulted in a total of 91% bacteria free. These differences were not significant (P > .05). There was no statistical difference between irrigation methods. Each protocol resulted in a high frequency of negative cultures. This high frequency of negative cultures obtained in 1 visit is most likely related to an increased volume and depth of irrigation compared with previously reported protocols. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Rotary endodontics in primary teeth - A review.

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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.

Management pain and anxiety in endodontic treatment

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Andi Sumidarti

2016-06-01

Full Text Available Dental pain is a common symptom that most often causes patient to seek dentist. A survey conducted by the American Association of Endodontics revealed that more than half patients who come to dentist have experienced pain, which originate from the teeth or of the surrounding tissue, can causes difficulties in handling, also the anxiety of the patient. Understanding the pain experienced by patient will help dentist to determine when to make an action. Most patient being fear with pain, so they delay to getting treatment from dentist, and led to the development of further infection and inflammation. Aim of this paper is to improve the understanding of pharmacology and procedures for pain and anxiety management in endodontic treatment. So, it was importance of determining accurate diagnosis, management and drug administration.

Regenerative endodontics: a true paradigm shift or a bandwagon about to be derailed?

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Nazzal, H; Duggal, M S

2017-02-01

Regenerative endodontic techniques (RETs) have been hailed as a paradigm shift for the management of traumatised non-vital immature permanent anterior teeth. In this article the aim was to critically appraise the literature with regards to the outcome of regenerative endodontics on root development. Critical review of the literature where regenerative endodontic techniques have been used in the management of immature non-vital teeth with continuation of root development as the main outcome reported. Most studies published were in the form of case reports and series with very few randomised controlled trials with a high risk of bias. Continuation of root development following the use of RET has been shown to be unpredictable at best with lower success in those teeth losing vitality as a result of dental trauma. Despite the high success of regenerative endodontics in terms of periodontal healing including resolution of clinical and radiographic signs and symptoms of infection, continuation of root development remains an unpredictable outcome. The use of a blood clot as a scaffold in regenerative endodontics should be reviewed carefully as that might offer an environment for repair rather than regeneration. In addition, preservation of structures, such as Hertwig's epithelial root sheath, may have an important bearing on the success of this approach and should be further investigated.

[Formulation of guidelines for microscopic endodontics suitable for the situation of China].

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Ling, J Q

2016-08-01

In order to promote the use of dental operating microscope in endodontics, Society of Cariology and Endodontology of Chinese Stomatological Association formulated these guidelines, after extensive consultation with related authorities and careful reference to the available published materials and literatures. It is hoped that these guidelines will be useful for dental practitioners embarking on microscopic endodontics.

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

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Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible

[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.

Diagnosis demystified: CT as diagnostic tool in endodontics

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Shruthi, Nagaraja; Sreenivasa Murthy, B V; Sundaresh, K J; Mallikarjuna, Rachappa

2013-01-01

Diagnosis in endodontics is usually based on clinical and radiographical presentations, which are only empirical methods. The role of healing profession is to apply knowledge and skills towards maintaining and restoring the patient's health. Recent advances in imaging technologies have added to correct interpretation and diagnosis. CT is proving to be an effective tool in solving endodontic mysteries through its three-dimensional visualisation. CT imaging offers many diagnostic advantages to produce reconstructed images in selected projection and low-contrast resolution far superior to that of all other X-ray imaging modalities. This case report is an endeavour towards effective treatment planning of cases with root fracture, root resorption using spiral CT as an adjuvant diagnostic tool. PMID:23814212

Regenerative Endodontic Treatment of a Maxillary Mature Premolar

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Qingan Xu

2018-01-01

Full Text Available Regenerative endodontic treatment was performed on a mature maxillary premolar diagnosed as chronic pulpitis. The root canals were chemomechanically prepared and placed intracanal medicaments at the first appointment. Then 2 weeks later, a blood clot was created in the canals, over which mineral trioxide aggregate was placed. At 6-month follow-up, cementum-like tissue seemed to be formed in the root canal along with nearly recovered pulp vitality. At 12-month recall, the radiographic results revealed evidence of root wall thickening. At 30-month recall, no periapical lesion was found. This case report indicates that regenerative endodontic treatment for the mature premolar is feasible. More cases are needed for further validation.

Regenerative endodontics and tissue engineering: what the future holds?

Science.gov (United States)

Goodis, Harold E; Kinaia, Bassam Michael; Kinaia, Atheel M; Chogle, Sami M A

2012-07-01

The work performed by researchers in regenerative endodontics and tissue engineering over the last decades has been superb; however, many questions remain to be answered. The basic biologic mechanisms must be elucidated that will allow the development of dental pulp and dentin in situ. Stress must be placed on the many questions that will lead to the design of effective, safe treatment options and therapies. This article discusses those questions, the answers to which may become the future of regenerative endodontics. The future remains bright, but proper support and patience are required. Copyright © 2012 Elsevier Inc. All rights reserved.

[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.

Scientific Retreats with ‘Speed Dating’: Networking to Stimulate New Interdisciplinary Translational Research Collaborations and Team Science

Science.gov (United States)

Alberg, Anthony J.; Brady, Kathleen T.; Obeid, Jihad S.; Davis, Randal; Halushka, Perry V.

2016-01-01

To stimulate the formation of new interdisciplinary translational research teams and innovative pilot projects, the South Carolina Clinical & Translational Research (SCTR) Institute (South Carolina Clinical and Translational Science Award, CTSA) initiated biannual scientific retreats with “speed dating” networking sessions. Retreat themes were prioritized based on the following criteria; cross-cutting topic, unmet medical need, generation of novel technologies and methodologies. Each retreat commences with an external keynote speaker followed by a series of brief research presentations by local researchers focused on the retreat theme, articulating potential areas for new collaborations. After each session of presentations, there is a 30 minute scientific “speed dating” period during which the presenters meet with interested attendees to exchange ideas and discuss collaborations. Retreat attendees are eligible to compete for pilot project funds on the topic of the retreat theme. The 10 retreats held have had a total of 1004 participants, resulted in 61 pilot projects with new interdisciplinary teams, and 14 funded projects. The retreat format has been a successful mechanism to stimulate novel interdisciplinary research teams and innovative translational research projects. Future retreats will continue to target topics of cross-cutting importance to biomedical and public health research. PMID:27807146

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

Science.gov (United States)

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

Antibacterial and antifungal activity of endodontic intracanal medications

Science.gov (United States)

TONEA, ANDRADA; BADEA, MANDRA; OANA, LIVIU; SAVA, SORINA; VODNAR, DAN

2017-01-01

Background and aims The sterilization of the entire root canal system represents the main goal of every endodontist, given the fact that the control of the microbial flora is the key point of every root canal treatment. The diversity of microorganisms found inside the root canal and also the resistance of some bacterial species to intracanal medications led to a continuous development of new endodontic products. The present study focuses on the comparison of the antibacterial and antifungal properties of different endodontic products, two commercially available, one experimental plant based extract, and two control substances. Methods The disc diffusion assay was used to determine the antibacterial and antifungal properties of chlorhexidine, calcium hydroxide, a mix extract between Arctium lappa root powder and Aloe barbadensis Miller gel, Amoxicillin with clavulanic acid and Fluconazole (as control substances). Two of the most common microorganisms found in endodontic infections were chosen: Enterococcus faecalis (ATCC 29212) and Candida albicans ATCC(10231). Results All tested substances showed inhibition zones around the discs, for Enterococcus faecalis and Candida albicans, including the experimental mix extract of Arctium lappa root powder with Aloe vera gel. Conclusion The experimental mix extract of Arctium lappa root powder and Aloe vera gel is able to inhibit very resistant microorganisms, like Enterococcus faecalis and Candida albicans. PMID:28781531

Endodontic treatment of an unusual connation of permanent mandibular molars: a case report.

Science.gov (United States)

Liu, Shengbo; Fan, Bing; Peng, Bin; Fan, Mingwen; Bian, Zhuan

2006-10-01

A 27-year-old patient with an anomalous mandibular molar was referred for endodontic therapy. Clinical and radiographic examination revealed the connation of a second mandibular molar with a third molar. Challenging endodontic therapy was performed in the unusual connated molars. A 2-year recall showed good treatment result.

Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

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Milana Drumond Ramos Santana

2017-01-01

Full Text Available We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1, during (T2, and immediately (T3 and T4 after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4 or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.

Non-surgical treatments for hidradenitis suppurativa: A systematic review.

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Robert, E; Bodin, F; Paul, C; Konstantinou, M-P; Gall, Y; Grolleau, J-L; Laloze, J; Chaput, B

2017-08-01

The management of hidradenitis suppurativa is multidisciplinary, involving general measures, medical treatment and surgery. Non-surgical treatments, often first-line procedures, mainly concern forms of low-to-moderate severity or, conversely, very severe forms in non-operable patients or those refusing surgery. While many treatments have been attempted, few randomized controlled trials have been conducted, so the choice of treatments is most often based on the personal experience of the clinicians. The objective of this systematic review is to propose a synthetic analysis of the currently available non-surgical procedures. This systematic review of the literature was conducted in accordance with the PRISMA criteria. We searched for articles in the Medline ® , PubMed Central, Embase and Cochrane databases published between January 2005 and September 2015. Sixty-four articles were included. They generally had a low level of evidence; indeed, the majority of them were retrospective observational studies. They involved biotherapy (44%), dynamic phototherapy (16%), antibiotics (11%), Laser (8%), retinoids (6%) and immunosuppressive therapies, anti-inflammatory drugs, zinc, metformin, gammaglobulins and fumarates. None of the non-surgical treatments can treat all stages of the disease and offer long-term remission. Antibiotics and biotherapy seem to have real effectiveness but their effect remains suspensive and the disease is almost certain to reappear once they are stopped. As regards antibiotics, no association has shown their superiority in a study with a high level of evidence. And while some biotherapies seem quite effective, due to their side effects they should be reserved for moderate-to-severe, resistant or inoperable forms of the disease. Randomized controlled studies are needed before valid conclusions can be drawn. In the resistant or disabling forms, it is consequently advisable to orientate to the greatest possible extent towards radical surgery, which

Endodontic treatment of a fused tooth. Report of a case.

Science.gov (United States)

Gallottini, L; Barbato Bellatini, R C; Migliau, G

2007-01-01

Dental fusion, a rare developmental anomaly present in 0.2% of the general population, consists of the union of two teeth originating from two different tooth germs. The irregular coronal morphology and the complex endodontic anatomy, characterized by the partial or total union of the pulp chambers, together with the peculiarity of the root canal systems, make diagnosis, therapy and rehabilitation difficult. The authors describe the endodontic treatment of a permanent lower second molar fused with a third molar and having four root canals.

Retreatment of Exudative Age-Related Macular Degeneration after Loading 3-Monthly Intravitreal Ranibizumab.

Science.gov (United States)

Sugiyama, Atsushi; Sakurada, Yoichi; Honda, Shigeru; Miki, Akiko; Matsumiya, Wataru; Yoneyama, Seigo; Kikushima, Wataru; Iijima, Hiroyuki

2018-01-01

The aim of this study was to investigate the clinical implications of required retreatment after 3-monthly intravitreal ranibizumab (IVR) injections followed by as-needed reinjections up to 5 years in eyes with exudative age-related macular degeneration (AMD). A retrospective cohort study was conducted for 165 treatment-naïve eyes from 165 patients with exudative AMD. Visual changes were investigated in terms of the required retreatments. Retreatment-free proportions were 37.0, 23.7, 16.6, 12.1, and 10.5% at 12, 24, 36, 48, and 60 months, respectively. Visual changes were significantly better in eyes which did not require retreatment at every yearly checkpoint within the 5 years. A multivariate logistic regression analysis revealed that requirement of additional IVR treatments in the first 12-24 months was associated with the T allele (risk allele) of ARMS2 A69S (p = 0.010 and 0.015, respectively). Cox regression analysis revealed that older age (p = 0.046) and the T allele of ARMS2 A69S (p = 0.036) were associated with required retreatment within the 5-year follow-up period. Age and the T allele of ARMS2 A69S are the risk factors requiring retreatments, leading to poor visual change in eyes with exudative AMD following the initial 3-monthly IVR. © 2017 S. Karger AG, Basel.

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

Science.gov (United States)

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.

An animal model to study regenerative endodontics.

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Torabinejad, Mahmoud; Corr, Robert; Buhrley, Matthew; Wright, Kenneth; Shabahang, Shahrokh

2011-02-01

A growing body of evidence is demonstrating the possibility for regeneration of tissues within the pulp space and continued root development in teeth with necrotic pulps and open apices. There are areas of research related to regenerative endodontics that need to be investigated in an animal model. The purpose of this study was to investigate ferret cuspid teeth as a model to investigate factors involved in regenerative endodontics. Six young male ferrets between the ages of 36-133 days were used in this investigation. Each animal was anesthetized and perfused with 10% buffered formalin. Block sections including the mandibular and maxillary cuspid teeth and their surrounding periapical tissues were obtained, radiographed, decalcified, sectioned, and stained with hematoxylin-eosin to determine various stages of apical closure in these teeth. The permanent mandibular and maxillary cuspid teeth with open apices erupted approximately 50 days after birth. Initial signs of closure of the apical foramen in these teeth were observed between 90-110 days. Complete apical closure was observed in the cuspid teeth when the animals were 133 days old. Based on the experiment, ferret cuspid teeth can be used to investigate various factors involved in regenerative endodontics that cannot be tested in human subjects. The most appropriate time to conduct the experiments would be when the ferrets are between the ages of 50 and 90 days. Copyright © 2011. Published by Elsevier Inc.

Hemisection for treatment of an advanced endodontic-periodontal lesion: a case report.

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Haueisen, H; Heidemann, D

2002-06-01

To emphasize the importance of primary endodontic treatment when dealing with endo-perio lesions and to demonstrate the considerable healing potential of the endodontic aspect. After several years of unsuccessful symptomatic periodontal treatment, an advanced endo-perio lesion on a right-mandibular first molar was successfully treated by root-canal treatment and hemisection after the re-evaluation of the lesion. This successful treatment appeared to have a positive effect on the patient's general well-being. The origin of a combined endo-perio lesion is indicated by its clinical and radiographic appearance. The periodontal situation is often misinterpreted. The prognosis for the endodontic element of treatment is excellent. Local pathologic processes in the oral cavity may affect a patient's general health.

Submergence of Roots for Alveolar Bone Preservation. I. Endodontically Treated Roots.

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1977-05-10

With Endodontic Submerged Roots Scale 0 1 2 3 Periapical 15 0 1 0 Pericoronal 7 3 3 3 (3 cysts ) = 1 _ _ _ _ _ _ _ _ _ = REFERENCES 1. Lam, R.: Contour...with coronal portions of the roots. These epithe lial-lined cysts prevented the formation of osteo- cementum over the coronal surface . In this study...the endodontically treated roots appeared to be primarily a response to the excess root cana l sealer that was expressed coronally and periapically

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.

Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals

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Bonny Paul

2014-01-01

Full Text Available Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.

In Vitro Biocompatibility of Endodontic Sealers Incorporating Antibacterial Nanoparticles

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Itzhak Abramovitz

2012-01-01

Full Text Available The main cause of endodontic disease is bacteria. Disinfection is presently achieved by cleaning the root canal system prior to obturation. Following setting, root canal filling is devoid of any antibacterial effect. Endodontic sealers with antimicrobial properties yet biocompatible may enhance root canal therapy. For this purpose, quaternized polyethylenimine nanoparticles which are antibacterial polymers, biocompatible, nonvolatile, and stable may be used. The aim of the present study was to examine the impact of added QPEI on the cytotoxicity of AH Plus, Epiphany, and GuttaFlow endodontic sealers. The effect of these sealers on the proliferation of RAW 264.7 macrophage and L-929 fibroblast cell lines and on the production of TNFα from macrophages was examined. Cell vitality was evaluated using a colorimetric XTT assay. The presence of cytokines was determined by two-site ELISA. Results show that QPEI at 1% concentration does not impair the basic properties of the examined sealers in both macrophages and fibroblast cell lines. Incorporation of 1% QPEI into the sealers did not impair their biocompatibility. QPEI is a potential clinical candidate to improve antibacterial activity of sealers without increasing cytotoxicity.

A century of ice retreat on Kilimanjaro: the mapping reloaded

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N. J. Cullen

2013-03-01

Full Text Available A new and consistent time series of glacier retreat on Kilimanjaro over the last century has been established by re-interpreting two historical maps and processing nine satellite images, which removes uncertainty about the location and extent of past and present ice bodies. Three-dimensional visualization techniques were used in conjunction with aerial and ground-based photography to facilitate the interpretation of ice boundaries over eight epochs between 1912 and 2011. The glaciers have retreated from their former extent of 11.40 km2 in 1912 to 1.76 km2 in 2011, which represents a total loss of about 85% of the ice cover over the last 100 yr. The total loss of ice cover is in broad agreement with previous estimates, but to further characterize the spatial and temporal variability of glacier retreat a cluster analysis using topographical information (elevation, slope and aspect was performed to segment the ice cover as observed in 1912, which resulted in three glacier zones being identified. Linear extrapolation of the retreat in each of the three identified glacier assemblages implies the ice cover on the western slopes of Kilimanjaro will be gone before 2020, while the remaining ice bodies on the plateau and southern slopes will most likely disappear by 2040. It is highly unlikely that any body of ice will be present on Kilimanjaro after 2060 if present-day climatological conditions are maintained. Importantly, the geo-statistical approach developed in this study provides us with an additional tool to characterize the physical processes governing glacier retreat on Kilimanjaro. It remains clear that, to use glacier response to unravel past climatic conditions on Kilimanjaro, the transition from growth to decay of the plateau glaciers must be further resolved, in particular the mechanisms responsible for vertical cliff development.

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

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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.

Features of clinical course and treatment principles of endodontic-periodontal lesions

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P I Moroz

2018-06-01

Full Text Available Aim. To study the characteristic differences in the clinical course of chronic generalized periodontitis in the presence of periapical infection focus and the principles of combined treatment of endodontium and periodontium. Methods. A clinical and X-ray examination of 1525 patients of different age groups was performed. As a result, a clinical group of 68 patients with chronic generalized moderate and severe periodontitis was formed, who were divided into two groups depending on the presence or absence of periapical destruction. In group 1, 32 patients with the presence of chronic generalized periodontitis and signs of chronic apical periodontitis were united. Group 2 included 36 patients with chronic generalized periodontitis and no periapical infection and damage. The index estimation of the periodontal tissues state in the dynamics of combined endodontic and periodontal treatment was performed. Results. The initial task of treating endodontic periodontal lesions, regardless of the localization of the primary lesion focus, is the elimination or reversal of chronic periapical inflammatory processes of the teeth. The proposed monitoring system in the course of treatment and dynamic follow-up for 18 months for patients suffering from endodontic periodontal lesions using clinical and radiological methods of examination involves: (1 interim epicrisis or conclusion about negative or positive compliance 1-2 months after the completion of endodontic treatment and hygiene procedures; (2 periodontal treatment (according to indications with the assessment of clinical efficacy 6 and 12 months after the start of treatment; (3 epicrisis after 18 months. Conclusion. The use of proposed concept of complex treatment of endodontic-periodontal lesions, monitoring system in the course of dental therapeutic and preventive measures and dynamic follow-up for 18 months allows achieving positive compliance in 85% of patients according to the clinical examination and

Critical Assessment of Search Strategies in Systematic Reviews in Endodontics.

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Yaylali, Ibrahim Ethem; Alaçam, Tayfun

2016-06-01

The aim of this study was to perform an overview of literature search strategies in systematic reviews (SRs) published in 2 endodontic journals, Journal of Endodontics and International Endodontic Journal. A search was done by using the MEDLINE (PubMed interface) database to retrieve the articles published between January 1, 2000 and December 31, 2015. The last search was on January 10, 2016. All the SRs published in the 2 journals were retrieved and screened. Eligible SRs were assessed by using 11 questions about search strategies in the SRs that were adapted from 2 guidelines (ie, AMSTAR checklist and the Cochrane Handbook). A total of 83 SRs were retrieved by electronic search. Of these, 55 were from the Journal of Endodontics, and 28 were from the International Endodontic Journal. After screening, 2 SRs were excluded, and 81 SRs were included in the study. Some issues, such as search of grey literature and contact with study authors, were not fully reported (30% and 25%, respectively). On the other hand, some issues, such as the use of index terms and key words and search in at least 2 databases, were reported in most of the SRs (97% and 95%, respectively). The overall quality of the search strategy in both journals was 61%. No significant difference was found between the 2 journals in terms of evaluation criteria (P > .05). There exist areas for improving the quality of reporting of search strategies in SRs; for example, grey literature should be searched for unpublished studies, no language limitation should be applied to databases, and authors should make an attempt to contact the authors of included studies to obtain further relevant information. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

An endodontic practice profile amongst general dental practitioners in Kathmandu: A questionnaire survey

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D Shrestha

2014-04-01

Full Text Available Objective To investigate the endodontic practice profile of general dental practitioners. To explore the materials and methods employed by them in Kathmandu valley. To compare these findings with well acknowledged international academic standards. Methods Questionnaires with 18 closed-ended questions were distributed among randomly chosen 120 general dental practitioners of Kathmandu, working in various government or private hospital or clinics.The data were collected and descriptive statistical analysis was done. Results Out of 120 questionnaires, only 110 that were completely filled were included in the study .Most general dental practitioners (97% regularly did multi-rooted root canal treatments and followed multivisit root canal treatment.. Radiograph with instrument in canal was used by 80% of general dental practitioners to determine the working length while only 36% used electronic apex locator which is considered to be more reliable. Half of them (57% used nickel-titanium files for cleaning and shaping but only 23% used crown down technique. Sodium hypochlorite and calcium hydroxide was the most popular irrigation solution and intra-canal medicament respectively. Majority of general dental practitioners (91% used lateral compaction technique for root canal obturation. Sixty three percent used zinc oxide eugenol as root canal sealer and 46% used endomethasone. They seem to overuse antibiotics in cases requiring endodontic therapy. Only 48% used autoclave for sterilization of endodontic files while 86% never used rubber dam. Eight three percent of them felt the need of further endodontic training and 42% of them preferred post-graduate dental program. Conclusion This study shows that the standard guidelines and new technologies for endodontic treatments are not implemented by many general dental practitioners of Kathmandu and require further endodontic trainings. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 40-50 DOI

Continuing evidence for poorer treatment outcomes for single male patients: Retreatment data from RTOG 97-14

International Nuclear Information System (INIS)

Konski, Andre; DeSilvio, Michelle; Hartsell, William; Watkins-Bruner, Deborah; Coyne, James; Scarantino, Charles; JanJan, Nora

2006-01-01

Purpose: The specific aim of this study was to evaluate outcome differences by gender and partner status for patients treated on Radiation Therapy Oncology Group (RTOG) protocol 97-14. Methods and Materials: RTOG 97-14 randomized patients with metastatic breast or prostate cancer to bone to receive 8 Gy in 1 fraction or 30 Gy in 10 fractions. Retreatment rates and overall survival were made based upon gender, marital status, and Karnofsky Performance Status (KPS). The cumulative incidence method was used to estimate retreatment time at 36 months from enrollment, and Gray's test was used to test for treatment differences within the same groupings. Marital status, gender, KPS, and treatment were variables tested in a univariate Cox model evaluating the time to retreatment. Results: Married men and women and single women receiving 30 Gy had significantly longer time to retreatment, p = 0.0067, p = 0.0052, and p = 0.0009 respectively. We failed to show a difference in retreatment rates over time in single men receiving either 30 Gy or 8 Gy. Univariate analysis of the entire group determined patients receiving 30 Gy in 10 fractions significantly less likely to receive retreatment, p < 0.0001, with a trend toward single patients less likely to be re-treated, p = 0.07. Conclusion: Non-disease-related variables, such as social support, might influence the results of clinical trials with subjective endpoints such as retreatment rates. The statistically nonsignificant difference in the 36-month retreatment rates observed in single male patients receiving 8 Gy may be a result of inadequate social support systems in place to facilitate additional care. Patients receiving 8 Gy in a single fraction had significantly higher retreatment rates compared with patients receiving 30 Gy in 10 fractions

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.

Adjunctive use of the diode laser in non-surgical periodontal therapy: exploring the controversy.

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Porteous, Mary Sornborger; Rowe, Dorothy J

2014-04-01

Despite the controversy regarding clinical efficacy, dental hygienists use the diode laser as an adjunct to non-surgical periodontal therapy. The technique to maximize successful laser therapy outcome is controversial as well. The purpose of this review is to explore the scientific foundation of the controversy surrounding the use of the diode laser as an adjunct to non-surgical periodontal therapy. Further, this paper addresses the weaknesses in study design, the heterogeneity of methodology in the published clinical studies, especially the laser parameters, and how these issues impact the collective clinical and microbial data, and thus conclusions regarding clinical efficacy. Evaluation of the literature identifies possible mechanisms that could contribute to the varied, often conflicting results among laser studies that are the foundation of the controversy surrounding clinical efficacy. These mechanisms include current paradigms of periodontal biofilm behavior, tissue response to laser therapy being dependent on tissue type and health, and that the successful therapeutic treatment window is specific to the target tissue, biofilm composition, laser wavelength, and laser energy delivered. Lastly, this paper discusses laser parameters used in the various clinical studies, and how their diversity contributes to the controversy. Although this review does not establish clinical efficacy, it does reveal the scientific foundation of the controversy and the need for standardized, well designed randomized controlled clinical trials to develop specific guidelines for using the laser as an adjunct to non-surgical periodontal therapy. Using evidence-based laser guidelines would allow dental hygienists to provide more effective non-surgical periodontal care.

The Role of Silence at the Retreats of a Buddhist Community

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Orsolya Huszár

2016-12-01

Full Text Available The purpose of the study is to establish that the definition of silence as simply an absence of something or as the background of communication proves to be inadequate in a number of communicative instances. The interpretation of silence is culturally determined, and the underappreciation of its role is typical in low-context Western cultures; this is also evinced by the neglect of the topic in the literature. The present study will describe the communicative functions of silence through the findings of field work conducted at the retreats of a Buddhist community in Hungary, providing empirical input for the relevant theoretical constructs. The research findings show that silence is accorded a central role in essentially every component of the retreat (meditations, relaxation, ceremonies, teachings, small-group sharings, meals and rest; and while each event at the retreat focuses primarily on a different specific function of communication, the entire retreat does involve the linkage, affecting, revelational and – to a certain extent – activating functions (to follow the five-element typology of J. Vernon Jensen, as well as – to a lesser extent – the judgmental function. The research also shows that it requires time for individuals in a low-context culture to recognize the “point” of silence – something that the retreats provide the right opportunity for. In fact, the insights the individuals arrived at through these occasions could be put to use in their daily lives, helping their problem-solving and social relationships and in general improving their quality of life.

Syringe irrigation: blending endodontics and fluid dynamics

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Boutsioukis, Christos; van der Sluis, Lucas; Basrani, Bettina

2015-01-01

This book reviews the available information on bacterial disinfection in endodontics, with emphasis on the chemical treatment of root canals based on current understanding of the process of irrigation. It describes recent advances in knowledge of the chemistry associated with irrigants and delivery

Transcending Gender: Female Non-Buddhists’ Experiences of the Vipassanā Meditation Retreat

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Brooke Schedneck

2018-03-01

Full Text Available Female non-Buddhists have been writing detailed descriptions of their personal experiences in vipassanā meditation retreats since the 1960s. These memoirists relate to the English-speaking world their experience of the retreat process and self-transformations. Early memoirists traveled Asia in order to learn and practice vipassanā meditation. These memoirs are as much about the meditation practice itself as living in an Asian culture. The mindfulness craze, beginning in the late 2000s, brought with it increased awareness of vipassanā practice. At this time we see a renewed interest in recording vipassanā retreat experiences, but these are even more personal and not concerned with travel, as many vipassanā meditation retreats are now available outside of Asia. I consider four female memoirists: Marie Byles and Jane Hamilton-Smith, writing in the 1960s and 1970s, and Raji Lukkoor, and Jennifer Howd, whose memoirs appeared in 2010 and 2014, respectively. These women’s writings demonstrate that, although non-Buddhist female meditators understand vipassanā meditation as a nongendered practice, it is still an embodied, gendered experience. Each of these women has different reactions to the female gender on the retreat, from outrage at gender discrimination to acceptance of it, from judgment of female teachers and meditators to revealing a more feminine self.

Management of persistent periapical infection on maxillary lateral incisorby apex resection of: A case report

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Yusri Yusri

2016-06-01

Full Text Available Endodontic failure can be caused by different etiology, one of them is a persistent periapical infection in the root canal system. If the endodontic convensional retreatment is difficult to be done, surgical endodontic will be recomended. Endodontic surgical can eliminate the causative agent of periradicular disease and to restore the biological condition of periodontium and functional. A 22 years old male patient came to the Dental Hospital Hasanuddin University at Tamalanrea with the chief complaint is discomfort of the left maxillary lateral incisor. Radiograph examinations showed radiolucency 4 mm of tooth 22. The diagnosis is chronic apical periodontitis.Three month after endodontic conventional, the patients complaint is settled. Extended care plan will be treated is apex resection. The purpose of this case report is to present the treatment protocol of apex resection on  the maxillary left lateral incisor.

Does smoking affect gingival crevicular fluid LL-37 levels following non-surgical periodontal treatment in chronic periodontitis?

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Türkoğlu, Oya; Eren, Gülnihal; Emingil, Gülnur; Azarsız, Elif; Kutukculer, Necil; Atilla, Gül

2016-01-01

LL-37 contributes to maintaining the balance between health and disease. Smoking is a risk factor for periodontitis that impairs neutrophil functions. The aim of the present study was to comparatively evaluate gingival crevicular fluid (GCF) LL-37 levels in smoker and non-smoker chronic periodontitis (CP) patients and controls, as well as the effect of non-surgical periodontal treatment on GCF LL-37 levels. Thirty-one CP patients (16 smokers, 15 non-smokers) and thirty-one controls (16 smokers, 15 non-smokers) were included in the study. CP patients received non-surgical treatment. GCF LL-37 levels and periodontal parameters were assessed at baseline, 1 and 3 months after completion of non-surgical periodontal treatment. GCF LL-37 levels were analyzed by ELISA. No significant difference was observed in GCF LL-37 levels between smoker and non-smoker controls (p>0.05). Smoker CP group had significantly lower GCF LL-37 level than non-smoker CP group at baseline (pnon-smoker CP group at first week, 1 and 3 months after completion of non-surgical periodontal treatment (psmoker CP group (p>0.05). Periodontal parameters were correlated with GCF LL-37 levels in non-smoker CP group (psmoker CP group (p>0.05). GCF LL-37 levels do not seem to be affected from smoking in periodontal health. However, smoking might have a suppressive effect on GCF LL-37 levels in CP. Non-surgical treatment is effective in decreasing GCF LL-37 levels in non-smoker CP patients but not in smokers with CP. Copyright © 2015. Published by Elsevier Ltd.

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.

Retreatment of a mandibular second premolar with two canals in two roots

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Chiara Fossati

2018-06-01

Full Text Available Aim: To present a case of retreatment in mandibular second premolar with two canals in two roots. Summary: Locating, cleaning and shaping the entire root canal system may represent a difficult challenge particularly in mandibular premolars, because of their complex canal systems.For this reason mandibular premolars are often considered the most difficult of all teeth on which to perform successful endodontic treatment. Vertucci stated that the second premolar has one root canal at the apex in 97.5% of the teeth studied and two canals in only 2.5%.1 The following case report describes the diagnosis and retreatment of a second premolar with two canal in two roots.Key learning points: (1 The major cause of failure in root canal therapy is the inability to localize and treat all of the canals of the root canal system. (2 Mandibular premolars have complex canal systems. (3 Mandibular premolars have a high risk of missed anatomy. (4 Preoperative radiograph interpretation is essential to evaluate and detect uncommon anatomies. (5 The operating microscope and CBCT interpretation are fundamental in confirming and preventing mistakes about the configuration of mandibular premolars. Riassunto: Obiettivi: Presentare un caso clinico di ritrattamento canalare di un secondo premolare mandibolare con due canali e due radici. Riassunto: Individuare, sagomare, detergere l’intero sistema radicolare presenta una sfida difficile in ambito endodontico e in particolar modo nei premolari mandibolari per il loro complesso sistema canalare. I premolari mandibolari sono spesso considerati i denti più difficili in cui effettuare una terapia endodontica.Vertucci riscontrò che i secondi premolari mandibolari hanno una radice e un canale nel 97.5% e due canali in solo il 2.5%.1Il case report seguente descrive la diagnosi e il ritrattamento di un secondo premolare con due canali in due radici.Punti chiave di apprendimento: 1. La maggior causa di fallimento endodontico �

Extreme beach retreat history inferred from cut-and-fill beach deposits at Moruya, SE Australia

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Tamura, T.; Woodroffe, C. D.; Oliver, T.; Cunningham, A. C.

2017-12-01

A sequence of beach ridges often records a `cut and fill', where the fair-weather swash accretion of beach sand is punctuated by storm erosion. The detailed chronology of the sequence is thus a clue to decipher past storm events and associated beach erosion, but has not been explored much. Here we explore the potential of such a sequence to detect past extreme retreats in Bengello Beach at Moruya, southeastern Australia. Beach monitoring since 1972 reveals that Bengello beach has shown a typical cut and fill, in which the beach retreats several tens of meters in relation to storms and recovers within a following few years. A storm event caused extreme retreat up to 50 m in 1974. Since then, no retreat exceeded 30 m. The beach monitoring highlights the sporadic nature of the prograded beach deposits; they can only be preserved as stratigraphic records during rapid beach recovery following a large retreat deeper than the beach profile envelope. Thus, ages of the preserved beach deposits roughly correspond to timings of large retreat. Optically-stimulated luminescence (OSL) ages were determined for beach deposits at 5-10 m intervals along a shore-normal transect from the modern foredune to beach ridge 120 m inland. The most landward sample was dated as 510 yr, indicating that the net progradation rate is 0.24 m/yr, concordant with both the long- and short-term rates since the mid Holocene and 1972, respectively. Other ages show four events of retreat around 350, 180, 130 and 90 yr, and also reflect the beach scarp resulting from the 1974 event. The retreat of each event is given by the distance between the shoreline position prior to storm erosion and relevant gap in OSL age. The position of the pre-storm shoreline is estimated by assuming a constant rate of the net progradation of 0.24 m/yr, as with long- and short-term rates. The retreat of the four events is then determined as 45-55 m, similar to the 1974 event. In summary, extreme beach retreats, including that in

Antibacterial Nanoparticles in Endodontics: A Review.

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Shrestha, Annie; Kishen, Anil

2016-10-01

A major challenge in root canal treatment is the inability of the current cleaning and shaping procedures to eliminate bacterial biofilms surviving within the anatomic complexities and uninstrumented portions of the root canal system. Nanoparticles with their enhanced and unique physicochemical properties, such as ultrasmall sizes, large surface area/mass ratio, and increased chemical reactivity, have led research toward new prospects of treating and preventing dental infections. This article presents a comprehensive review on the scientific knowledge that is available on the application of antibacterial nanoparticles in endodontics. The application of nanoparticles in the form of solutions for irrigation, medication, and as an additive within sealers/restorative materials has been evaluated to primarily improve the antibiofilm efficacy in root canal and restorative treatments. In addition, antibiotic or photosensitizer functionalized nanoparticles have been proposed recently to provide more potent antibacterial efficacy. The increasing interest in this field warrants sound research based on scientific and clinical collaborations to emphasize the near future potential of nanoparticles in clinical endodontics. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Non-surgical and non-chemical attempts to treat echinococcosis: do they work?

Directory of Open Access Journals (Sweden)

Tamarozzi Francesca

2014-01-01

Full Text Available Cystic echinococcosis (CE and alveolar echinococcosis (AE are chronic, complex and neglected diseases. Their treatment depends on a number of factors related to the lesion, setting and patient. We performed a literature review of curative or palliative non-surgical, non-chemical interventions in CE and AE. In CE, some of these techniques, like radiofrequency thermal ablation (RFA, were shelved after initial attempts, while others, such as High-Intensity Focused Ultrasound, appear promising but are still in a pre-clinical phase. In AE, RFA has never been tested, however, radiotherapy or heavy-ion therapies have been attempted in experimental models. Still, application to humans is questionable. In CE, although prospective clinical studies are still lacking, therapeutic, non-surgical drainage techniques, such as PAIR (puncture, aspiration, injection, re-aspiration and its derivatives, are now considered a useful option in selected cases. Finally, palliative, non-surgical drainage techniques such as US- or CT-guided percutaneous biliary drainage, centro-parasitic abscesses drainage, or vascular stenting were performed successfully. Recently, endoscopic retrograde cholangiopancreatography (ERCP-associated techniques have become increasingly used to manage biliary fistulas in CE and biliary obstructions in AE. Development of pre-clinical animal models would allow testing for AE techniques developed for other indications, e.g. cancer. Prospective trials are required to determine the best use of PAIR, and associated procedures, and the indications and techniques of palliative drainage.

Update of guidelines for surgical endodontics - the position after ten years.

Science.gov (United States)

Evans, G E; Bishop, K; Renton, T

2012-05-25

This is the first of a series of articles, which will summarise new or updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). Important developments for the dental profession from a number of clinical guidelines will be presented, commencing with the Guidelines for surgical endodontics. The impact of recent evidence relating to the outcome of surgical endodontics and techniques such as cone beam computed tomography and microsurgical techniques are considered.

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...

Clinical Approach of High Technology Techniques for Control and Elimination of Endodontic Microbiota

Science.gov (United States)

Chiniforush, Nasim; Pourhajibagher, Maryam; Shahabi, Sima; Bahador, Abbas

2015-01-01

The main goal in endodontic treatment is to eradicate or at least reduce intraradicular microbial population to levels that are more compatible with periapical lesions healing process. Since endodontic infections are polymicrobial in nature, intraradicular survival of endodontic microbiota and their pathogenic properties are influenced by a combination of their virulence factors. The purpose of this article is to review the endodontic microbiota and their respective virulence attributes, as well as perform a literature review of the effects of disinfection procedures in the treatment of endodontic infections to gain best practices. Conventional technique for root canal preparation includes mechanical debridement and application of antimicrobial irrigants. Recently, laser irradiation has been used to enhance the results of root canal treatment through its thermal effect. To reduce thermal side effects, laser activated irrigation (LAI) and photon induced photoacoustic streaming (PIPS) were introduced. Antimicrobial photodynamic therapy (aPDT) by photochemical reaction uses light at a specific wavelength to activate a nontoxic photosensitizer (PS) in the presence of oxygen to produce cytotoxic products. Different PSs are used in dentistry including methylene blue (MB), toluidine blue O (TBO), indocyanine green (ICG) and curcumin. Among different options, ICG could be the best choice due to its peak absorption at wavelength of 808 nm, which coincides with the commercial diode laser devices. Also, this wavelength has more penetration depth compared to other wavelengths used in aPDT. PMID:26705458

Non-surgical interventions for adolescents with idiopathic scoliosis: an overview of systematic reviews.

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Płaszewski, Maciej; Bettany-Saltikov, Josette

2014-01-01

Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Systematic overview of systematic reviews. Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute's hierarchies were applied to analyze the levels of evidence from included reviews. From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms

Spiral computed tomography assessment of the efficacy of different rotary versus hand retreatment system

OpenAIRE

Neelam Mittal; Jyoti Jain

2014-01-01

Aims: The purpose of this study was to evaluate the efficacy of nickel-titanium rotary retreatment systems versus stainless steel hand retreatment system with or without solvent for gutta-percha removal during retreatment. Materials and Methods: Sixty extracted human mandibular molar teeth with single canal in a distal root was prepared with ProTaper rotary nickel-titanium files and obturated with gutta-percha and sealer. The teeth were randomly divided into six groups of 10 specimens in ...

Endotoxin content in endodontically involved teeth. 1975.

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Schein, Benjamin; Schilder, Herbert

2006-04-01

Fluid was aspirated from the root canals of 40 endodontically involved teeth. This fluid was assayed for endotoxin with the limulus lysate test. Pulpless teeth contained greater concentrations of endotoxin than those with vital pulps. Symptomatic teeth also contained more endotoxin than asymptomatic teeth.

Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis.

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Nascimento, Eduarda Helena Leandro; Gaêta-Araujo, Hugo; Andrade, Maria Fernanda Silva; Freitas, Deborah Queiroz

2018-01-21

The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images. Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square's test and descriptive analyses were performed. Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (p technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively. There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals. Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.

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

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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.

Chlorhexidine gluconate, its properties and applications in endodontics

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Mohammadi, Zahed

2008-01-01

The major objective in endodontic therapy is to disinfect the entire root canal system. This requires that the pulpal content be eliminated as sources of infection. This goal may be accomplished by mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria from the root canal system, various irrigants have been used during treatment. Chlorhexidine is a cationic solution which can be used during treatment. It has a wide range of antimicrobial activity. Furthermore, because of its cationic structure, chlorhexidine has a unique property named substantivity. The purpose of this paper is to review different aspects of chlorhexidine in endodontics. PMID:24265633

Platelet-rich fibrin: a boon in regenerative endodontics.

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Rebentish, Priyanka D; Umashetty, Girish; Kaur, Harpreet; Doizode, Trupthi; Kaslekar, Mithun; Chowdhury, Shouvik

2016-12-01

Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

Endodontic treatment completion following emergency pulpectomy.

LENUS (Irish Health Repository)

Lynch, C D

2010-06-01

Emergency pulpectomy is frequently performed to relieve pain experienced by patients following acute episodes of endodontic pain, or to limit the risks of infection or possible root resorption following traumatic pulpal exposures. The aim of this study was to examine subsequent patient attendance for completion of root canal treatment following pulpectomy procedures in a dental emergency unit.

Platelet rich fibrin - a novel acumen into regenerative endodontic therapy

Directory of Open Access Journals (Sweden)

Kavita Hotwani

2014-02-01

Full Text Available Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

Indexing of Iranian Publications in Well-known Endodontic Textbooks: A Scientometric Analysis.

Science.gov (United States)

Kakooei, Sina; Mostafavi, Mahshid; Parirokh, Masoud; Asgary, Saeed

2016-01-01

Quoting an article in well-known textbooks is held as a credit for that paper. The numbers of Iranian publications mentioned in endodontic textbooks have increased during recent years. The aim of this investigation was to evaluate the number of Iranian articles quoted in eminent endodontic textbooks. Three known textbooks (Ingle's Endodontics, Seltzer and Bender's Dental Pulp and Cohen's Pathways of the Pulp) were chosen and all the editions of the textbooks since 2000 were investigated for quoted Iranian publications. Only Iranian authors with affiliations from a domestic university were chosen. All references at the end of each chapter were read by hand searching, and results were noted. The trend and percentage of Iranian publications in different editions of the textbooks were also calculated. The number of citations of these publications in Google Scholar and Scopus databases were also obtained. The number of Iranian publications in all well-known textbooks have notably increased since 2000. The number and percentage of Iranian publications in the latest edition of Cohen's Pathways of the Pulp was higher compared to other textbooks as well as the previous edition of the same text. Number and percentage of Iranian publications in the field of endodontics in all three textbooks have remarkably increased since 2000.

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

Science.gov (United States)

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.

Diagnosis and decision making in endodontics with the use of cone beam computed tomography

NARCIS (Netherlands)

Metska, M.E.

2014-01-01

In the current thesis the use of cone beam computed tomography (CBCT) in endodontics has been evaluated within the framework of ex vivo and in vivo studies. The first objective of the thesis was to examine whether CBCT scans can be used for the detection of vertical root fractures in endodontically

Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series

DEFF Research Database (Denmark)

Givol, Navot; Rosen, Eyal; Bjørndal, Lars

2011-01-01

The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication.......The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication....

Comparing ProFile Vortex to ProTaper Next for the efficacy of removal of root filling material: An ex vivo micro-computed tomography study

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Emad AlShwaimi

2018-01-01

Conclusion: Our findings suggest that PV is as effective as PTN for removal of root canal filling material. Therefore, PV can be considered for use in endodontic retreatment, although more effective files or techniques are still required.

Evaluation of apically extruded debris during root canal retreatment with two different rotary systems followed by a self-adjusting file.

Science.gov (United States)

Cakici, Fatih; Cakici, Elif B; Küçükekenci, Funda Fundaoglu

2016-02-01

To compare the amount of apically extruded debris during root canal retreatment using ProTaper retreatment system (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper retreatment system with Self-Adjusting File (SAF) system (ReDent-Nova, Ra'anana, Israel), Mtwo retreatment system (VDW, Munich, Germany), Mtwo retreatment system with SAF instruments. In total, 72 extracted human mandibular incisor teeth were used. All root canals were prepared with ProTaper universal (Dentsply Maillefer) up to F2 file and filled with gutta percha and AH plus sealer using cold lateral condensation before being assembled randomly into 4 groups (n = 18 each). Root canal filling materials were removed using the ProTaper retreatment system, the ProTaper retreatment system followed by SAF system, Mtwo retreatment system and Mtwo retreatment system followed by SAF system. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The data obtained were analyzed using Kruskal-Wallis test. All retreatment techniques caused the apical extrusion of debris. There was no significant difference between the groups statistically (p>0.05). The results of this study showed that SAF system after Mtwo retreatment system and ProTaper retreatment system for improving retreatment has no significant effect on the amount of debris extruded apically.

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

Safety of BTZ retreatment for patients with low-grade peripheral neuropathy during the initial treatment.

Science.gov (United States)

Vidisheva, Aleksandra P; Wang, James; Spektor, Tanya M; Bitran, Jacob D; Lutzky, Jose; Tabbara, Imad A; Ye, Joseph Z; Ailawadhi, Sikander; Stampleman, Laura V; Steis, Ronald G; Moezi, Mehdi M; Swift, Regina A; Maluso, Tina M; Udd, Kyle A; Eshaghian, Shahrooz; Nassir, Youram; Berenson, James R

2017-10-01

Neuropathy is an important complication that may limit treatment options for patients with multiple myeloma. Previous studies have focused on treatment efficacy and have shown that retreatment with bortezomib (BTZ) is an effective treatment option. The goal of this study was to focus on the clinical manifestations of peripheral neuropathy (PN) and to retrospectively compare the incidence and severity of PN between the initial BTZ regimen and upon retreatment. Furthermore, this study evaluated how certain factors affect BIPN, which will help determine what conditions should be considered prior to retreatment. Charts were reviewed from 93 patients who were retreated with a BTZ-containing regimen after previously being treated with this drug. Among the patients who developed PN, most patients in the study had low-grade neuropathy during the initial BTZ treatment (n = 52, 68%). The results showed no evidence of cumulative toxicity, and there was no significant difference in the incidence and severity of PN upon retreatment. Factors such as the presence of baseline PN, number of prior treatments, dose of BTZ, and comorbidities did not increase the severity of PN upon retreatment. The lapse of time between the two regimens also did not affect the severity of PN. The results suggest that retreatment with BTZ may be a feasible option, without additional risks of PN, for MM patients even with peripheral neuropathy during their initial treatment with this drug.

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.

Long-term results of nonsurgical management of condylar fractures in children

NARCIS (Netherlands)

Hovinga, J; Boering, G; Stegenga, B

1999-01-01

Twenty-five patients with 28 condylar or subcondylar fractures, sustained during their growth period and treated nonsurgically, have been followed for an average period of 15 years. The fractures were classified as intracapsular, high condylar neck and low condylar neck fractures, In 5 patients, two

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

Science.gov (United States)

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.

Influence of Cone-Beam Computed Tomography filters on diagnosis of simulated endodontic complications.

Science.gov (United States)

Verner, F S; D'Addazio, P S; Campos, C N; Devito, K L; Almeida, S M; Junqueira, R B

2017-11-01

To evaluate the influence of cone-beam computed tomography (CBCT) filters on diagnosis of simulated endodontic complications. Sixteen human teeth, in three mandibles, were submitted to the following simulated endodontic complications: (G1) fractured file, (G2) perforations in the canal walls, (G3) deviated cast post, and (G4) external root resorption. The mandibles were submitted to CBCT examination (I-Cat ® Next Generation). Five oral radiologists evaluated the images independently with and without XoranCat ® software filters. Accuracy, sensitivity and specificity were determined. ROC curves were calculated for each group with the filters, and the areas under the curves were compared using anova (one-way) test. McNemar test was applied for pair-wise agreement between all images versus the gold standard and original images versus images with filters (P originals images (P = 0.00 for all filters) only in G1 group. There were no differences in the other groups. The filters did not improve the diagnosis of the simulated endodontic complications evaluated. Their diagnosis remains a major challenge in clinical practice. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Efficiency of nonsurgical periodontal therapy in moderate chronic periodontitis.

Science.gov (United States)

Mlachkova, Antoaneta M; Popova, Christina L

2014-01-01

Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate

Contrasting evidence of Holocene ice margin retreat, south-western Greenland

DEFF Research Database (Denmark)

Levy, L. B.; Larsen, N. K.; Davidson, T. A.

2017-01-01

Constraining the Greenland Ice Sheet's (GrIS) response to Holocene climate change provides calibrations for ice sheet models that hindcast past ice margin fluctuations. Ice sheet models predict enhanced ice retreat in south-western Greenland during the middle Holocene; however, few geological...... observations corroborating the extensive retreat are available. We present new data from lake sediment cores from the Isua region, south-western Greenland, which provide constraints on Holocene fluctuations of the GrIS margins. Our data indicate that the main GrIS margin was 30 km west of its present...

Measuring Surface Deformation in Glacier Retreated Areas Based on Ps-Insar - Geladandong Glacier as a Case Study

Science.gov (United States)

Mohamadi, B.; Balz, T.

2018-04-01

Glaciers are retreating in many parts of the world as a result of global warming. Many researchers consider Qinghai-Tibetan Plateau as a reference for climate change by measuring glaciers retreat on the plateau. This retreat resulted in some topographic changes in retreated areas, and in some cases can lead to geohazards as landslides, and rock avalanches, which is known in glacier retreated areas as paraglacial slope failure (PSF). In this study, Geladandong biggest and main glacier mass was selected to estimate surface deformation on its glacier retreated areas and define potential future PSF based on PS-InSAR technique. 56 ascending and 49 descending images were used to fulfill this aim. Geladandong glacier retreated areas were defined based on the maximum extent of the glacier in the little ice age. Results revealed a general uplift in the glacier retreated areas with velocity less than 5mm/year. Obvious surface motion was revealed in seven parts surround glacier retreated areas with high relative velocity reached ±60mm/year in some parts. Four parts were considered as PSF potential motion, and two of them showed potential damage for the main road in the study area in case of rock avalanche into recent glacier lakes that could result in glacier lake outburst flooding heading directly to the road. Finally, further analysis and field investigations are needed to define the main reasons for different types of deformation and estimate future risks of these types of surface motion in the Qinghai-Tibetan Plateau.

Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts.

Science.gov (United States)

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

2009-05-01

It is a general belief that large cyst-like periapical lesions and apical true cysts caused by root canal infection are less likely to heal after nonsurgical root canal therapy. Nevertheless, there is no direct evidence to support this assumption. A large cyst-like periapical lesion or an apical true cyst is formed within an area of apical periodontitis and cannot form by itself. Therefore, both large cyst-like periapical lesions and apical true cysts are of inflammatory and not of neoplastic origin. Apical periodontitis lesions, regardless of whether they are granulomas, abscesses, or cysts, fail to heal after nonsurgical root canal therapy for the same reason, intraradicular and/or extraradicular infection. If the microbial etiology of large cyst-like periapical lesions and inflammatory apical true cysts in the root canal is removed by nonsurgical root canal therapy, the lesions might regress by the mechanism of apoptosis in a manner similar to the resolution of inflammatory apical pocket cysts. To achieve satisfactory periapical wound healing, surgical removal of an apical true cyst must include elimination of root canal infection.

A cost-effective simulation curriculum for preclinical endodontics.

Science.gov (United States)

Pileggi, Roberta; Glickman, Gerald N

2004-02-01

A challenge in contemporary dental education is to achieve a smooth transition from preclinical teaching environments to patient-care clinics in a cost-effective manner. The preclinical endodontic courses at The University of Texas, Dental Branch at Houston provide a unique learning environment that enables the student to perform endodontic treatment on extracted teeth in a typodont, and be involved in diagnosis and treatment-planning discussions. The specially designed stone typodont used has built-in radiographic capability, and is mounted at each chair in the clinic. During each preclinical session, students are assigned clinical cubicles and proper aseptic protocol is followed. Students are required to wear gloves, masks and eyewear, and place a rubber dam during treatment. Written self-assessment evaluations based upon prescribed criteria are utilised; feedback is given by faculty composed of both full-time endodontists and graduate students who periodically rotate and are calibrated on a regular basis. In the lecture phase, clinical case scenarios are presented to reinforce concepts of diagnosis and emergency care and to help integrate endodontics with other disciplines; a Socratic-like teaching style is established by the faculty facilitator to create an environment for developing critical-thinking and problem-solving skills. The overall feedback from graduating students has been very positive. Advantages of this format are an easier transition to patient management, a more keen interest in specialsation and a perceived increase in levels of confidence.

Flare-ups in endodontics: II. Therapeutic measures. 1985.

Science.gov (United States)

Seltzer, Samuel; Naidorf, Irving J

2004-07-01

Various treatment regimens for the relief of pain during endodontic therapy, including relief of occlusion, pre-medication, establishment of drainage, and intracanal and systemic medications are presented. In addition, the rationale for the use of placebos is discussed.

Pathogenesis of apical periodontitis and the causes of endodontic failures.

Science.gov (United States)

Nair, P N R

2004-11-01

Apical periodontitis is a sequel to endodontic infection and manifests itself as the host defense response to microbial challenge emanating from the root canal system. It is viewed as a dynamic encounter between microbial factors and host defenses at the interface between infected radicular pulp and periodontal ligament that results in local inflammation, resorption of hard tissues, destruction of other periapical tissues, and eventual formation of various histopathological categories of apical periodontitis, commonly referred to as periapical lesions. The treatment of apical periodontitis, as a disease of root canal infection, consists of eradicating microbes or substantially reducing the microbial load from the root canal and preventing re-infection by orthograde root filling. The treatment has a remarkably high degree of success. Nevertheless, endodontic treatment can fail. Most failures occur when treatment procedures, mostly of a technical nature, have not reached a satisfactory standard for the control and elimination of infection. Even when the highest standards and the most careful procedures are followed, failures still occur. This is because there are root canal regions that cannot be cleaned and obturated with existing equipments, materials, and techniques, and thus, infection can persist. In very rare cases, there are also factors located within the inflamed periapical tissue that can interfere with post-treatment healing of the lesion. The data on the biological causes of endodontic failures are recent and scattered in various journals. This communication is meant to provide a comprehensive overview of the etio-pathogenesis of apical periodontitis and the causes of failed endodontic treatments that can be visualized in radiographs as asymptomatic post-treatment periapical radiolucencies.

Er:YAG laser for endodontics: efficiency and safety

Science.gov (United States)

Hibst, Raimund; Stock, Karl; Gall, Robert; Keller, Ulrich

1997-12-01

Recently it has been shown that bacterias can be sterilized by Er:YAG laser irradiation. By optical fiber transmission the bactericidal effect can also be used in endodontics. In order to explore potential laser parameters, we further investigated sterilization of caries and measured temperatures in models simulating endodontic treatment. It was found out that the bactericidal effect is cumulative, with single pulses being active. This offers to choose all laser parameters except pulse energy (radiant exposure) from technical, practical or safety considerations. For clinical studies the following parameter set is proposed for efficient and safe application (teeth with a root wall thickness > 1 mm, and prepared up to ISO 50): pulse energy: 50 mJ, repetition rate: 15 Hz, fiber withdrawal velocity: 2 mm/s. With these settings 4 passes must be performed to accumulate the total dose for sterilization.

Benthic Trophic Interactions in an Antarctic Shallow Water Ecosystem Affected by Recent Glacier Retreat.

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Francesca Pasotti

Full Text Available The western Antarctic Peninsula is experiencing strong environmental changes as a consequence of ongoing regional warming. Glaciers in the area are retreating rapidly and increased sediment-laden meltwater runoff threatens the benthic biodiversity at shallow depths. We identified three sites with a distinct glacier-retreat related history and different levels of glacial influence in the inner part of Potter Cove (King George Island, South Shetland Islands, a fjord-like embayment impacted since the 1950s by a tidewater glacier retreat. We compared the soft sediment meio- and macrofauna isotopic niche widths (δ13C and δ15N stable isotope analysis at the three sites to investigate possible glacier retreat-related influences on benthic trophic interactions. The isotopic niches were locally shaped by the different degrees of glacier retreat-related disturbance within the Cove. Wider isotopic niche widths were found at the site that has become ice-free most recently, and narrower niches at the older ice-free sites. At an intermediate state of glacier retreat-related disturbance (e.g. via ice-growler scouring species with different strategies could settle. The site at the earliest stage of post-retreat development was characterized by an assemblage with lower trophic redundancy. Generally, the isotopic niche widths increased with increasing size spectra of organisms within the community, excepting the youngest assemblage, where the pioneer colonizer meiofauna size class displayed the highest isotopic niche width. Meiofauna at all sites generally occupied positions in the isotopic space that suggested a detrital-pool food source and/or the presence of predatory taxa. In general ice scour and glacial impact appeared to play a two-fold role within the Cove: i either stimulating trophic diversity by allowing continuous re-colonization of meiofaunal species or, ii over time driving the benthic assemblages into a more compact trophic structure with

Benthic Trophic Interactions in an Antarctic Shallow Water Ecosystem Affected by Recent Glacier Retreat.

Science.gov (United States)

Pasotti, Francesca; Saravia, Leonardo Ariel; De Troch, Marleen; Tarantelli, Maria Soledad; Sahade, Ricardo; Vanreusel, Ann

2015-01-01

The western Antarctic Peninsula is experiencing strong environmental changes as a consequence of ongoing regional warming. Glaciers in the area are retreating rapidly and increased sediment-laden meltwater runoff threatens the benthic biodiversity at shallow depths. We identified three sites with a distinct glacier-retreat related history and different levels of glacial influence in the inner part of Potter Cove (King George Island, South Shetland Islands), a fjord-like embayment impacted since the 1950s by a tidewater glacier retreat. We compared the soft sediment meio- and macrofauna isotopic niche widths (δ13C and δ15N stable isotope analysis) at the three sites to investigate possible glacier retreat-related influences on benthic trophic interactions. The isotopic niches were locally shaped by the different degrees of glacier retreat-related disturbance within the Cove. Wider isotopic niche widths were found at the site that has become ice-free most recently, and narrower niches at the older ice-free sites. At an intermediate state of glacier retreat-related disturbance (e.g. via ice-growler scouring) species with different strategies could settle. The site at the earliest stage of post-retreat development was characterized by an assemblage with lower trophic redundancy. Generally, the isotopic niche widths increased with increasing size spectra of organisms within the community, excepting the youngest assemblage, where the pioneer colonizer meiofauna size class displayed the highest isotopic niche width. Meiofauna at all sites generally occupied positions in the isotopic space that suggested a detrital-pool food source and/or the presence of predatory taxa. In general ice scour and glacial impact appeared to play a two-fold role within the Cove: i) either stimulating trophic diversity by allowing continuous re-colonization of meiofaunal species or, ii) over time driving the benthic assemblages into a more compact trophic structure with increased

Can shrubs help to reconstruct historical glacier retreats?

International Nuclear Information System (INIS)

Buras, Allan; Hallinger, Martin; Wilmking, Martin

2012-01-01

In the 21st century, most of the world’s glaciers are expected to retreat due to further global warming. The range of this predicted retreat varies widely as a result of uncertainties in climate and glacier models. To calibrate and validate glacier models, past records of glacier mass balance are necessary, which often only span several decades. Long-term reconstructions of glacier mass balance could increase the precision of glacier models by providing the required calibration data. Here we show the possibility of applying shrub growth increments as an on-site proxy for glacier summer mass balance, exemplified by Salix shrubs in Finse, Norway. We further discuss the challenges which this method needs to meet and address the high potential of shrub growth increments for reconstructing glacier summer mass balance in remote areas. (letter)

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

Science.gov (United States)

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.

Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: A systematic review

Science.gov (United States)

Silvestre-Rangil, Javier; Bagan, Leticia; Bagan, Jose V.

2016-01-01

Background Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. Material and Methods A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment. Results Eight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP, IL-6 and TNFα showed a non significant tendency to decrease as a result of treatment. Conclusions Nonsurgical treatment improved the periodontal condition of patients with periodontitis and RA, with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies are therefore needed to more firmly establish possible significant relations between the two disease processes. Key words:Periodontitis, rheumatoid arthritis, periodontal treatment. PMID:26946202

The Application of Microencapsulation Techniques in the Treatment of Endodontic and Periodontal Diseases

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José Blanco Méndez

2011-08-01

Full Text Available In the treatment of intracanal and periodontal infections, the local application of antibiotics and other therapeutic agents in the root canal or in periodontal pockets may be a promising approach to achieve sustained drug release, high antimicrobial activity and low systemic side effects. Microparticles made from biodegradable polymers have been reported to be an effective means of delivering antibacterial drugs in endodontic and periodontal therapy. The aim of this review article is to assess recent therapeutic strategies in which biocompatible microparticles are used for effective management of periodontal and endodontic diseases. In vitro and in vivo studies that have investigated the biocompatibility or efficacy of certain microparticle formulations and devices are presented. Future directions in the application of microencapsulation techniques in endodontic and periodontal therapies are discussed.

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

Energy Technology Data Exchange (ETDEWEB)

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)

Variability, trends, and predictability of seasonal sea ice retreat and advance in the Chukchi Sea

Science.gov (United States)

Serreze, Mark C.; Crawford, Alex D.; Stroeve, Julienne C.; Barrett, Andrew P.; Woodgate, Rebecca A.

2016-10-01

As assessed over the period 1979-2014, the date that sea ice retreats to the shelf break (150 m contour) of the Chukchi Sea has a linear trend of -0.7 days per year. The date of seasonal ice advance back to the shelf break has a steeper trend of about +1.5 days per year, together yielding an increase in the open water period of 80 days. Based on detrended time series, we ask how interannual variability in advance and retreat dates relate to various forcing parameters including radiation fluxes, temperature and wind (from numerical reanalyses), and the oceanic heat inflow through the Bering Strait (from in situ moorings). Of all variables considered, the retreat date is most strongly correlated (r ˜ 0.8) with the April through June Bering Strait heat inflow. After testing a suite of statistical linear models using several potential predictors, the best model for predicting the date of retreat includes only the April through June Bering Strait heat inflow, which explains 68% of retreat date variance. The best model predicting the ice advance date includes the July through September inflow and the date of retreat, explaining 67% of advance date variance. We address these relationships by discussing heat balances within the Chukchi Sea, and the hypothesis of oceanic heat transport triggering ocean heat uptake and ice-albedo feedback. Developing an operational prediction scheme for seasonal retreat and advance would require timely acquisition of Bering Strait heat inflow data. Predictability will likely always be limited by the chaotic nature of atmospheric circulation patterns.

Endodontic misdiagnosis of periapical central giant cell granuloma: Report of case with 2 years of follow-up

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Rahul Kumar

2012-01-01

Full Text Available Central giant cell granuloma is considered as reactive lesion of jaws possibly to intramedullary hemorrhage or trauma. It may manifest as radiolucencies anywhere in the mandible or maxilla. In rare cases, it can appear as a localized periapical area and mimic an endodontic lesion. This report presents a case where central giant cell granuloma was misdiagnosed as a periapical cyst in 20-year-old male and was treated by conventional endodontic treatment. However the lesion was refractory to endodontic treatment and proved to be central giant cell granuloma after surgical intervention and histopathological examination. The purpose of this case report is to emphasize on periodic follow-up of periapical lesions after endodontic treatment and surgical intervention if required.

Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine

OpenAIRE

Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

2014-01-01

Introduction: Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic - endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove.

Treatment of combined endodontic: periodontic lesion by sealing of palato-radicular groove using biodentine.

Science.gov (United States)

Naik, Mayuri; de Ataide, Ida de Noronha; Fernandes, Marina; Lambor, Rajan

2014-11-01

Palatoradicular groove is a developmental anomaly which is predominantly found in maxillary lateral incisors. It provides a susceptible alcove for the progression of localised periodontal inflammation which can further cause pulpal involvement. This case report describes the successful treatment of a large periodontic - endodontic lesion usingnon surgical endodontic therapy and biodentine for the sealing of the palatoradicular groove.

Penatalaksanaan Lesi Endo-Perio dengan Perawatan Endodontik Non Bedah

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Irene Sulistio

2014-06-01

Full Text Available Secara anatomis pulpa dan periodontal saling berhubungan. Pada keadaan tertentu bisa terjadi inflamasi di pulpa dan periodontal. Hal ini disebut dengan lesi endodontik-periodontal. Perkembangan dan progresi lesi endo-perio ini dipengaruhi oleh faktor etiologi seperti bakteri, jamur, dan virus serta faktor pendukung seperti trauma, resorpsi akar, perforasi, dan malformasi gigi. Pada lesi endo-perio diperlukan rencana perawatan yang tepat agar prognosis perawatan dari gigi tersebut dapat baik. Artikel ini bertujuan memaparkan perawatan kasus lesi endo-perio yang berhasil setelah manajemen endodontik tanpa dilakukan bedah endodontik. Seorang pasien laki-laki berusia 21 tahun datang ke RSGM dengan keluhan gigi belakang kiri bawah sakit. Gigi tersebut pernah ditumpat 1 tahun yang lalu.Pada gambaran radiograf terdapat lesi radiolusen luas pada tulang alveolar sekitar akar distal. Perawatan endodontik dilakukan dengan pergantian bahan dressing kalsium hidroksida sebanyak 3 kali. Pada kontrol bulan kedua terlihat terjadi penulangan pada bagian lesi periodontal tersebut dan pasien tidak mengeluhkan rasa sakit. Kesimpulan hasil perawatan lesi endodontik periodontal dapat dirawat dengan perawatan endodontik non bedah. Management of Nonsurgical Endodontic Treatment on A Combined Endo-period Lesion. The pulp and periodontium have anatomic interrelationships. As the tooth matures, and the root is formed, three main avenues are created between pulp and periodontal ligament, i.e. dentinal tubules, lateral and accessory canals, apical foramen. These are the pathways that may provide a means by which pathological agent pass between the pulp and periodontium, thereby creating the endo - period lesion. Etiologic factors such as bacteria, fungi, and viruses as well as contributing factors such as trauma, root resorption, and dental malformations play a significant role in the development and progression of such lesions. In the endodontic - periodontal lesion is

Re-treatment tuberculosis cases categorised as "other": are they properly managed?

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Hannock Tweya

Full Text Available BACKGROUND: Although the World Health Organization (WHO provides information on the number of TB patients categorised as "other", there is limited information on treatment regimens or treatment outcomes for "other". Such information is important, as inappropriate treatment can lead to patients remaining infectious and becoming a potential source of drug resistance. Therefore, using a cohort of TB patients from a large registration centre in Lilongwe, Malawi, our study determined the proportion of all TB re-treatment patients who were registered as "other", and described their characteristics and treatment outcomes. METHODS: This retrospective observational study used routine program data to determine the proportion of all TB re-treatment patients who were registered as "other" and describe their characteristics and treatment outcomes between January 2006 and December 2008. RESULTS: 1,384 (12% of 11,663 TB cases were registered as re-treatment cases. Of these, 898 (65% were categorised as "other": 707 (79% had sputum smear-negative pulmonary TB and 191 (21% had extra pulmonary TB. Compared to the smear-positive relapse, re-treatment after default (RAD and failure cases, smear-negative "other" cases were older than 34 years and less likely to have their HIV status ascertained. Among those with known HIV status, "other" TB cases were more likely to be HIV positive. Of TB patients categorised as "other", 462 (51% were managed on the first-line regimen with a treatment success rate of 63%. CONCLUSION: A large proportion of re-treatment patients were categorised as "other". Many of these patients were HIV-infected and over half were treated with a first-line regimen, contrary to national guidelines. Treatment success was low. More attention to recording, diagnosis and management of these patients is warranted as incorrect treatment regimen and poor outcomes could lead to the development of drug resistant forms of TB.

Non-surgical management of extradural haematomas

International Nuclear Information System (INIS)

Tysvaer, A.T.; Oedegaard, H.

1987-01-01

The widespread use of computed tomographic (CT) scanning has shown that not all extradural haematomas require surgical evacuation. Eleven patients with epidural haematomas, 8-113 ml in volume, were treated successfully non-surgically. Seven were diagnosed later than four days after the head injury. The haematomas showed complete resolution over a period of 5-12 weeks. As some epidural haematomas have been shown to undergo considerable enlargement during the first weeks of treatment, conservative management of those greather than 35-40 ml initially is not advisable. In patients showing a decreasing level of consciousness and neurological deficits, even smaller haematomas must be evacuated. Extradural haematomas of the posterior fossa are high risk lesion and therefore unsuitable for conservative management

Review of osteoimmunology and the host response in endodontic and periodontal lesions

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Dana T. Graves

2011-01-01

Full Text Available Both lesions of endodontic origin and periodontal diseases involve the host response to bacteria and the formation of osteolytic lesions. Important for both is the upregulation of inflammatory cytokines that initiate and sustain the inflammatory response. Also important are chemokines that induce recruitment of leukocyte subsets and bone-resorptive factors that are largely produced by recruited inflammatory cells. However, there are differences also. Lesions of endodontic origin pose a particular challenge since that bacteria persist in a protected reservoir that is not readily accessible to the immune defenses. Thus, experiments in which the host response is inhibited in endodontic lesions tend to aggravate the formation of osteolytic lesions. In contrast, bacteria that invade the periodontium appear to be less problematic so that blocking arms of the host response tend to reduce the disease process. Interestingly, both lesions of endodontic origin and periodontitis exhibit inflammation that appears to inhibit bone formation. In periodontitis, the spatial location of the inflammation is likely to be important so that a host response that is restricted to a subepithelial space is associated with gingivitis, while a host response closer to bone is linked to bone resorption and periodontitis. However, the persistence of inflammation is also thought to be important in periodontitis since inflammation present during coupled bone formation may limit the capacity to repair the resorbed bone.

Biofilm in endodontics: a review

OpenAIRE

Zambrano de la Peña, Sonia; Salcedo-Moncada, Doris; Petkova- Gueorguieva, Marieta; Ventocilla Huasupoma, María

2017-01-01

It is demonstrated the efforts made endodontic microbiology and science to get to decipher the secrets of this unique structure although every day new questions arise. We need the treatments we use to combat biofilm achieve oxygenate the periapical ecosystem and basically scrape and loosen the tightly adhering bacteria Knowing the process of biofilm formation, microbial metabolism and strategies that they use to resist and remain hidden but active , we know why we observe refractory periapica...

The effect of LED illumination on endodontic biofilms

DEFF Research Database (Denmark)

Markvart, Merete

Within endodontics photodynamic therapy (PDT) has been suggested as a disinfectant procedure during root canal treatment. A photoactive dye (photosensitizer), methylene blue or toluidine blue, are activated by a light source, usually lasers or light emitting diodes (LEDs), thereby forming free...

Healing of Horizontal Intra-alveolar Root Fractures after Endodontic Treatment with Mineral Trioxide Aggregate.

Science.gov (United States)

Kim, Dohyun; Yue, Wonyoung; Yoon, Tai-Cheol; Park, Sung-Ho; Kim, Euiseong

2016-02-01

The purpose of this retrospective study was to evaluate the healing type and assess the outcome of horizontal intra-alveolar root fractures after endodontic treatment with mineral trioxide aggregate (MTA) as filling material. The clinical database of the Department of Conservative Dentistry at Yonsei University Dental Hospital, Seoul, Korea, was searched for patients with histories of intra-alveolar root fractures and endodontic treatments with MTA between October 2005 and September 2014. Radiographic healing at the fracture line was evaluated independently by 2 examiners and was classified into 4 types according to Andreasen and Hjørting-Hansen. Of the 22 root-fractured teeth that received endodontic treatment with MTA, 19 cases participated in the follow-up after a period of at least 3 months. Seventeen of the 19 teeth (89.5%) exhibited healing of the root fractures. For each healing type, 7 teeth (36.8%) showed healing with calcified tissue, 8 teeth (42.1%) showed interposition of connective tissue, 2 teeth (10.5%) showed interposition of connective tissue and bone, and 2 teeth (10.5%) showed interposition of granulation tissue without healing. Within the limitations of this study, intra-alveolar root fractures showed satisfactory healing outcomes after endodontic treatment with MTA. MTA could be considered to be suitable filling material for the endodontic treatment of horizontal intra-alveolar root fractures. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Scaffolds in regenerative endodontics: A review

Science.gov (United States)

Gathani, Kinjal M.; Raghavendra, Srinidhi Surya

2016-01-01

Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. ‘A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria ‘Platelet rich plasma’, ‘Platelet rich fibrin’, ‘Stem cells’, ‘Natural and artificial scaffolds’ from 1982–2015’. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon. PMID:27857762

Scaffolds in regenerative endodontics: A review

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Kinjal M Gathani

2016-01-01

Full Text Available Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. ′A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria ′Platelet rich plasma′, ′Platelet rich fibrin′, ′Stem cells′, ′Natural and artificial scaffolds′ from 1982-2015′. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon.

Damage to root dentin during retreatment procedures

NARCIS (Netherlands)

Shemesh, H.; Roeleveld, A.C.; Wesselink, P.R.; Wu, M.K.

2011-01-01

Introduction: The aim of this study was to explore the influence of retreatment procedures on the appearance of defects on the root canal walls. Methods: Two hundred mandibular premolars were divided into 4 groups. One group was left unprepared. The rest of the teeth were prepared with ProTaper

Retreating academics: creating spaces for the scholarship of ...

African Journals Online (AJOL)

, this paper explores particular spaces created to support academic engagement in the scholarship of teaching and learning: the space of writing retreats. The metaphor of 'tapestry' is used to capture the development of a complex conceptual ...

Endodontic radiology, practice, and knowledge of radiation biology, hazard, and protection among clinical dental students and interns

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Joan Emien Enabulele

2015-01-01

Full Text Available Objective: To evaluate the practice and knowledge of endodontic radiology as well as assess the knowledge of radiation biology, hazard, and protection among clinical dental students and interns. Materials and Methods: Cross-sectional study of clinical dental students and interns at University of Benin and University of Benin Teaching hospital respectively. Data was collected using a questionnaire which covered practice and knowledge of endodontic radiography, knowledge of radiation biology, hazard, and protection. Data was analyzed using Statistical Package for Social Sciences (SPSS version 17.0. Result: Seventy participants were included in the study, 40% were final year students and 24.3% house officers. Majority (95.7% agreed that they exposed radiographs as part of endodontic treatment. Only 18.6% knew that the apices of teeth should be 3mm from the border of the X-ray film, while 24.3% knew that 3mm of periapical bone should be visible on X-ray. Less than half (31.4% knew that paralleling technique was the technique of choice for endodontic radiography and this was statistically Significant in relationship to the status of the of the respondents. A few (4.3% of the respondents had knowledge of new horizons in endodontic imaging. Half of the respondents knew that damage by X-rays is mainly due to formation of free radicals. The most frequently reported radiation hazards was reduced salivary flow, while the least reported was rampant caries. Most knew how to protect patients, themselves, and other persons while exposing radiographs. Conclusion: There is need for inclusion of endodontic radiography in the undergraduate curriculum to ensure proper and correct radiographs during endodontic procedure.

Endodontic treatment of a mandibular first molar with three mesial canals and broken instrument removal.

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Faramarzi, Farhad; Fakhri, Hamidreza; Fakri, Hamidreza; Javaheri, Homan H

2010-04-01

To succeed in any dental procedure, the clinician's awareness of the patient's dental anatomy and its variations is crucial. In endodontic therapy, obtaining full information about the root canals' variations can affect the outcome substantially. This case report presents the endodontic treatment of a mandibular first molar exhibiting three mesial root canals with 4 mm of a separated K-file in the coronal third of the mesiolingual canal on an 18-year-old female patient. This case demonstrates the importance of locating additional canals in any roots undergoing endodontic treatment and how the clinician's awareness of aberrant internal anatomy may change the treatment results.

Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction: 12-Month Outcomes.

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Polly, David W; Cher, Daniel J; Wine, Kathryn D; Whang, Peter G; Frank, Clay J; Harvey, Charles F; Lockstadt, Harry; Glaser, John A; Limoni, Robert P; Sembrano, Jonathan N

2015-11-01

Sacroiliac joint (SIJ) dysfunction is a prevalent cause of chronic, unremitting lower back pain. To concurrently compare outcomes after surgical and nonsurgical treatment for chronic SIJ dysfunction. A total of 148 subjects with SIJ dysfunction were randomly assigned to minimally invasive SIJ fusion with triangular titanium implants (n = 102) or nonsurgical management (n = 46). Pain, disability, and quality-of-life scores were collected at baseline and at 1, 3, 6, and 12 months. Success rates were compared using Bayesian methods. Crossover from nonsurgical to surgical care was allowed after the 6-month study visit was complete. Six-month success rates were higher in the surgical group (81.4% vs 26.1%; posterior probability of superiority > 0.9999). Clinically important (≥ 15 point) Oswestry Disability Index improvement at 6 months occurred in 73.3% of the SIJ fusion group vs 13.6% of the nonsurgical management group (P dysfunction caused by degenerative sacroiliitis or SIJ disruptions. Pain, disability, and quality of life also improved after crossover from nonsurgical to surgical treatment.

Antimicrobial Agents Used in Endodontic Treatment

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Marina George Kudiyirickal

2008-01-01

Full Text Available Biomechanical preparation alone does not completely eradicate microorganisms from the root canal, hence the next logical step is to perform root canal procedures in conjunction with antimicrobials. The use of an antimicrobial agent improves the efficacy and prognosis of endodontic treatment. This review enumerates the most widely used antimicrobial agents, their mechanism of action and their potential use in reducing the microbial load.

Associations of endodontic symptoms and signs with particular combinations of specific bacteria.

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Gomes, B P; Lilley, J D; Drucker, D B

1996-03-01

Significant associations have been reported between (a) specific bacterial species isolated from root canals and (b) between individual bacterial species and endodontic symptoms and signs. The prime objective of this study was to determine whether particular combinations of specific bacteria are associated with individual endodontic symptoms and signs. Seventy root canals were investigated microbiologically taking care to maintain the viability of obligate anaerobes, which accounted for 64% of the total species isolated, including Peptostreptococcus micros, Prevotella melaninogenica, Prevotella oralis, Eubacterium aerofaciens, Eubacterium lentum, Fusobacterium nucleatum, Prevotella buccae and Prevotella intermedia. Significant associations were found between individual clinical features and the following pairs of species: (a) pain (37 cases) and Peptostreptococcus spp./Prevotella spp., Peptostreptococcus spp./Prevotella melaninogenica, Pstr. micros/Prev. melaninogenica (all P spp. (P spp./Eubacterium spp. (P spp./Eubacterium spp. (P < 0.05). Thus data from this investigation suggests that statistically significant associations exist between individual endodontic symptoms and signs and particular combinations of specific bacteria.

Reasons for Retreatment of Amalgam and Composite Restorations among the Patients Referring to Tabriz Faculty of Dentistry

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Siavash Savadi Oskoee

2007-06-01

Full Text Available

Background and aims. Retreatment of existing restorations not only requires a lot of money and time but also there is a danger of weakening tooth structure and irritating the pulp. Since awareness of the reasons for the retreatment of teeth will save the teeth from possible future failure, the aim of this study was to assess the reasons for retreatment of amalgam and composite restorations in patients referring to Tabriz Faculty of Dentistry.

Materials and methods. In this descriptive study, the subjects had previously received an amalgam or a composite restoration in the Operative Department by dental students and were judged to need retreatment in their second visit. A total of 300 defective teeth were selected by simple random sampling method. The data was collected through examination and questionnaires and analyzed using chi-square test.

Results. There was a statistically significant association between the type of the restorative material and the reason for retreatment (p=0.001.

Conclusion. Although the reasons for the retreatment of amalgam and composite restorations were different, recurrent caries was the main reason for the retreatment for both restorative materials.

Patient Demonstration Videos in Predoctoral Endodontic Education: Aspects Perceived as Beneficial by Students.

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Edrees, Hadeel Y; Ohlin, Johan; Ahlquist, Michael; Tessma, Mesfin K; Zary, Nabil

2015-08-01

The aim of this study was to assess the perceived benefits of video-mediated demonstrations in learning endodontics. Participants in the study were 75 third-year students enrolled in the undergraduate dentistry program at Karolinska Institute, Stockholm, Sweden. After the endodontic preclinical course, the students were introduced to the treatment protocol in the clinic by watching two live patient-demonstrated videos. The first video demonstrated how to communicate with the patient and perform diagnosis and root canal instrumentation. The second video illustrated how to perform bacterial sampling and root canal filling. After the students watched each video, a questionnaire was used to evaluate their opinions about various steps of the endodontic treatment protocol and the benefit of such educational material for their practice. Of the total 75 students, 72 completed the first questionnaire (96% response rate), and 65 completed the second questionnaire (87% response rate). The results showed that the students perceived high value in the video demonstrations related to treatment procedure. A statistically significant difference was observed between the perceived benefits of the first and second sessions in communication and treatment procedure (p<0.001). Further studies are needed to assess improvement in the design and delivery format for video demonstrations to enhance their effectiveness as a teaching modality for endodontics.

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.

Physical characterisation of endodontic instruments in NiTi alloy

International Nuclear Information System (INIS)

Torrisi, L.

2000-01-01

NiTi based endodontic instruments are investigated in functionality and wear. The instrument surfaces have been studied applying Auger electron spectroscopy, mechanical analysis, differential-scanning calorimetry, wear tests, and scanning electron microscopy. (orig.)

Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

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Płaszewski, Maciej; Bettany-Saltikov, Josette

2014-01-01

Background Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. Objectives Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. Design Systematic overview of systematic reviews. Methods Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute’s hierarchies were applied to analyze the levels of evidence from included reviews. Results From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. Conclusions Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers

Non-surgical treatment of lateral epicondylitis: a systematic review of randomized controlled trials.

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Sims, Susan E G; Miller, Katherine; Elfar, John C; Hammert, Warren C

2014-12-01

Non-surgical approaches to treatment of lateral epicondylitis are numerous. The aim of this systematic review is to examine randomized, controlled trials of these treatments. Numerous databases were systematically searched from earliest records to February 2013. Search terms included "lateral epicondylitis," "lateral elbow pain," "tennis elbow," "lateral epicondylalgia," and "elbow tendinopathy" combined with "randomized controlled trial." Two reviewers examined the literature for eligibility via article abstract and full text. Fifty-eight articles met eligibility criteria: (1) a target population of patients with symptoms of lateral epicondylitis; (2) evaluation of treatment of lateral epicondylitis with the following non-surgical techniques: corticosteroid injection, injection technique, iontophoresis, botulinum toxin A injection, prolotherapy, platelet-rich plasma or autologous blood injection, bracing, physical therapy, shockwave therapy, or laser therapy; and (3) a randomized controlled trial design. Lateral epicondylitis is a condition that is usually self-limited. There may be a short-term pain relief advantage found with the application of corticosteroids, but no demonstrable long-term pain relief. Injection of botulinum toxin A and prolotherapy are superior to placebo but not to corticosteroids, and botulinum toxin A is likely to produce concomitant extensor weakness. Platelet-rich plasma or autologous blood injections have been found to be both more and less effective than corticosteroid injections. Non-invasive treatment methods such as bracing, physical therapy, and extracorporeal shockwave therapy do not appear to provide definitive benefit regarding pain relief. Some studies of low-level laser therapy show superiority to placebo whereas others do not. There are multiple randomized controlled trials for non-surgical management of lateral epicondylitis, but the existing literature does not provide conclusive evidence that there is one preferred method

Effects of nonsurgical periodontal therapy on C-reactive protein and serum lipids in Jordanian adults with advanced periodontitis.

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Kamil, W; Al Habashneh, R; Khader, Y; Al Bayati, L; Taani, D

2011-10-01

Data on whether periodontal therapy affects serum CRP levels are inconclusive. The aim of this study was to determine if nonsurgical periodontal therapy has any effect on CRP and serum lipid levels in patients with advanced periodontitis. Thirty-six systemically healthy patients, ≥ 40 years of age and with advanced periodontitis, were recruited for the study. Patients were randomized consecutively to one of two groups: the treatment group (n = 18) or the control group (n = 18). Treated subjects received nonsurgical periodontal therapy, which included oral hygiene instructions and subgingival scaling and root planing. Systemic levels of inflammatory markers [C-reactive protein (CRP) and the lipid profile] were measured at baseline and 3 mo after periodontal therapy. Nonsurgical periodontal therapy in the treatment group resulted in a significant reduction in the serum CRP level. The average CRP level decreased from 2.3 mg/dL at baseline to 1.8 mg/dL (p periodontal therapy. The average reduction (95% confidence interval) in CRP was 0.498 (95% confidence interval = 0.265-0.731). In the treatment group, the reduction in CRP was significantly, linearly and directly correlated with the reduction in the plaque index, the gingival index and the percentage of sites with pocket depth ≥ 7 mm (Pearson correlation coefficient = 0.746, 0.425 and 0.621, respectively). Nonsurgical periodontal therapy had no effect on the lipid parameters. This study demonstrated that nonsurgical periodontal therapy results in a significant reduction in the serum CRP level. The effect of this outcome on systemic disease is still unknown. © 2011 John Wiley & Sons A/S.

A quality assessment of randomized controlled trial reports in endodontics.

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Lucena, C; Souza, E M; Voinea, G C; Pulgar, R; Valderrama, M J; De-Deus, G

2017-03-01

To assess the quality of the randomized clinical trial (RCT) reports published in Endodontics between 1997 and 2012. Retrieval of RCTs in Endodontics was based on a search of the Thomson Reuters Web of Science (WoS) database (March 2013). Quality evaluation was performed using a checklist based on the Jadad criteria, CONSORT (Consolidated Standards of Reporting Trials) statement and SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials). Descriptive statistics were used for frequency distribution of data. Student's t-test and Welch test were used to identify the influence of certain trial characteristics upon report quality (α = 0.05). A total of 89 RCTs were evaluated, and several methodological flaws were found: only 45% had random sequence generation at low risk of bias, 75% did not provide information on allocation concealment, and 19% were nonblinded designs. Regarding statistics, only 55% of the RCTs performed adequate sample size estimations, only 16% presented confidence intervals, and 25% did not provide the exact P-value. Also, 2% of the articles used no statistical tests, and in 87% of the RCTs, the information provided was insufficient to determine whether the statistical methodology applied was appropriate or not. Significantly higher scores were observed for multicentre trials (P = 0.023), RCTs signed by more than 5 authors (P = 0.03), articles belonging to journals ranked above the JCR median (P = 0.03), and articles complying with the CONSORT guidelines (P = 0.000). The quality of RCT reports in key areas for internal validity of the study was poor. Several measures, such as compliance with the CONSORT guidelines, are important in order to raise the quality of RCTs in Endodontics. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Risk Factors for Retreatment Following Myopic LASIK with Femtosecond Laser and Custom Ablation for the Treatment of Myopia.

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Kruh, Jonathan N; Garrett, Kenneth A; Huntington, Brian; Robinson, Steve; Melki, Samir A

2017-01-01

To identify risks factors for retreatment post-laser in situ keratomeliusis (LASIK). A retrospective chart review from December 2008 to September 2012 identified 1,402 patients (2,581 eyes) that underwent LASIK treatment for myopia with the Intralase™ FS, STAR S4 IR™ Excimer Laser, and WaveScan WaveFront™ technology. In this group, 83 patients were retreated. All charts were reviewed for preoperative age, gender, initial manifest refraction spherical equivalent (MRSE), total astigmatism, and iris registration. Increased incidence rates of retreatment post-LASIK were preoperative age >40 years (p -3.0 D (p = 0.02), and astigmatism >1D (p = 0.001). Iris registration capture did not significantly reduce the retreatment rate (p = 0.12). Risk factors for retreatment included preoperative age >40 years, initial MRSE > -3.0 D, and astigmatism >1D. There was no difference in retreatment rate for patients based on gender or iris registration capture.

Chemical properties of gutta-percha endodontic filling material: investigation of five commercial brands

International Nuclear Information System (INIS)

Silva Junior, Joao Batista A.; Paula, Regina C.M.; Feitosa, Judith P.A.; Gurgel Filho, Eduardo; Teixeira, Fabricio B

2001-01-01

Chemical composition e thermal stability of five brands of gutta-percha endodontic filling material were investigated. Samples with higher amount of organic materials possess higher thermal stability. Investigation of gutta-percha polymer extracted from the endodontic filling by IR and NMR shows that the polymer is predominantly trans-polyisoprene. The thermal stability and molar mass were similar for four brands, however the 'Tanari' brand has got lower molar mass value than the other ones. (author)

Investigations into localized re-treatment of the retina with a 3-nanosecond laser.

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Chidlow, Glyn; Plunkett, Malcolm; Casson, Robert J; Wood, John P M

2016-08-01

Subvisual retinal lasers necessarily cause clinically invisible lesions, hence, they could intentionally or inadvertently be targeted at precisely the same or an overlapping location during repeat laser treatment. Herein, we investigated the structural integrity and cellular responses of localized re-treatment using a nanosecond laser (2RT) currently in trials for early age-related macular degeneration. Rats were randomly assigned to one of five groups: sham, subvisual 2RT, subvisual 2RT re-treatment, visual effect 2RT, visual effect 2RT re-treatment. Re-treatment groups were lasered on days 0 and 21; single laser groups were only lasered on day 21. All rats were euthanized at day 28 and eyes were then dissected and processed for immunohistochemistry. For re-treatment, the laser was targeted at precisely the same locations on both delivery occasions. Analytical endpoints included monitoring of retinal vascular integrity overlying lesions, investigation into any potential choroidal neovascularization, assessment of the RPE, quantification of collateral injury to photoreceptors or other neuronal classes, and delineation of glial reactivity. Repeat laser administration to rats caused ostensibly identical retinal-RPE-choroid responses to those obtained in age-matched rats that received only a single application. Specifically, 7 days after treatment, RPE cells were re-populating lesion sites. No obvious consistent differences were evident between the single and repeat laser groups. Moreover, repeat laser caused no (measurable) additive injury to photoreceptors or other retinal neuronal classes from single laser treatment. In re-lasered animals, there was no increase in microglial activity overlying and adjacent to lesion sites relative to single lasered rats. Finally, there was no evidence of choroidal neovascularization after repeat laser treatment. The overall results provide a measure of confidence that re-treatment of patients with 2RT should not provide any

Innovations in endodontic filling materials: guttapercha vs Resilon.

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de Souza Filho, Francisco José; Gallina, Giuseppe; Gallottini, Livio; Russo, Riccardo; Cumbo, Enzo Maria

2012-01-01

One of the goals of endodontic treatment is to achieve a complete, tridimensional, hermetic sealing of the root canal system to prevent the entry of microorganisms or their products through both the coronal and apical pathways. Gutta-percha is the most widely used material for root canal filling and despite its numerous properties, such as biocompatibility and thermoplasticity, it has however an important limit: the lack of adhesion to the canal walls. Attempts to address this problem have been made over the years by using endodontic cements capable of bonding to canal dentine but their tendency to resorption in time can compromise the quality of treatment. The first step towards a real adhesive endodontic filling(4) is rather recent; in fact, it goes back to 2003 when, on the occasion of the American Dental Association (ADA) Annual Session, Resilon Research LLC introduced a new canal filling adhesive system based on a thermoplastic synthetic resin material called Resilon™. The real innovation of this system is its capacity of creating a core made of Resilon™ bonded to the cement which adheres to dentine walls previously conditioned with a self-etching primer(4) so no changes in the techniques of canal preparation are required. The aim of this study was to evaluate the capacity of two filling materials (gutta-percha and Resilon) to adapt to the canal anatomy, especially on the apical third, using the continuous wave of condensation technique. Our data suggest that in the third apical the gutta-percha best shows rheological properties that are as important as the bond capability.

MEASURING SURFACE DEFORMATION IN GLACIER RETREATED AREAS BASED ON PS-INSAR – GELADANDONG GLACIER AS A CASE STUDY

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B. Mohamadi

2018-04-01

Full Text Available Glaciers are retreating in many parts of the world as a result of global warming. Many researchers consider Qinghai-Tibetan Plateau as a reference for climate change by measuring glaciers retreat on the plateau. This retreat resulted in some topographic changes in retreated areas, and in some cases can lead to geohazards as landslides, and rock avalanches, which is known in glacier retreated areas as paraglacial slope failure (PSF. In this study, Geladandong biggest and main glacier mass was selected to estimate surface deformation on its glacier retreated areas and define potential future PSF based on PS-InSAR technique. 56 ascending and 49 descending images were used to fulfill this aim. Geladandong glacier retreated areas were defined based on the maximum extent of the glacier in the little ice age. Results revealed a general uplift in the glacier retreated areas with velocity less than 5mm/year. Obvious surface motion was revealed in seven parts surround glacier retreated areas with high relative velocity reached ±60mm/year in some parts. Four parts were considered as PSF potential motion, and two of them showed potential damage for the main road in the study area in case of rock avalanche into recent glacier lakes that could result in glacier lake outburst flooding heading directly to the road. Finally, further analysis and field investigations are needed to define the main reasons for different types of deformation and estimate future risks of these types of surface motion in the Qinghai-Tibetan Plateau.

Restoration of the endodontically treated posterior tooth

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Andrea Polesel

2014-06-01

Results and conclusions: Direct adhesive restorations, indirect bonded restorations and traditional full crown are three therapeutic options for the single posterior endodontically treated teeth. The amount of remaining sound tooth structure is the most significant factor influencing the therapeutic approach. The clinician's operative skill is a determining aspect for long-term success of adhesive inlays.

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.

Non-surgical sterilisation methods may offer a sustainable solution to feral horse (Equus caballus) overpopulation.

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Hall, Sally Elizabeth; Nixon, Brett; Aitken, R John

2017-09-01

Feral horses are a significant pest species in many parts of the world, contributing to land erosion, weed dispersal and the loss of native flora and fauna. There is an urgent need to modify feral horse management strategies to achieve public acceptance and long-term population control. One way to achieve this is by using non-surgical methods of sterilisation, which are suitable in the context of this mobile and long-lived species. In this review we consider the benefits of implementing novel mechanisms designed to elicit a state of permanent sterility (including redox cycling to generate oxidative stress in the gonad, random peptide phage display to target non-renewable germ cells and the generation of autoantibodies against proteins essential for conception via covalent modification) compared with that of traditional immunocontraceptive approaches. The need for a better understanding of mare folliculogenesis and conception factors, including maternal recognition of pregnancy, is also reviewed because they hold considerable potential in providing a non-surgical mechanism for sterilisation. In conclusion, the authors contend that non-surgical measures that are single shot and irreversible may provide a sustainable and effective strategy for feral horse control.

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.

Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser

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Marisa Roncati

2013-01-01

Full Text Available An 810-nm diode laser was used to non-surgically treat a 7-mm pocket around an implant that had five threads of bone loss, BoP+, and exudate, and the patient was followed up for 5 years. Non-surgical treatment, home care reinforcement, clinical indices records, and radiographic examination were completed in two consecutive 1-h appointments within 24 h. The patient was monitored frequently for the first 3 months. Subsequently, maintenance debridement visits were scheduled at 3-month intervals. The patient had a decreased probing pocket depth and a negative BoP index compared to initial clinical data, and the results were stable after 1 year. After 5 years of follow-up visits, there appeared to be rebound of the bone level radiographically. Within the limits of this case report, conventional non-surgical periodontal therapy with the adjunctive use of an 810-nm diode laser may be a feasible alternative approach for the management of peri-implantitis. The 5-year clinical and radiographic outcomes indicated maintenance of the clinical improvement.

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.

Detection of Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Prevotella nigrescens in chronic endodontic infection.

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Tomazinho, Luiz Fernando; Avila-Campos, Mario J

2007-02-01

Black-pigmented anaerobic rods such as Prevotella spp. and Porphyromonas spp. are involved in the etiology and perpetuation of endodontic infections. The aim of this study was to evaluate the prevalence of these species in chronic endodontic infections by using culture and polymerase chain reaction (PCR) techniques. Samples of 100 patients with root canals displaying chronic endodontic infections were obtained by sterilized paper points. Bacterial identification was performed by using culture and PCR techniques. By culture, in 33% of the samples, P. intermedia-P. nigrescens (75.8%), P. gingivalis (27.3%), and P. endodontalis (9.1%) were identified, and by PCR 60% of the samples harbored P. nigrescens (43.3%), P. gingivalis (43.3%), P. intermedia (31.7%), and P. endodontalis (23.3%). The presence of these black-pigmented anaerobic rods alone or in association in chronic endodontic infections seems to be frequent. PCR is a very sensitive technique for detecting DNA from bacterial cells. Culturing is only able to reveal living bacteria and is less sensitive for the identification of low numbers of bacterial cells.

Sudden improvement of insulin sensitivity related to an endodontic treatment.

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Schulze, A; Schönauer, M; Busse, M

2007-12-01

Inflammation contributes to the pathogenesis of diabetes. A reciprocal relationship exists between diabetes and chronic periodontitis. This report describes the effects of an acute focal dental inflammation and subsequent endodontic treatment on the required insulin dosage of a 70-year-old man who had moderately controlled diabetes. Following an exacerbation of a combined endodontic-periodontic (endo-perio) lesion of tooth #3, the patient noticed a sudden increase in his insulin demand. After 3 weeks, the required dosage was approximately 100% greater. In association with hyperglycemic incidents, he reported a prickling sensation in this tooth. The radiograph showed circular bone loss around the tooth. Just 1 day after the root-canal preparation, the insulin need decreased to approximately 50% of that required prior to treatment. Subsequently, an incision and systemic antibiotics were necessary because of the formation of a periodontal abscess. The insulin demand remained low despite this complication. Forty days after endodontic treatment, the insulin dosage was at a level comparable to that taken 4 weeks before the root-canal preparation. This clinical case revealed a highly relevant correlation between insulin resistance and a local dental inflammation. To avoid an increase in insulin resistance, it seems important to attend to radically non-vital teeth as well as any other dental inflammation in diabetic patients.

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.

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.

Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis.

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Ioannidou-Marathiotou, Ioulia; Zafeiriadis, Anastasios A; Papadopoulos, Moschos A

2013-09-01

The aim of this meta-analysis was to investigate the effect of orthodontic treatment on root resorption of endodontically treated teeth compared to vital teeth. A literature search was conducted in 18 electronic databases. Review articles and relevant articles were searched for cross-references. Two independent reviewers screened all articles according to predefined inclusion and exclusion criteria and extracted the corresponding data. The pooled estimate of mean difference of root resorption weighted by the fixed-effect model and the corresponding 95 % confidence intervals (CIs) were used to construct a forest plot by implementing the "RevMan 5.1" software. Quality and heterogeneity assessments as well as publication bias evaluation and sensitivity analyses were performed. Inter-reviewer agreement for data selection, data extraction and quality analysis was evaluated by Cohen's kappa. Six out of 1,942 original papers met the inclusion criteria. Four out of six studies were included in the quantitative analysis. Root resorption was less in endodontically treated teeth than in vital teeth (MD = -0.48 mm; 95 % CI = -0.81 to -0.14 mm). The funnel plot indicated no evidence of publication bias, while no data heterogeneity was present (I(2) = 0 %). However, the overall quality of the included studies was considered as "low." Following orthodontic treatment, endodontically treated teeth exhibit relatively less root resorption than teeth with vital pulps. Clinicians should consider orthodontic movement of endodontically treated teeth as a relatively safe clinical procedure.

Means of Slope Retreat on the Na Pali Cliffs, Kauai, Hawaii

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Osborn, G.; Sheardown, A.; Blay, C.

2016-12-01

The spectacular, 500 to 600 m high, deeply grooved escarpment referred to as the Na Pali cliffs, on the northwest coast of Kauai, requires a substrate competent enough to hold up high steep cliffs yet erodible enough to allow generation of wide, deep grooves. These opposing tendencies are afforded by weathering of originally strong basalt that keeps pace with erosion. The fluted cliffs maintain a rather consistent slope angle, generally 50-60°, whether they are close to the shoreline or have retreated some distance from it, indicating that the slopes are retreating parallel to themselves. Previous literature promotes groundwater sapping or waterfall-plunge-pool erosion as the chief means of valley-head retreat, but there is no evidence that either concept provides a general explanation for retreat of the fluted cliffs. The eroding cliffs maintain steepness because as much rock is eroded at the base as at the top, and transported sediment is washed completely out of the gully system. The thin-bedded basalts exposed in the steep flutes are decomposed into irregularly alternating fine sediment of low to moderate cohesion and thoroughly fractured beds or lenses of solid but chemically weathered rock, and covered with a veneer of sparse grass. Erosion proceeds by episodic removal of thin grass-covered surficial sheets of the weathering products. Some of this process may be facilitated by shallow mass movement, but probably most of the work is done by overland and channelized flow during intense rainstorms. The Na Pali coast experiences one-hour rainfalls of 2-2.5 inches (1 year recurrence interval) and 5-6 inches (100 year recurrence interval); experiments by others on basaltic soils in Molokai suggest such rain is more than enough to generate erosion-inducing overland flow. Between the deep grooves and the shoreline are slopes with lesser drainage densities and lesser slope angles. The rocks here are not distinguished from the rocks above in previous literature, and

Climate Change and Glacier Retreat: Scientific Fact and Artistic Opportunity

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Fagre, D. B.

2008-12-01

Mountain glaciers continue to retreat rapidly over most of the globe. In North America, at Glacier National Park, Montana, recent research results from Sperry Glacier (2005-2007) indicate negative mass balances are now 3-4 times greater than in the 1950s. A geospatial model of glacier retreat in the Blackfoot-Jackson basin suggested all glaciers would be gone by 2030 but has proved too conservative. Accelerated glacier shrinkage since the model was developed has mirrored an increase in actual annual temperature that is almost twice the rate used in the model. The glaciers in Glacier National Park are likely to be gone well before 2030. A variety of media, curricula, and educational strategies have been employed to communicate the disappearance of the glaciers as a consequence of global warming. These have included everything from print media and television coverage to podcasts and wayside exhibits along roads in the park. However, a new thrust is to partner with artists to communicate climate change issues to new audiences and through different channels. A scientist-artist retreat was convened to explore the tension between keeping artistic products grounded in factually-based reality while providing for freedom to express artistic creativity. Individual artists and scientists have worked to create aesthetic and emotional images, using painting, poetry, music and photography, to convey core messages from research on mountain ecosystems. Finally, a traveling art exhibit was developed to highlight the photography that systematically documents glacier change through time. The aim was to select photographs that provide the most compelling visual experience for an art-oriented viewer and also accurately reflect the research on glacier retreat. The exhibit opens on January 11, 2009

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

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

Psychological effects of a one-month meditation retreat on experienced meditators: the role of nonattachment

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Jesus Montero-Marin

2016-12-01

Full Text Available Background. There are few studies devoted to assessing the impact of meditation-intensive retreats on the well-being, positive psychology and personality of experienced meditators. We aimed to assess whether a 1-month Vipassana retreat: a would increase mindfulness and well-being; b would increase prosocial personality traits; and c whether psychological changes would be mediated and/or moderated by non-attachment.Method. A controlled, non-randomized, pre-post-intervention trial was used. The intervention group was a convenience sample (n=19 of experienced meditators who participated in a 1-month Vipassana meditation retreat. The control group (n=19 comprised matched experienced meditators who did not take part in the retreat. During the retreat, the mean duration of daily practice was 8-9 hours, the diet was vegetarian and silence was compulsory. The Experiences Questionnaire (EQ, Non-Attachment Scale (NAS, Positive and Negative Affect Schedule (PANAS, Satisfaction With Life Scale (SWLS, Temperament Character Inventory Revised (TCI-R-67, Five Facets Mindfulness Questionnaire (FFMQ, Self-Other Four Immeasurables (SOFI and the MINDSENS Composite Index were administered. ANCOVAs and linear regression models were used to assess pre-post changes and mediation/moderation effects.Results. Compared to controls, retreatants showed increases in non-attachment, observing, MINDSENS, positive-affect, balance-affect and cooperativeness; and decreases in describing, negative-others, reward-dependence and self-directedness. Non-attachment had a mediating role in decentring, acting aware, non-reactivity, negative-affect, balance-affect and self-directedness; and a moderating role in describing and positive others, with both mediating and moderating effects on satisfaction with life.Conclusions. A 1-month Vipassana meditation retreat seems to yield improvements in mindfulness, well-being and personality, even in experienced meditators. Non-attachment might

Comparison of surgical and non-surgical orthodontic treatment approaches on occlusal and cephalometric outcomes in patients with Class II Division I malocclusions

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Sheila Daniels

2017-07-01

Full Text Available Abstract Background This study aimed to examine end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical or non-surgical approaches. This study tests the hypotheses that occlusal outcomes (ABO-OGS and cephalometric outcomes differ between these groups. Methods A total of 60 patients were included: 20 of which underwent surgical correction and 40 of which did not. Cast grading of initial and final study models was performed and information was gathered from pre- to post-treatment cephalometric radiographs. The end-of-treatment ABO-OGS and cephalometric outcomes were compared to Mann-Whitney U tests and multivariable linear regression models. Results Following adjustment for multiple confounders (age, gender, complexity of case, and skeletal patterns, the final deband score (ABO-OGS was similar for both groups (23.8 for surgical group versus 22.5 for non-surgical group. Those treated surgically had a significantly larger reduction in ANB angle, 3.4° reduction versus 1.5° reduction in the non-surgical group (p = 0.002. The surgical group also showed increased maxillary incisor proclination (p = 0.001 compared to the non-surgical group. This might be attributed to retroclination of maxillary incisors during treatment selection in the non-surgical group—namely, extraction of premolars to mask the discrepancy. Conclusions Those treated surgically had a significantly larger reduction in ANB angle and increased maxillary incisor proclination compared to those treated non-surgically with no significant changes in occlusal outcomes.

The Applications of Cone-Beam Computed Tomography in Endodontics: A Review of Literature

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Kiarudi, Amir Hosein; Eghbal, Mohammad Jafar; Safi, Yaser; Aghdasi, Mohammad Mehdi; Fazlyab, Mahta

2015-01-01

By producing undistorted three-dimensional images of the area under examination, cone-beam computed tomography (CBCT) systems have met many of the limitations of conventional radiography. These systems produce images with small field of view at low radiation doses with adequate spatial resolution that are suitable for many applications in endodontics from diagnosis to treatment and follow-up. This review article comprehensively assembles all the data from literature regarding the potential applications of CBCT in endodontics. PMID:25598804

Systematic review of the adjunctive use of diode and Nd:YAG lasers for nonsurgical periodontal instrumentation.

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Roncati, Marisa; Gariffo, Annalisa

2014-04-01

The aims of this study were (1) to conduct a literature search and systematically evaluate the additional therapeutic effects of pulsed Nd:YAG or diode laser use in patients with periodontitis, (2) to assess evidence supporting the additional benefit of laser-mediated periodontal treatment in conjunction with scaling and root planning (SRP) (not as monotherapy), and (3) to interpret the evidence presented in retrieved publications. Opinions about the additional use of diode lasers in the nonsurgical treatment of plaque-induced periodontal lesions are conflicting. The April 2011 American Academy of Periodontology's "Statement on the Efficacy of Lasers in the Non-Surgical Treatment of Inflammatory Periodontal Disease" asserted that the use of a laser as monotherapy or in addition to nonsurgical periodontal instrumentation conveyed no advantage. After initial screening, 23/77 potentially relevant articles and abstracts identified through electronic and manual searches of the MEDLINE(®)/PubMed database and the Cochrane Central Register of Controlled Trials (1990-2012) were included in this review. A meta-analysis could be performed. The results indicate that Nd:YAG or diode laser, used in an adjunctive capacity to SRP, may provide some additional benefit, in 6 month studies, compared with mechanical debridement. The results show the adjunctive benefits that diode laser treatment can provide when it is used as an adjunct to nonsurgical periodontal treatment in adults with chronic periodontitis. Further long-term, well-designed, parallel randomized clinical trials are needed to assess the effectiveness of the adjunctive use of the diode laser, as well as the appropriate dosimetry and laser settings.

Sub-ice-shelf sediments record history of twentieth-century retreat of Pine Island Glacier.

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Smith, J A; Andersen, T J; Shortt, M; Gaffney, A M; Truffer, M; Stanton, T P; Bindschadler, R; Dutrieux, P; Jenkins, A; Hillenbrand, C-D; Ehrmann, W; Corr, H F J; Farley, N; Crowhurst, S; Vaughan, D G

2017-01-05

The West Antarctic Ice Sheet is one of the largest potential sources of rising sea levels. Over the past 40 years, glaciers flowing into the Amundsen Sea sector of the ice sheet have thinned at an accelerating rate, and several numerical models suggest that unstable and irreversible retreat of the grounding line-which marks the boundary between grounded ice and floating ice shelf-is underway. Understanding this recent retreat requires a detailed knowledge of grounding-line history, but the locations of the grounding line before the advent of satellite monitoring in the 1990s are poorly dated. In particular, a history of grounding-line retreat is required to understand the relative roles of contemporaneous ocean-forced change and of ongoing glacier response to an earlier perturbation in driving ice-sheet loss. Here we show that the present thinning and retreat of Pine Island Glacier in West Antarctica is part of a climatically forced trend that was triggered in the 1940s. Our conclusions arise from analysis of sediment cores recovered beneath the floating Pine Island Glacier ice shelf, and constrain the date at which the grounding line retreated from a prominent seafloor ridge. We find that incursion of marine water beyond the crest of this ridge, forming an ocean cavity beneath the ice shelf, occurred in 1945 (±12 years); final ungrounding of the ice shelf from the ridge occurred in 1970 (±4 years). The initial opening of this ocean cavity followed a period of strong warming of West Antarctica, associated with El Niño activity. Thus our results suggest that, even when climate forcing weakened, ice-sheet retreat continued.

Type III apical transportation of root canal

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Shiv P Mantri

2012-01-01

Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

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.

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.

RISK FACTOR EPIDEMIOLOGY OF ECTOPIC PREGNANCY AND SUCCESS OF NONSURGICAL MANAGEMENT

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Vijayan C.P

2016-10-01

Full Text Available BACKGROUND Ectopic pregnancies are increasing in number and proportions. Real increase and better detection methods are contributing for this rise. All the cases diagnosed now are not surgical emergencies. Medical management and expectant line of management are possible. Revised clinical guidelines are there for the selection of cases for nonsurgical management. Knowledge about the risk factors is good for prophylaxis and to have a high suspicion about ectopic pregnancy in high-risk individuals. Knowing the success rate is absolutely essential for counselling before starting the therapy. Aim of the study- 1. To study the risk factor profile of ectopic pregnancies and to compare them with the old data of the study setting. 2. To follow up the cases receiving nonsurgical treatment and to assess the success rate. MATERIALS AND METHODS Study Setting- Department of Obstetrics and Gynaecology, Government Medical College, Kottayam. It is a tertiary care centre with 1500 beds and catering for the population of five districts of Kerala. Study Design- Observational Study Study Period- This study was completed by eighteen months from April 2014 to September 2015. RESULTS 219 cases of ectopic pregnancies were diagnosed during the study period. The ratio of this number with the total number of deliveries during that period is 3.48% and this is three times higher than that of the ratio twenty years ago (1.23%. Risk factor profile is also showing changes over this period. 15.1% had medical treatment and 11% had expectant line of therapy. Success rates are 87.87% and 95.65%, respectively. CONCLUSIONS Incidence and detection of ectopic pregnancies are increasing and the risk factor profile is changing. In properly selected cases, the success of nonsurgical management is excellent.

Increased incidence of bowel cancer after non-surgical treatment of appendicitis.

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Enblad, Malin; Birgisson, Helgi; Ekbom, Anders; Sandin, Fredrik; Graf, Wilhelm

2017-11-01

There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013. The cohort was matched with the Swedish Cancer Registry and the standardised incidence ratios (SIR) with 95% confidence interval (95% CI) for appendiceal, colorectal and small bowel cancers were calculated. Of 13 595 patients with non-surgical treatment of appendicitis, 352 (2.6%) were diagnosed with appendiceal, colorectal or small bowel cancer (SIR 4.1, 95% CI 3.7-4.6). The largest incidence increase was found for appendiceal (SIR 35, 95% CI 26-46) and right-sided colon cancer (SIR 7.5, 95% CI 6.6-8.6). SIR was still elevated when excluding patients with less than 12 months since appendicitis and the incidence of right-sided colon cancer was elevated five years after appendicitis (SIR 3.5, 95% CI 2.1-5.4). An increased incidence of bowel cancer was found after appendicitis with abscess (SIR 4.6, 95% CI 4.0-5.2), and without abscess (SIR 3.5, 95% CI 2.9-4.1). Patients with non-surgical treatment of appendicitis have an increased short and long-term incidence of bowel cancer. This should be considered in the discussion about optimal management of patients with appendicitis. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction: 12-Month Outcomes

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Polly, David W.; Wine, Kathryn D.; Whang, Peter G.; Frank, Clay J.; Harvey, Charles F.; Lockstadt, Harry; Glaser, John A.; Limoni, Robert P.; Sembrano, Jonathan N.

2015-01-01

BACKGROUND: Sacroiliac joint (SIJ) dysfunction is a prevalent cause of chronic, unremitting lower back pain. OBJECTIVE: To concurrently compare outcomes after surgical and nonsurgical treatment for chronic SIJ dysfunction. METHODS: A total of 148 subjects with SIJ dysfunction were randomly assigned to minimally invasive SIJ fusion with triangular titanium implants (n = 102) or nonsurgical management (n = 46). Pain, disability, and quality-of-life scores were collected at baseline and at 1, 3, 6, and 12 months. Success rates were compared using Bayesian methods. Crossover from nonsurgical to surgical care was allowed after the 6-month study visit was complete. RESULTS: Six-month success rates were higher in the surgical group (81.4% vs 26.1%; posterior probability of superiority > 0.9999). Clinically important (≥ 15 point) Oswestry Disability Index improvement at 6 months occurred in 73.3% of the SIJ fusion group vs 13.6% of the nonsurgical management group (P Sacroiliac Fusion Treatment MCS, mental component summary NSM, nonsurgical management ODI, Oswestry Disability Index PCS, physical component summary RFA, radiofrequency ablation SF-36, Short Form-36 SIJ, sacroiliac joint TTO, time trade-off VAS, visual analog scale PMID:26291338

Pain and flare-up after endodontic treatment procedures.

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Sipavičiūtė, Eglė; Manelienė, Rasmutė

2014-01-01

Flare-ups can occur after root canal treatment and consist of acute exacerbations of an asymptomatic pulpal and/or periradicular pathologic condition. The causative factors of interappointment pain encompass mechanical, chemical, and/or microbial injury to the pulp or periradicular tissues. Microorganisms can participate in causation of interappointment pain in the following situations: apical extrusion of debris; incomplete instrumentation leading to changes in the endodontic microbiota or in environmental conditions; and secondary intraradicular infections. Interappointment pain is almost exclusively due to the development of acute inflammation at the periradicular tissues in response to an increase in the intensity of injury coming from the root canal system. The mechanical irritation of apical periodontal tissue is caused by overinstrumentation of the root canal and filling material extrusion through the apical foramen. Incorrectly measured working length of the root canal has inherent connection with these causative factors of endodontic flare - up. This review article discusses these many facets of the flare-up: definition, incidence causes and predisposing factors.

Biofilms in Endodontics-Current Status and Future Directions.

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Neelakantan, Prasanna; Romero, Monica; Vera, Jorge; Daood, Umer; Khan, Asad U; Yan, Aixin; Cheung, Gary Shun Pan

2017-08-11

Microbiota are found in highly organized and complex entities, known as biofilms, the characteristics of which are fundamentally different from microbes in planktonic suspensions. Root canal infections are biofilm mediated. The complexity and variability of the root canal system, together with the multi-species nature of biofilms, make disinfection of this system extremely challenging. Microbial persistence appears to be the most important factor for failure of root canal treatment and this could further have an impact on pain and quality of life. Biofilm removal is accomplished by a chemo-mechanical process, using specific instruments and disinfecting chemicals in the form of irrigants and/or intracanal medicaments. Endodontic research has focused on the characterization of root canal biofilms and the clinical methods to disrupt the biofilms in addition to achieving microbial killing. In this narrative review, we discuss the role of microbial biofilms in endodontics and review the literature on the role of root canal disinfectants and disinfectant-activating methods on biofilm removal.

Black-pigmented gram-negative anaerobes in endodontic infections.

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Haapasalo, M

1993-03-01

Necrotic dental root canal infections are polymicrobial infections dominated by anaerobic bacteria. The number of different species in one canal is usually low, approx. 4-7 species. The species isolated most frequently belong to the genera Prevotella, Porphyromonas, Fusobacterium, Peptostreptococcus, Eubacterium and Streptococcus. The frequency of isolation of black-pigmented Gram-negative anaerobes in endodontic infections varies from 25% to > 50%. Pr. intermedia is the most commonly found pigmented species, followed by Pr. denticola and two Porphyromonas species, P. gingivalis and P. endodontalis. Several studies have shown that P. gingivalis and P. endodontalis are closely related to the presence of acute symptoms in endodontic infections, whereas other black-pigmented Gram-negative anaerobes are not. However, several other species may also be involved in acute infections. Moreover, Porphyromonas species have occasionally been isolated from cases with no symptoms. Although Porphyromonas spp. are clearly related to symptoms at the beginning of therapy, they are not important for the prognosis of the treatment.

Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study

NARCIS (Netherlands)

M.C. Vos (Margreet); A. Ott (Alewijn); A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); C.M.J.E. Vandenbroucke-Grauls (Christina); M.H.M. Meester (Marlene); P.H.J. van Keulen (Peter); H.A. Verbrugh (Henri); H.F.L. Wertheim (Heiman)

2004-01-01

textabstractBACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical

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

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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.