WorldWideScience

Sample records for pulpitis

  1. Respons imun humoral pada pulpitis (Humoral immune response on pulpitis

    Directory of Open Access Journals (Sweden)

    Trijoedani Widodo

    2005-06-01

    Full Text Available Pulpitis is an inflammation process on dental pulp tissue, and usually as the continuous of caries. The microorganism in the caries is a potential immunogenic triggering the immune respons, both humoral and celluler immune responses. The aim of this research is to explain the humoral immune response changes in the dental pulp tissues of pulpitis. This research was done on three group samples: Irreversible pulpitis, Reversible pulpitis and sound teeth as the control group. The result showed that there were three pulpitis immunopathologic patterns: the sound teeth immunopathologic pattern showing a low humoral immune response, in a low level of IgG, IgA and IgM, the reversible pulpitis pattern showing that in a higher humoral immune response, IgG and IgA decreased but IgM increased, the irreversible pulpitis pattern showing that IgG and IgM increased, but it couldn't be repaired although it has highly immunity, and it showed an unusually low level of IgA. This low level of IgA meant that irreversible pulpitis had a low mucosal immunity.

  2. Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial.

    Science.gov (United States)

    Allegretti, Carlos E; Sampaio, Roberta M; Horliana, Anna C R T; Armonia, Paschoal L; Rocha, Rodney G; Tortamano, Isabel Peixoto

    2016-01-01

    Inferior alveolar nerve block has a high failure rate in the treatment of mandibular posterior teeth with irreversible pulpitis. The aim of this study was to compare the anesthetic efficacy of 4% articaine, 2% lidocaine and 2% mepivacaine, all in combination with 1:100,000 epinephrine, in patients with irreversible pulpitis of permanent mandibular molars during a pulpectomy procedure. Sixty-six volunteers from the Emergency Center of the School of Dentistry, University of São Paulo, randomly received 3.6 mL of local anesthetic as a conventional inferior alveolar nerve block (IANB). The subjective signal of lip numbness, pulpal anesthesia and absence of pain during the pulpectomy procedure were evaluated respectively, by questioning the patient, stimulation using an electric pulp tester and a verbal analogue scale. All patients reported the subjective signal of lip numbness. Regarding pulpal anesthesia success as measured with the pulp tester, the success rate was respectively 68.2% for mepivacaine, 63.6% for articaine and 63.6% for lidocaine. Regarding patients who reported no pain or mild pain during the pulpectomy, the success rate was, respectively 72.7% for mepivacaine, 63.6% for articaine and 54.5% for lidocaine. These differences were not statistically significant. Neither of the solutions resulted in 100% anesthetic success in patients with irreversible pulpitis of mandibular molars.

  3. Prevention of complications after pulpi-tis treatment in pediatrics at the stage of root system formation and its resorption

    Directory of Open Access Journals (Sweden)

    Makhonova E.M.

    2011-03-01

    Full Text Available Most frequently pulpitis develops as a complication of caries. In pediatric practice both acute and chronic forms of pulpitis are observed. However, primary chronic process is more often among milk teeth. The devital amputation is the most popular method of pulpitis treatment in pediatrics. Its professional and accurate implementation is the first step to avoid any possible future complications

  4. MTA pulpotomy of human permanent molars with irreversible pulpitis.

    Science.gov (United States)

    Eghbal, Mohammad Jafar; Asgary, Saeed; Baglue, Reza Ali; Parirokh, Masoud; Ghoddusi, Jamileh

    2009-04-01

    The histological success of mineral trioxide aggregate (MTA) pulpotomy for treatment of irreversible pulpitis in human teeth as an alternative treatment was investigated in this study. Fourteen molars which had to be extracted were selected from patients 16-28 years old. The selection criteria include carious pulp exposure with a history of lingering pain. After isolation, caries removal and pulp exposure, MTA was used in pulpotomy treatment. Patients were evaluated for pain after 24 h. Two patients were lost from this study. Twelve teeth were extracted after 2 months and were assessed histologically. Recall examinations confirmed that none of the patients experienced pain after pulpotomy. Histological observation revealed that all samples had dentin bridge formation completely and that the pulps were vital and free of inflammation. Although the results favour the use of MTA as a pulpotomy material, more studies with larger samples and a longer recall period are suggested to justify the use of MTA for treatment of irreversible pulpitis in human permanent teeth.

  5. Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study

    OpenAIRE

    2016-01-01

    Objectives: To evaluate the outcome of vital pulp therapy in primary teeth with irreversible pulpitis by using calcium-enriched mixture (CEM) cement according to clinical and radiographic assessment. Participants and Methods: Fifty primary molar teeth with irreversible pulpitis in 50 children aged 6-8 years underwent pulpotomy using CEM cement as the dressing material. Following pulpotomy, pain intensity was evaluated by use of a visual analog scale at 1 and 7 days from the treatment and in c...

  6. Perubahan Sel Imun Pulpitis Akibat Biomodulasi Laser GaA1As

    Directory of Open Access Journals (Sweden)

    Nugrohowati Nugrohowati

    2015-08-01

    Full Text Available The objective of this study was to disclose the effect of GaA1As laser biomodulation on pulpitis immune response. The use of laser is still disputable, because of the biomodulation effect of laser remains unclear, particularly on immune response of pulpitis. Laser is  astressor because it produces stress wave that may cause stress on pulp. Modulation of immune system occurred in each variable of immune system component was considred to be GAS (General Adaptation Syndrome. The applied design of this research was experimental clinical trial that involved laser application on those reversible pulpitis and irreversible pulpitis. Each group consist of 10 samples. To identify biomodulation effect of 2 minutes, 5 minutes laser exposure in reversible and irreversible pulpitis, manova test was done. The different result of biomodulation effect on the control group was only indicated by the exposure of GaAIAs laser for 5 minute in reversible pulpitis on decreasing macrophage, T helper, T cytotoxic, IgM and increasing IgG.

  7. Interpretación fisiopatológica de los diferentes estadios de una pulpitis Physiopathological interpretation of the different pulpitis stages

    Directory of Open Access Journals (Sweden)

    Andrés O. Pérez Ruiz

    2005-08-01

    Full Text Available La caries dental que vulnera los tejidos duros del diente y compromete a la pulpa provoca un proceso inflamatorio que progresa por varias fases o estadios: pulpitis reversible, pulpitis transicional, pulpitis irreversible y pulpa necrótica. El tejido pulpar agredido por microorganismos no experimenta una necrosis repentina, sino que va sucumbiendo progresivamente, y cada uno de los estadios pulpares por los que transita el proceso, se puede ir identificando mediante el dolor con sus características semiológicas propias de cada fase, lo que permite precisar con bastante certeza el estado pulpar por el que avanza el proceso inflamatorio en dicho tejido. La interpretación fisiopatológica de los diferentes estadios pulpares por los que transita una pulpitis y el seguimiento del dolor como síntoma cardinal del proceso inflamatorio, es una forma de diagnóstico que complementa el pensamiento interpretativo del clínico que atiende estas urgencias, y le permite una mejor comprensión de su evolución y establecer así el correcto tratamiento.The dental caries that harms the hard tissues of the tooth and compromises the pulp produces an inflammatory process that progresses through various phases or stages: reversible pulpitis, transitional pulpitis, irreversible pulpitis and necrotic pulp. The pulpar tissue attacked by microorganisms does not experiment a sudden necrosis, but it progressively succumbs and each of the pulpar stages the process goes through may be identified by the pain with its own semiological characteristics of every stage, which allows to determine with enough accuracy the pulpar stage through which the inflammatory process advances in this tissue. The physiopathological interpretation of the different pulpar stages of a pulpitis and the follow-up of pain as a cardinal symptom of the inflammatory process is a form of diagnosis complementing the interpretative thinking of the clinician that gives attention to these emergencies

  8. Nuevo enfoque de la interpretación del dolor en una pulpitis aguda

    OpenAIRE

    Andrés O Pérez Ruiz; Liulia Cartaya Padrón; Juan A. Rodríguez Palacios; Ileana Grau León

    2000-01-01

    El dolor es probablemente el principal motivo de consulta en las urgencias estomatológicas y es precisamente el dolor de la pulpitis aguda el que comentamos en este trabajo. El dolor pulpar en sí mismo es similar al dolor que resulta por inflamación de los órganos viscerales y, por lo tanto, podrían ser inadecuados los intentos de explicarlos por comparación con los nociceptores de estructuras somáticas. Se propone analizar el comportamiento del dolor como consecuencia de una pulpitis aguda, ...

  9. A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis.

    Science.gov (United States)

    Tortamano, Isabel Peixoto; Siviero, Marcelo; Costa, Carina Gisele; Buscariolo, Inês Aparecida; Armonia, Paschoal Laércio

    2009-02-01

    The purpose of the present study was to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth. Forty volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of São Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients' subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analogue scale. All tested patients reported lip anesthesia after the application of either inferior alveolar nerve block. Regarding pulpal anesthesia success as measured with the pulp tester, the lidocaine solution had a higher success rate (70%) than the articaine solution (65%). For patients reporting none or mild pain during pulpectomy, the success rate of the articaine solution (65%) was higher than that of the lidocaine solution (45%). Yet, none of the observed differences between articaine and lidocaine were statistically significant. Apparently, therefore, both local anesthetic solutions had similar effects on the patients with irreversible pulpitis in mandibular posterior teeth. Neither of the solutions, however, resulted in an effective pain control during irreversible pulpitis treatments.

  10. [Padma 28 in the treatment of chronic dental pulpitis: an observational case study in 49 patients].

    Science.gov (United States)

    Füllemann, Fritz

    2006-02-01

    In the case of pulpitis the dentist has to differentiate between a reversible and therefore treatable pulpal inflammation and an irreversible damage of the pulpa, accord-ing to the clinical symptoms. From these one cannot draw conclusions about the effective histological condition of the pulpa. Early stages of pulpitis cannot be recognized by X-rayeither. By means of case studies in the course of daily dental practice the following questions are addressed:Is dental pulpitis an indication for the use of the Tibetan remedy Padma 28? Can a root canal treatment be prevented by administering Padma 28? What dosage is appropriate in this indication? 53 patients with symptoms of chronic dental pulpitis but without clear indication for an im-mediate root canal treatment were prescribed 2 x 2 tablets Padma 28 daily, for 15 days. 49 patients took the preparation,and the course of symptoms was recorded and analyzed according to a simple scheme. 27 of these patients(55%) were free of pain within 1 month. A total of 40 patients(81%) reached a pain-free state after a longer period. By now, in most cases observations have been made for a period of 2-3 years (maximum: 5.5 years). 12 patients (24%) remained without relapse so far for more than 3 years. These experiences allow to deduce possible indications and clinical symptoms for the use of Padma 28. These results en-courage the use of Padma 28 as a complementary preparation with little side effects, in unclear cases of pulpitis. The clinical development can be observed without further treatment if the patient does not need pain medication. Most patients (>80%) showed a complete remission, positively affect-ed and expedited by Padma 28; root canal treatments or ex-tractions could be prevented. In many cases the improvement has sustained over observation periods of >3 years. Criteria for therapeutic decisions are proposed.

  11. Roles of dental pulp fibroblasts in the recognition of bacterium-related factors and subsequent development of pulpitis

    OpenAIRE

    Tadashi Nakanishi; Daisuke Takegawa; Kouji Hirao; Kanako Takahashi; Hiromichi Yumoto; Takashi Matsuo

    2011-01-01

    As caries-related bacteria invade deeply into dentin and come into close proximity to the pulp, inflammatory cells (such as lymphocytes, macrophages and neutrophils) infiltrate into the bacterium-invaded area and consequently pulpitis develops. Many types of cytokines and adhesion molecules are responsible for the initiation and progression of pulpitis. Dental pulp fibroblasts, a major cell type in the dental pulp, also have capacity to produce pro-inflammatory cytokines and express adhesion ...

  12. Management of Chronic Hyperplastic Pulpitis in Mandibular Molars of Middle Aged Adults- A Multidisciplinary Approach

    Science.gov (United States)

    Lingeswaran, Somiya; Ari, Geetha; Thyagarajan, Ramakrishnan; Logaranjani, Anitha

    2016-01-01

    The molar tooth of children and young adults is a common site for chronic hyperplastic pulpitis (pulp polyp). It rarely occurs in middle aged adults. This condition is usually characterized by extensive involvement of the pulp, dictating the extraction of involved tooth. Extraction of permanent molars can lead to transient or permanent malocclusion, aesthetic, phonetic and functional problems. Here we report a case of pulp polyp in mandibular first molar of a 33-year-old woman that grew into the carious cavity. The aim of this case report is to describe the diagnosis of a chronic hyperplastic pulpitis involving the permanent molar as well as to describe its management in order to preserve them as a functional unit of the dentition. PMID:26894192

  13. Microbiome of Deep Dentinal Caries Lesions in Teeth with Symptomatic Irreversible Pulpitis.

    Directory of Open Access Journals (Sweden)

    Isabela N Rôças

    Full Text Available This study used a next-generation sequencing approach to identify the bacterial taxa occurring in the advanced front of caries biofilms associated with pulp exposure and irreversible pulpitis. Samples were taken from the deepest layer of dentinal caries lesions associated with pulp exposure in 10 teeth diagnosed with symptomatic irreversible pulpitis. DNA was extracted and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. Bacterial taxa were mapped to 14 phyla and 101 genera composed by 706 different OTUs. Three phyla accounted for approximately 98% of the sequences: Firmicutes, Actinobacteria and Proteobacteria. These phyla were also the ones with most representatives at the species level. Firmicutes was the most abundant phylum in 9/10 samples. As for genera, Lactobacillus accounted for 42.3% of the sequences, followed by Olsenella (13.7%, Pseudoramibacter (10.7% and Streptococcus (5.5%. Half of the samples were heavily dominated by Lactobacillus, while in the other half lactobacilli were in very low abundance and the most dominant genera were Pseudoramibacter, Olsenella, Streptococcus, and Stenotrophomonas. High bacterial diversity occurred in deep dentinal caries lesions associated with symptomatic irreversible pulpitis. The microbiome could be classified according to the relative abundance of Lactobacillus. Except for Lactobacillus species, most of the highly prevalent and abundant bacterial taxa identified in this study have been commonly detected in infected root canals. The detected taxa can be regarded as candidate pathogens for irreversible pulpitis and possibly the pioneers in pulp invasion to initiate endodontic infection.

  14. The anti-inflammatory effects of matrix metalloproteinase-3 on irreversible pulpitis of mature erupted teeth.

    Directory of Open Access Journals (Sweden)

    Hisanori Eba

    Full Text Available Matrix metalloproteinases (MMPs are involved in extracellular matrix degradation and the modulation of cell behavior. These proteinases have also been implicated in tissue repair and regeneration. Our previous studies have demonstrated that MMP-3 elicits stimulatory effects on the proliferation and the migration of endothelial cells as well as anti-apoptotic effects on these cells in vitro. In addition, we found that MMP-3 enhanced the regeneration of lost pulp tissue in a rat incisor pulp injury model. However, continuously erupting rodent incisors exhibit significantly different pulp organization compared with mature erupted teeth. Therefore, we have further extended these studies using a canine irreversible pulpitis model to investigate the effects of MMP-3. In this study, the crowns of the canine mature premolars were removed and the pulp tissues were amputated. The amputated pulp tissues remained exposed for 24 or 72 hours to induce mild or severe irreversible pulpitis, respectively, followed by sealing of the cavities. In both models, the whole pulp tissues became necrotic by day 14. In this mild pulpitis model, the regeneration of pulp tissue with vasculature and nerves was observed until 14 days after sealing with MMP-3, followed by extracellular matrix formation in the regenerated pulp tissues until day 28. The treatment with MMP-3 resulted in a decrease in the number of macrophage and antigen-presenting cells and a significant inhibition of IL-6 expression on day 3. The inhibition of MMP-3 activity abolished these anti-inflammatory effects. Immunofluorescence staining demonstrated that MMP-3 was involved in the modification of serum-derived hyaluronan-associated proteins and hyaluronan (SHAP-HA complexes possibly through the degradation of versican. These results demonstrate that MMP-3 can act as an anti-inflammatory agent and suggest that MMP-3 might represent a useful therapy for the treatment of mild irreversible pulpitis.

  15. DIRECT PULP CAPPING IN TREATMENT OF REVERSIBLE PULPITIS IN PRIMARY TEETH- CLINICAL PROTOCOL

    Directory of Open Access Journals (Sweden)

    Nina Milcheva

    2016-10-01

    Full Text Available The pulp of primary teeth is identical morphologically and physiologically to that of permanent teeth and it is capable to answer to pathological stimuli by producing tertiary dentin. When the inflammation of the pulp is in its reversible stage vital methods of treatment are indicated in order to stimulate the healing processes in it and protect its vitality. In Bulgaria the most popular method of treatment of inflammation diseases of the pulp in primary dentition is the mortal amputation. The biological way of treatment is not very common even in cases where there are indications for it. Purpose: The aim of this paper is to present the approbated by us protocol for application of direct pulp capping for treatment of reversible pulpitis in primary teeth. Material and methods: On the base of world experience and our contemporary meta- analysis of the researches published in the last 15 years concerning the problems of diagnostics. We determined clinical and radiographic diagnostic criteria for reversible pulpitis in primary teeth and indications for application of direct pulp capping as a method of treatment. We give clinical steps for application of the method and summarized the clinical and radiographic criteria for success after treatment. Results/conclusion: We gather all the information for applying direct pulp cappingfor treatment of reversible pulpitis in primary dentition. We offer the method of direct pulp capping as a clinical protocol “step by step” and illustrated by scheme which can be useful for students and dentists in their everyday practice.

  16. Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study

    Science.gov (United States)

    Memarpour, Mahtab; Fijan, Soleiman; Asgary, Saeed; Keikhaee, Marzieh

    2016-01-01

    Objectives: To evaluate the outcome of vital pulp therapy in primary teeth with irreversible pulpitis by using calcium-enriched mixture (CEM) cement according to clinical and radiographic assessment. Participants and Methods: Fifty primary molar teeth with irreversible pulpitis in 50 children aged 6-8 years underwent pulpotomy using CEM cement as the dressing material. Following pulpotomy, pain intensity was evaluated by use of a visual analog scale at 1 and 7 days from the treatment and in clinical appointments at 3, 6 and 12 months after baseline. Radiographic evaluation was performed at 6 and 12 months. Data were analyzed using the McNemar test. Results: A total of 42 children (mean age 7.26 ± 0.82 year) completed the study. After one day treatment 56 % of children reported complete relief of pain and after 7 days 62% reported the same. However, two children complained of increased pain 1 day after treatment. None of the children reported pain in the subsequent appointments. One child complained of tenderness in percussion after 6 months. Pulp canal obliteration was the most common change in the radiographic assessment. There was no significant difference between clinical (92.8%) and radiographic (90.4%) success (p=0.990). Conclusion: Pulpotomy using CEM cement could present a successful treatment in primary molar teeth with irreversible pulpitis. PMID:27326265

  17. Roles of dental pulp fibroblasts in the recognition of bacterium-related factors and subsequent development of pulpitis

    Directory of Open Access Journals (Sweden)

    Tadashi Nakanishi

    2011-08-01

    Full Text Available As caries-related bacteria invade deeply into dentin and come into close proximity to the pulp, inflammatory cells (such as lymphocytes, macrophages and neutrophils infiltrate into the bacterium-invaded area and consequently pulpitis develops. Many types of cytokines and adhesion molecules are responsible for the initiation and progression of pulpitis. Dental pulp fibroblasts, a major cell type in the dental pulp, also have capacity to produce pro-inflammatory cytokines and express adhesion molecules in response to pathogen-associated molecular patterns (PAMPs, including lipopolysaccharide. The innate immune system senses microbial infection using pattern recognition receptors, such as Toll-like receptors (TLRs and nucleotide-binding oligomerization domain (NOD, for PAMPs. In this review, we summarize the roles of dental pulp fibroblasts in the recognition of invaded bacterium-related factors via TLR and NOD pathways, and the subsequent pulpal immune responses, leading to progressive pulpitis.

  18. Conditional TNF-α Overexpression in the Tooth and Alveolar Bone Results in Painful Pulpitis and Osteitis.

    Science.gov (United States)

    Hall, B E; Zhang, L; Sun, Z J; Utreras, E; Prochazkova, M; Cho, A; Terse, A; Arany, P; Dolan, J C; Schmidt, B L; Kulkarni, A B

    2016-02-01

    Tumor necrosis factor-α (TNF-α) is a proalgesic cytokine that is commonly expressed following tissue injury. TNF-α expression not only promotes inflammation but can also lead to pain hypersensitivity in nociceptors. With the established link between TNF-α and inflammatory pain, we identified its increased expression in the teeth of patients affected with caries and pulpitis. We generated a transgenic mouse model (TNF-α(glo)) that could be used to conditionally overexpress TNF-α. These mice were bred with a dentin matrix protein 1 (DMP1)-Cre line for overexpression of TNF-α in both the tooth pulp and bone to study oral pain that would result from subsequent development of pulpitis and bone loss. The resulting DMP1/TNF-α(glo) mice show inflammation in the tooth pulp that resembles pulpitis while also displaying periodontal bone loss. Inflammatory infiltrates and enlarged blood vessels were observed in the tooth pulp. Pulpitis and osteitis affected the nociceptive neurons innervating the orofacial region by causing increased expression of inflammatory cytokines within the trigeminal ganglia. With this new mouse model morphologically mimicking pulpitis and osteitis, we tested it for signs of oral pain with an oral function assay (dolognawmeter). This assay/device records the time required by a mouse to complete a discrete gnawing task. The duration of gnawing required by the DMP1/TNF-α(glo) mice to complete the task was greater than that for the controls; extended gnaw time in a dolognawmeter indicates reduced orofacial function. With the DMP1/TNF-α(glo) mice, we have shown that TNF-α expression alone can produce inflammation similar to pulpitis and osteitis and that this mouse model can be used to study dental inflammatory pain. © International & American Associations for Dental Research 2015.

  19. Pulpa dentis D30 for acute reversible pulpitis: A prospective cohort study in routine dental practice.

    Science.gov (United States)

    Hamre, Harald Johan; Mittag, Inge; Glockmann, Anja; Kiene, Helmut; Tröger, Wilfried

    2011-01-01

    Pulpa dentis D30 (PD: dental pulp of the calf, prepared in a homeopathic D30 potency) has been used in acute reversible pulpitis for pain relief and to avoid or postpone invasive dental treatment. To study short-term clinical outcomes of PD therapy for acute reversible pulpitis in routine dental practice. Prospective, observational, open-label, single-arm cohort study. Eleven dental primary care practices in Germany. Thirty-two patients starting monotherapy with PD for acute reversible pulpitis without visible or radiological abnormalities. PD was applied as 1-mL submucous injections into the mucobuccal fold, repeated daily as needed. Avoidance of invasive dental treatment (pulp capping, root canal therapy, tooth extraction) and remission of pain, measured on a 0-10 point scale (partial remission: reduction by > or =3 points; complete remission: reduction from > or =4 points to 0-1 points) during the 10-day follow-up period. Median pain duration was 14.0 days. The patients received a median of two PD applications (range 1-7). A total of 81% (n=26/32) of patients did not require invasive dental treatment, and 19% (n= 6) had root canal therapy. Remission status was evaluable in 24 patients. Of these, 63% (n = 15/24) achieved pain remission, 58% (n = 14) remitted without invasive dental treatment (complete remission: n=12, partial remission: n=2), and 29% (n= 7) had a close temporal relationship between PD and remission (ratio "time to remission after first PD application vs pain duration prior to first PD application" dental treatment. The open-label pre-post design does not allow for conclusions about comparative effectiveness. However, more than one-fourth of evaluable patients remitted with a close temporal relationship between the first PD application and pain remission, suggesting a causal relationship between therapy and remission.

  20. Nuevo enfoque de la interpretación del dolor en una pulpitis aguda

    Directory of Open Access Journals (Sweden)

    Andrés O Pérez Ruiz

    2000-04-01

    Full Text Available El dolor es probablemente el principal motivo de consulta en las urgencias estomatológicas y es precisamente el dolor de la pulpitis aguda el que comentamos en este trabajo. El dolor pulpar en sí mismo es similar al dolor que resulta por inflamación de los órganos viscerales y, por lo tanto, podrían ser inadecuados los intentos de explicarlos por comparación con los nociceptores de estructuras somáticas. Se propone analizar el comportamiento del dolor como consecuencia de una pulpitis aguda, con un nuevo enfoque, asimilándolo como el dolor proveniente de estructuras viscerales con manifestaciones dolorosas alejadas del sitio o zona dañada y en el propio diente en que el tejido ha sido injuriado y evoluciona rápidamente hacia la necrosis. Establecemos una analogía entre el dolor visceral como el generado de la pulpa y el del tipo somático profundo como el correspondiente a la afectación periapical por rápida evolución de la inflamación hacia la necrosis.Pain is probably the chief complaint in dental emergencies and this paper deals precisely with the pain caused by acute pulpitis. The pulpar pain itself is similar to the one resulting from inflammation of the visceral organs and, therefore, the attempts to explain these pains by comparing them with the nociceptors of somatic structures may be inappropiate. It is our objective to analyze the behaviour of pain caused by acute pulpitis with a new approach, assimilating it as the pain from visceral structures with painful manifestations far from the damaged site or zone and it is the own tooth whose tissue has been affected and evolves rapidly to necrosis.We establish an analogy between the visceral pain as the one generated by the pulpa and that of deep somatic type as the corresponding to the periapical affection by the fast evolution of inflammation to necrosis.

  1. Comparison of the oral health-related quality of life and dental pain in symptomatic irreversible pulpitis and pericoronitis

    Directory of Open Access Journals (Sweden)

    Hale Cimilli

    2012-09-01

    Conclusion: The DePaQ gives detailed information about clinical conditions related to pain and the OHRQoL status in both symptomatic irreversible pulpitis and pericoronitis. VAS scores differed between the groups according to the DePaQ items.

  2. Histology of Irreversible pulpitis premolars treated with mineral trioxide aggregate pulpotomy.

    Science.gov (United States)

    Chueh, Ling-Huey; Chiang, Chun-Pun

    2010-01-01

    Studies show that human permanent teeth with carious pulpal exposures can result in a high clinical success rate when treated with pulpotomy and direct pulp capping with mineral trioxide aggregate (MTA pulpotomy). In this case report, a 19-year-old female patient with a second premolar with irreversible pulpitis and symptomatic apical periodontitis was treated with MTA pulpotomy. Follow-up electric pulp tests showed viability of the tooth at three and 10 months. Ten months after the initial treatment, the tooth was extracted for orthodontic reasons and processed for histological examination. Microscopically, the pulpal wound treated with MTA was free from inflammation and covered with a thin layer of reparative dentin. The authors conclude that, when caries and bacterial contamination can be removed from the dentin-pulp complex, the inflamed but vital pulp of a permanent tooth may have a chance to return to a healthy, functional status after MTA pulpotomy.

  3. Vital Pulp Therapy of a Mature Molar with Concurrent Hyperplastic Pulpitis, Internal Root Resorption and Periradicular Periodontitis: A Case Report

    Science.gov (United States)

    Asgary, Saeed; Kemal Çalışkan, Mehmet

    2015-01-01

    Vital pulp therapy (VPT) of permanent mature teeth is continuously ascertaining to be a more reliable endodontic treatment. The purpose of this case report was to describe successful VPT of a mature mandibular left first molar with concurrent hyperplastic pulpitis, internal root resorption and periradicular periodontitis in a 35-year-old male patient. After complete caries removal and access cavity preparation, the dental pulp was removed from the coronal third of the roots. To protect the remaining pulp, calcium-enriched mixture (CEM) cement was placed and adapted into the cavities; the tooth was then restored with amalgam. Six months after VPT, radiographic examination showed evidence of periradicular healing. Clinically, the tooth was functional without signs and symptoms of infection/inflammation. The successful outcome of this case suggests that diseased dental pulp (i.e. irreversible pulpitis) has the potential to heal after pulp protection with CEM biocement. PMID:26523145

  4. EVALUATION OF THE EFFICIENCY OF INTRALIGAMENTARY DICLOFENAC SODIUM IN REDUCING POST OPERATIVE ENDODONTIC PAIN IN PATIENTS WITH IRREVERSIBLE PULPITIS

    Directory of Open Access Journals (Sweden)

    Bhat Raksha

    2013-03-01

    Full Text Available Management of pain is the key to success in endodontic treatment. Diclofenac Sodium is the most commonly prescribed and most effective when administered to patients with irreversible pulpitis. The primary mechanism responsible for its anti-inflammatory and analgesic action is due to the suppression of the cyclo-oxegenase pathway by inhibition of prostaglandin synthesis. However, the traditional oral route is less commonly preferred as gastrointestinal complaints are more pronounced. In this study 52 patients with irreversible pulpitis are randomly divided into 2 groups. The active group is given intraligamentary injection totaling 0.4ml of Diclofenac Sodium while the placebo group received the same amount of Lidocaine. Single visit endodontic therapy is performed by the same endodontist. Visual analogue scale will be used to score pain before treatment and 4,8,12,24,48 hrs postoperatively. The prime focus of this randomized double blinded study was to evaluate the analgesic efficacy of Diclofenac Sodium through the intraligamentary route in reducing post treatment endodontic pain. Prophylactic intraligamentary injection of 0.4ml of 30 mg of Diclofenac Sodium was found to be highly effective in reducing post-endodontic pain of vital teeth with irreversible pulpitis during the first 48 h. It was much more effective than a similar Lidocaine injection in reducing postoperative endodontic pain.

  5. Second-generation platelet concentrate (PRF) as a pulpotomy medicament in a permanent molar with pulpitis: a case report.

    Science.gov (United States)

    Hiremath, H; Saikalyan, S; Kulkarni, S S; Hiremath, V

    2012-01-01

      To discuss the clinical and radiographic success of a pulpotomy with second-generation platelet concentrate (PRF), in a human mature permanent molar tooth.   A 19-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with established pulpitis in tooth 36. The tooth had a carious pulp exposure, with a history of lingering pain. After isolation, caries removal and pulp exposure, pulpotomy with PRF was performed and a permanent restoration was placed immediately. At the first recall (+1 day), no postoperative pain was reported. At 6, 12, 18 and 22 months recall, the tooth responded positively to pulp sensibility tests, and radiographic examination revealed a normal periodontal ligament space. Positive results of this case imply the need for more studies with larger sample sizes and a longer recall period to justify the use of this novel material for the treatment of pulpitis in human permanent molar teeth. Pulpotomy with PRF could be an alternate treatment to mineral trioxide aggregate or other materials in mature permanent teeth with pulpitis. © 2011 International Endodontic Journal.

  6. [Correlation between dental pulp demyelination degree and pain visual analogue scale scores data under acute and chronic pulpitis].

    Science.gov (United States)

    Korsantiia, N B; Davarashvili, X T; Gogiashvili, L E; Mamaladze, M T; Tsagareli, Z G; Melikadze, E B

    2013-05-01

    The aim of study is the analysis of pulp nerve fibers demyelination degree and its relationship with Visual Analogue Scale (VAS) score that may be measured as objective criteria. Material and methods of study. Step I: electron micrografs of dental pulp simples with special interest of myelin structural changes detected in 3 scores system, obtained from 80 patients, displays in 4 groups: 1) acute and 2) chronic pulpitis without and with accompined systemic deseases, 20 patients in each group. Dental care was realized in Kutaisi N1 Dental clinic. Step II - self-reported VAS used for describing dental pain. All data were performed by SPSS 10,0 version statistics including Spearmen-rank and Mann-Whitny coefficients for examine the validity between pulp demyelination degree and pain intensity in verbal, numbered and box scales. Researched Data were shown that damaged myelin as focal decomposition of membranes and Schwann cells hyperthrophia correspond with acute dental pain intensity as Spearman index reported in VAS numbered Scales, myelin and axoplasm degeneration as part of chronic gangrenous pulpitis disorders are in direct correlation with VAS in verbal, numbered and behavioral Rating Scales. In fact, all morphological and subjective data, including psychomotoric assessment of dental painin pulpitis may be used in dental practice for evaluation of pain syndrome considered personal story.

  7. Clinical analysis of heat gutta-percha vertical condensation in the treatment of pulpitis and periapical periodontitis

    Institute of Scientific and Technical Information of China (English)

    Li Fan; Dongqi Wang; Yanchun Xu

    2016-01-01

    Objective:To explore the clinical effect of heat gutta-percha vertical condensation in the treatment of pulpitis and periapical periodontitis. Methods:A total of 120 patients with pulpitis and periapical periodontitis who were admitted in our hospital from February, 2015 to February, 2016 were included in the study and randomized into the observation group and the control group. The patients in the observation group were given heat gutta-percha vertical condensation for root canal filling, while the patients in the control group were given cold gutta-percha lateral condensation root canal filling. The root canal filling was evaluated. The changes of GI, SBI, and PD before and after treatment were observed. Results:The correct filling, shorting filling, and extra filling in the observation group were significantly superior to those in the control group. After treatment, GI, SBI, and PD were significantly reduced, and the reduced degree in the observation group was significantly superior to that in the control group. Conclusions:Heat gutta-percha vertical condensation in the treatment of pulpitis and periapical periodontitis can significantly enhance the therapeutic effect, and improve GI, SBI, and PD, with a significant clinical effect;therefore, it deserves to be widely recommended.

  8. Identification of pulpitis at dental X-ray periapical radiography based on edge detection, texture description and artificial neural networks

    Directory of Open Access Journals (Sweden)

    Bernard Y Tumbelaka

    2014-01-01

    Full Text Available Objectives: The aim of the present research was to identify pulpitis through periapical radiography by applying edges as basis image features, the texture description and the artificial neural networks (ANNs. Materials and Methods: Input image data records of 10 molar and 10 canine teeth were used. The clinical diagnosis of interest cases were represented as normal pulp, reversible and irreversible pulpitis, and necrotic pulp. The following image processing steps were done. First, the data records were converted digitally and preprocessed as its original image using the Gaussian Filter to obtain the best smoothed intensity distribution. Second, the local image differentiation was used to produce edge detector operators, e(x,y as the image gradient; ∇f(x,y providing useful information about the local intensity variations. Third, these results were analyzed by using the texture descriptors to obtain digitally the image entropy, H. The fourth step, all were characterized by the ANNs. Results: The edge detection carried important information about the object boundaries of pulpal health and pain conditions in the dental pulp significantly. The image entropy which was identified, the diagnostic term, was obtained from texture descriptors in the segmentation regions where the curves of pulp states tent convergence with the normal pulp line from 4.9014 to 4.6843 decreasing to the reversible and the irreversible pulpitis line include the nectrotic pulp line from 4.6812 to 4.5926 and then inputting to the ANNs analysis at the same of mean square error around 0.0003. Conclusions: Referred to these results, the correlation of the image entropy and the ANNs analysis could be linearly classified with the critical point of 4.6827. Finally, it could be concluded that the direct reading radiography is better to be digitized in order to provide us the best choice for diagnosis validation.

  9. A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis.

    Science.gov (United States)

    Ramalho, Karen Müller; de Souza, Lárissa Marcondes Paladini; Tortamano, Isabel Peixoto; Adde, Carlos Alberto; Rocha, Rodney Garcia; de Paula Eduardo, Carlos

    2016-12-01

    This randomized placebo-blind study aimed to evaluate the effect of laser phototherapy (LPT) on pain caused by symptomatic irreversible pulpitis (SIP). Sixty patients diagnosed with SIP were randomly assigned to treatment groups (n = 15): G1 (control), G2 (laser placebo-sham irradiation), G3 (laser irradiation at 780 nm, 40 mW, 4 J/cm(2)), and G4 (laser irradiation at 780 nm, 40 mW, 40 J/cm(2)). Spontaneous pain was recorded using a VAS score before (T0), immediately after (T1), and 15 min after treatment (T2). Local anesthetics failure during emergency endodontic treatment was also assessed. There was no pain difference in T1 and T2 between the experimental laser groups (G3 and G4) and the placebo group (G2). The 4-J/cm(2) (G3) irradiation resulted in significant increase in the local anesthetics failure in lower jar teeth. This effect could be suggested as consequence of the LPT improvement in local circulation and vasodilatation that would result in the increase of local anesthetic agent absorption. The application of 780-nm diode laser irradiation, at 4 and 40 J/cm(2), showed no effect in reducing the pain in SIP in comparison to the placebo group. The fluence of 4 J/cm(2) showed a negative effect in local anesthetics, resulting in significant increase of complimentary local anesthesia during emergency endodontic treatment. This work provides evidence of the consequence of LPT application on teeth with symptomatic irreversible pulpitis. LPT should be avoided in teeth with pain due to irreversible pulpitis.

  10. Evaluation of the effect of locally administered amitriptyline gel as adjunct to local anesthetics in irreversible pulpitis pain

    Directory of Open Access Journals (Sweden)

    Moghadamnia A

    2009-01-01

    Full Text Available Background: Amitriptyline is one of the most common tricyclic antidepressants, which binds to pain sensory nerve fibers close to the sodium channel; hence, it could interact to some degree with receptors of local anesthetics. This study was designed to assess the additional analgesic effects of 2% Amitriptyline local gel administration in irreversible pulpitis pain of the molars. Materials and Methods: This study was a randomized, double-blind clinical trial that was performed on 56 consented adult patients who did not receive enough analgesia after a lidocaine nerve block for their tooth pulpitis pain. Patients were treated with 0.2 ml of either 2% amitriptyline or placebo, which was directly injected into their mandibular molar pulp chamber after they had received two routine lidocaine injections. Patients were asked to score their pain as a mark on a 10-cm Visual Analogue Scale (VAS at different timepoints: 0 (just before gel administration, 1, 3, 5, 7, and 9 minutes after the treatments. Results: There was a 92.5% decrease in VAS scores of patients 9 minutes after amitriptyline administration compared to Time 0, while in the placebo group this difference was only 13.5%. Further, in the amitriptyline group, the VAS score at all timepoints was statistically different from Time 0 ( P < 0.01. The overall pain reduction and its trend was significantly higher in the amitriptyline group compared with the placebo group ( P < 0.001. Conclusion: Inter-pulp space administration of amitriptyline 2% gel for completing analgesia in irreversible pulpitis pain could be effective and useful as a conjunctive therapy to injections of local anesthetics.

  11. The relationship between the level of salivary alpha amylase activity and pain severity in patients with symptomatic irreversible pulpitis

    Directory of Open Access Journals (Sweden)

    Fatemeh Ahmadi-Motamayel

    2013-08-01

    Full Text Available Objectives Assessment of dental pain severity is very challenging in dentistry. Previous studies have suggested that elevated salivary alpha amylase may contribute to increased physical stresses. There is a close association between salivary alpha amylase and plasma norepinephrine under stressful physical conditions. The aim of this study was to evaluate the relationship between pain severity and salivary alpha amylase levels in patients with symptomatic irreversible pulpitis. Materials and Methods Thirty-six patients (20 females and 16 males with severe tooth pain due to symptomatic irreversible pulpitis were selected. The visual analogue scale (VAS score was used to assess the pain severity in each patient. Unstimulated whole saliva was collected, and the level of alpha amylase activity was assessed by the spectrophotometric method. Statistical analysis was performed using SPSS 13. Results The level of alpha amylase was significantly increased in the saliva in association with pain severity assessed by VAS. The salivary alpha amylase was also elevated with increased age and in males. Conclusions There was a significant correlation between the VAS pain scale and salivary alpha amylase level, which indicates this biomarker may be a good index for the objective assessment of pain intensity.

  12. Interferon-gamma improves impaired dentinogenic and immunosuppressive functions of irreversible pulpitis-derived human dental pulp stem cells.

    Science.gov (United States)

    Sonoda, Soichiro; Yamaza, Haruyoshi; Ma, Lan; Tanaka, Yosuke; Tomoda, Erika; Aijima, Reona; Nonaka, Kazuaki; Kukita, Toshio; Shi, Songtao; Nishimura, Fusanori; Yamaza, Takayoshi

    2016-01-18

    Clinically, irreversible pulpitis is treated by the complete removal of pulp tissue followed by replacement with artificial materials. There is considered to be a high potential for autologous transplantation of human dental pulp stem cells (DPSCs) in endodontic treatment. The usefulness of DPSCs isolated from healthy teeth is limited. However, DPSCs isolated from diseased teeth with irreversible pulpitis (IP-DPSCs) are considered to be suitable for dentin/pulp regeneration. In this study, we examined the stem cell potency of IP-DPSCs. In comparison with healthy DPSCs, IP-DPSCs expressed lower colony-forming capacity, population-doubling rate, cell proliferation, multipotency, in vivo dentin regeneration, and immunosuppressive activity, suggesting that intact IP-DPSCs may be inadequate for dentin/pulp regeneration. Therefore, we attempted to improve the impaired in vivo dentin regeneration and in vitro immunosuppressive functions of IP-DPSCs to enable dentin/pulp regeneration. Interferon gamma (IFN-γ) treatment enhanced in vivo dentin regeneration and in vitro T cell suppression of IP-DPSCs, whereas treatment with tumor necrosis factor alpha did not. Therefore, these findings suggest that IFN-γ may be a feasible modulator to improve the functions of impaired IP-DPSCs, suggesting that autologous transplantation of IFN-γ-accelerated IP-DPSCs might be a promising new therapeutic strategy for dentin/pulp tissue engineering in future endodontic treatment.

  13. Anesthetic efficacy of the supplemental X-tip intraosseous injection using 4% articaine with 1:100,000 adrenaline in patients with irreversible pulpitis: An in vivo study

    Directory of Open Access Journals (Sweden)

    Atool Chandra Bhuyan

    2014-01-01

    Full Text Available Introduction: Pain management remains the utmost important qualifying criteria in minimizing patient agony and establishing a strong dentist-patient rapport. Symptomatic irreversible pulpitis is a painful condition necessitating immediate attention and supplemental anesthetic techniques are often resorted to in addition to conventional inferior alveolar nerve block. Aim: The purpose of the study was to evaluate the anesthetic efficacy of X-tip intraosseous injection in patients with symptomatic irreversible pulpitis, in mandibular posterior teeth, using 4% Articaine with 1:100,000 adrenaline as local anesthetic, when the conventional inferior alveolar nerve block proved ineffective. Materials and Methods: X-tip system was used to administer 1.7 ml of 4% articaine with 1:100,000 adrenaline in 30 patients diagnosed with irreversible pulpitis of mandibular posterior teeth with moderate to severe pain on endodontic access after administration of an inferior alveolar nerve block. Results: The results of the study showed that 25 X-tip injections (83.33% were successful and 5 X-tip injections (16.66% were unsuccessful. Conclusion: When the inferior alveolar nerve block fails to provide adequate pulpal anesthesia, X-tip system using 4% articaine with 1:100,000 adrenaline was successful in achieving pulpal anesthesia in patients with irreversible pulpitis.

  14. Prophylactic intraligamentary injection of piroxicam (feldene) for the management of post-endodontic pain in molar teeth with irreversible pulpitis.

    Science.gov (United States)

    Atbaei, Adnan; Mortazavi, Nazanin

    2012-04-01

    The purpose of this prospective research was to evaluate the post-endodontic pain-reducing effect of piroxicam (feldene), a non-selective non-steroidal anti-inflammatory drug. Pain following endodontic treatment is often linked to the inflammatory process as well as additional central mechanisms. The effects of intraligamentary injection of piroxicam have not previously been studied. Sixty-five patients with irreversible pulpitis were randomly divided into two groups. The active group received intraligamentary injections totalling 0.4 mL of piroxicam, while the placebo group received the same amount of lidocaine. One-appointment endodontic therapy was performed by a single endodontist. Visual Analogue Scale was used to record pain before treatment and 4, 8, 12, 24 and 48 h postoperatively. The decrease in the intensity of post-treatment pain between the two groups was very significant. Intraligamentary injection of piroxicam can be considered an effective method for reducing post-endodontic pain.

  15. Calcium-enriched mixture pulpotomy of a human permanent molar with irreversible pulpitis and condensing apical periodontitis

    Directory of Open Access Journals (Sweden)

    Saeed Asgary

    2011-01-01

    Full Text Available This case report describes a pulpotomy treatment of a permanent mature molar tooth with established irreversible pulpitis and condensing apical periodontitis, using calcium-enriched mixture (CEM cement. Clinical examination revealed that the first right lower molar had a large carious lesion with history of spontaneous/lingering pain; radiographic examination showed condensing apical periodontitis. Pulpotomy was opted as the treatment; cervical pulpotomy was carried out. Following hemostasis, the radicular pulp stumps were covered with ~2-mm-thick layer of the prepared CEM cement; the tooth was restored with amalgam. Two-year follow-up showed that the treated tooth had been symptomless, and there were no clinical signs/symptoms of either inflammation or infection. Radiographically, the periradicular lesion was completely healed with reconstruction of bone structures to normal appearance; the root canals were not calcified. According to chemical, physical, and biological properties of the CEM cement, this novel biomaterial may be suitable for endodontic treatment.

  16. Analysis of the clinical diagnosis and treatment on irreversible pulpitis%不可复性牙髓炎临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    成改莲

    2015-01-01

    Objective:To summarize the clinical characteristics and misdiagnosis causes of irreversible pulpitis.Methods:88 patients with irreversible pulpitis were selected from January 2013 to January 2014.We analyzed their data retrospectively. Results:Among 88 patients of this group,there were 34 cases with simple acute pulpitis,36 cases with acute exacerbation of chronic pulpitis,and 15 cases of retrograde pulpitis.In addation,2 cases were missed diagnosis;1 cases of misdiagnosis;86 cases were treated with pulpotomy and mummification of pulp or root canal therapy;the curative effect were reliable;the last 3 cases which were misdiagnosis had poor efficacy.Conclusions:Most of the irreversible pulpitis patients has typically clinical manifestations,which can be clearly diagnosised,and effective treatment.There are individual cases with atypical clinical manifestation,so those part of cases may be misdiagnosised.%目的:总结不可复性牙髓炎的临床特征和误诊原因。方法:2013年1月-2014年1月收治不可复性牙髓炎患者88例,对其进行回顾性分析。结果:本组88例中单纯急性牙髓炎34例,慢性牙髓炎急性发作36例,逆行性牙髓炎15例,漏诊2例,误诊1例,对前85例行活髓切断术、干髓术或者根管治疗术,疗效可靠,后3例诊断有误疗效不佳。结论:不可复性牙髓炎大多临床表现典型,诊断明确,治疗有效,个别病例临床表现不典型,有误诊现象。

  17. Comparative evaluation of platelet-rich fibrin, mineral trioxide aggregate, and calcium hydroxide as pulpotomy agents in permanent molars with irreversible pulpitis: A randomized controlled trial

    Science.gov (United States)

    Kumar, Varun; Juneja, Ruchi; Duhan, Jigyasa; Sangwan, Pankaj; Tewari, Sanjay

    2016-01-01

    Background: Pulpotomy has been proposed as an alternative for the management of irreversible pulpitis in permanent molars with closed apices. Aim: To compare the performances of calcium hydroxide (CH), mineral trioxide aggregate (MTA), and platelet-rich fibrin (PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis. Materials and Methods: Fifty-four permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups, and full pulpotomy was performed using CH, MTA, or PRF as pulpotomy agents. Pain intensity was recorded using numeric rating scale score at baseline, 24 h, 7 days, 6 months, and 1 year. Clinical and radiographic assessments were done at 6 months and 1 year. Statistical Analysis: Kruskal–Wallis test and Friedman test were used for intergroup and intragroup comparison of pain scores, respectively. The radiographic outcomes between the three study arms were compared using Chi-square test. Results: Clinical success rate was 94.4% at 7 days, which dropped to 85.4% at 12 months. All three agents were equally effective in providing pain relief at all the intervals tested, with no significant difference between them (P > 0.05 at all intervals). However, at 6 months and 12 months, 26.2% and 52.4% teeth depicted slight widening of periodontal ligament space. No significant difference was observed between the radiographic success rates observed with the three groups (P = 0.135 at 6 months, 0.717 at 12 months). Conclusion: Pulpotomy exhibited a high clinical success rate in mature molars with irreversible pulpitis and selection of biomaterial did not affect its outcome. PMID:27994420

  18. Comparative evaluation of platelet-rich fibrin, mineral trioxide aggregate, and calcium hydroxide as pulpotomy agents in permanent molars with irreversible pulpitis: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Varun Kumar

    2016-01-01

    Full Text Available Background: Pulpotomy has been proposed as an alternative for the management of irreversible pulpitis in permanent molars with closed apices. Aim: To compare the performances of calcium hydroxide (CH, mineral trioxide aggregate (MTA, and platelet-rich fibrin (PRF as pulpotomy agents in mature permanent molars with irreversible pulpitis. Materials and Methods: Fifty-four permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups, and full pulpotomy was performed using CH,MTA, or PRF as pulpotomy agents. Pain intensity was recorded using numeric rating scale score at baseline, 24 h, 7 days, 6 months, and 1 year. Clinical and radiographic assessments were done at 6 months and 1 year. Statistical Analysis: Kruskal–Wallis test and Friedman test were used for intergroup and intragroup comparison of pain scores, respectively. The radiographic outcomes between the three study arms were compared using Chi-square test. Results: Clinical success rate was 94.4% at 7 days, which dropped to 85.4% at 12 months. All three agents were equally effective in providing pain relief at all the intervals tested, with no significant difference between them (P > 0.05 at all intervals. However, at 6 months and 12 months, 26.2% and 52.4% teeth depicted slight widening of periodontal ligament space. No significant difference was observed between the radiographic success rates observed with the three groups (P = 0.135 at 6 months, 0.717 at 12 months. Conclusion: Pulpotomy exhibited a high clinical success rate in mature molars with irreversible pulpitis and selection of biomaterial did not affect its outcome.

  19. SUCCESS RATE OF ONE SESSION AND TWO SESSION TECHNIQUES FOR TREATMENT OF ASYMPTOMATIC PULPITIS OF PRIMARY TEETH WITH INDIRECT PULP CAPPING.

    Directory of Open Access Journals (Sweden)

    Rossitza Kabaktchieva

    2013-01-01

    Full Text Available Objective: Objective: To compare the success rate between the one session and two session indirect pulp capping of asymptomatic pulpitis for 1 year after the treatment was performed in children with different caries risk. Material and Methods: The children and the teeth were selected according to certain criteria for inclusion in the study. According to that, 72 children with low, moderate and high caries risk were included and 131 teeth with asymptomatic pulpitis were treated. The clinical protocols for indirect pulp capping (IPC in one session and two sessions were defined. The review appointments were performed 6 and 12 months after the treatment using certain clinical and radiographic criteria which defined success or post-treatment complications. The results are statistically analysed using One Sided Exact Two-Proportion Test with 95% Significance level (5% risk of type I error. Results: The statistical test showed that between the compared success rates of the one session and two sessions IPC, on the 6th and 12th month, there wasn’t a significant difference (p>0.05. This was valid for every one of the examined groups of patients (p>0. 05. This proves that there is no difference in the success rates of treatment of pulpitis in primary teeth using one or two sessions. Conclusions: The results about the success of treatment of asymptomatic pulpitis in primary teeth during one or two sessions have confirmed the results showed in other current studies. Our study has confirmed (clinically and radiographically the success of both techniques and we have concluded that in children with high caries risk, more appropriate technique is the one performed in two sessions. Treatment in one session is recommended in children with low or moderate caries risk.

  20. Anesthetic effectiveness of the supplemental intraligamentary injection, administered with a computer-controlled local anesthetic delivery system, in patients with irreversible pulpitis.

    Science.gov (United States)

    Nusstein, John; Claffey, Elizabeth; Reader, Al; Beck, Mike; Weaver, Joel

    2005-05-01

    The purpose of this study was to determine the anesthetic effectiveness of the supplemental intraligamentary injection, administered with a computer-controlled local anesthetic delivery system, in mandibular posterior teeth diagnosed with irreversible pulpitis when the conventional inferior alveolar nerve block failed. Fifty-four emergency patients, diagnosed with irreversible pulpitis of a mandibular posterior tooth, received an inferior alveolar nerve block and had moderate to severe pain upon endodontic access. A computer-controlled local anesthetic delivery system was then used to administer intraligamentary injections of 1.4 ml of 2% lidocaine with 1:100,000 epinephrine. Success of the intraligamentary injection was defined as none or mild pain upon endodontic access or initial instrumentation. The results demonstrated that anesthetic success was obtained in 56% (30 of 54) of the patients. We concluded that when the inferior alveolar nerve block failed to provide profound pulpal anesthesia in mandibular posterior teeth of patients presenting with irreversible pulpitis, the intraligamentary injection administered with a computer-controlled local anesthetic delivery system was successful approximately 56% of the time.

  1. X-tip intraosseous injection system as a primary anesthesia for irreversible pulpitis of posterior mandibular teeth: A randomized clinical trail.

    Science.gov (United States)

    Razavian, Hamid; Kazemi, Shantia; Khazaei, Saber; Jahromi, Maryam Zare

    2013-03-01

    Successful anesthesia during root canal therapy may be difficult to obtain. Intraosseous injection significantly improves anesthesia's success as a supplemental pulpal anesthesia, particularly in cases of irreversible pulpitis. The aim of this study was to compare the efficacy of X-tip intraosseous injection and inferior alveolar nerve (IAN) block in primary anesthesia for mandibular posterior teeth with irreversible pulpitis. Forty emergency patients with an irreversible pulpitis of mandibular posterior teeth were randomly assigned to receive either intraosseous injection using the X-tip intraosseous injection system or IAN block as the primary injection method for pulpal anesthesia. Pulpal anesthesia was evaluated using an electric pulp tester and endo ice at 5-min intervals for 15 min. Anesthesia's success or failure rates were recorded and analyzed using SPSS version 12 statistical software. Success or failure rates were compared using a Fisher's exact test, and the time duration for the onset of anesthesia was compared using Mann-Whitney U test. P < 0.05 was considered significant. Intraosseous injection system resulted in successful anesthesia in 17 out of 20 patients (85%). Successful anesthesia was achieved with the IAN block in 14 out of 20 patients (70%). However, the difference (15%) was not statistically significant (P = 0.2). Considering the relatively expensive armamentarium, probability of penetrator separation, temporary tachycardia, and possibility of damage to root during drilling, the authors do not suggest intraosseous injection as a suitable primary technique.

  2. X-tip intraosseous injection system as a primary anesthesia for irreversible pulpitis of posterior mandibular teeth: A randomized clinical trail

    Directory of Open Access Journals (Sweden)

    Hamid Razavian

    2013-01-01

    Full Text Available Background: Successful anesthesia during root canal therapy may be difficult to obtain. Intraosseous injection significantly improves anesthesia′s success as a supplemental pulpal anesthesia, particularly in cases of irreversible pulpitis. The aim of this study was to compare the efficacy of X-tip intraosseous injection and inferior alveolar nerve (IAN block in primary anesthesia for mandibular posterior teeth with irreversible pulpitis. Materials and Methods: Forty emergency patients with an irreversible pulpitis of mandibular posterior teeth were randomly assigned to receive either intraosseous injection using the X-tip intraosseous injection system or IAN block as the primary injection method for pulpal anesthesia. Pulpal anesthesia was evaluated using an electric pulp tester and endo ice at 5-min intervals for 15 min. Anesthesia′s success or failure rates were recorded and analyzed using SPSS version 12 statistical software. Success or failure rates were compared using a Fisher′s exact test, and the time duration for the onset of anesthesia was compared using Mann-Whitney U test. P < 0.05 was considered significant. Results: Intraosseous injection system resulted in successful anesthesia in 17 out of 20 patients (85%. Successful anesthesia was achieved with the IAN block in 14 out of 20 patients (70%. However, the difference (15% was not statistically significant ( P = 0.2. Conclusion: Considering the relatively expensive armamentarium, probability of penetrator separation, temporary tachycardia, and possibility of damage to root during drilling, the authors do not suggest intraosseous injection as a suitable primary technique.

  3. Comparison of the Anesthetic Efficacy of Mepivacaine and Lidocaine in Patients with Irreversible Pulpitis: A Double-blind Randomized Clinical Trial.

    Science.gov (United States)

    Visconti, Renata Pieroni; Tortamano, Isabel Peixoto; Buscariolo, Inês Aparecida

    2016-09-01

    The objective of this study was to compare the anesthetic efficacy of 2% mepivacaine combined with 1:100,000 epinephrine with 2% lidocaine combined with 1:100,000 epinephrine during pulpectomy of mandibular posterior teeth in patients with irreversible pulpitis. Forty-two patients with irreversible pulpitis who were admitted to the Emergency Center at the University of São Paulo School of Dentistry volunteered to take part in the study and were randomized to receive conventional inferior alveolar nerve block containing 1.8 or 3.6 mL of either 2% mepivacaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. We recorded patients' subjective assessments of lip anesthesia, absence/presence of pulpal anesthesia tested by using electric pulp stimulation, and absence/presence of pain during the subsequent pulpectomy by using a verbal analogue scale. All patients tested reported lip anesthesia after application of either type of inferior alveolar nerve block. Pulpal anesthesia success rates measured by using the pulp tester were satisfactory for both solutions (86% for mepivacaine and 67% for lidocaine). Success rates according to patient report of no pain or mild pain during pulpectomy were higher for mepivacaine solution (55%) than for lidocaine solution (14%). The differences between mepivacaine and lidocaine were statistically significant. Mepivacaine resulted in effective pain control during irreversible pulpitis treatments. The success rates with either solution were not high enough to ensure complete pulpal anesthesia. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  4. Establishment and verification of rat experimental hyperalgesic pulpitis%大鼠实验性牙髓炎痛敏模型的建立及检验

    Institute of Scientific and Technical Information of China (English)

    高磊; 栗红师; 闫磊; 孙亚男; 张海; 吴礼安

    2015-01-01

    目的:验证牙髓暴露法建立大鼠实验性牙髓炎痛敏模型的可行性。方法:取健康雄性SD大鼠36只,随机分为2组;对照组(n=10)麻醉后不作任何处理,牙髓炎模型组(n=26)麻醉后于左侧上颌第一磨牙穿髓并使之暴露于口腔。然后,每组中各随机抽取6只分别检测其术前及术后1、3、7、14 d的擦面行为。对照组所余4只于术后2 h取延髓及牙髓,牙髓炎组所余20只分别于术后2 h 取延髓,1、3、7、14 d取牙髓;用免疫荧光染色检测延髓中c-Fos蛋白及牙髓中TNF-α的表达,HE染色观察牙髓炎症情况。结果:①牙髓炎组在建模术后1d时的擦面总时间最高,其次为术后3d组,两者分别与组内其他各时间相比,以及与同一时间点的对照组相比差异均有统计学意义(P<0.05);②HE染色显示,牙髓暴露1 d时即可见明显炎症,术后1、3、7、14 d,其坏死组织的边缘分别位于髓角和根上、中、下1/3处;③牙髓炎组在术后1、3、7、14 d各时间点的TNF-α表达强度的平均光密度值均明显高于对照组(P<0.05);④术后2 h牙髓炎组和对照组延髓背角的c-Fos 阳性细胞数为176.8±14.82和18.2±4.08(P<0.05)。结论:牙髓暴露法能有效模拟临床牙髓炎及其痛敏过程。%AIM:To establish and verify rat experimental hyperalgesic pulpitis.METHODS:36 male SD rats were randomly divided into 2 groups.The rats in control group (n=10)received no treatment after anesthesia,while the left maxillary first molar pulp of the rats in the pulpitis group (n=26)were exposed after anesthesia.6 rats of each group were randomly selected for face grooming test before and after 1,3,7 and 14 d of surgery respectively.The medul-la oblongatas and pulps of the remaining 4 rats in the control group were taken after 2 h of surgery.The remaining 20 rats in the pulpitis group were randomly divided into 5

  5. Effect of Oral Premedication on the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Double-Blind, Randomized Controlled Clinical Trial

    Science.gov (United States)

    Saha, Suparna Ganguly; Dubey, Sandeep; Kala, Shubham; Misuriya, Abhinav; Kataria, Devendra

    2016-01-01

    Introduction It is generally accepted that achieving complete anaesthesia with an Inferior Alveolar Nerve Block (IANB) in mandibular molars with symptomatic irreversible pulpitis is more challenging than for other teeth. Therefore, administration of Non-Steroidal Anti-Inflammatory Agents (NSAIDs) 1 hour prior to anaesthetic administration has been proposed as a means to increase the efficacy of the IANB in such patients. Aim The purpose of this prospective, double-blind, randomized clinical trial was to determine the effect of administration of oral premedication with ketorolac (KETO) and diclofenac potassium (DP) on the efficacy of IANB in patients with irreversible pulpitis. Materials and Methods One hundred and fifty patients with irreversible pulpitis were evaluated preoperatively for pain using Heft Parker visual analogue scale, after which they were randomly divided into three groups. The subjects received identical tablets of ketorolac, diclofenac pottasium or cellulose powder (placebo), 1 hour prior to administration of IANB with 2% lidocaine containing 1:200 000 epinephrine. Lip numbness as well as positive and negative responses to cold test were ascertained. Additionally pain score of each patient was recorded during cavity preparation and root canal instrumentation. Success was defined as the absence of pain or mild pain based on the visual analog scale readings. The data was analysed using One-Way Anova, Post-Hoc Tukey pair wise, Paired T – Test and chi-square test. Trial Registery Number is 4722/2015 for this clinical trial study. Results There were no significant differences with respect to age (p =0.098), gender (p = 0.801) and pre-VAS score (DP-KETO p=0.645, PLAC-KETO p =0.964, PLAC-DP p = 0.801) between the three groups. All patients had subjective lip anaesthesia with the IAN blocks. Patients of all the three groups reported a significant decrease in active pain after local anaesthesia (p< 0.05). The post injection VAS Score was least in group

  6. 急性牙髓炎患者的心理分析及护理对策%Psychoanalysis and Nursing Strategy for Acute Pulpitis Patients

    Institute of Scientific and Technical Information of China (English)

    李芳萍; 张珑

    2013-01-01

    Objective:To investigate the psychoanalysis and nursing strategy for acute pulpitis patients. Methods :Through inquiry and record in 90 cases of acute pulpitis patients, the psychological state was collected and analyzed, then explore the effective psychological nursing countermeasures. Results;The 90 cases of acute pulpitis patients have six different degree of psychological problems, which were: eager for treatment in 35, strangeness and fear more in 38 male patients, tension and anxiety in 20 with higher education, disappointment and fidget in 10 illiterate patients, inferiority and timidity in 15 rural patients, seeking for famous doctors in 12 patients with little medical knowledge. According to these types this paper put forward different psychological nursing countermeasures. Conclusions: Psychological care throughout the whole process of patients with acute pulpitis treatment can help patients eliminate existing and potential psychological problems and reaction, the disease's treatment has the positive role.%目的 探讨急性牙髓炎患者的心理问题及心理护理对策.方法 通过询问并记录90例急性牙髓炎患者的心理状态,经归纳总结后,探讨有效的心理护理对策.结果 90例急性牙髓炎患者存在6种不同程度的心理问题.求治急切:35例患者表现突出;陌生、恐惧:38例男性患者较52例女性患者表现突出;紧张、焦虑:文化程度较高的20例患者表现突出;失望、烦躁:10例文盲患者表现突出;自卑、胆怯:来自农村的15例患者表现较为突出;寻求名医:对急性牙髓炎的了解和认识较少的12例患者表现突出.针对每种心理问题提出不同的心理护理对策.结论 心理护理贯穿于急性牙髓炎患者治疗的全过程,可帮助患者排除已存在的及潜在的心理问题和反应,对疾病的治疗有积极作用.

  7. Incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population.

    Science.gov (United States)

    Hashemipour, Maryam Alsadat; Borna, Roya

    2014-02-01

    This study was designed to evaluate incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population. In this cross-sectional study, 3,150 patients (1,400 males and 1,750 females) with pain in the orofacial region were evaluated via clinical and radiographic examination to determine their pain source. Patients completed a standardized clinical questionnaire consisting of a numerical rating scale for pain intensity and chose verbal descriptors from short form McGill questionnaire to describe the quality of their pain. Visual analog scale (VAS) was used to score pain intensity. In addition, patients indicated sites to which pain referred by drawing on an illustration of the head and neck. Data were analyzed using chi-square, fisher exact, and Mann-Whitney tests. Two thousand and hundred twenty patients (67/3%) reported pain in sites that diagnostically differed from the pain source. According to statistical analysis, sex (P = 0.02), intensity of pain (0.04), and quality (P = 0.001) of pain influenced its referral nature, while age of patients and kind of stimulus had no considerable effect on pain referral (P > 0.05). The results of the present study show the prevalence of referred pain in the head, face, and neck region is moderately high. Therefore, in patients with orofacial pain, it is essential to carefully examination before carrying out treatment that could be inappropriate. © 2013 The Authors Pain Practice © 2013 World Institute of Pain.

  8. The success rate of bupivacaine and lidocaine as anesthetic agents in inferior alveolar nerve block in teeth with irreversible pulpitis without spontaneous pain

    Directory of Open Access Journals (Sweden)

    Masoud Parirokh

    2015-05-01

    Full Text Available Objectives Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine for IANB when treating teeth with irreversible pulpitis. Materials and Methods Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

  9. 不同方法治疗急性牙髓炎控制疼痛的效果观察%The Effect of Different Methods for Treatment of Acute Pulpitis Pain Control Observation

    Institute of Scientific and Technical Information of China (English)

    热百·卡德尔; 阿孜古丽·阿不都热依木

    2015-01-01

    目的:研究在治疗急性牙髓炎时不同治疗方法对控制疼痛的效果。方法选取我院因急性牙髓炎而入院治疗的患者180例作为研究对象,分为开髓引流组,开髓封药组,开髓拔髓组。结果三组急性牙髓炎患者根据临床情况应用不同治疗方案后,差异具有统计学意义,P<0.05。结论三种不同的治疗方法对急性牙髓炎都能很好的控制疼痛,而牙髓摘除术能迅速有效地缓解患者疼痛。%ObjectiveTo study the effect in the treatment of acute pulpitis of different treatment methods for pain control.Methods In our hospital because of acute pulpitis and hospitalized patients with 180 cases as the object of study,divided into pulp drainage group,pulp sealing medicine group,open pith to unplug pith group.Results In three groups of acute pulpitis patients according to the clinical application of different treatments,the difference was statisticaly significant,P< 0.05.ConclusionThree different treatment methods of acute pulpitis can very good pain control and pulp extirpation operation can quickly and effectively relieve the pain of the patients.

  10. Anesthetic efficacy of X-tip intraosseous injection using 2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis after inferior alveolar nerve block: A clinical study

    Directory of Open Access Journals (Sweden)

    Pushpendra Kumar Verma

    2013-01-01

    Full Text Available Introduction: The inferior alveolar nerve block (IAN is the most frequently used mandibular injection technique for achieving local anesthesia in endodontics. Supplemental injections are essential to overcome failure of IAN block in patients with irreversible pulpitis. Aim: To evaluate the anesthetic efficacy of X-tip intraosseous injection (2% lidocaine with 1:80,000 epinephrine in patients with irreversible pulpitis in mandibular posterior teeth when conventional IAN block failed. Materials and Methods: Thirty emergency patients diagnosed with irreversible pulpitis in a mandibular posterior tooth received an IAN block and experienced moderate to severe pain on endodontic access or initial instrumentation. The X-tip system was used to administer 1.8 ml of 2% lidocaine with 1:80,000 epinephrine. The success of X-tip intraosseous injection was defined as none or mild pain (Heft-Parker visual analogue scale ratings < 54 mm on endodontic access or initial instrumentation. Results: Ninety-three percent of X-tip injections were successful and 7% were unsuccessful. Discomfort rating for X-tip perforation: 96.66% patients reported none or mild pain, whereas 3.34% reported moderate to severe pain. For discomfort rating during solution deposition, 74.99% patients reported none or mild pain and 24.92% reported moderate to severe pain. Ninety-six percent of the patients had subjective/objective increase in heart rate. Conclusions: Supplemental X-tip intraosseous injection using 2% lignocaine with 1:80,000 epinephrine has a statistically significant influence in achieving pulpal anesthesia in patients with irreversible pulpitis.

  11. The significance of odontoblast P2X7 receptor expression in pulpitis%牙髓炎成牙本质细胞P2X7受体表达意义

    Institute of Scientific and Technical Information of China (English)

    姜威; 李恩东; 李月玲; 俞明; 陈劼

    2016-01-01

    Objective To investigate the significance expression of P2X7 receptor(P2X7R)from odontoblast cells in the pathogenesis and progression of pulpitis. Methods Sixty cases with mild pulpitis,severe pulpitis and healthy third molars(20 cases in each group) was enrolled in this study,and P2X7R mRNA expression of which was detected by real time PCR,and P2X7R protein expression of which was detected by Western blotting,and IL-1β,IL-6 and TNF-a level in the serum samples of the third molar donor were detected by ELISA method. Results According to the healthy group,mild pulpitis group and severe pulpitis group order,P2X7R mRNA and protein expression in odontoblast cells of the third molars increased significantly,and IL-1βand IL-6 levels in serum sample increased significantly,and TNF-α of mild pulpitis patients were significantly higher than healthy people(P<0. 05). However,TNF-α of severe pulpitis patients significantly decreased(P<0. 05)than mild pulpitis patients. In mild pulpitis patients,P2X7R mRNA expression was positively correlated with IL-1β levels(P<0. 05),and P2X7R protein expression was positively correlated with IL-1β,IL-6 and TNF-α(P<0.05).In severe pulpitis,P2X7R mRNA expression was positively correlated with IL-1β(P <0.05)and IL-6(P <0.05), P2X7R protein expression was positively correlated with IL-1β(P<0. 05),IL-6(P<0. 05). Conclusion P2X7R expression level in odontoblast cells increased in pulpitis onset and progression,following with inflammatory cytokines IL-1β,IL-6 and TNF-a expression increasing.%目的:探讨成牙本质细胞中P2X7受体(P2X7R)表达在牙髓炎发病及病情进展中的意义。方法取轻度牙髓炎、重度牙髓炎患者和健康者第三磨牙各20例,采用Real-time PCR法检测P2X7R mRNA表达水平,采用Western blotting法检测P2X7R蛋白表达水平;另采用 ELISA 法检测上述第三磨牙供者的血清样本中 IL-1β、IL-6和 TNF-α等炎症因子水平。结果按健康组、轻度牙髓炎组、

  12. The Clinical Effect of Indirect Pulp Capping in Treatment of 69 Cases of Hone Pulpitis%间接盖髓术治疗69例可复性牙髓炎的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘国哲

    2015-01-01

    目的:探讨间接盖髓术治疗可复性牙髓炎的临床疗效。方法选取我院2011年1月~2013年1月收治的69例69颗确诊为可复性牙髓炎的患牙采用 Dycal 间接盖髓,术后定期复查,即半年复查1次,复查2年,测定牙髓活力及拍摄 X 线片。结果69颗患牙中,成功52例,失败17例,成功率75.36%。结论保存活髓,应用间接盖髓术治疗可复性牙髓炎疗效满意。%Objective To explore the treatment of indirect pulp capping hone clinical curative effect of pulpitis. Methods Our hospital in January 2011 to January 2013 69 cases of 69 diagnosed with hone with teeth of pulpitis Dycal indirect pulp capping were selected, postoperative, periodic review of the 1st half year review, review for two years, determination of dental pulp vitality and X-ray films. Results 69 of tooth, successful 52, 17 failure, success rate of 75.36%. Conclusion preserved pulp used for the treatment of indirect pulp capping hone pulpitis curative effect is satisfied.

  13. Cracked pulpitis root canal treatment curative effect observation%隐裂性牙髓炎患者根管治疗的疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡红军

    2015-01-01

    Objective In our hospital 70 cases of patients with cracked pulpitis root canal treatment curative effect observation.methods Selection of Stomatology Department of our hospital in 2013 from 5 months to 2014 may split 70 cases of patients with pulpitis as the object of study, all patients were anesthetized for root canal therapy and postoperative making the return visit of a patient record form, for a period of 1 year. Patients have to go to the hospital for consultation within the stipulated time, through every patients after treatment were recorded.Results A total of 150 patients with teeth, after the root canal treatment, the success of the 135, the efifciency of 90%, 15, no efifciency is 10%. After root canal therapy ineffective after the 15 teeth, originally had teeth bifurcation phenomenon of 10 stars, after the Department of Radiology shooting 10 teeth in the teeth of bifurcation lesions range is continuing to expand, 5 teeth by radiological examination found furcation.Conclusion After treatment of the patients with root canal treatment, and then the full crown restoration, the service life of the teeth, the expected effect of the treatment, so that the quality of life of the patients were improved, the curative effect is remarkable, it is worth to be popularized in clinical.%目的:对隐裂性牙髓炎患者进行根管治疗的疗效进行观察。方法选取我院口腔科2013年5月~2014年5月收治的隐裂性牙髓炎患者70例作为研究对象,对所有患者进行麻醉后再行根管治疗术,术后制作患者的复诊记录表格,为期1年。嘱咐患者在规定时间内必须到医院进行复诊,通过每一次的复诊记录患者治疗后的疗效。结果患者共150颗患牙,经过根管治疗后,成功135颗,有效率为90%,无效15颗,无效率为10%。在经过根管治疗后无效的15颗患牙中,原本就有牙齿分叉现象10颗,后经过放射科拍片发现这10颗患牙的分叉

  14. Sensitivity, Specificity, Predictive Values, and Accuracy of Three Diagnostic Tests to Predict Inferior Alveolar Nerve Blockade Failure in Symptomatic Irreversible Pulpitis

    Directory of Open Access Journals (Sweden)

    Daniel Chavarría-Bolaños

    2017-01-01

    Full Text Available Introduction. The inferior alveolar nerve block (IANB is the most common anesthetic technique used on mandibular teeth during root canal treatment. Its success in the presence of preoperative inflammation is still controversial. The aim of this study was to evaluate the sensitivity, specificity, predictive values, and accuracy of three diagnostic tests used to predict IANB failure in symptomatic irreversible pulpitis (SIP. Methodology. A cross-sectional study was carried out on the mandibular molars of 53 patients with SIP. All patients received a single cartridge of mepivacaine 2% with 1 : 100000 epinephrine using the IANB technique. Three diagnostic clinical tests were performed to detect anesthetic failure. Anesthetic failure was defined as a positive painful response to any of the three tests. Sensitivity, specificity, predictive values, accuracy, and ROC curves were calculated and compared and significant differences were analyzed. Results. IANB failure was determined in 71.7% of the patients. The sensitivity scores for the three tests (lip numbness, the cold stimuli test, and responsiveness during endodontic access were 0.03, 0.35, and 0.55, respectively, and the specificity score was determined as 1 for all of the tests. Clinically, none of the evaluated tests demonstrated a high enough accuracy (0.30, 0.53, and 0.68 for lip numbness, the cold stimuli test, and responsiveness during endodontic access, resp.. A comparison of the areas under the curve in the ROC analyses showed statistically significant differences between the three tests (p<0.05. Conclusion. None of the analyzed tests demonstrated a high enough accuracy to be considered a reliable diagnostic tool for the prediction of anesthetic failure.

  15. The effect of pulpotomy using a calcium-enriched mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial.

    Science.gov (United States)

    Asgary, Saeed; Eghbal, Mohammad Jafar

    2010-07-01

    The purpose of this noninferiority trial was to compare postoperative pain relief after one-visit root canal therapy (ORCT) with a pulpotomy performed with a new endodontic calcium-enriched mixture cement (PCEM) in human permanent molars with irreversible pulpitis. A total of 407 selected patients were randomly allocated into the ORCT group (n = 202) or the PCEM group (n = 205). Numerical Rating Scale questionnaires were used to record pain intensity (PI) by the patients during the first 7 days after treatment. While there was no statistically significant difference in the mean PI at baseline between the two study groups (P = 0.45), changes in mean PI were significantly different between them (P < 0.001). In the ORCT group, pain relief was achieved after 36 h [95% confidence interval (CI), 27.00-45.00], compared to 18 h in the PCEM group (95% CI, 15.00-21.00), a significant difference (P < 0.01). Comparison of the mean PI sum recorded over 7 days showed that patients in the ORCT group experienced significantly more pain than those in the PCEM group (P < 0.001); a similar difference was observed for pain in response to percussion tests (P < 0.001). Treatment with PCEM thus had the better pain-reducing effects than ORCT in irreversible pulpitis cases.

  16. 一次性根管填充方法对牙髓炎的治疗价值分析%Therapeutic Value of Root Canal Filling Method in Pulpitis

    Institute of Scientific and Technical Information of China (English)

    尹双珠

    2015-01-01

    Objective To analyze the therapeutic value of root canal fil ing in the pulpitis. Methods 84 patients were divided into treatment group and control group of 42 patients each were given a one-time and multiple root canal fil ing therapy. Results The total effective rate was 95.2%higher than 73.8%, VAS score,inflammation and pain less than the control group,P<0.05. Conclusion The root canal fil ing therapy pulpitis effect is remarkable.%目的:分析一次性根管填充对牙髓炎的治疗价值。方法84例患者分为治疗组、对照组各42例,分别给予一次性和多次根管填充治疗。结果治疗组总有效率95.2%高于对照组73.8%,VAS评分、炎症和疼痛消失时间少于对照组,P<0.05。结论一次性根管填充治疗牙髓炎效果显著。

  17. Efficacy of mepivacaine-tramadol combination on the success of inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis: a randomized clinical trial.

    Science.gov (United States)

    Rodríguez-Wong, L; Pozos-Guillen, A; Silva-Herzog, D; Chavarría-Bolaños, D

    2016-04-01

    To compare the success of an inferior alveolar nerve block (IANB) after injecting a combination of mepivacaine and tramadol or mepivacaine alone in patients with symptomatic irreversible pulpitis (SIP) in mandibular permanent molars. This study was a double-blind, randomized, controlled clinical trial. Two study groups were selected, each consisting of 28 patients who exhibited SIP on the first or second mandibular molars. All included patients presented with moderate-to-severe preoperative pain according to the modified Heft-Parker visual analogue scale (VAS). Patients were anaesthetized using the IANB technique employing identical cartridges that contained either 1.3 mL of 2% mepivacaine with epinephrine 1 : 100 000 plus 0.5 mL of tramadol 50 mg mL(-1) (experimental group) or 1.8 mL of 2% mepivacaine with epinephrine 1 : 100 000 (control group). After 15 min, anaesthesia was evaluated by a progressive four-test examination, that is numbness of the lip, positive or negative cold test, asymptomatic management of dental hard tissues and access to dental pulp. Success of the IANB was defined as the absence of pain during any of these evaluations. The data were analysed with a chi-square, Fisher's or Mann-Whitney U test. A total of 74 patients were initially assessed, with 56 patients eventually included and 18 excluded. No significant differences in age (P = 0.384) or gender (P = 1) were found between the two groups. The success rates of anaesthesia with the IANB for the experimental and control groups were 57.1 and 46.4%, respectively. The success rate of anaesthesia in the experimental group was not significantly different (P ˃ 0.05) from that of the control group. The duration of the anaesthetic effect was significantly longer for the experimental group (P = 0.026). The combination of mepivacaine-tramadol achieved similar success rates for IANB when compared to mepivacaine 2% epinephrine 1 : 100 000. There was no significant difference in the anaesthetic efficacy

  18. 笑气吸入治疗急性牙髓炎的疗效分析%Analysis of curative effect of the treatment of acute pulpitis of nitrous oxide inhalation

    Institute of Scientific and Technical Information of China (English)

    徐佳妮

    2014-01-01

    Objective Analyzing the effect of nitrous oxide inhalation therapy of acute pulpitis and nursing measures.Methods Selection in October 2013 to October 2014 of our hospital, 84 cases of patients with acute pulpitis the research object, according to the numerical method was divided into control group and observation group, control group, 42 cases observed 42 groups, control group patients with opening under local anesthesia, observation group of patients used nitrous oxide inhalation and opening under local anesthesia, application of the WHO criteria for evaluation of clinical pain pain of the patients with case analysis.Results Control group of patients with painless rate was 73.81%, the observation group of patients with painless rate was 92.56%, the control group signiifcantly lower than the experimental group, the difference between groups was statistically signiifcant (P<0.05).Conclusion In the treatment of acute pulpitis laughing gas suction method has good effect, can effectively improve the patient's pain, and is worth popularizing in clinic use.%目的:研究分析笑气吸入治疗急性牙髓炎的疗效。方法选取2013年10月~2014年10月我院收治的急性牙髓炎患者84例作为研究对象,按照数字法分为对照组和观察组,各42例,对照组患者进行局麻下开髓,观察组患者应用笑气吸入并在局麻下开髓,应用WHO临床疼痛评估标准对患者的疼痛情况进行分析。结果对照组患者的无痛率为73.81%,观察组患者的无痛率为92.56%,对照组明显低于观察组,组间差异有统计学意义(P<0.05)。结论在急性牙髓炎的治疗中应用笑气吸入方法具有较好的疗效,能够有效的改善患者的疼痛情况,值得在临床上推广以及使用。

  19. Clinical effect of liquid nitrogen cryotherapy applied to acute pulpitis treatment%液氮冷冻法用于急性牙髓炎治疗的临床效果

    Institute of Scientific and Technical Information of China (English)

    陈丹宇; 符起亚; 郭玉苏; 张旭凤; 庞红霞

    2013-01-01

    目的 研究液氮冷冻疗法应用于急性牙髓炎治疗的临床疗效.方法 选取急性牙髓炎患者300例300颗患牙,随机分成3组,每组各100颗患牙.液氮组用液氮冷冻疗法,麻醉组用麻醉法,失活组用失活法,比较3种方法用于急性牙髓炎应急治疗的镇痛效果、止血情况、术后疼痛缓解效果、术后并发症及患者心理状态.结果 液氮组镇痛效果明显优于失活组,差异有统计学意义(x2=31.25,P<0.01).液氮组止血效果优于麻醉组,差异有统计学意义(x2=55.17,P<0.05).液氮组在术后疼痛缓解方面优于麻醉组和失活组,差异有统计学意义(P<0.05),液氮组在术后并发症方面低于麻醉组和失活组,差异有统计学意义(P<0.05).在术前、术中、术后的患者心理状态方面液氮组优于麻醉组和失活组,差异有统计学意义(P<0.05).结论 液氮冷冻疗法用于急性牙髓炎治疗是一种操作简单、患者易于接受、无副作用、无创、无痛的新疗法,具有临床应用价值.%Objective To observe the effect of liquid nitrogen cryotherapy in the treatment of acute pulpitis.Methods Three hundred patients suffered from acute pulpitis were randomly divided into 3 groups,treated with liquid nitrogen cryotherapy (group A),anesthesia (group B),inactivation (group C) respectively.The analgesic effects and bleeding,postoperative pain mitigation of the effects and complications,preoperative,intraoperative,and postoperative mental state of patients were compared among the three methods in the emergency treatment of acute pulpitis.Results In group A and group B,analgesic effect was obviously better than group C (P < 0.01).The hemostatic effect of group A was better than that of group B (P<0.01).Group A in postoperative pain relief was superior to group B and C (P<0.01).Acute apical periodontitis incidence of Group A was significantly lower than those of group B and C (P < 0.01).There was significant

  20. Clinical investigation of the symptom and signs of 3432 cases of acute pulpitis%3432例急性牙髓炎临床症状和体征的调查分析

    Institute of Scientific and Technical Information of China (English)

    王津; 姬爱平

    2011-01-01

    目的 调查分析急性牙髓炎的临床症状和体征,以提高诊断准确率.方法 采用调查表的形式,记录患者的临床症状和体征,然后整理并分析.结果 多数急性牙髓炎疼痛表现为阵发病、夜间痛、温度刺激痛;少数病例疼痛表现呈多样化,疼痛放散区域可以提示重点临床检查范围;龋病是主要感染来源,隐裂和牙周病是重要感染来源;大多数急性牙髓炎患牙叩诊及温度测试呈阳性反应.结论 临床医师应根据患者所指牙位重点检查,不同放散区域和叩诊阳性表现可以提示重点检查范围,牙髓温度测试是必须检查的步骤之一,医师需要对临床症状和体征综合判断.%Objective To investigate the clinical symptom and physical signs of acute pulpitis in order to improve the accuracy rate of the diagnosis. Methods The clinical symptom and the physical signs of patients were recorded and analyzed by using questionnaire forms. Results Most of patients with acute pulpitis were suffered by paroxysmal pain, night pain or thermal stimulating pain. Few patients were suffered by multiple pains. The referred pain area could indicate the preferential scope of examination. Caries was the main infection origin. Incompletely fractured tooth and periodontal disease were the other two major infection origins. The percussion and temperature tests were positive for most cases. Conclusion The dentists should perform the extensive check to the teeth which the patients refer to. The referred pain regions and positive percussion could indicate the preferential scope of examination. Temperature pulp test was one of the essential steps for check. The dentists should make a comprehensive judgment based on the clinical symptoms and signs.

  1. Comparative Evaluation of Anesthetic Efficacy of 2% Lidocaine, 4% Articaine, and 0.5% Bupivacaine on Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Randomized, Double-blind Clinical Trial.

    Science.gov (United States)

    Aggarwal, Vivek; Singla, Mamta; Miglani, Sanjay

    2017-01-01

    To compare the anesthetic efficacy of 1.8 mL of 2% lidocaine with 1:200,000 epinephrine, 4% articaine with 1:100,000 epinephrine, and 0.5% bupivacaine with 1:200,000 epinephrine on producing inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. A total of 91 adult patients who were actively experiencing mandibular molar pain were involved in this study. The patients were randomly divided into three groups on the basis of the anesthetic solution used. The first group received IANB with 1.8 mL of 2% lidocaine with 1:200,000 epinephrine, the second group received IANB with 4% articaine with 1:100,000 epinephrine, and the third group received IANB with 0.5% bupivacaine with 1:200,000 epinephrine. After 15 minutes of IANB, conventional endodontic access preparation was started. The pain during the treatment was noted on a Heft-Parker visual analog scale (HP VAS). The primary outcome measure was anesthetic success, and anesthesia was considered successful if the patient reported no pain or weak/mild pain (HP VAS score 2% lidocaine, 4% articaine, and 0.5% bupivacaine were 23%, 33%, and 17%, respectively. The differences were statistically insignificant (P > .05). The 2% lidocaine solution used for IANB had similar success rates when compared with 4% articaine and 0.5% bupivacaine.

  2. The effect of preoperative submucosal administration of tramadol on the success rate of inferior alveolar nerve block on mandibular molars with symptomatic irreversible pulpitis: a randomized, double-blind placebo-controlled clinical trial.

    Science.gov (United States)

    De Pedro-Muñoz, A; Mena-Álvarez, J

    2017-02-18

    This randomized, double-blind, placebo-controlled, clinical trial was designed to improve the success of inferior alveolar nerve blocks (IANB) in mandibular molars with symptomatic irreversible pulpitis (SIP) by means of preoperative submucosal administration of 50 mg tramadol. Forty-two patients with a mandibular molar diagnosed with SIP took part in the trial. Patients were assigned randomly to one of two groups: tramadol group (n = 21), who received 50 mg tramadol in 1 mL by mandibular infiltration, and a placebo group (n = 21), who received 1 mL of normal saline administered to the affected tooth by the same means. Ten minutes later, all patients received an IANB with 4% articaine with epinephrine 1 : 100 000. A 10-min waiting time was established after local anaesthetic (LA) administration before carrying out three consecutive tests to assess anaesthesia of the pulp, that is two consecutive negative responses to an electric pulp test, positive or negative response to a cold test and no pain during access cavity preparation. IANB was considered successful only if the patient did not experience pain arising from these tests. Data were analysed by the Chi-squared frequency test and the Fisher's exact test, for qualitative variables, Mann-Whitney U-test for independent samples and two-way anova for more than two independent samples. In the tramadol group IANB was achieved successfully in 57% of the sample, whilst the placebo group obtained 29%. The difference between groups was not significant (P = 0.06). When performing endodontic access, the anaesthetic success rate was significantly in favour of tramadol (P = 0.03). Preoperative submucosal administration of 50 mg tramadol in mandibular molars with SIP significantly improved the success of IANB using 4% articaine with 1 : 100 000 epinephrine during access cavity preparation in comparison with a placebo. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  3. Notch-2在大鼠牙髓炎中的时空分布及其意义%Time-sequenced alteration of immunolocalization and significance of Notch-2 expression in rat pulpitis

    Institute of Scientific and Technical Information of China (English)

    马亮; 张亚庆; 王胜朝; 黄贞贞

    2009-01-01

    目的:研究单纯开髓导致大鼠牙髓炎进程中Notch-2在牙髓损伤修复中的作用.方法:通过开髓建立大鼠牙髓炎模型,用免疫组织化学染色方法研究Notch-2的时空表达变化及其意义.结果:牙髓损伤早期(3 d),牙髓间充质细胞和牙髓成纤维细胞中Notch-2均呈弱阳性表达,成牙本质细胞为阴性表达.牙髓损伤中期(5 d),靠近损伤区的成牙本质细胞深层细胞Notch-2阳性表达达到高峰;同时,新生毛细血管内皮细胞呈强阳性表达.牙髓损伤晚期(7 d),Notch-2在牙髓间充质细胞、血管内皮细胞中表达均减弱,而在成牙本质细胞阳性表达达到高峰.牙髓损伤末期(14 d),Notch-2仅在成牙本质细胞下层细胞中尚有微弱表达,而其余牙髓细胞均为阴性表达.对照组正常牙髓组织Notch-2表达为阴性.结论:Notch-2在牙髓损伤应激情况下在牙髓间充质细胞和成牙本质细胞中上调表达,对于启动牙髓自我修复、诱导牙髓间充质细胞功能性分化以及抑制受损成牙本质细胞凋亡、维系和调动其相对正常的生理功能可能具有重要作用.%Objective; To investigate the immunolocalization and significance of Notch-2 expression in the process of dental pulp repair after injury. Methods: An experimental animal model of injury-induced pulpitis was established to observe the time-sequenced alteration of the expression of Notch-2. Results: Three days post-operation, weak positive staining of Notch-2 was observed in pulp mesenchyme cells and pulp fibroblasts but not in vascular endothelial cells or odontoblasts. Five days post-operation, strong Notch-2 reactivity was found in subodontoblasts as well as newly bom capillary endothelial cells. Seven days after cavity preparation, Notch-2 staining became weaker in pulp mesenchyme cells and capillary endothelial cells, but stronger positive staining was found in odontoblasts. Two weeks post-operation, weak Notch-2 staining was seen in pulp

  4. Risk assessment of different grades of hypertension during the treatment of patients with acute pulpitis%不同高血压分级患者急性牙髓炎开髓治疗的风险评估

    Institute of Scientific and Technical Information of China (English)

    陈红涛; 王文英; 王津; 梁亚平; 王小婷; 侯光敏; 姬爱平

    2016-01-01

    施来规避风险。%Objective:To evaluate the vital signs changes,influence factors in different grades of hy-pertension patients during the treatment of acute pulpitis,in order to obtain the risk prevention measures. Methods:In this study,90 different grades of hypertension patients with acute pulpitis were recruited from February 201 4 to February 201 5 in the Department of Oral Emergency,Peking University School and Hospital of Stomatology.The information about the patients’general health,oral treatment,life signs of change information was collected.Patients were divided into high risk group,middle risk group, and low risk group (30 patients for each group).Results:(1 )Compared with the preoperative,systolic blood pressure (90%),diastolic blood pressure (80%),heart rate increase (1 00%)were increased in the high risk group.The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (P<0.01 ).At the same time,the systolic blood pressure of 1 /4 (26.7%)patients in high risk group increased more than 20 mmHg (1 mmHg=0.1 33 kPa),and the diastolic blood pressure of 2/5 patients in high risk group increased more than 1 0 mmHg,the difference was statistically significant compared with the other two groups (P<0.05).(2)Compared with the pre-operative,the average increase of the maximum peak were increased [systolic blood pressure (1 8.0 ± 1 .5)mmHg,diastolic blood pressure (8.0 ±1 .7)mmHg],the mean of heart rate changes [(7.0 ± 0.3)beats per minute]was also increased in the high risk group,while these two indicators were de-creased in the low risk group and the middle risk group.The electrocardiogram (ECG)was changed in 6 cases during the treatment in the high risk group.No significantly changed were observed in the low risk group and the middle risk group.(3 ) Compared the risk assessment in preoperative with that in postoperative,in the middle risk group,23 cases were evaluated as medium risk in final evaluation,6 as low risk,and 1 as

  5. 消丁球治疗乳牙牙髓炎封失活剂后疼痛的临床观察%A clinical observation on the pain treatment of pulpitis in opalescent teethwith the sterilized eugenol cotton bah after blockade of the pulp devitalizer

    Institute of Scientific and Technical Information of China (English)

    王惠欣

    2000-01-01

    目的:减轻或消除乳牙牙髓炎患者封失活剂后产生的剧痛,使治疗能顺利进行。方法:将蘸有适量消炎痛粉的丁香油棉球("消丁球")置入已做好穿髓孔并且干燥好的窝洞中,暂封1~2天后再封入乳牙失活剂。结果:采用穿髓孔处封"消、丁"棉球,在预防牙髓炎疼痛方面取得了满意的临床疗效。结论:不同个体对疼痛的敏感性耐受性等不同,消炎痛、丁香油酚能阻断牙髓炎症介质,从而减轻或消除乳牙牙髓炎患者封失活剂后产生的剧痛。%Objective: To relieve and even eliminate the pain of pulpitis in opalescent teeth with the sterilized eugenol cottonball after the blockade of the pulp devitalizer. Methods: The method is to till the perforated and dried pulp cavity with thesterilized eugenol cotton ball and block it after one or two days with the pulp devitalizer. Results: The result shew a considerably satisfying curative and preventive effect. Conclusion: The conclusion is drawn that the anti-inflammatory agent andeugenol, on the basis of the fact that individuals may vary in pain reaction and sensitivity, can prevent inflammation of pulpitis,hence relieve and even eliminate the acute pain after the blockade of the pulp devitalizer.

  6. 三氧化矿物凝聚体牙髓切断术治疗年轻恒牙不可复性牙髓炎的初步研究%Mineral trioxide aggragate pulpotomy for the treatment of immature permanent teeth with irreversible pulpitis: a preliminary clinical study

    Institute of Scientific and Technical Information of China (English)

    彭楚芳; 赵玉鸣; 杨媛; 秦满

    2015-01-01

    目的 评估三氧化矿物凝聚体(mineral trioxide aggragate,MTA)牙髓切断术治疗年轻恒牙不可复性牙髓炎的临床效果,为年轻恒牙不可复性牙髓炎的治疗提供新思路.方法 选取北京大学口腔医学院·口腔医院儿童口腔科就诊的26例患者,对其临床诊断为不可复性牙髓炎的26颗年轻恒牙应用MTA作为盖髓剂,根据切断牙髓部位的出血情况行部分或全部冠髓切断,术后1年随访,通过临床和X线片检查评估治疗效果.结果 术后1年,4例患者失访,其他22例患者(共计22颗患牙)进行了复查.22颗牙中20颗牙判为治愈或有效,临床成功率为91%(20/22);13颗牙在X线片上可见钙化桥,钙化桥形成率为65%(13/20).结论 MTA牙髓切断术是治疗年轻恒牙不可复性牙髓炎的有效方法,但长期疗效还需进一步观察.%Objective To evaluate the preliminary clinical effect of mineral trioxide aggragate (MTA) pulpotomy on immature permanent teeth with irreversible pulpitis.Methods Twenty-six immature permanent teeth with irreversible pulpitis were recuited from Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology.These teeth were treated with partial or full pulpotomy according to the condition of pulp bleeding.MTA was used as pulp capping material.Patients were recalled periodically after the treatment.Clinical and radiographic effects were evaluated.Results At one year follow-up, 20 teeth were evaluated as healed or healing, 2 teeth were evaluated as failure and 4 teeth were dropped out.The success rate was considered 91%(20/22).A dentinal bridge was radiographcally observed underneath the pulpotomy site in 13 teeth(65%, 13/20).Conclusions MTA pulpotomy is an effective method for the treatment of immature permanent teeth with irreversible pulpitis.But further research with longer follow up period is required.

  7. Clinical observation on efficacy of three kinds of root canal sealers in elderly patients with pulpitis and diabetes%3种根充糊剂对伴有糖尿病的老年牙髓炎患者疗效观察

    Institute of Scientific and Technical Information of China (English)

    孟晓慧; 刘克礼; 李培; 杨成; 史艳霞

    2016-01-01

    ObjectiveTo observe the clinical efficacy of three kinds of root canal sealers in elderly patients with pulpitis and diabetes.MethodsOne hundred andfifty elderly patients with pulpitis and diabetes were selected as the research objets and were randomly divided into three groups with 50 patients of each group. One root canal therapy were adopted. The teeth in group I was adopted root canal treatment by Cortisomol plus gutta percha, and the teeth group II was adopted root canal treatment by Vitapex plus gutta percha, and the teeth in group III was adopted root canal treatment by zinc oxide eugenol plus gutta percha obtueation of the root canal. The degree of pain postoperation one week and the success rate of 2 years in three groups were observed.Results After one week, the number of patients who felt no pain was 40,34 and 18 for group I, II and III respectively, and the number of patients who felt mild pain was 7, 8 and 15 respectively, and the number of patients who felt moderate pain was 2,6 and 10 respectively, and the number of patients who felt moderate pain was 1, 2 and 7 respectively. There was statistically significant difference among the three groups(P<0.05). After two years , the success rate of the three groups were 88%,94% and 78% for group I, II and III respectively, the success rate of group II was higher than group III(P<0.05).ConclusionsCortisomol could effectively reduce the pain of elderly patients with pulpitis and diabetes after root canalfilling, while the success rate of root canal therapy with zinc oxide as root canalfilling materials was rather low.%目的:比较不同根充糊剂对伴有糖尿病的老年牙髓炎患者的治疗效果。方法选取因牙髓炎就诊的150例糖尿病患者,随机分为3组,每组50例。采用一次性根管治疗术。I组用Cortisomol+牙胶尖根管充填;II组用Vitapex+牙胶尖根管充填;III组用氧化锌丁香油糊剂+牙胶尖根管充填。观察不同组别术后1

  8. Diagnostic Criteria for the Treatment of Caries-Induced Pulpitis.

    Science.gov (United States)

    1981-03-01

    filling". Seltzer and Bender (3) advocate maintenance of pulp vitality if there is no evidence of severe pathosis, even though a chronic pulp...34. Seltzer and Bender (3) maintain that the dentist is generally unable to make an accurate pathologic diagnosis of the state of the pulp by clinical means...described as "transitional stage" by Seltzer and Bender (3). Specimens with minimal inflammatory or atrophic changes in the pulp are also included in

  9. Anesthetic Efficacy in Irreversible Pulpitis: A Randomized Clinical Trial

    OpenAIRE

    Allegretti,Carlos E.; Sampaio,Roberta M.; Horliana,Anna C. R. T.; Armonia,Paschoal L.; Rocha,Rodney G.; Tortamano,Isabel Peixoto

    2016-01-01

    Resumo O bloqueio do nervo alveolar inferior apresenta uma alta taxa de falha para o tratamento de dentes posteriores mandibulares com pulpite irreversível. O objetivo deste estudo foi comparar a eficácia anestésica da articaína 4%, lidocaína 2% e mepivacaína 2%, todas em combinação com epinefrina 1:100.000, em pacientes com pulpite irreversível de molares mandibulares durante um procedimento de pulpectomia. Sessenta e seis voluntários do Centro de Emergência da Faculdade de Odontologia da Un...

  10. 比较一次法与多次法根管治疗术治疗慢性牙髓炎、根尖周炎疗效的系统评价%Single versus multiple visit RCT for treatment of chronic pulpitis and periapical periodontitis: a systematic review

    Institute of Scientific and Technical Information of China (English)

    孙玉亮; 梁学萍; 赵今

    2011-01-01

    目的:比较一次与多次根管治疗术治疗慢性牙髓炎、根尖周炎的疗效和安全性.方法:采用Cochrane系统评价方法,计算机检索Cochrane图书馆、MEDLINE、EMbase、CBM、CNKI、VIP等数据库.同时手工检索相关期刊和会议论文,收集相关随机对照试验和半随机对照试验.由两名评价者独立评价研究质量和提取数据,对同质研究采用RevMan 5.0软件进行Meta分析.结果:最终纳入16个随机对照试验.其中5个研究发生偏倚的可能性很低,7个研究有发生偏倚的中度可能性,另外4个研究有发生偏倚的高度可能性.Meta分析显示一次法与多次根管治疗术后72 h疼痛发生的差异无统计学意义[RR=1.10,95% CI(0.82,1.49)].影象学:一次法根管治疗与多次根管治疗相比有一些优势,但两者差异无统计学意义[RR=0.89,95% CI(0.64,1.25)].一次法根管治疗术后使用止痛药的病人比多次根管治疗明显增多,差异有统计学意义[RR=2.42,95% CI(1.62,3.62)].多次根管治疗发生肿胀[RR=1.40,95% CI(0.67,2.93)]和术后1周时疼痛[RR=1.25,95% CI(0.99,1.60)]的几率比一次性治疗要低,但差异无统计学意义.结论:一次法根管治疗术后使用止痛药的病人比多次法根管治疗术多,但从总体分析两者疗效差异无统计学意义.由于纳入研究设计的一些缺陷,此结论还需要今后更多高质量、大样本的随机对照试验来验证.%AIM: To assess the effectiveness and safety of single versus multiple-visit root canal treatment(RCT) for treatment of chronic pulpitis and periapical periodontitis. METHODS: The Cochrane Library, MEDLINE, Embase, CBM, CNKI and VIP were searched for randomized controlled trials or quasi-randomized controlled trials. And the reference lists of all papers identified were also checked. Quality assessment and data extraction were performed by two reviewers independently according to the Cochrane Handbook for Systematic Reviews of Interventions

  11. Effects of the serjania erecta and zeyheria montana ethanol extracts in experimental pulpitis in rats: a histological study

    OpenAIRE

    2013-01-01

    Objectives: The aim of this study was to evaluate, by the semi-quantitative histological analysis, the anti-inflammatory activity of the ethanolic extracts of Serjania erecta e Zeyheria Montana, in experimental pulpits in rats. Study Design: In order to induce pulp inflammation, cavities were performed on the occlusal surface of the mandibular first molars of 45 male rats, without pulp exposure. The animals were distributed into 4 groups: GI, teeth without cavities; GII, single dose of saline...

  12. Distribution of bacterial plankton, bacterial colonies and microbial biofilm on deciduous teeth with pulpitis and pulp necrosis

    OpenAIRE

    Valéria Lopes de Godoy

    2000-01-01

    As bactérias constituem fatores primordiais da contaminação da polpa dentária de dentes decíduos resultando em implicações clínicas e terapêuticas. Com a finalidade de analisar a presença de bactérias planctônicas, colônias bacterianas e biofilmes microbianos nas estruturas de dentes decíduos portadores de pulpite e necrose pulpar, utilizaram-se 32 dentes decíduos com cárie profunda. Dezesseis dentes foram seccionados no sentido longitudinal e os outros dezesseis no sentido transversal. Os es...

  13. 露髓孔在龋源性牙髓病诊断中的意义%Effect of exposed point of dental pulp on diagnosis of irreversible pulpitis caused by caries

    Institute of Scientific and Technical Information of China (English)

    陈乃焰

    2007-01-01

    目的 探讨露髓孔在龋源性牙髓病诊断中的意义,以及露髓孔大小与温度试验结果的关系,以提高龋源性牙髓病诊断的准确性.方法 对391例经探诊、叩诊及温度试验等检查,初步诊断为牙髓病后局麻,用球钻及龋洞挖匙基本去除软化牙本质,再用探针探查穿髓孔情况.结果 全部病例均有大小不等的露髓孔.大部分牙髓部分坏死及露髓孔大的慢性牙髓炎病例,温度试验结果类似可复性牙髓炎;慢性牙髓炎急性发作温度试验结果与露髓孔大小关系不大.结论 露髓孔可作为诊断龋源性牙髓病的主要依据;温度试验刺激去除后疼痛立即消失,并不是可复性牙髓炎的特有表现.

  14. A Clinical Study on the Low Pulpotomy for Treating Pulpitis of Primary Molars%根管低位断髓术治疗乳磨牙牙髓病临床探讨

    Institute of Scientific and Technical Information of China (English)

    耿文元

    2002-01-01

    目的探讨乳磨牙牙髓病根管低位断髓术临床应用价值.方法338例乳磨牙随机分为根管低位活髓切断术直接盖髓充填治疗212例和FC半失活根管低位断髓术充填治疗126例.结果治疗后分别观察6个月~3年.两组乳磨牙根管低位断髓术治疗的成功率分别为82.08%和83.33%.结论乳磨牙有其生理的特殊性,对乳磨牙牙髓病作根管低位断髓应尽量去除病变的冠髓组织,严密充填根管口和覆盖封闭髓室底副根管,减少根分又及根尖周病变的发生,提高疗效.

  15. Study of one-visit root canal therapy on chronic pulpitis and periapical periodontitis%一次法根管充填治疗慢性牙髓炎、根尖周炎的探讨

    Institute of Scientific and Technical Information of China (English)

    黄文; 王凤琼

    2007-01-01

    目的:探讨一次完成根管充填治疗慢性牙髓炎、慢性根尖周炎的方法和效果.方法:随机选择77例慢性牙髓炎、慢性根尖周炎患者分为两组,一组患者用镍钛机扩行根管预备,另一组患者以手用不锈钢扩锉针预备根管,一次就诊完成根管充填治疗,对照两组不同方法的治疗效果.结果:两组治疗慢性牙髓炎1年有效率分别是91.7%和92.3%,两组间无显著性差异.结论:镍钛机扩和不锈钢手扩锉预备根管对一次法根管充填治疗慢性牙髓炎、慢性根尖周炎的效果无明显影响.

  16. Eficacia de la moxifloxacina en infecciones odontogénicas

    National Research Council Canada - National Science Library

    Ardila Medina, Carlos Martín

    2009-01-01

    .... Most of these infections are odontogenics, being the most frequent decays, periodontitis, periapical abscess, periodontal abscess, pericoronitis, pulpitis, sinusitis, osteitis and infection of the aponeurotic spaces...

  17. Eficacia de la moxifloxacina en infecciones odontogénicas Efficacy of moxifloxacin in odontogenic infections

    National Research Council Canada - National Science Library

    C.M. Ardila Medina

    2009-01-01

    .... La mayor parte de estas infecciones son odontogénicas, siendo las más frecuentes caries, periodontitis, absceso periapical, absceso periodontal, pericoronaritis, pulpitis, sinusitis, osteítis...

  18. Status of bacterial colonization in teeth associated with different types of pulpal and periradicular disease: A scanning electron microscopy analysis

    Directory of Open Access Journals (Sweden)

    Yan-Hua Huang

    2015-03-01

    Conclusion: Bacterial infection was lighter in the root canals with pulpitis than in those with apical periodontitis, which might require special considerations regarding different stages of pulp and periapical pathology in root canal treatment.

  19. INFLUENCE OF PAIN FROM ACUTE PULPITIS ON THE LEVELS OF SALIVA CORTISOL AND SECRETORY IMMUNOGLOBULIN A%急性牙髓炎疼痛对唾液皮质醇及分泌型免疫球蛋白A水平的影响

    Institute of Scientific and Technical Information of China (English)

    康艳凤; 张薇; 李德利; 甄亚萍; 陈昭燃

    2015-01-01

    目的:探讨急性牙髓炎患者治疗前后唾液中皮质醇(cortisol)及分泌型免疫球蛋白A(secretory immunoglobulin A,sIgA)的变化和临床意义.方法:选择21例急性牙髓炎并自愿参加该实验的患者作为受试者.使用疼痛分级语言评估量表(verbal rating scale,VRS)记录患者牙髓炎急性疼痛发作时和治疗2周后的疼痛指数及不适指数,同时测量脉搏及血压等生理指标.使用无菌唾液收集管留取患者牙髓炎急性发作时和治疗后自然分泌的唾液,经离心机离心后,使用ELISA酶联免疫试剂盒对唾液cortisol及sIgA进行测定,记录检测结果并进行统计学分析.结果:急性牙髓炎患者治疗后同治疗前相比较,疼痛指数及不适指数显著降低(P<0.05),收缩压、舒张压均降低,统计学差异有显著性(P<0.05),脉搏虽有降低但统计学差异无显著性,cortisol显著降低,差异有统计学意义(P<0.05),而sIgA虽呈下降趋势但差异无统计学意义.结论:急性牙髓炎疼痛可引起机体唾液中cortisol水平的显著升高,唾液中cortisol水平可反映急性牙髓炎的病情及治疗效果.

  20. Clinical application of the WandTM computer controlled local anesthesia on the treatment of geriatric pulpitis%The WandTM计算机控制局部麻醉仪在老年人牙髓病治疗中的临床应用

    Institute of Scientific and Technical Information of China (English)

    郭斌; 谢思静; 杨帆; 阙克华; 刘静; 张琼

    2007-01-01

    目的:观察TheWandTM系统在老年牙髓病治疗中的镇痛效果.方法:将38例急性牙髓炎或慢性牙髓炎急性发作的老年患者,采用单纯随机法分为试验组和对照组.试验组(n=19)采用The WandTM系统麻醉下开髓、拔髓,对照组(n=19)采用常规中空注射器抽取相同局部麻醉药手持推注作局部麻醉,同样进行开髓、拔髓,完成后立即请患者在疼痛表上自行评估划记.结果:麻药注射过程中试验组疼痛明显轻于对照组(P<0.05);老年牙科恐惧试验组较对照组明显减轻(P<0.05);麻药生效时间试验组快于对照组(P<0.05);开髓、拔髓中的镇痛效果试验组与对照组无显著差异(P>0.05).结论:The WandTM系统在老年牙髓病治疗中能明显缓解老年人牙科恐惧症,减轻注射疼痛,麻药生效时间优于传统的常规局部麻醉.

  1. Pulpite crônica hiperplásica: análise histológica ao microscópio de luz e microscópio eletrônico de transmissão = Chronic hyperplastic pulpitis: histological analysis in light microscope and transmission electron microscope

    Directory of Open Access Journals (Sweden)

    Moura, Camilla Christian Gomes

    2006-01-01

    Full Text Available Este estudo analisou as características morfológicas de pólipos pulpares de adultos jovens ao microscópio de luz (ML e ao microscópio eletrônico de transmissão (MET. Foram analisados 5 pólipos de primeiros molares, que foram removidos e fixados em glutaraldeído 2,5%. Após a fixação, cada pólipo foi dividido em duas metades, uma foi processada para inclusão em glicol metacrilato e a outra para inclusão em resina epóxica. Os cortes histológicos com 3 µm de espessura foram corados em azul de toluidina e analisados ao ML e os cortes com 80 nm foram contrastados em citrato de chumbo e acetato de uranila e analisados ao MET. Ao ML foi observado epitélio espesso não queratinizado com alguns mastócitos na camada basal. O conjuntivo apresentou infiltrado inflamatório crônico, com ninhos de plasmócitos e vasos neoformados. A análise ao MET mostrou células epiteliais da camada basal com núcleo ovóide, citoplasma com muitos ribossomas livres, mitocôndrias e poucos feixes de tonofilamentos. A lâmina basal apresentou-se nítida com muitos hemidesmossomas. Na camada espinhosa observou-se células grandes, núcleos com cromatina descondensada e nucléolos evidentes. No citoplasma foi observado muitos feixes de tonofilamentos, muitas mitocôndrias, ribossomas livres e muitos desmossomas. No conjuntivo observou-se macrófagos, mastócitos e plasmócitos na região adjacente ao epitélio. Nas regiões mais profundas predominavam fibroblastos entres feixes de fibrilas colágenas, vasos sangüíneos com células endoteliais proeminentes e pericitos associados. Os resultados confirmaram que o epitélio do pólipo pulpar apresenta características morfológicas semelhantes ao da mucosa oral humana. O conjuntivo mostrou características de inflamação crônica de intensidade variada

  2. Observation on the treatment of pulpitis and periapial periodontitis of deciduous molar by iodoform-metronidazole paste%碘灭糊剂空管治疗乳磨牙牙髓炎及尖周炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    邓蔓菁

    1999-01-01

    @@ 儿童乳牙牙髓炎及尖周炎由于其解剖特殊性和生长发育特点,一般不进行充填式根管治疗.本研究采用自制碘灭糊剂空管治疗乳磨牙牙髓炎及尖周炎取得满意效果.

  3. Endodontic diagnosis: evaluation between clinical and histological findings

    Directory of Open Access Journals (Sweden)

    Paloma Souza Gonçalves

    2008-01-01

    Full Text Available Objective: In this study, the aim was to analyze the histologic alterations in thirty dental pulps and correlate them with the clinical findings to verify agreement between the clinical and histopathologic diagnosis and contribute to knowledge about endodontic diagnosis. Methods: Using the methodology of Oliveira4, the pulpal conditions were clinically classified as normal, reversible pulpitis, pulpitis at the stage of transition, irreversible pulpitis and necrosis. Results: Lack of correlation was observed between the clinical and histopathologic diagnoses in the cases classified as reversible and at the stage of transition, which histologically consisted of irreversible lesions or degenerative alterations. All the cases clinically classified as irreversible corresponded to the histologic diagnoses. Conclusion: It was concluded that the correlation between clinical and histopathologic diagnosis of dental pulp was shown to be controversial, even though the semiotechnique used had been imperative for guidance about the irreversibility of pulpal lesion.

  4. Vital pulp therapy in symptomatic immature permanent molars: Report of 3 cases

    Directory of Open Access Journals (Sweden)

    SheikhRezaie MS.

    2009-11-01

    Full Text Available "nEndodontic treatment of immature permanent teeth accompanies with several issues. The primary goal when treating such teeth is to maintain pulp vitality so that root development can occur normally. Indications and requirements for vital pulp therapy include asymptomatic and reversible pulpitis. Also there are controversial opinions regarding the ultimate clinical treatment of the vital pulp therapy techniques. In this manuscript we report 3 cases of immature symptomatic permanent molars with irreversible pulpitis caused by caries exposure of the pulp that have been undergone vital pulp therapy successfully.

  5. Incidence and possible causes of dental pain during simulated high altitude flights.

    Science.gov (United States)

    Kollmann, W

    1993-03-01

    Of 11,617 personnel participating in simulated high altitude flights up to 43,000 feet, only 30 (0.26%) complained of toothache (barodontalgia). The cause of the barodontalgia in 28 episodes of pain in 25 of these subjects was investigated. Chronic pulpitis was suspected as the cause in 22 cases and maxillary sinusitis in 2. No pathosis was detected in the other four. In 10 cases in which the pulpitis was treated by root filling or replacing a deep filling, subsequent exposure to low pressure caused no pain.

  6. Pijn tijdens of na de wortelkanaalbehandeling

    NARCIS (Netherlands)

    Wesselink, P.R.

    2012-01-01

    Een wortelkanaalbehandeling kan pijn veroorzaken tijdens en/of na de behandeling. Tijdens de behandeling moet dan onderscheid worden gemaakt tussen pijn bij een pulpitis en pijn bij een necrotische pulpa. In beide gevallen kan die pijn effectief worden bestreden, afhankelijk van de toestand waarin h

  7. Intracoronal radiolucency in an incompletely erupted permanent molar with a diagnosis of pericoronitis: importance of radiographic examination.

    Science.gov (United States)

    Segura, J J; Jiménez-Rubio, A; Cabrera, R

    1998-04-01

    Because of clinical signs and symptoms, a diagnosis of pericoronitis in a partially erupted, partially impacted first molar was made. A more thorough diagnosis was made with the help of a periapical radiograph that showed caries and thus revealed an irreversible pulpitis. Appropriate treatment was the result.

  8. Spontaneous pain attacks: neuralgic pain

    NARCIS (Netherlands)

    de Bont, L.G.

    2006-01-01

    Paroxysmal orofacial pains can cause diagnostic problems, especially when different clinical pictures occur simultaneously. Pain due to pulpitis, for example, may show the same characteristics as pain due to trigeminal neuralgia would. Moreover, the trigger point of trigeminal neuralgia can either

  9. Spontaneous pain attacks: neuralgic pain

    NARCIS (Netherlands)

    de Bont, L.G.

    2006-01-01

    Paroxysmal orofacial pains can cause diagnostic problems, especially when different clinical pictures occur simultaneously. Pain due to pulpitis, for example, may show the same characteristics as pain due to trigeminal neuralgia would. Moreover, the trigger point of trigeminal neuralgia can either b

  10. Pijn tijdens of na de wortelkanaalbehandeling

    NARCIS (Netherlands)

    Wesselink, P.R.

    2012-01-01

    Een wortelkanaalbehandeling kan pijn veroorzaken tijdens en/of na de behandeling. Tijdens de behandeling moet dan onderscheid worden gemaakt tussen pijn bij een pulpitis en pijn bij een necrotische pulpa. In beide gevallen kan die pijn effectief worden bestreden, afhankelijk van de toestand waarin

  11. Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group

    DEFF Research Database (Denmark)

    Johansen, Jeanne Duus; Hald, Marianne; Andersen, Bo Lasthein

    2011-01-01

    aetiological diagnosis. Results. Irritant contact dermatitis was most frequent in chronic, dry fissured hand eczema (44.3%), pulpitis (41.7%), and nummular hand eczema (40.9%), whereas allergic contact dermatitis dominated in vesicular types of hand eczema, with recurrent (35%) and few (24.2%) eruptions...

  12. [Comparative study of immunocompetent cells of dental pulp of intact teeth, teeth with carious lesion and its complications combined with parodontitis].

    Science.gov (United States)

    Moskovskiĭ, A V

    2007-01-01

    Results of the comparative immunohistochemical study of dental pulp by means of monoclonal antibodies to CD3, CD20, capital ES, CD68 are described. Pulp from the patients with caries, acute and chronic pulpitis in combination with periodontitis on different stages was studied, the qualitative and quantitative feature of dental pulp immune cells--T- and B-lymphocytes and macrophages was determined.

  13. [Immunological status of patients with caries and its complications in combination with parodontitis].

    Science.gov (United States)

    Moskovskiĭ, A V; Shumskiĭ, A V

    2008-01-01

    Results of complex clinical and immunological study of patients with caries and pulpitis in combination with periodontitis were presented. It was revealed that high intensity of caries and parodontitis combines with significant disturbances in cellular and humoral parts of immune system.

  14. Acute dental pain II

    DEFF Research Database (Denmark)

    Jonasson, Peter; Kirkevang, Lise-Lotte; Rosen, Annika;

    2016-01-01

    undersøgelse er afgørende for både diagnosticering og behandlingsvalg. Der vil i denne artikel blive fokuseret på diagnostik og behandling af pulpitis, pulpal nekrose og apikal parodontitis, parodontal abscess og endodontisk-parodontale læsioner, pericoronitis og post-operative problemer. Når en patient...

  15. Spontaneous pain attacks: neuralgic pain

    NARCIS (Netherlands)

    de Bont, L.G.

    2006-01-01

    Paroxysmal orofacial pains can cause diagnostic problems, especially when different clinical pictures occur simultaneously. Pain due to pulpitis, for example, may show the same characteristics as pain due to trigeminal neuralgia would. Moreover, the trigger point of trigeminal neuralgia can either b

  16. Treatment Outcomes of Mineral Trioxide Aggregate Pulpotomy in Vital Permanent Teeth with Carious Pulp Exposure: The Retrospective Study.

    Science.gov (United States)

    Linsuwanont, Pairoj; Wimonsutthikul, Kongthum; Pothimoke, Uht; Santiwong, Busayarat

    2017-02-01

    This study aimed to illustrate the treatment outcomes of mineral trioxide aggregate (MTA) pulpotomy in vital permanent teeth with carious pulp exposure. MTA pulpotomy was performed in 66 vital permanent teeth with carious pulp exposure including teeth with signs and symptoms of irreversible pulpitis and the presence of periapical radiolucency. Patients were assessed for clinical and radiographic outcomes by 2 examiners. The relationship between treatment outcomes and factors was analyzed by means of univariate analysis and binary logistic regression. Fifty patients (a total of 55 teeth) attended the follow-up examination. The age of the patients ranged from 7-68 years old (mean = 29 years old). For the follow-up period as far as 62 months, 48 teeth showed successful outcomes (success rate = 87.3%). Teeth with clinical signs of irreversible pulpitis and the presence of periapical radiolucency could be treated successfully by MTA pulpotomy with success rates of 84% and 76%, respectively.Three of 7 failed cases required pulpectomy after MTA pulpotomy to relieve painful pulpitis. Four other failed cases were asymptomatic, and failure was detected from radiographic examination. The relationship between treatment outcomes and treatment factors could not be detected statistically. Teeth with carious pulp exposure can be treated successfully by MTA pulpotomy. Clinical signs of irreversible pulpitis and the presence of periapical radiolucency should not be considered as a contraindication for pulpotomy. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. Isolation of Mesenchymal Stem Cells from Human Deciduous Teeth Pulp

    Directory of Open Access Journals (Sweden)

    Aileen I. Tsai

    2017-01-01

    Full Text Available This study aimed to identify predictors of success rate of mesenchymal stem cell (MSC isolation from human deciduous teeth pulp. A total of 161 deciduous teeth were extracted at the dental clinic of Chang Gung Memorial Hospital. The MSCs were isolated from dental pulps using a standard protocol. In total, 128 colonies of MSCs were obtained and the success rate was 79.5%. Compared to teeth not yielding MSCs successfully, those successfully yielding MSCs were found to have less severe dental caries (no/mild-to-moderate/severe: 63.3/24.2/12.5% versus 12.5/42.4/42.4%, P<0.001 and less frequent pulpitis (no/yes: 95.3/4.7% versus 51.5/48.5%, P<0.001. In a multivariate regression model, it was confirmed that the absence of dental caries (OR = 4.741, 95% CI = 1.564–14.371, P=0.006 and pulpitis (OR = 9.111, 95% CI = 2.921–28.420, P<0.001 was significant determinants of the successful procurement of MSCs. MSCs derived from pulps with pulpitis expressed longer colony doubling time than pulps without pulpitis. Furthermore, there were higher expressions of proinflammatory cytokines, interleukin- (IL- 6 and monocyte chemoattractant protein- (MCP- 1, P<0.01, and innate immune response [toll-like receptor 1 (TLR1 and TLR8, P<0.05; TLR2, TLR3, and TLR6, P<0.01] in the inflamed than noninflamed pulps. Therefore, a carious deciduous tooth or tooth with pulpitis was relatively unsuitable for MSC processing and isolation.

  18. Isolation of Mesenchymal Stem Cells from Human Deciduous Teeth Pulp

    Science.gov (United States)

    Tsai, Aileen I.; Hong, Hsiang-Hsi; Fu, Jen-Fen; Chang, Chih-Chun; Wang, I-Kuan; Huang, Wen-Hung; Weng, Cheng-Hao; Hsu, Ching-Wei

    2017-01-01

    This study aimed to identify predictors of success rate of mesenchymal stem cell (MSC) isolation from human deciduous teeth pulp. A total of 161 deciduous teeth were extracted at the dental clinic of Chang Gung Memorial Hospital. The MSCs were isolated from dental pulps using a standard protocol. In total, 128 colonies of MSCs were obtained and the success rate was 79.5%. Compared to teeth not yielding MSCs successfully, those successfully yielding MSCs were found to have less severe dental caries (no/mild-to-moderate/severe: 63.3/24.2/12.5% versus 12.5/42.4/42.4%, P < 0.001) and less frequent pulpitis (no/yes: 95.3/4.7% versus 51.5/48.5%, P < 0.001). In a multivariate regression model, it was confirmed that the absence of dental caries (OR = 4.741, 95% CI = 1.564–14.371, P = 0.006) and pulpitis (OR = 9.111, 95% CI = 2.921–28.420, P < 0.001) was significant determinants of the successful procurement of MSCs. MSCs derived from pulps with pulpitis expressed longer colony doubling time than pulps without pulpitis. Furthermore, there were higher expressions of proinflammatory cytokines, interleukin- (IL-) 6 and monocyte chemoattractant protein- (MCP-) 1, P < 0.01, and innate immune response [toll-like receptor 1 (TLR1) and TLR8, P < 0.05; TLR2, TLR3, and TLR6, P < 0.01] in the inflamed than noninflamed pulps. Therefore, a carious deciduous tooth or tooth with pulpitis was relatively unsuitable for MSC processing and isolation. PMID:28377925

  19. 心理督导对康复病人心理免疫的作用%Effect of psychological supervision on psychological immunity in rehabilitating patients

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Background:The development of root of tooth lasted for 3~ 5 years after eruption.Pulpitis and apical periodontitis may contribute to the development stasis of root of tooth,and impair the masticatory function.In order to improve the development of root of tooth and root apiex formation ,the induced formation of cement in root of tooth by drugs was very important in clinic. Objective:To investigate the effect of ultra- short wave combined with antibiotics in the induction of root apiex and functional recovery of affected teeth.Design:Yung adults with Pulpitis and apical periodontitis were randomly divided into two groups,study group(41 teeth) and control group(20 teeth).All patients recepted the routine root canal preparation.3- year X- ray follow- up was performed after treatment.

  20. Pulp-dentine complex changes and root resorption during intrusive orthodontic tooth movement in patients prescribed nabumetone.

    Science.gov (United States)

    Villa, Paula A; Oberti, Giovanni; Moncada, Cesar A; Vasseur, Olga; Jaramillo, Alejandro; Tobón, Diego; Agudelo, Jaime A

    2005-01-01

    Pulpitis, external root resorption, and pain may be experienced during orthodontic movement. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been suggested to control these changes. The purpose of this study was to observe pulp-dentinal reactions, root resorption, tooth pain, and tooth movement after the application of a 4-ounce intrusive orthodontic force to human maxillary first premolars in patients given the NSAID nabumetone. Thirty-four maxillary first premolars were evaluated. A placebo was prescribed to 17 patients after an intrusive force was activated and reactivated for an 8-week period on the right side. The same procedure was repeated on the left side after patients were given nabumetone. Pulp-dentinal reactions and external root resorption were evaluated by histology. Pain and movement were also evaluated. Nabumetone was found to be useful in reducing pulpitis, external root resorption, and pain caused by intrusive orthodontic movement, without altering tooth movement in response to the application of orthodontic force.

  1. Vital Pulp Therapy of a Symptomatic Immature Permanent Molar with Long-Term Success

    Science.gov (United States)

    Sabbagh, Sedigheh; Sarraf Shirazi, Alireza; Eghbal, Mohammad Jafar

    2016-01-01

    Vital pulp therapy (VPT) is the preferred conservative treatment for preservation of symptomatic pulps in immature permanent teeth. The present case report summarizes VPT of an immature permanent molar with irreversible pulpitis associated with apical periodontitis in a 9-year-old boy. Cervical pulpotomy was performed and radicular pulp stumps were covered with calcium-enriched mixture (CEM) cement; the tooth was then restored with stainless steel crown. After a 50-month follow-up period, the pulpotomized molar was clinically functional and asymptomatic. Moreover, radiographic evaluation revealed evidence of complete root development as well as normal periodontal ligament around the roots. The successful outcome achieved through VPT using CEM biomaterial in the reported case suggests that this method may produce favorable outcome for vital immature permanent teeth with irreversible pulpitis and periapical disease. PMID:27790270

  2. Acquired maxillofacial defects from motor vehicle accidents: statistics and prosthodontic considerations.

    Science.gov (United States)

    Wiens, J P

    1990-02-01

    Trauma from motor vehicle accidents is one of the leading causes of death in the United States; moreover, the costs related to personal harm are only second to cancer. Head and neck injuries predominate and involve contact with the vehicle's interior (80%), contact with the vehicle's exterior (12%), or noncontact with the vehicle (8%). The patient with maxillofacial defects resulting from motor vehicle accident will have numerous soft tissue and hard tissue injuries ranging from neurologic involvement to fractures and/or avulsions of the temporomandibular joint, maxillae, mandible, teeth, and supporting structures. Tooth avulsions, pulpitis, and fractures without pulpitis have been found in a 4:2:1 ratio. The prosthodontist plays an important team role by anticipating the increased functional demands that may be placed on the required prostheses and by anticipating the preprosthetic procedures and counseling that may be necessary to assist in the total treatment.

  3. Endodontic Management of a Mandibular First Molar with Radix Entomolaris and Conservative Post-endodontic Restoration with CAD/CAM Onlay: A Novel Clinical Technique

    Science.gov (United States)

    De Ataide, Ida De Noronha; Fernandes, Marina; Lambor, Rajan; Alreja, Dalip

    2016-01-01

    This case report describes a novel technique of restoring endodontically treated teeth. Hidden caries causing irreversible pulpitis in a mandibular molar with Radix Entomolaris (RE) was evident. The intact occlusal surface anatomy was duplicated before preparing an access cavity to replicate the original occlusal surface in the post endodontic restoration using (Computer-Aided Design and Computer-Aided Manufacturing) CAD/CAM technique. This report highlights uniquely designed onlay utilizing the benefits of contemporary materials and advanced technology. PMID:28050515

  4. A new understanding of oral and dental pathology of the equine cheek teeth.

    Science.gov (United States)

    Casey, Miriam

    2013-08-01

    Equine dental disease has a high prevalence. Because of developmental, functional, and anatomic differences, limited inference can be made from brachydont dental pathology to that of equine cheek teeth. This article reviews the pathology of equine cheek teeth and their associated oral tissues, with specific information on periodontitis, pulpitis, maxillary infundibular changes, dental fractures, dental overgrowths, mucosal ulceration, and the regenerative capacity of equine teeth.

  5. Internal granuloma with perforation – 2 case report

    Directory of Open Access Journals (Sweden)

    Ioana Suciu

    2015-11-01

    Full Text Available Internal resorption was associated with long-term chronic inflammation of the pulp (chronic granulomatous pulpitis. When internal resorption is radiographically confirmed, endodontic treatment becomes a necessity. Vital teeth internal resorption appears radiographically as an oval enlargement of the pulp chamber and root canal with smooth, symmetrical outline. Internal granuloma is assumed to be an effect of the trauma, or pulp inflammation, the ailment is rare, asymptomatic and might progress rapidly, causing perforation.

  6. Odontoma compuesto: aplicación a la regeneración ósea guiada con membrana absorbible de colágeno en un defecto de dos corticales

    OpenAIRE

    Patiño Illa, C.; Buenechea Imaz, Ramón; Berástegui, Esther; Gay Escoda, Cosme

    1997-01-01

    Describimos el caso de una paciente que consultó por una pulpitis aguda en el 11 asociada a un odontoma compuesto periapical. La extracción quirúrgica del odontoma provocó un defecto en túnel que fue tratado según el principio de la regeneración ósea guiada con una membrana de colágeno reabsorbible.

  7. Management of recently traumatized maxillary central incisors by partial pulpotomy using MTA: Case reports with two-year follow-up

    OpenAIRE

    2010-01-01

    In traumatized, young, permanent teeth, pulpotomy is classically undertaken to promote apexogenesis. The objective is to promote root development and apical closure. Once root end development and apical closure is achieved, the root canal treatment is completed. However, it has been suggested that mere pulp exposure does not cause pulpitis in the absence of bacteria. Recent studies have proposed that as long as a good seal is ensured, root canal treatment may not be necessary following pulpot...

  8. Vital Pulp Therapy with Three Different Pulpotomy Agents in Immature Molars: A Case Report

    OpenAIRE

    2013-01-01

    Introduction This case report describes apexogenesis treatment of three molar teeth of an 8-year-old boy using three different pulpotomy agents. Methods Pulpotomy was performed on decayed immature molar teeth with established irreversible pulpitis and the remaining pulp was capped with either zinc oxide eugenol, ProRoot mineral trioxide aggregate or calcium-enriched mixture (CEM) cement. Teeth were restored with stainless steel crowns. Results Eighteen months clinical and radiographic follow-...

  9. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

    OpenAIRE

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a carious...

  10. Class II barodontalgia: review and report of a case.

    Science.gov (United States)

    Woodmansey, Karl

    2008-01-01

    Barodontalgia is a rarely reported condition involving changes in ambient pressure resulting in tooth pain. According to Ferjentsik and Aker, Class II barodontalgia is observed in teeth that have pre-existing pulpal disease and an ultimate diagnosis of irreversible pulpitis.1 This article describes a case of Class II barodontalgia that was experienced on a commercial airline flight and reviews current knowledge regarding this phenomenon, including proposed etiologic mechanisms.

  11. Medical Effects and Dosimetric Data from Nuclear Tests at the Semipalatinsk Test Site

    Science.gov (United States)

    2006-10-01

    Pronounced toxicity 8 10 14 Normal thyroid gland 48 72 98 Diabetes mellitus 12 9 13 Glucose intolerance 1 Hypopituitarism 3 4 2 Chronic adrenal insuffi...widespread, as are dental diseases; caries have been diagnosed in every fourth adult inhabitant, not infrequently in association with periodontitis . 71...28.7%) 116 (17.8%) 68 (10.8%) Dental: Caries (uncomplicated) 110 87 Caries with associated pulpitis and periodontal complications 81 61 Glossitis 12

  12. Medical Effects and Dosimetric Data from Nuclear Tests at Semipalatinsk

    Science.gov (United States)

    2006-10-01

    Pronounced toxicity 8 10 14 Normal thyroid gland 48 72 98 Diabetes mellitus 12 9 13 Glucose intolerance 1 Hypopituitarism 3 4 2 Chronic adrenal insuffi...widespread, as are dental diseases; caries have been diagnosed in every fourth adult inhabitant, not infrequently in association with periodontitis . 71...28.7%) 116 (17.8%) 68 (10.8%) Dental: Caries (uncomplicated) 110 87 Caries with associated pulpitis and periodontal complications 81 61 Glossitis 12

  13. ESTUDIO CLÍNICO-RADIOGRÁFICO COMPARATIVO DEL RECUBRIMIENTO PULPAR INDIRECTO CON PASTA A BASE DE UNCARIA TOMENTOSA VS. HIDRÓXIDO DE CALCIO Y CEMENTO ÓXIDO DE ZINC - EUGENOL.

    OpenAIRE

    Lahoud S., Víctor; Pas Director de la Escuela Académico Profesional.; Llizarbe E., Saúl; Profesor Asociado. Departamento Académico Estomatología Rehabilitadora.; Ballona Ch., Pedro; Profesor Departamento Académico Médico Quirúrgico.

    2014-01-01

    90 premolares and molares diagnosed with deep caries groud with symptoms of reversable pulpitis, were divided in 3 groups: Group I, 30 teeth having indirect pulp cap (IPC) Uncaria tomentosa; Group II, 30 teeth having indirect pulp cap with calcium Hidroxyde; Group III, 30 teeth having on indirect pulp cap with Zinc Oxide Eugenol. The clinical radiographic study 90 days demostrated comparativity the advantages of the aplication of Uncaria Tomentosa in the Indirect pulp Cap over the utilization...

  14. Effectiveness and Safety of Computer-controlled Periodontal Ligament Injection System in Endodontic Access to the Mandibular Posterior Teeth

    Institute of Scientific and Technical Information of China (English)

    Quan Jing; Kuo Wan; Xiao-jun Wang; Lin Ma

    2014-01-01

    Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis. Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth:the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4%articaine and 1∶100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure. Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively;χ2=34.3, P Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

  15. Clinical profile of orofacial infections: An experience from two primary care dental practices

    Science.gov (United States)

    Hollinshead, Frank

    2012-01-01

    Objectives: Orofacial infections are common reasons for dental consultations worldwide. However, there is scarcity of data on clinico-epidemiological profiles reported from primary care dental practices. To address this issue, a study was done to characterize the clinical pattern, age groups affected and sex predilection of orofacial infections in the primary care dental practice. Study design: Clinical data was evaluated from random electronic files of patients for whom antimicrobials were prescribed at two Dental Practices in UK between January 2009 and December 2010. Results: 200 case records were studied. 104 (52%) cases were females. Mean age was 37.2 (+/-15.1) years. 107 (53.5%) cases belonged to age group 21-40 years. Posterior teeth were involved in 112 (56%) cases. Types of disease were as follows: dentoalveolar abscess 63(31.5%), pulpitis 27(13.5%), apical periodontitis 21(10.5%), pericoronitis 21(10.5%), dry socket 13(6.5%), periodontitis 9(4.5%) infected root stump 5(2.5%), facial swelling 5(2.5%) and infections unspecified 36(18%) cases. Conclusions: Orofacial infections affect both sexes equally. 21-40 years is the commonest age-group affected. Dentoalveolar abscess is the commonest infection followed by unspecified infections and pulpitis. Key words:Orofacial infections, primary care dental practice, dentoalveolar abscess and pulpitis. PMID:22322492

  16. Clinical application of light curing calcium hydroxide in primary teeth pulpotomy surgery%光固化氢氧化钙在乳牙牙髓切断术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    陈虹; 席微; 来洁

    2016-01-01

    目的:探讨适合乳牙牙髓炎的早期最简单、有效的治疗方法。方法:收治乳牙牙髓炎早期患儿196例,应用光固化氢氧化钙行乳牙牙髓切断术,观察效果。结果:196例患者中,177例取得成功,成功率90.75%。结论:乳牙牙髓炎早期患儿应用光固化氢氧化钙行乳牙牙髓切断术,是一种简单有效的治疗方法。%Objective:To investigate the most simple and effective treatment methods for primary teeth pulpitis.Methods:196 cases of children with early primary teeth pulpitis were selected.They were treated with light curing calcium hydroxide for primary teeth pulpotomy.We observed the effect.Results:In the 196 patients,177 cases were successful,and the success rate was 90.75% . Conclusion:The application of light curing calcium hydroxide in primary teeth pulpotomy surgery for children with early primary teeth pulpitis was a simple and effective treatment.

  17. Effectiveness and safety of computer-controlled periodontal ligament injection system in endodontic access to the mandibular posterior teeth.

    Science.gov (United States)

    Jing, Quan; Wan, Kuo; Wang, Xiao-jun; Ma, Lin

    2014-03-01

    To evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis. A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth: the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4% articaine and 1:100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure. The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively; χ² = 34.3, Pcomputer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

  18. Descripción de las propiedades funcionales del sistema nociceptivo trigeminal en relación con el dolor pulpar

    Directory of Open Access Journals (Sweden)

    Andrés O Pérez Ruíz

    Full Text Available El sistema trigeminal nociceptivo es un componente del sistema sensorial somestésico que tiene la capacidad de discriminar cuatro variables básicas de los estímulos que provocan daño tisular, ellas son: cualidad, curso temporal, localización e intensidad. Las fibras A delta y C, vinculadas a la nocicepción están presentes en la pulpa dental. Se utilizan varias clasificaciones del dolor, atendiendo a diversos criterios: calidad de la sensación, velocidad de transmisión por las fibras, en relación con el lugar del cuerpo donde se exprese, y a la ubicación del nociceptor. La evolución de las condiciones pulpares se clasifican como: pulpitis reversible, pulpitis transicional, pulpitis irreversible y pulpa necrótica.Según su cualidad, el dolor pulpar puede ser punzante o continuo; atendiendo a su aparición, provocado o espontáneo; por su curso, intermitente o continuo; por su localización puede ser limitado a una región, irradiado y referido; y en relación con su intensidad se considera leve, moderado o severo. La capacidad del sistema sensorial nociceptivo en cuanto a discriminar la modalidad, curso temporal, localización e intensidad del estímulo, permite conocer las diferentes etapas de un proceso inflamatorio pulpar.

  19. EVALUATION OF THE PRECISION OF CLINICAL DIAGNOSIS IN PULPOPATHIES

    Directory of Open Access Journals (Sweden)

    Raluca Mihaela Rosca

    2011-09-01

    Full Text Available Most clinicians universally acknowledge the difficulty of establishing a precise clinical diagnosis of the pathological status of the pulpal-dentinary organ, considering both the diversity of the etiological factors and especially the different histopatological forms that may characterize the same lesion. The aim of the present investigation is to identify and quantify the precision of the presumtive diagnosis established on the basis of clinical data and of paraclinical exams, comparatively with the results of the morphopathological work, which establishes the final diagnosis. There have been analyzed 45 teeth, 43 of which with various inflammatory pulpal problems, and 2 clinically-healthy teeth, extracted from orthodontic reasons. Taking advantage of the fact that, along with the development of the treatment, the dental pulp was also available, after its taking over, the surgical piece was prepared and microscopically examined, which permitted an undisputable morphopathological dignosis. To attain scientifically valid results, both the clinically and the morphopathologically obtained results were statistically interpreted by the non-parametric Wilcoxon test. If, from a clinical perspective, most of the cases were classified as mild hyperemia and partially serous acute pulpitis, the morphopathological examination viewed them as irreversible pulpitis, with major supurative and necrotic modifications. The actual diagnosis means cannot establish whether the pulpitis is a serous, a purulent or a combined manifestation in the various pulp sections.

  20. A clinical trial of pulpotomy vs. root canal therapy of mature molars.

    Science.gov (United States)

    Asgary, S; Eghbal, M J

    2010-10-01

    Root canal therapy (RCT) and tooth extraction are the main treatment options for irreversible pulpitis or its sequelae. Pulpotomy is an alternative treatment; however, more evidence is required. If outcomes of pulpotomy with a calcium-enriched mixture (PCEM) are non-inferior for mature molars with irreversible pulpitis compared with those from one-visit RCT (ORCT), this may be a beneficial treatment option. Four hundred seven individuals met the inclusion criteria and were randomly allocated [PCEM (n = 205), ORCT (n = 202)]. We used NRS questionnaires to record pain intensity. Six-month clinical and radiographic successes were assessed. Individuals in the ORCT arm reported significantly more post-operative pain than those in the PCEM arm (P < 0.001). Clinical success rates in the two arms showed no statistically significant difference; however, the radiographic success rates were significantly greater in the PCEM arm (P < 0.001). This trial suggests PCEM as an alternative for treatment of irreversible pulpitis. If long-term results confirm initial ones, PCEM may revolutionize oral health worldwide.

  1. Coronal Pulpotomy Technique Analysis as an Alternative to Pulpectomy for Preserving the Tooth Vitality, in the Context of Tissue Regeneration: A Correlated Clinical Study across 4 Adult Permanent Molars

    Directory of Open Access Journals (Sweden)

    Raji Viola Solomon

    2015-01-01

    Full Text Available Aim. (1 The aim of the clinical study revolves around the accurate diagnosis, proper case selection, and the management of acute irreversible pulpitis in permanent molars with closed apices using conservative and economical treatment modalities like vital pulpotomies with regenerative approaches over conventional root canal procedures. (2 To evaluate the use of autologous substances such as platelet concentrates and calcium silicate based materials in promoting the healing and regeneration of the inflamed pulp. Summary. Vital pulpotomy was performed on 5 carious involved, permanent molars diagnosed with acute irreversible pulpitis in 17- to 22-year-old patients. Taking into consideration the patient’s age and the condition of the underlying pulp tissue, PRF pulpotomy was planned in view of preserving the vitality of the intact radicular pulps. Regenerative procedures with second generation blood matrices were chosen to encourage the recovery of the inflamed pulps. The systematic follow-up examinations performed at 3, 6, 9, 12, 18, 22, and 24 months revealed a successful clinical and radiological outcome. Within the limits of the present clinical study and correlating the success across the treated clinical cases, we safely conclude the potential scope of regenerative pulpotomy approaches in acute irreversible pulpitis in adult permanent teeth.

  2. Urgencias estomatológicas por lesiones pulpares Dental emergencies caused by pulpar lesions

    Directory of Open Access Journals (Sweden)

    Yunaisy Montoro Ferrer

    2012-12-01

    Full Text Available Varias son las enfermedades que llevan a los pacientes a acudir a la consulta de urgencias estomatológicas, la gran mayoría corresponde a afecciones pulpares debido a la sintomatología dolorosa que las caracteriza. El objetivo de este trabajo describir el comportamiento de las enfermedades pulpares en pacientes del área de salud de la clínica estomatológica “27 de Noviembre” en el período comprendido entre los meses de octubre 2008 a diciembre 2009, se realizó un estudio analítico de corte transversal en el cual se incluyeron 173 pacientes adultos entre 19 y 59 años que acudieron al servicio con diagnóstico de cualquiera de las enfermedades pulpares agudas. Del total de casos diagnosticados el 81 para un 46,8 % correspondió a la pulpitis aguda irreversible, el 34,7 % a pulpitis transitoria y el 18,5 % a hiperemia pulpar. El grupo dentario más afectado fue el de los molares y el tipo de lesión pulpar resultó independiente del grupo dentario al igual que resultó independiente del factor causal, entre los cuales aparece con un alto predominio la caries dental con un 65,9 %; el dolor tanto en tipo como en intensidad dependen del tipo de lesión que tenga la pulpa según los resultados del estadígrafo X² de Pearson obtenidos en el estudio, donde el dolor espontáneo se presentó solamente para los pacientes con pulpitis aguda irreversible, en los que ningún caso se reportó el dolor con categoría leve.There is a range of diseases that make the patients go to the dental emergency service; most of them result from pulp disorders due to the painful symptoms that characterize them. The objective of this paper was to describe the behavior of pulp diseases in patients from the health area of "27 de Noviembre2dental clinic in the period of October 2008 through December 2009. To this end, a cross-sectional analytical study was conducted in 173 adult patients aged 19 to 59 years and diagnosed as having any of the acute pulp diseases

  3. Repair and regeneration in endodontics.

    Science.gov (United States)

    Lin, L M; Rosenberg, P A

    2011-10-01

    The ideal objective of treatment of established diseases, including irreversible pulpitis and apical periodontitis, is to achieve wound healing. Wound healing can result in repair or regeneration. The ultimate goal of wound healing is to restore the original architecture and biological function of the injured tissue or organ. Although humans are equipped with powerful innate and adaptive immune defence mechanisms, many intrinsic and extrinsic factors can affect wound healing. Complete regeneration following injury in humans can occur only in the pre-natal foetus within 24 weeks of gestation. Post-natal wounds including irreversible pulpitis or apical periodontitis always heal by repair or by a combination of repair and regeneration. Somatic cells, such as fibroblasts, macrophages, cementoblasts and osteoblasts, in the pulp and periapical tissues have limited potential for regeneration following injury and lack of telomerase. Wound healing of irreversible pulpitis and apical periodontitis requires recruitment and differentiation of progenitor/stem cells into tissue-committed somatic cells. Stem cell differentiation is regulated by intrinsic factors and extrinsic micro-environmental cues. Functionality of stem cells appears to show an age-related decline because of the change in intrinsic properties and diminished signals within the extrinsic local and systemic environment that modulate the function of stem cells or their progeny. Infection induces an immuno-inflammatory response and tissue destruction, which hinders the potential of tissue regeneration. Therefore, prevention, early detection and treatment of inflammation/infection of pulpal and periapical disease can enhance regeneration and minimize the repair of pulpal and periapical tissues after endodontic therapy. © 2011 International Endodontic Journal.

  4. Effect of single dose pretreatment analgesia with three different analgesics on postoperative endodontic pain: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Priyank Sethi

    2014-01-01

    Full Text Available Introduction: One of the aims of root canal treatment is to prevent or eliminate pain. Postoperative endodontic pain control continues to be a significant challenge. Aim: To compare and evaluate the effect of single oral dose of 100 mg of tapentadol, 400 mg of etodolac, or 10 mg of ketorolac as a pretreatment analgesic for the prevention and control of postoperative endodontic pain in patients with symptomatic irreversible pulpitis. The incidence of side effects was recorded as secondary outcome. Materials and Methods: Sixty emergency patients with moderate to severe pain, diagnosed with symptomatic irreversible pulpitis were randomly allocated (1:1:1 to any of the three groups; tapentadol, etodolac, or ketorolac. Medications were administered 30 min before beginning of the endodontic treatment. Patients recorded pain intensity on 10 cm visual analog scale (VAS after treatment, for upto 24 h. Results: At 24 h, mean ±standard deviation (SD of VAS scores (in cm for tapentadol, etodolac, and ketorolac were 0.89 ± 0.83, 2.68 ± 2.29, and 0.42 ± 0.69, respectively. Kruskal-Wallis (K-W test showed significant difference among the three groups (P = 0.001. Mann-Whitney test showed significantly lower VAS scores in tapentadol and ketorolac than etodolac group (P = 0.013 and 0.001, respectively. Conclusions: Single oral dose of 10 mg of ketorolac and 100mg of tapentadol as a pretreatment analgesic significantly reduced postoperative endodontic pain in patients with symptomatic irreversible pulpitis when compared to 400 mg of etodolac.

  5. Interleukin 1-beta analysis in chronically inflamed and healthy human dental pulp

    Directory of Open Access Journals (Sweden)

    Šubarić Ljiljana

    2017-01-01

    Full Text Available Background/Aim. Proinflammatory cytokines can act like endogenous pyrogen interleukin 1 (IL-1, interleukin 6 (IL-6 and tumour necrosis factor alpha (TNF α which regulate the synthesis of secondary mediators and other proinflammatory cytokines through macrophages and mesenchymal cells. They stimulate acute-phase proteins and attract inflammatory cells. The aim of this study was to determine interleukin 1-β (IL-1 β concentrations in chronically inflamed and healthy dental pulps. Methods. A total of 41 pulps (19 from patients with pulpitis chronic causa and 22 from patients with pulpatis chronic aperta, divided into two groups, were obtained from teeth with chronic pulp inflammation. The control group consisted of 12 teeth with healthy pulp. After extirpation, pulp samples were immediately placed in sterile Eppendorf tubes and frozen. After that, homogenisation was performed by a Teflon® pestle in ice-cold phosphate buffer solution at pH 7.4 whose volume was adjusted according to the weight of tissue. The supernatant was then frozen at -70°C until the performance of appropriate biochemical analyses. Cytokine IL-1 β value was determined by a commercial enzyme- linked immunosorbent assay (ELISA test. We applied the high sensitivity system technique, which may register low levels of cytokines, ranging from 0.125 to 8.0 pg/mL for IL-1 β. Results. By comparing the mean value of IL-1β, in the pulps we can see a statistically significant difference (p < 0.01 among them. The highest value of IL-1 β was in the subjects with pulpitis chronica clausa and it was 6.21 ± 2.70 pg/mL. Conclusion. Proinflammatory cytokine IL-1 β is present in detectable quantities in the pulp tissue of all vital pulps. Its highest concentrations were found in the sample group with pulpitis chronica clausa.

  6. Urgencias estomatológicas por lesiones pulpares

    Directory of Open Access Journals (Sweden)

    Yunaisy Montoro Ferrer

    2012-12-01

    Full Text Available Varias son las enfermedades que llevan a los pacientes a acudir a la consulta de urgencias estomatológicas, la gran mayoría corresponde a afecciones pulpares debido a la sintomatología dolorosa que las caracteriza. El objetivo de este trabajo describir el comportamiento de las enfermedades pulpares en pacientes del área de salud de la clínica estomatológica “27 de Noviembre” en el período comprendido entre los meses de octubre 2008 a diciembre 2009, se realizó un estudio analítico de corte transversal en el cual se incluyeron 173 pacientes adultos entre 19 y 59 años que acudieron al servicio con diagnóstico de cualquiera de las enfermedades pulpares agudas. Del total de casos diagnosticados el 81 para un 46,8 % correspondió a la pulpitis aguda irreversible, el 34,7 % a pulpitis transitoria y el 18,5 % a hiperemia pulpar. El grupo dentario más afectado fue el de los molares y el tipo de lesión pulpar resultó independiente del grupo dentario al igual que resultó independiente del factor causal, entre los cuales aparece con un alto predominio la caries dental con un 65,9 %; el dolor tanto en tipo como en intensidad dependen del tipo de lesión que tenga la pulpa según los resultados del estadígrafo X² de Pearson obtenidos en el estudio, donde el dolor espontáneo se presentó solamente para los pacientes con pulpitis aguda irreversible, en los que ningún caso se reportó el dolor con categoría leve.

  7. A Comparison of Equivalent Doses of Lidocaine and Articaine in Maxillary Posterior Tooth Extractions: Case Series

    Directory of Open Access Journals (Sweden)

    Christopher C. Friedl

    2012-06-01

    Full Text Available Objectives: Local anaesthesia is the standard of care during dental extractions. With the advent of newer local anesthetic agents, it is often difficult for the clinician to decide which agent would be most efficacious in a given clinical scenario. This study assessed the efficacy of equal-milligram doses of lidocaine and articaine in achieving surgical anaesthesia of maxillary posterior teeth diagnosed with irreversible pulpitis. Material and Methods: This case-series evaluated a total of 41 patients diagnosed with irreversible pulpitis in a maxillary posterior tooth. Patients randomly received an infiltration of either 3.6 mL (72 mg 2% lidocaine with 1:100,000 epinephrine or 1.8 mL (72 mg 4% articaine with 1:100,000 epinephrine in the buccal fold and palatal soft tissue adjacent to the tooth. After 10 minutes, initial anaesthesia of the tooth was assessed by introducing a sterile 27-gauge needle into the gingival tissue adjacent to the tooth, followed by relief of the gingival cuff. Successful treatment was considered to have occurred when the tooth was extracted with no reported pain. Data was analyzed with the Fisher’s exact test, unpaired t-test and normality test. Results: Twenty-one patients received lidocaine and 20 received articaine. Forty of the 41 patients achieved initial anaesthesia 10 minutes after injection: 21 after lidocaine and 19 after articaine (P = 0.488. Pain-free extraction was accomplished in 33 patients: 19 after lidocaine and 14 after articaine buccal and palatal infiltrations (P = 0.226. Conclusions: There was no significant difference in efficacy between equivalent doses of lidocaine and articaine in the anaesthesia of maxillary posterior teeth with irreversible pulpitis.

  8. Correlation between Histological Status of the Pulp and Its Response to Sensibility Tests

    Science.gov (United States)

    Naseri, Mandana; Khayat, Akbar; Zamaheni, Sara; Shojaeian, Shiva

    2017-01-01

    Introduction: The purpose of this study was to assess the accuracy of sensibility tests by correlating it with histologic pulp condition. Methods and Materials: Assessment of clinical signs and symptoms were performed on 65 permanent teeth that were scheduled to be extracted for periodontal, prosthodontic or orthodontic reasons. The normal pulp and reversible pulpitis were considered as treatable tooth conditions while irreversible pulpitis and necrosis were considered as untreatable conditions. The teeth were then extracted and sectioned for histological analysis of dental pulp. Histologic status and classification corresponded to the treatable or untreatable pulp condition. Comparisons between histological treatable and untreatable pulp condition were performed with chi-square analysis for sensibility test responses. The positive predictive value (PPV), negative predictive value (NPV) and accuracy to detect untreatable from treatable pulp condition were calculated for each test. Results: A significant difference was detected in the normal and a sharp lingered response to heat and cold tests. There was significant difference in the negative response to EPT between histological groups. The kappa agreement coefficient between clinical and histological diagnosis of pulp condition was about 0.843 (P<0.001). The accuracy of cold and heat tests and EPT to detect treatable pulp or untreatable pulp states were 78, 74 and 62%, respectively. The sensibility tests diagnosed untreatable pulpitis with a higher probability (NPV=63%-67% -54%, PPV=83%-91% -95% for heat, cold and EPT, respectively). Conclusion: Sensibility test results were more likely to diagnose pulpal disease or untreatable pulp conditions. However, to increase the diagnostic accuracy patient history, clinical signs and symptoms and also radiographic findings in conjunction with sensibility tests must be used. The result of this small study demonstrated a good agreement between clinical and histological pulp

  9. Sodium channel Nav1.7 immunoreactivity in painful human dental pulp and burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    Yiangou Yiangos

    2010-06-01

    Full Text Available Abstract Background Voltage gated sodium channels Nav1.7 are involved in nociceptor nerve action potentials and are known to affect pain sensitivity in clinical genetic disorders. Aims and Objectives To study Nav1.7 levels in dental pulpitis pain, an inflammatory condition, and burning mouth syndrome (BMS, considered a neuropathic orofacial pain disorder. Methods Two groups of patients were recruited for this study. One group consisted of patients with dental pulpitis pain (n = 5 and controls (n = 12, and the other patients with BMS (n = 7 and controls (n = 10. BMS patients were diagnosed according to the International Association for the Study of Pain criteria; a pain history was collected, including the visual analogue scale (VAS. Immunohistochemistry with visual intensity and computer image analysis were used to evaluate levels of Nav1.7 in dental pulp tissue samples from the dental pulpitis group, and tongue biopsies from the BMS group. Results There was a significantly increased visual intensity score for Nav1.7 in nerve fibres in the painful dental pulp specimens, compared to controls. Image analysis showed a trend for an increase of the Nav1.7 immunoreactive % area in the painful pulp group, but this was not statistically significant. When expressed as a ratio of the neurofilament % area, there was a strong trend for an increase of Nav1.7 in the painful pulp group. Nav1.7 immunoreactive fibres were seen in abundance in the sub-mucosal layer of tongue biopsies, with no significant difference between BMS and controls. Conclusion Nav1.7 sodium channel may play a significant role in inflammatory dental pain. Clinical trials with selective Nav1.7 channel blockers should prioritise dental pulp pain rather than BMS.

  10. Characterization of patient’s inflammatory pulpal diseases. Caracterización de pacientes con afecciones pulpares inflamatorias

    Directory of Open Access Journals (Sweden)

    Ana Isabel Palenque Guillemí

    2008-06-01

    Full Text Available Background: Pulpal diseases are the most common entities in the dentist emergency consultation. For a correct indication of the treatment, it is very important to establish an accurate diagnosis. Objective: to characterize carrier patients with inflammatory pulpal disease. Methods: a descriptive, prospective cases series study which included 222 patients who came to the dentistry emergency consultation in Area I health policlinic. Age, type of disease, cause, more implicated teeth in the disease, visits, and previous treatments were the variables included. Results: there was no difference at all regarding sex. The most affected group of age was from 35 to 59 years old. The inferior molars were the most affected teeth. The main cause was dental cavities. Obturation was the previous treatment more presented. 46% of the patients attended the dentist in more than one occasion with the same process. Acute irreversible pulpitis was the most predominant pulpal disease. Conclusions: The most common pulpal diseases in our milieu was the acute irreversible pulpitis among the ages 35 and 59 years old.
    Fundamento: Las afecciones pulpares son las enfermedades que más llevan a los pacientes a una consulta de urgencia estomatológica. En estos casos, para una correcta indicación de tratamiento, es de suma importancia el establecimiento de un diagnóstico preciso. Objetivo: Caracterizar pacientes portadores de afectaciones pulpares inflamatorias. Métodos: Estudio descriptivo, prospectivo de serie de casos que incluyó 222 pacientes que asistieron a consulta de urgencia estomatológica en la policlínica del Área 1. Se incluyeron las siguientes variables: edad, tipo de afectación, causa, dientes más afectados, visitas y tratamientos previos. Resultados: No hubo diferencias en cuanto al sexo, el

  11. Eficacia de la moxifloxacina en infecciones odontogénicas Efficacy of moxifloxacin in odontogenic infections

    OpenAIRE

    C.M. Ardila Medina

    2009-01-01

    Las infecciones de la boca se caracterizan por ser polimicrobianas, endógenas, oportunistas, dinámicas y mixtas debido a que intervienen bacterias aerobias y especialmente anaerobias. La mayor parte de estas infecciones son odontogénicas, siendo las más frecuentes caries, periodontitis, absceso periapical, absceso periodontal, pericoronaritis, pulpitis, sinusitis, osteítis e infección de los espacios aponeuróticos. Las quinolonas presentan una alta penetración tisular y una buena absorción cu...

  12. Dental magnetic resonance tomography (dental-MRT) as a method for imaging of the maxillo-mandibular bone; Dentale Magnetresonanztomographie (Dental-MRT) als Verfahren zur Darstellung des maxillomandibulaeren Zahnhalteapparates

    Energy Technology Data Exchange (ETDEWEB)

    Gahleitner, A.; Nasel, C.; Schick, S.; Dorffner, S.; Imhof, H.; Trattnig, S. [Wien Univ. (Austria). Abt. fuer Osteologie; Bernhart, T.; Mailath, G.; Watzek, G. [Wien Univ. (Austria). Abt. fuer Orale Chirurgie

    1998-10-01

    Purpose: To establish a new method for dental imaging using magnetic resonance tomography named Dental-MRT and to demonstrate its usefulness in diagnosing dentogen pathologies of the mandible and maxilla. Methods: Seven healthy volunteers, three patients with pulpitis, two patients with dentigerous cysts, two patients after tooth transplantation, and three patients with atrophic mandibles have been evaluated. Optimized axial T{sub 1}- and T{sub 2}-weighted gradient echo and spin echo sequences in 2D and 3D technique have been established to perform studies of the jaws. The acquired images were reconstructed with a standard dental software package on a workstation as panorama and cross-sectional views of the mandible or maxilla. Results: The entire maxillo-mandibular bone, teeth, dental pulp, and the content of the mandibular canal were well depicted. Patients with pulpitis demonstrate bone marrow edema in the periapical region. Dentigerous cysts and their relation to the surrounding structures are clearly shown. After contrast media administration marked enhancement of the dental pulp can be demonstrated. Conclusion: Dental-MRT promises to provide a new tool for visualization and detection of dental diseases. (orig.) [Deutsch] Ziel: Das Vorstellen der Dental-MRT als neue Methode zur Darstellung des Ober- und Unterkiefers und ihre Anwendung bei der Diagnose zahnmedizinischer Erkankungen. Methoden: 7 gesunde Probanden, drei Patienten mit Pulpitis, zwei Patienten mit odontogenen Zysten, zwei Patienten nach Zahntransplantationen und drei Patienten mit atrophem Unterkiefer wurden untersucht. Optimierte axiale T{sub 1}- und T{sub 2}-gewichtete Gradienten-Echo- und Spin-Echo-Sequenzen in 2D und 3D-Technik wurden angewandt. Nach der Untersuchung wurden Panoramaschnitte und dentale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebraeuchlichen Dental-Software, angefertigt. Ergebnisse: Der gesamte Kieferbereich, Zaehne, Pulpa und der Inhalt des

  13. Interdisciplinary Management of an Isolated Intrabony Defect

    Directory of Open Access Journals (Sweden)

    Sheetal Ghivari

    2014-01-01

    Full Text Available The treatment of intrabony defects is a real challenge in molar teeth as it is chronic, slowly progressing disease which needs timely intervention. Periodontal inflammation associated with intrabony defect is not a separate entity as it secondarily affects the pulp causing retrograde pulpitis. However, treatment of these lesions will be complicated due to extensive bone loss. The tooth was endodontically treated followed by periodontal surgery to eliminate the deep periodontal pocket and promote bone fill in osseous defect. PepGen P-15 composited with platelet rich plasma was utilized for enhancing bone formation. The combination of these graft materials provides synergistic effect on bone regeneration.

  14. Antiinflamatorios no esteroideos (AINES).: Consideraciones para su uso estomatológico

    OpenAIRE

    Andrés A. Pérez Ruiz; Ana Marta López Mantecón; Ileana Grau León

    2002-01-01

    Se realiza una revisión extensa y actualizada sobre los antiinflamatorios no esteroideos (AINEs), con el fin de actualizar al estomatólogo en su uso. Para ello se revisan aspectos importantes del proceso inflamatorio en estructuras de la boca que como las pulpitis, presentan sus peculiaridades. Se identifica a una de las 2 familias de autacoides provenientes de los fosfolípidos de membrana celular, es decir, los eicosanoides derivados a partir de algunos ácidos grasos polisaturados, en partic...

  15. Maturogenesis of a cariously exposed immature permanent tooth using MTA for direct pulp capping: a case report.

    Science.gov (United States)

    Patel, Rajiv; Cohenca, Nestor

    2006-12-01

    Successful direct pulp capping of cariously exposed permanent teeth with reversible pulpitis and incomplete apex formation can prevent the need for root canal treatment. A case report is presented which demonstrates the use of mineral trioxide aggregate (MTA) as a direct pulp capping material for the purpose of continued maturogenesis of the root. Clinical and radiographic follow-up demonstrated a vital pulp and physiologic root development in comparison with the contralateral tooth. MTA can be considered as an effective material for vital pulp therapy, with the goal of maturogenesis.

  16. PENERAPAN FUZZY INFERENCE SYSTEM TAKAGI-SUGENO-KANG PADA SISTEM PAKAR DIAGNOSA PENYAKIT GIGI

    Directory of Open Access Journals (Sweden)

    Lutfi Salisa Setiawati

    2016-04-01

    Full Text Available Generally, expert system only show types of disease after user choose symptoms. In the study is done the addition of disease severity level. The method applied in the calculation of the severity is a method of Fuzzy Inference System Takagi-Sugeno-Kang (Method of Sugeno. This study attempts to know whether method Fuzzy Inference System Takagi-Sugeno-Kang can work for expert system in giving the diagnosis diseases of the teeth. The result of this research or severity for diseases of pulpitis reversible 38,53%, pulpitis irreversible 59,64%, periodontitis 69,62%, acute periodontitis 51,43%, gingivitis 45.5%, acute pericoronitis 53,93%, sub acute pericoronitis 52,14%, chronic pericoronitis 46,05%, caries dentist an early stage 37,61%, caries dentist toward an advanced stage 43,89%, caries dentist an advanced stage 51,76%, gangrene pulpa 42,5%, polyps pulpa 56,43%, and periostitis 58,55%. A conclusion that was obtained from the study that is a method of Fuzzy Inference System Takagi-Sugeno-Kang could be applied to expert system of the teeth. Key Word: Teeth , Expert System , Expert System Teeth , Fuzzy Logic , Fuzzy Inference System , Takagi-Sugeno-Kang , Fuzzy Sugeno Pada umumnya, istem pakar hanya menampilkan jenis penyakit setelah user memilih gejala-gejala. Pada penelitian ini dilakukan penambahan tingkat keparahan penyakit. Metode yang diterapkan dalam perhitungan tingkat keparahan ini yaitu Metode Fuzzy Inference System Takagi-Sugeno-Kang (Metode Sugeno. Penelitian ini bertujuan untuk mengetahui apakah metode Fuzzy Inference System Takagi-Sugeno-Kang dapat diterapkan pada sistem pakar dalam memberikan diagnosa penyakit gigi. Hasil dari penelitian ini didapatkan tingkat keparahan untuk penyakit Pulpitis Reversibel 38,53%, Pulpitis Irreversibel 59,64%, Periodontitis 69,62%, Periodontitis Akut 51,43%, Gingivitis 45,5%, Perikoronitis Akut 53,93%, Perikoronitis Sub Akut 52,14%, Perikoronitis Kronis 46,05%, Karies Denties Tahap Awal 37,61%, Karies

  17. Advanced techniques and armamentarium for dental local anesthesia.

    Science.gov (United States)

    Clark, Taylor M; Yagiela, John A

    2010-10-01

    Computer-controlled local anesthetic delivery (C-CLAD) devices and systems for intraosseous (IO) injection are important additions to the dental anesthesia armamentarium. C-CLAD using slow infusion rates can significantly reduce the discomfort of local anesthetic infusion, especially in palatal tissues, and facilitate palatal approaches to pulpal nerve block that find special use in cosmetic dentistry, periodontal therapy, and pediatric dentistry. Anesthesia of single teeth can be obtained using either C-CLAD intraligamentary injections or IO injections. Supplementary IO anesthesia is particularly suited for providing effective pain control of teeth diagnosed with irreversible pulpitis.

  18. Facial Cellulitis Arising from Dens Evaginatus: A Case Report

    Directory of Open Access Journals (Sweden)

    Chun-Ming Chen

    2005-07-01

    Full Text Available Dens evaginatus is a developmental anomaly that produces a tubercle on the occlusal surface of a tooth. It is found most frequently in the mandibular premolars. The occlusal tubercle easily causes occlusal interferences. Attrition or fracture of the tubercle can lead to pulpitis, pulp necrosis, periapical pathosis, and periapical infection. This case report illustrates the treatment of facial cellulitis arising from dens evaginatus with open apex. Calcium hydroxide was used for the apexification procedure. One year after canal obturation, radiography revealed no apical pathosis and the apical seal was evident.

  19. Mineral Trioxide Aggregate (MTA direct pulp capping: 10 years clinical results

    Directory of Open Access Journals (Sweden)

    Lucio Daniele

    2017-06-01

    After 10-years follow-up period, 6 out of 80 teeth required an endodontic treatment, we did not find an increase of pulp calcifications, root resorptions, endodontic lesions. All teeth still alive have responded positively to the cold-temperature test. The three lesions had disappeared at the last X-ray control. All four symptomatic teeth preserved their pulp vitality. The successful treatment rate was 92.5%. Direct pulp capping with MTA can be considered an effective treatment of exposure due to tooth decay and can be considered a valid treatment option for teeth with a diagnosis of not-severe reversible pulpitis.

  20. Taurodontism: A case report of successful treatment of root and crown

    Directory of Open Access Journals (Sweden)

    Abdolsamadi HR.

    2006-08-01

    Full Text Available Taurodontism is a rare dental anomaly in which the involved tooth has enlarged and elongated body and pulp chamber with apical displacement of the pulpal floor. Endodontic treatment of these teeth is challenging because it requires identifying the number of root canals. A case of bilateral involvement of maxillary first molar teeth is presented. Endodontic treatment of the right maxillary first molar with taurodontism was indicated due to irreversible pulpitis. In this article, we described the procedure of root canal therapy for this case.

  1. Manejo clínico de la resorción dental interna utilizando agregad o trióxido mineral como material de obturación intracanal

    OpenAIRE

    Alvaro Francisco Negrete Barbosa

    2013-01-01

    ResumenLa resorción dental interna es una patología poco común, asintomática, que por lo general es detectada accidentalmente en una radiografía de rutina; su etiología es desconocida pero se cree que puede ser producida por trauma, persistencia de una pulpitis crónica, aparatología ortodóntica, entre otras causas. Aunque esta patología es poco frecuente, el endodoncista no puede pasar por alto el conocimiento de esta y mucho menos su tratamiento, ya que de este, depende que la patología se d...

  2. Quistes odontogénicos radiculares. Estudio clínico patológico de 62 casos.

    OpenAIRE

    Zaragozá Dolz, Vicente

    2007-01-01

    RESUMEN Este estudio fue realizado con 62 pacientes del Hospital General Universitario de Valencia, afectados de quiste radicular. Recogimos los siguientes datos: Edad, sexo, localización en los maxilares y la relación del quiste con el diente, tratamientos dentales previos, flemón, pulpitis, caries, traumatismo, movilidad dental, desplazamiento dental o radicular, rizolisis, progresión, dolor, tumefacción, supuración, fístula, pericoronaritis, fiebre, ulceración mucosa, trismus, densidad ...

  3. Endodoncia regenerativa: utilización de fibrina rica en plaquetas autóloga en dientes permanentes vitales con patología pulpar. Revisión narrativa de la literatura*

    OpenAIRE

    Tatiana Ramírez Giraldo; Henry Sossa Rojas

    2014-01-01

    Actualmente una de las mayores controversias en el tratamiento de dientes permanentes con diagnóstico de pulpitis está en la decisión de realizar una Terapia Pulpar Vital (TPV) o un tratamiento convencional de conductos. Diferentes estudios han reportado que se pueden obtener resultados previsibles mediante la realización de una TPV. El éxito del tratamiento dependerá de una adecuada comprensión de la  biología pulpar, un estricto protocolo de tratamiento y una adecuada selección del caso. Co...

  4. Vital tooth with periapical lesion: spontaneous healing after conservative treatment

    Directory of Open Access Journals (Sweden)

    Hyun-Joo Kim

    2012-05-01

    Full Text Available It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.

  5. Estudio de biocompatibilidad celular de distintos materiales utilizados en los recubrimientos pulpar

    OpenAIRE

    Saura Miñano, Diego

    2014-01-01

    La protección pulpar indirecta, o recubrimiento pulpar indirecto, es el tratamiento de caries profundas, mediante el cual evitamos a propósito la entrada en la cámara pulpar, para colocar una base cavitaria y favorecer los mecanismos biológicos de curación. Está indicado en casos de caries profundas asintomáticas o con pulpitis reversible, sin signos ni síntomas de inflamación irreversible, dolor o infección. Para este procedimiento utilizamos diversos materiales, como son los ionómer...

  6. Estudio de biocompatibilidad celular de distintos materiales utilizados en los recubrimientos pulpares

    OpenAIRE

    Saura Miñano, Diego

    2014-01-01

    La protección pulpar indirecta, o recubrimiento pulpar indirecto, es el tratamiento de caries profundas, mediante el cual evitamos a propósito la entrada en la cámara pulpar, para colocar una base cavitaria y favorecer los mecanismos biológicos de curación. Está indicado en casos de caries profundas asintomáticas o con pulpitis reversible, sin signos ni síntomas de inflamación irreversible, dolor o infección. Para este procedimiento utilizamos diversos materiales, como son los ionómeros de vi...

  7. A Comparison of the Anesthesia Efficacy of Articaine and Articaine plus

    Directory of Open Access Journals (Sweden)

    Tahere Aliabadi

    2014-07-01

    Full Text Available Background: Successful local anesthesia is the bedrock of pain control in endodontics. Pain control is essential to reduce fear and anxiety associated with endodontic procedure. The aim of study was, identifying and comparison of the anesthesia efficacy of articaine and articaine plus morphine for buccal infiltration in mandibular posterior teeth with irriversible pulpitis. Materials and Methods: This randomized double-blind clinical trial included 75 patients with symtomatically irreversible pulpitis in mandibular teeth. Patient divided 3 groups randomly received either a buccal infiltration of 4% articaine with 1:100000 epinephrine or articaine morphine with 1:100000 epinephrine or IAN block of 2% lidocaine with 1:800000 epinephrine. Self-reported pain response was recorded on VAS scale before and after local anesthetic injection during access preparation. For statistical analysis were used χ2, t-test, one way ANOVA and Mann Whitney. Results: Statistical analysis result show success rate of articaine (68%, articaine morphine (52% and lidocaine (64%. There was no statistically difference in the success rate between groups. Conclusion: Addition of the morphine to articaine does not increase success rate of buccal infiltration.

  8. Bacterial infections of pulp and periodontal origin.

    Science.gov (United States)

    González-Moles, Miguel Angel; González, Nabila M

    2004-01-01

    The anatomical and structural characteristics of the pulp make this structure prone to altering as a result of, for instance, periodontal conditions (proximity), iatrogenic alterations, infections and involvement of vascular and nerve structures (it is surrounded by hard tissues that prevent expansion), to name just a few. Pulpitis is a process that courses with pain of varying intensity that allows us to determine the location of the lesion in clinical terms. Its evolution varies and may even progress to pulpar necrosis that in turn, produces neuritis-like pain. Diagnosis is established by means of clinical symptomatology and supported by X-rays, palpation of tissues at painful sites, application of electrical stimuli, heat, etc. Periodontitis is a bacterial infection originating in the apex. The most important form is the so-called acute apical periodontitis that arises as a result of a prior episode of pulpitis. It is characterized by acute pain located in the tooth, accompanied by the feeling of having a long-tooth. The patient refers being unable to chew on that side; there may be painful mobility of the tooth and an outflow of pus that alleviates symptoms. X-rays do not provide a lot of information, but may attest to a widening of the apical space. This pathology may disseminate to surrounding tissues, leading to conditions of considerable severity.

  9. Properties of the "Orgamax" osteoplastic material made of a demineralized allograft bone

    Science.gov (United States)

    Podorognaya, V. T.; Kirilova, I. A.; Sharkeev, Yu. P.; Uvarkin, P. V.; Zhelezny, P. A.; Zheleznaya, A. P.; Akimova, S. E.; Novoselov, V. P.; Tupikova, L. N.

    2016-08-01

    We investigated properties of the "Orgamax" osteoplastic material, which was produced from a demineralized bone, in the treatment of extensive caries, in particular chronic pulpitis of the permanent teeth with unformed roots in children. The "Orgamax" osteoplastic material consists of demineralized bone chips, a collagen additive, and antibiotics. The surface morphology of the "Orgamax" osteoplastic material is macroporous, with the maximum pore size of 250 µm, whereas the surface morphology of the major component of "Orgamax", demineralized bone chips, is microporous, with a pore size of 10-20 µm. Material "Orgamax" is used in the treatment of complicated caries, particularly chronic pulpitis of permanent teeth with unformed roots in children. "Orgamax" filling a formed cavity exhibits antimicrobial properties, eliminates inflammation in the dental pulp, and, due to its osteoconductive and osteoinductive properties, undergoes gradual resorption, stimulates regeneration, and provides replacement of the defect with newly formed tissue. The dental pulp viability is completely restored, which ensures the complete formation of tooth roots with root apex closure in the long-term period.

  10. Clinical Survey of Successfulness of DPC with MTA and Calcium Hydroxide

    Directory of Open Access Journals (Sweden)

    E.Yasini

    2005-02-01

    Full Text Available Statement of Problem: The pulp may be exposed during remove of caries or by traumatic and iatrogenicinjuries. The material used to DPC, must be biocompatible, scalable and prevent bacterial leakage.Furthermore, it is better to stimulate dentinogenesis. Calcium hydroxide is most usual material for DPC. But itcannot provide a suitablcbiologic seal. Mineral irioxide aggregate (MTA is also a suitable material for DPC.Purpose: The aim of this study was to compare the clinical success of DPC done with MTA or calciumhydroxide cement.Materials and Methods: In this study eighteen posterior teeth without previous spontaneous pain thatinvolved mechanicaly exposure was randomly selected and capped with MTA or calcium hydroxide. These teeth were evaluated by clinical vitality test and radiograph after 3 and 12 months, and patients werequestioned about irritative or spontancus pain in this period. Statistical analysis was carried out by Usher exacttest (a-0.05.Results: This study showed that in calcium hydroxid groud three had irreversible pulpitis and two teeth had symptom and signs of reversible pulpitis. While, In MTA group all cases were normaL and no clinical sign was evident.Conclusion: MTA exhibited better results than calcium hydroxide cement for the capping of the pulp in human

  11. Biodentine Pulpotomy in Mature Permanent Molar: A Case Report

    Science.gov (United States)

    2016-01-01

    Irreversible pulpitis is the most common reason for endodontic treatment in primary and permanent teeth. Root canal therapy and extraction are the two viable and most documented treatment options for the same. Studies with regards to management of mature permanent teeth with carious exposure and treatment with vital pulp therapies such as adult permanent tooth pulpotomy are scarce. However, permanent tooth pulpotomy with the new calcium-silicate based cements (Mineral Trioxide Aggregate and Biodentine) can help preserve the tooth pulp vitality and promote healing and repair foregoing the more invasive root canal therapy procedure. A 12-year old male patient with irreversible pulpitis in right mandibular first permanent molar was treated with complete coronal pulpotomy with placement of Biodentine in the pulp chamber and a full coronal coverage using stainless steel crown. Clinical and radiographic examinations were performed at three, six, twelve and eighteen months. At the end of 18 months, the patient was completely asymptomatic and the tooth was free of any clinical and radiographic signs of inflammation and infection. PMID:27630966

  12. Scaffolds to control inflammation and facilitate dental pulp regeneration.

    Science.gov (United States)

    Colombo, John S; Moore, Amanda N; Hartgerink, Jeffrey D; D'Souza, Rena N

    2014-04-01

    In dentistry, the maintenance of a vital dental pulp is of paramount importance because teeth devitalized by root canal treatment may become more brittle and prone to structural failure over time. Advanced carious lesions can irreversibly damage the dental pulp by propagating a sustained inflammatory response throughout the tissue. Although the inflammatory response initially drives tissue repair, sustained inflammation has an enormously destructive effect on the vital pulp, eventually leading to total necrosis of the tissue and necessitating its removal. The implications of tooth devitalization have driven significant interest in the development of bioactive materials that facilitate the regeneration of damaged pulp tissues by harnessing the capacity of the dental pulp for self-repair. In considering the process by which pulpitis drives tissue destruction, it is clear that an important step in supporting the regeneration of pulpal tissues is the attenuation of inflammation. Macrophages, key mediators of the immune response, may play a critical role in the resolution of pulpitis because of their ability to switch to a proresolution phenotype. This process can be driven by the resolvins, a family of molecules derived from fatty acids that show great promise as therapeutic agents. In this review, we outline the importance of preserving the capacity of the dental pulp to self-repair through the rapid attenuation of inflammation. Potential treatment modalities, such as shifting macrophages to a proresolving phenotype with resolvins are described, and a range of materials known to support the regeneration of dental pulp are presented. Copyright © 2014. Published by Elsevier Inc.

  13. Characterization of patient’s inflammatory pulpal diseases.

    Directory of Open Access Journals (Sweden)

    Ana Gloria Vázquez de León

    2008-08-01

    Full Text Available Background: Pulpal diseases are the most common entities in the dentist emergency consultation. For a correct indication of the treatment, it is very important to establish an accurate diagnosis. Objective: to characterize carrier patients with inflammatory pulpal disease. Methods: a descriptive, prospective cases series study which included 222 patients who came to the dentistry emergency consultation in Area I health policlinic. Age, type of disease, cause, more implicated teeth in the disease, visits, and previous treatments were the variables included. Results: there was no difference at all regarding sex. The most affected group of age was from 35 to 59 years old. The inferior molars were the most affected teeth. The main cause was dental cavities. Obturation was the previous treatment more presented. 46% of the patients attended the dentist in more than one occasion with the same process. Acute irreversible pulpitis was the most predominant pulpal disease. Conclusions: The most common pulpal diseases in our milieu was the acute irreversible pulpitis among the ages 35 and 59 years old.

  14. Role of intraseptal anesthesia for pain-free dental treatment

    Directory of Open Access Journals (Sweden)

    G Gazal

    2016-01-01

    Full Text Available Pain control during the dental procedure is essentials and challenging. A complete efficacious pulp anesthesia has not been attained yet. The regional anesthesia such as inferior alveolar nerve block (IANB only does not guarantee the effective anesthesia with patients suffering from irreversible pulpitis. This main aim of this review was to discuss various aspects of intraseptal dental anesthesia and its role significance in pain-free treatment in the dental office. In addition, reasons of failure and limitations of this technique have been highlighted. Literature search was conducted for peer-reviewed articles published in English language in last 30 years. Search words such as dental anesthesia, pain control, intraseptal, and nerve block were entered using a web of knowledge and Google scholar databases. Various dental local anesthesia techniques were reviewed. A combination of block anesthesia, buccal infiltration and intraligamentary injection resulted in deep anesthesia (P = 0.003, and higher success rate compared to IANB. For pain-free management of conditions such as irreversible pulpitis, buccal infiltration (4% articaine, and intraosseous injection (2% lidocaine are better than intraligamentary and IANB injections. Similarly, nerve block is not always effective for pain-free root canal treatment hence, needing supplemental anesthesia. Intraseptal anesthesia is an efficient and effective technique that can be used in maxillary and mandibular adult dentition. This technique is also beneficial when used in conjunction to the regional block or local dental anesthesia.

  15. Indirect pulp therapy in a symptomatic mature molar using calcium enriched mixture cement

    Directory of Open Access Journals (Sweden)

    Hassan Torabzadeh

    2013-01-01

    Full Text Available Dental pulp has the ability of repair/regeneration. Indirect pulp therapy (IPT is recommended for pulp preservation in asymptomatic teeth with extremely deep caries as well as teeth with clinical symptoms of reversible pulpitis. In this case study, we performed IPT with calcium enriched mixture (CEM cement on a symptomatic permanent molar. After clinical/radiographic examinations the tooth was diagnosed with irreversible pulpitis and associated apical periodontitis. IPT involved partial caries removal, the placement of CEM cement pulp cap and overlying adhesive permanent restoration. At the 1 week follow-up, patient′s spontaneous symptoms had resolved. One-year follow-up demonstrated pulp vitality, clinical function, as well as the absence of pain/tenderness to percussion/palpation/cold sensitivity tests; periapical radiograph showed a healing periradicular lesion with newly formed bone, that is normal pulp with normal periodontium. These favorable results indicate that IPT/CEM may be a good treatment option in comparison to endodontic treatment in young patients. IPT of deep-caries lesion is an easier, more practical and valuable treatment plan than complete caries removal.

  16. Induction of maturogenesis by partial pulpotomy: 1 year follow-up.

    Science.gov (United States)

    Bacaksiz, A; Alaçam, A

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.

  17. Functional Roles of NOD1 in Odontoblasts on Dental Pulp Innate Immunity

    Directory of Open Access Journals (Sweden)

    Yuki Hosokawa

    2016-01-01

    Full Text Available Caries-related pathogens are first recognized by odontoblasts and induce inflammatory events that develop to pulpitis. Generally, initial sensing of microbial pathogens is mediated by pattern recognition receptors, such as Toll-like receptor and nucleotide-binding oligomerization domain (NOD; however, little is known about NODs in odontoblasts. In this study, the levels of NODs expressed in rat odontoblastic cell line, KN-3, were assessed by flow cytometry and the levels of chemokines in NOD-specific ligand-stimulated KN-3 cells were analyzed by real-time PCR and ELISA. The signal transduction pathway activated with NOD-specific ligand was assessed by blocking assay with specific inhibitors and reporter assay. In KN-3 cells, the expression level of NOD1 was stronger than that of NOD2 and the production of chemokines, such as CINC-1, CINC-2, CCL20, and MCP-1, was upregulated by stimulation with NOD1-specific ligand, but not with NOD2-specific ligand. CINC-2 and CCL20 production by stimulation with NOD1-specific ligand was reduced by p38 MAPK and AP-1 signaling inhibitors. Furthermore, the reporter assay demonstrated AP-1 activation in NOD1-specific ligand-stimulated KN-3 cells. These findings indicated that NOD1 expressed in odontoblasts functions to upregulate the chemokines expression via p38-AP-1 signaling pathway and suggested that NOD1 may play important roles in the initiation and progression of pulpitis.

  18. Understanding about the classification of pulp inflammation

    Directory of Open Access Journals (Sweden)

    Trijoedani Widodo

    2007-03-01

    Full Text Available Since most authors use the reversible pulpitis and irreversible pulpitis classification, however, many dentists still do not implement these new classifications. Research was made using a descriptive method by proposing questionnaire to dentists from various dental clinics. The numbers of the dentists participating in this research are 22 dentists. All respondents use the diagnosis sheet during their examinations on patients. Nonetheless, it can't be known what diagnosis card used and most of the dentists are still using the old classification. Concerning responses given towards the new classification: a the new classification had been heard, however, it was not clear (36.3%; b the new classification has never been heard at all (63.6%. Then, responses concerning whether a new development is important to be followed-up or not: a there are those who think that information concerning new development is very important (27.2%; b those who feel that it is important to have new information (68.3%; c those who think that new information is not important (8%. It concluded that information concerning the development of classification of pulp inflammation did not reach the dentists.

  19. Static Magnetic Field Attenuates Lipopolysaccharide-Induced Inflammation in Pulp Cells by Affecting Cell Membrane Stability

    Directory of Open Access Journals (Sweden)

    Sung-Chih Hsieh

    2015-01-01

    Full Text Available One of the causes of dental pulpitis is lipopolysaccharide- (LPS- induced inflammatory response. Following pulp tissue inflammation, odontoblasts, dental pulp cells (DPCs, and dental pulp stem cells (DPSCs will activate and repair damaged tissue to maintain homeostasis. However, when LPS infection is too serious, dental repair is impossible and disease may progress to irreversible pulpitis. Therefore, the aim of this study was to examine whether static magnetic field (SMF can attenuate inflammatory response of dental pulp cells challenged with LPS. In methodology, dental pulp cells were isolated from extracted teeth. The population of DPSCs in the cultured DPCs was identified by phenotypes and multilineage differentiation. The effects of 0.4 T SMF on DPCs were observed through MTT assay and fluorescent anisotropy assay. Our results showed that the SMF exposure had no effect on surface markers or multilineage differentiation capability. However, SMF exposure increases cell viability by 15%. In addition, SMF increased cell membrane rigidity which is directly related to higher fluorescent anisotropy. In the LPS-challenged condition, DPCs treated with SMF demonstrated a higher tolerance to LPS-induced inflammatory response when compared to untreated controls. According to these results, we suggest that 0.4 T SMF attenuates LPS-induced inflammatory response to DPCs by changing cell membrane stability.

  20. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

    Directory of Open Access Journals (Sweden)

    A. Bacaksiz

    2013-01-01

    Full Text Available In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis, but also physiologic root development (maturogenesis after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development.

  1. Urgency in Pediatric Dentistry: Care Profile of the Integrated Pediatric Clinic of FOUFAL

    Directory of Open Access Journals (Sweden)

    Noelle Albuquerque AMORIM

    2007-09-01

    Full Text Available Objective: To analyze the profile of the urgency care provided atthe Integrated Pediatric Clinic of the School of Dentistry of theFederal University of Alagoas (FOUFAL.Method: 221 patient files were analyzed between April toNovember 2006 and the following data were analyzed by descriptivestatistics: patient identification, type of urgency, involved tooth(teeth, diagnosis and proposed treatment. Only complete files wereincluded.Results: Urgency care was most frequently sought by femalechildren (55.7%; the age ranged between 2 and 14 years (meanage =7.6 years; toothache was the most common cause of urgencycare (53.84%; most cases of dental urgencies involved primarymandibular second molars (34.7%; the maxillary central incisorswere the most affected by traumatic injuries in both the primary(78.5% and permanent (76.2% dentitions; extraction (44% wasthe most common dental procedure followed by root canal therapy(34.5% and restorative treatment (24.5%; dental caries (48.3%was the diagnosis most frequently associated with toothachefollowed by irreversible pulpitis (22.8% and reversible pulpitis(16.1%.Conclusions: Most patients that sought treatment at the UrgencyService of the Pediatric Dentistry Clinic at FOUFAL were femalechildren with a low socioeconomic level. Toothache was the mostfrequent reason for the urgency appointments, extraction was themost common procedure, affecting mainly the primary dentition andthe mandibular second molars.

  2. Miniature Pulpotomy of Symptomatic Mature Permanent Teeth: A Report of Two Cases

    Science.gov (United States)

    Asgary, Saeed; Nourzadeh, Mahdieh; Eghbal, Mohammad Jafar

    2016-01-01

    Human dental pulp inflammation can progress to periapical lesion formation and conventional root canal treatment (RCT) has been the traditional method for disease management. This observational study presents two cases of vital pulp therapy in mature molars diagnosed with irreversible pulpitis and associated with apical periodontitis. In these two clinical cases, the involved teeth had deep carious lesions with a history of spontaneous/lingering pain and radiographic examinations revealed the presence of apical radiolucencies. A conservative miniature pulpotomy (MP) using calcium-enriched mixture (CEM) was performed and the teeth were permanently restored with amalgam. Clinical evaluations indicated resolution of pain 24 hours after treatment; the teeth showed normal vitality, remained asymptomatic and maintained normal function after recall examinations. Furthermore, the 18-month radiographic evaluation showed healing of the apical lesions. Vital pulp therapy using the MP technique with CEM appeared successful in avoiding RCT intervention. These two reports of case outcome suggest that simple MP using a CEM bioregenerative technique may provide a favorable outcome for permanent teeth diagnosed with irreversible pulpitis and associated with apical periodontitis. PMID:26843883

  3. Permanent molar pulpotomy with a new endodontic cement: A case series

    Directory of Open Access Journals (Sweden)

    Asgary Saeed

    2009-01-01

    Full Text Available The aim of this case series was to determine the clinical and radiographic success rate of pulpotomy, with new endodontic cement (NEC, in human mature permanent molar teeth. Twelve molars with established irreversible pulpitis were selected from patients 14 - 62 years old. The selection criteria included carious pulp exposure with a positive history of lingering pain. After isolation, caries removal, and pulp exposure, pulpotomy with NEC was performed and a permanent restoration was immediately placed. At the first recall (+1 day no patients reported postoperative pain. One wisdom tooth had been extracted after two months because of failure in coronal restoration. Eleven patients were available for the second recall, with a mean time of 15.8 months. Clinical and radiographic examination revealed that all teeth were functional and free of signs and symptoms. Histological examination of the extracted teeth revealed complete dentin bridge formation and a normal pulp. Although the results favored the use of NEC, more studies with larger samples and a longer recall period were suggested, to justify the use of this novel material for treatment of irreversible pulpitis in human permanent molar teeth.

  4. Biodentine Pulpotomy in Mature Permanent Molar: A Case Report.

    Science.gov (United States)

    Soni, Harleen Kaur

    2016-07-01

    Irreversible pulpitis is the most common reason for endodontic treatment in primary and permanent teeth. Root canal therapy and extraction are the two viable and most documented treatment options for the same. Studies with regards to management of mature permanent teeth with carious exposure and treatment with vital pulp therapies such as adult permanent tooth pulpotomy are scarce. However, permanent tooth pulpotomy with the new calcium-silicate based cements (Mineral Trioxide Aggregate and Biodentine) can help preserve the tooth pulp vitality and promote healing and repair foregoing the more invasive root canal therapy procedure. A 12-year old male patient with irreversible pulpitis in right mandibular first permanent molar was treated with complete coronal pulpotomy with placement of Biodentine in the pulp chamber and a full coronal coverage using stainless steel crown. Clinical and radiographic examinations were performed at three, six, twelve and eighteen months. At the end of 18 months, the patient was completely asymptomatic and the tooth was free of any clinical and radiographic signs of inflammation and infection.

  5. Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System

    Directory of Open Access Journals (Sweden)

    Alicja Nowicka

    2016-01-01

    Full Text Available Objective. This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system. Methods. Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated. The pulps of 22 teeth were mechanically exposed and randomly assigned to 1 of 2 groups: Single Bond Universal or calcium hydroxide. Another group of 6 teeth acted as the intact control group. The periapical response was assayed, and a clinical examination was performed. The teeth were extracted after 6 weeks, and a histological analysis was performed. The pulp status was assessed, and the thickness of the dentin bridge was measured and categorized using a histological scoring system. Results. The clinical phase was asymptomatic for Single Bond Universal patients. Patients in the calcium hydroxide group reported mild symptoms of pain, although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth. The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis (P>0.05 and a significantly weaker thin mineralized tissue layer (P<0.001 compared with the calcium hydroxide group. Conclusion. The results suggest that Single Bond Universal is inappropriate for human pulp capping; however, further long-term studies are needed to determine the biocompatibility of this agent.

  6. Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System

    Science.gov (United States)

    Parafiniuk, Mirosław; Grocholewicz, Katarzyna; Sobolewska, Ewa; Buczkowska-Radlińska, Jadwiga

    2016-01-01

    Objective. This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system. Methods. Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated. The pulps of 22 teeth were mechanically exposed and randomly assigned to 1 of 2 groups: Single Bond Universal or calcium hydroxide. Another group of 6 teeth acted as the intact control group. The periapical response was assayed, and a clinical examination was performed. The teeth were extracted after 6 weeks, and a histological analysis was performed. The pulp status was assessed, and the thickness of the dentin bridge was measured and categorized using a histological scoring system. Results. The clinical phase was asymptomatic for Single Bond Universal patients. Patients in the calcium hydroxide group reported mild symptoms of pain, although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth. The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis (P > 0.05) and a significantly weaker thin mineralized tissue layer (P < 0.001) compared with the calcium hydroxide group. Conclusion. The results suggest that Single Bond Universal is inappropriate for human pulp capping; however, further long-term studies are needed to determine the biocompatibility of this agent. PMID:27803922

  7. Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth.

    Science.gov (United States)

    Hegde, Swaroop; Sowmya, B; Mathew, Sylvia; Bhandi, Shilpa H; Nagaraja, Shruthi; Dinesh, K

    2017-01-01

    Root canal treatment has been a routine treatment option for carious exposure of the dental pulp. In the context of minimally invasive dentistry, direct pulp capping (DPC) procedure with a reliable biomaterial may be considered as an alternative provided the pulp status is favorable. Mineral trioxide aggregate (MTA), a bioactive cement with excellent sealing ability and biocompatibility is capable of regenerating relatively damaged pulp and formation of dentin bridge when used as DPC agent. Biodentine is comparatively a new biomaterial claimed to possess properties similar to MTA and is currently explored for vital pulp therapy procedures. The aim of the present study was to evaluate the clinical response of pulp-dentin complex after DPC with MTA and biodentine in carious teeth. Twenty-four permanent molars with carious exposure having no signs and symptoms of irreversible pulpitis were selected and assigned to one of the two groups, Group I - MTA and Group II - biodentine. Patients were recalled at 3 weeks, 3 months, and 6 months for clinical and radiographic evaluation. Fisher's exact test was used along with Chi-square test for statistical analysis. Over a period of 6 months, MTA and biodentine showed 91.7% and 83.3% success rate, respectively, based on the subjective symptoms, pulp sensibility tests, and radiographic appearance. MTA and biodentine may be used as DPC agents when the pulpal diagnosis is not more than reversible pulpitis.

  8. Evidence-based assessment: evaluation of the formocresol versus ferric sulfate primary molar pulpotomy.

    Science.gov (United States)

    Loh, Alex; O'Hoy, Polly; Tran, Xuan; Charles, Rachael; Hughes, Andrew; Kubo, Kotaro; Messer, Louise Brearley

    2004-01-01

    Formocresol and ferric sulfate were evaluated as pulpotomy medicaments using evidence-based dentistry principles. Formocresol has been challenged as a potential carcinogen and mutagen, leading to consideration of ferric sulfate. The PICOT statement was: (P) In human carious primary molars with reversible coronal pulpitis, (I) does a pulpotomy performed with ferric sulfate, (C) compared with formocresol, (O) result in dinical/radiographic success, (T) in time periods up to exfoliation? Relevant papers (N=894) were identified from databases and inclusion criteria were applied; 94 papers remained (randomized clinical trials [RCTs]=7; clinical trials [CTs]=28; case-control studies=14; opinions, cohort, and cross-sectional studies=4; reviews=22; irretrievable papers=19). Three RCTs and 10 CTs (total teeth: formocresol=753; ferric sulfate=90) were meta-analyzed; 1 RCT and 1 CT were tested for homogeneity (odds ratios; 95% confidence intervals); 3 RCTs and 10 CTs were examined by student's t test. Clinical data indicated ferric sulfate was significantly more successful than formocresol (OR=1.95; CI=1.01-3.80). Radiographic data indicated no difference between medicaments (OR=0.90; CI=0.58-1.39). Medicaments did not differ with t-tests of clinical (P>.10) and radiographic (P>.50) data. This evidence-based assessment concluded that, in human carious primary molars with reversible coronal pulpitis, pulpotomies performed with either formocresol or ferric sulfate are likely to have similar clinical/radiographic success.

  9. A Comparative Study of Clinical Effect of Root Canal Therapy for Patients with and Without Diabetes%糖尿病与非糖尿病患者根管治疗术后临床疗效的对比研究

    Institute of Scientific and Technical Information of China (English)

    杜春艳

    2015-01-01

    Objective To discuss the clinical curative effect of root canal therapy for patients with and without diabetes so as to improve the level of diagnosis and treatment. Methods 140 patients with pulpitis or periapical periodontitis who underwent single-visit root canal therapy in our hospital during January 2013 and January 2014 were randomized into pulpitis group (n=73) and pe-riapical periodontitis group (n=67). The clinical manifestations of the two diseases in combination with diabetes were discussed re-spectively. The clinical effects and postoperative pain of the patients with and without diabetes in the two groups were compared. Results In the pulpitis group, there was no statistically significant difference between the postoperative pain of the patients with and without diabetes (P>0.05); in the periapical periodontitis group, the rate of postoperative pain of the patients with diabetes, 26.7%, was obviously higher than that of the patients without diabetes, 5.4%, and there was statistically significant difference (P0.05); in the periapical periodontitis group, the total effective rate of the patients with diabetes, 20.0%, was obviously lower than that of the patients without diabetes, 67.6%, and there was statistically significant difference (P0.05);根尖周炎组患者糖尿病患者疼痛发生率为26.7%,显著高于非糖尿病患者的5.4%,差异有统计学意义(P0.05);根尖周炎组患者糖尿病患者总有效率为20.0%,显著低于非糖尿病患者的67.6%,差异有统计学意义(P<0.05)。结论牙髓炎患者由于感染程度较轻、病变范围有限,所以糖尿病与非糖尿病患者之间临床表现无显著差异;根尖周炎患者由于感染更严重,且病变范围较大,其糖尿病患者临床表现较非糖尿病患者差,临床治疗此类患者时应注重血糖控制和合并症状处理。

  10. Oxidative stress in patients with endodontic pathologies

    Directory of Open Access Journals (Sweden)

    Vengerfeldt V

    2017-08-01

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

  11. Peripheral Mechanisms of Dental Pain: The Role of Substance P

    Directory of Open Access Journals (Sweden)

    Paola Sacerdote

    2012-01-01

    Full Text Available Current evidence supports the central role of neuropeptides in the molecular mechanisms underlying dental pain. In particular, substance P, a neuropeptide produced in neuron cell bodies localised in dorsal root and trigeminal ganglia, contributes to the transmission and maintenance of noxious stimuli and inflammatory processes. The major role of substance P in the onset of dental pain and inflammation is increasingly being recognised. Well-grounded experimental and clinical observations have documented an increase in substance P concentration in patients affected by caries, pulpitis, or granulomas and in those undergoing standard orthodontic or orthodontic/dental care procedures. This paper focuses on the role of substance P in the induction and maintenance of inflammation and dental pain, in order to define future lines of research for the evaluation of therapeutic strategies aimed at modulating the complex effects of this mediator in oral tissues.

  12. Peripheral mechanisms of dental pain: the role of substance P.

    Science.gov (United States)

    Sacerdote, Paola; Levrini, Luca

    2012-01-01

    Current evidence supports the central role of neuropeptides in the molecular mechanisms underlying dental pain. In particular, substance P, a neuropeptide produced in neuron cell bodies localised in dorsal root and trigeminal ganglia, contributes to the transmission and maintenance of noxious stimuli and inflammatory processes. The major role of substance P in the onset of dental pain and inflammation is increasingly being recognised. Well-grounded experimental and clinical observations have documented an increase in substance P concentration in patients affected by caries, pulpitis, or granulomas and in those undergoing standard orthodontic or orthodontic/dental care procedures. This paper focuses on the role of substance P in the induction and maintenance of inflammation and dental pain, in order to define future lines of research for the evaluation of therapeutic strategies aimed at modulating the complex effects of this mediator in oral tissues.

  13. Oral diagnosis and treatment planning: part 2. Dental caries and assessment of risk.

    Science.gov (United States)

    Yip, K; Smales, R

    2012-07-27

    Dental caries or tooth decay may be defined as a dynamic process causing progressive destruction of hard tooth substance (enamel, dentine and cementum) involving demineralisation of the inorganic portion of the tooth, and dissolution of the organic portion. The onset and progression of carious lesions involves multiple host, micro-organism and substrate factors interacting in a continuous flux. The diagnosis of initial lesions remains a challenge for practitioners and, despite numerous studies, the assessment of future caries risk is still based largely on a patient's past caries experience. If caries is allowed to progress then pulpitis will occur, which may result in subsequent pulpal necrosis and lead to a local periapical and perhaps a systemic infection.

  14. Coscienze e città: la predicazione a Firenze tra la fine del XIII e gli inizi del XV. Considerazioni introduttive

    Directory of Open Access Journals (Sweden)

    Isabella Gagliardi

    2014-04-01

    Full Text Available Il contributo s’incentra sulla predicazione dei Frati Minori, dei Frati Predicatori e degli Eremitani di Sant’Agostino a Firenze nel periodo compreso tra gli anni Trenta del XIII secolo e gli inizi del XV secolo, in altre parole dalla lotta al catarismo fino all’affermazione delle Osservanze. In particolare nella predicazione mendicante si ricercano le tracce della visione politica dei frati che si sono avvicendati sui vari pulpiti urbani, cercando di rilevare se esista una peculiarità delle Regole e quali siano le analogie e le differenze tra le prediche di ambiente minoritico, domenicano e agostiniano a riguardo. Si rileva, quindi, una sorta di ‘eccellenza’ politica dei Frati Predicatori che dettero prova di nutrire una ben precisa consapevolezza relativa alla costruzione di una società migliore che muoveva dalla centralità del concetto e della pratica dell’equitas.

  15. Changes of microbic associations qualitative contents in caries and its complications with the use of low-intensity laser radiation

    Science.gov (United States)

    Kunin, Anatoly A.; Shumilovitch, Bogdan R.; Stepanov, Nicolay N.

    1996-01-01

    Favorable clinical data at the absence of positive dynamics microbiological research findings in the treatment of caries and their complications give a reason to consider the treatment insufficiently effective and it is necessary to reduce the terms of an additional prophylactic observation and an antirelapse treatment of the disease. That is why researchers all over the world search for new effective methods of influence on the microflora of carious foci. Using the experience of the treatment of 40 patients with caries, 40 patients with chronic pulpitis, and 40 with chronic periodontitis high bactericidal properties of low intensive laser radiation are shown. If after the traditional treatment of foci microflora was inoculated in 62.3% of the cases, after the laser therapy session -- in 26.3% of the cases. The efficiency, ease of handling, and low expenditure of time allow us to recommend this method for a massive use in the treatment of caries and their complications.

  16. Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

    Directory of Open Access Journals (Sweden)

    Evaldo Rodrigues

    2017-02-01

    Full Text Available Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3, two distobuccal (DB1 and DB2, and two palatal (P1 and P2. Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

  17. Indirect pulp capping and primary teeth: is the primary tooth pulpotomy out of date?

    Science.gov (United States)

    Coll, James A

    2008-07-01

    Formocresol pulpotomy (FP) in the United States is most frequently used to treat asymptomatic caries near the pulp in primary teeth. Indirect pulp therapy (IPT) is also indicated and has a significantly higher long-term success. Pulpotomy is thought to be indicated for primary teeth with carious pulp exposures, but research shows the majority of such teeth are nonvital or questionable for treatment with vital pulp therapy. IPT has a significantly higher success in treating all primary first molars, but especially those with reversible pulpitis compared with FP. The purpose of this article was to review the dental literature and new research in vital pulp therapy to determine the following: (1) Is a pulpotomy indicated for a true carious pulp exposure? (2) Is there a diagnostic method to reliably identify teeth that are candidates for vital pulp therapy? (3) Is primary tooth pulpotomy out of date, and should indirect pulp therapy replace pulpotomy?

  18. Painful neuropathy caused by compression of the inferior alveolar nerve by focal osteosclerotic lesion of the mandible: A case report.

    Science.gov (United States)

    Debevc, David; Hitij, Tomaž; Kansky, Andrej

    2017-01-01

    Osteosclerotic lesions are a common finding on dental radiographs. They are considered developmental variants of a normal bone architecture and they usually do not need any treatment. The purpose of this article is to present a rare case of osteosclerotic lesion of the mandible causing trigeminal neuropathy by compression of the alveolar nerve. The pain started with dental hypersensitivity of the mandibular right first molar. Later on, signs of irreversible molar tooth pulpitis developed. Endodontic therapy and apicoectomy did not resolve the pain, which later intensified, and painful neuropathy localized to inferior alveolar nerve developed; therefore, surgical decompression was indicated. Treating a dental patient with neuralgic pain is always a challenge, especially if there is no obvious source or reason for this type of pain. A clear evaluation and treatment protocol are important to minimize the patient's morbidity and avoid unnecessary overtreatment.

  19. Florid cemento-osseous dysplasia mimicking apical periodontitis: A case report.

    Science.gov (United States)

    Rekabi, Ali Reza; Ashouri, Rezvan; Torabi, Molok; Parirokh, Masoud; Abbott, Paul V

    2013-12-01

    Cemento-osseous dysplasia may present as a focal, periapical or florid lesion in the mandible or maxilla. The lesion may sometimes appear similar to peri-radicular lesions on a periapical radiograph. This report presents a case with irreversible pulpitis and root resorption as well as a mixed radiolucent/radiopaque lesion around a mandibular molar tooth root. Root canal treatment was performed and because of the radiographic signs of root resorption and the patient's fear of having a malignant disease, periapical surgery was also performed. The histopathology report confirmed the presence of florid cement-osseous dysplasia which was mimicking apical periodontitis. Follow-up radiography 12 months after the surgery illustrated complete healing of the radiolucent area. © 2011 The Authors. Australian Endodontic Journal © 2011 Australian Society of Endodontology.

  20. Anesthetic effect on mandibular permanent molar by periodontal ligament injection using single tooth anesthetic delivery system%牙周韧带注射对下颌磨牙牙髓麻醉效果的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨勤; 杨素真; 张国金; 郑晖

    2013-01-01

    Objective To assess the anesthetic effect on mandibular permanent molar by periodontal ligament (PDL) injection using single tooth anesthetic (STA) delivery system. Methods 120 mandibular permanent molars diagnosised as deep caries, chronic pulpitis and acute pulpitis were randomly divided into two groups. Using STA system, 60 teeth received PDL injection by standard technique, 60 teeth received PDL injection by improved technique. After anesthetic injection, cavity filling treatment or root canal therapy was performed. Anesthetic effectiveness according to pain sense during treatment period was recorded. Results The anesthetic effect rate on mandibular permanet molars was 92.5%. In deep caries group, the anesthetic effect rate was 100. 0%. In chronic pulpitis group, the anesthetic effective rate was 90%. In acute pulpitis group, the anesthetic effect rate was 85% injected by standard technique and 90% injected by improved technique respectively. There was no significant statistic difference between standard and improved technique (χ2 = 9.445, P = 0.49 ). Conclusion It is a satisfied approach to use either standard or improved technique in PDL injection with STA system in mandibular permanent molar anesthesia.%目的 观察单颗牙麻醉(single tooth anesthesia,STA)系统对下颌磨牙进行牙周韧带(periodontal ligament,PDL)注射后的牙髓麻醉效果.方法 120颗患牙分为深龋、慢性牙髓炎、急性牙髓炎3组,每组各40颗.每组再按照随机原则平均分为2个亚组,分别采用STA系统标准法和改良法麻醉,其中标准法注射点为舌侧PDL,改良法注射点为颊侧PDL.观察记录患者治疗中的疼痛反应,评价牙髓麻醉效果.结果 STA系统对下颌磨牙进行PDL注射后牙髓麻醉的总有效率为92.5%.深龋组标准法和改良法的牙髓麻醉有效率均为100%;慢性牙髓炎组标准法和改良法的牙髓麻醉有效率均为90%;急性牙髓炎组标准法的牙髓麻醉有效率为85

  1. Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

    Science.gov (United States)

    Rodrigues, Evaldo; Braitt, Antônio Henrique; Galvão, Bruno Ferraz

    2017-01-01

    Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

  2. Comparative evaluation of the efficacy of two modes of delivery of Piroxicam (Dolonex®) for the management of postendodontic pain: A randomized control trial

    Science.gov (United States)

    Joshi, Nidhi; Mathew, Sylvia; George, John V.; Hegde, Swaroop; Bhandi, Shilpa; Madhu, K. S.

    2016-01-01

    Background: Alleviating pain is of utmost importance when treating patients with endodontic pain. Aim: To compare and evaluate the efficacy of two modes of delivery of pretreatment Piroxicam (Dolonex®, Pfizer) for the management of postendodontic pain. Materials and Methods: Sixty-six patients with symptomatic irreversible pulpitis were randomly divided into three groups of 22 subjects Group I - control group, no pharmacological intervention, Group II - patients received pretreatment oral Piroxicam (40 mg), Group III - patients received pretreatment intraligamentary injections totaling 0.4 mL of Piroxicam. Single visit endodontic therapy was performed by a single endodontist. Visual analogue scale was used to record pain before treatment and 4, 8, 12, 24, and 48 h postoperatively. Mann–Whitney U-test and Kruskal–Wallis tests were used to analyze the data. Results: The patients in Groups II and III perceived less postendodontic pain as compared to Group I (P Piroxicam was more efficacious. PMID:27563175

  3. An unexpected positive hypersensitive reaction to eugenol.

    Science.gov (United States)

    Tammannavar, Praveen; Pushpalatha, C; Jain, Shrenik; Sowmya, S V

    2013-09-18

    Eugenol is an active, principal aromatic liquid responsible for several pharmacological activities. It is widely used in dental practice to relieve pain arising from various sources, such as pulpitis and dentinal hypersensitivity. As a primary irritant and sensitiser, it is known to cause contact urticaria as well as chronic urticaria. However, eugenol causes allergic contact dermatitis, possibly because it can react directly with proteins to form conjugate and reactive haptens. It is found that eugenol in various dental preparations-especially in the case of some zinc oxide-contains preparations such as periodontal dressings and root canal cements. This can cause hypersensitivity when it comes in contact with gingiva or teeth. This article presents a case of immediate allergic contact urticaria to eugenol during dental treatment.

  4. A case report of multiple cysts in the jaws

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won; Lee, Sang Rae [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1973-11-15

    The authors have interpreted one patient's full mouth intra-oral films, oblique-lateral film of the left mandible and orthopantomograph which revealed 6 radicular and 1 residual cysts. As results of interpretation of these serial films, we have drawn following conclusions: 1. Radicular cyst arose from the cell rests contained in an apical granuloma which was sequel to advanced pulpitis due to dental caries. 2. Radicular cyst was developed from remaining cell rests after the extraction of a tooth with such a radicular cyst of apical dental granuloma. 3. Cyst grew in size by absorption of fluid into cystic cavity due to difference in osmotic pressure between the cystic fluid and adjacent tissue fluid.

  5. Efficiency of Intraligamentary Anesthesia of Inferior Molars for Endodontic Treatment

    Directory of Open Access Journals (Sweden)

    Peycheva K.

    2014-12-01

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

  6. Numb Chin Syndrome Leading to a Diagnosis of Salivary Ductal Adenocarcinoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Lei Wu

    2017-07-01

    Full Text Available Numb chin syndrome (NCS refers to a rare sensory neuropathy characterized by numbness of the chin within the distribution of the mental or inferior alveolar nerve. Although NCS is usually caused by a benign process, it should not be underestimated and a thorough diagnostic evaluation for a new or known progressive malignancy should always be performed. Here, we report a case of salivary ductal adenocarcinoma that mimicked a pulpitis and periodontitis in its early presentation accompanied by numbness of chin. The course and diagnosis of this case are discussed, and a brief review of the literature is presented. It is hoped for clinicians to keep the malignant possibility of NCS in mind and take a thorough examination.

  7. [A comparative study of the effectiveness of the analgesic effect of electropuncture stimulation and nonnarcotic analgesics in therapy patients in an emergency dental care office].

    Science.gov (United States)

    Moroz, B T; Kalinin, V I; Emel'ianova, M V; Rozin, I Ia; Trebich, I Ia

    1990-01-01

    Analysis of patients' subjective sensations, of rheography and electro-odontometry data has lead the authors to a conclusion that the analgesic effect of rengasil was higher than that of ibuprofen and that rengasil combination with electropuncture was still more effective. The analgesic effect was the most marked in alveolitis and periodontitis, less so in inflammations of the pulp, and no effect could be achieved in acute purulent pulpitis. The authors suppose that pain syndrome alleviation after electropuncture stimulation and after administration of anti-inflammatory drugs is explained mainly by changed hemodynamics at the site of inflammation, this resulting in reduction of the edema and in diminished effects of biochemical substances released in the course of inflammation.

  8. Urgencias estomatológicas en pacientes con VIH/SIDA de la Clínica Estomatológica Docente "Yuri Gómez Reinoso" Stomatology urgencies in HIV/AIDS patients in "Yuri Gómez Reinoso" Stomatology Teaching Clinic

    Directory of Open Access Journals (Sweden)

    Susel Quesada Peña

    2011-09-01

    Full Text Available Se realizó un estudio observacional descriptivo transversal con el objetivo de identificar la edad, el sexo y la frecuencia de urgencias estomatológicas y su relación con el tiempo de infección por el virus de inmunodeficiencia humana y el consumo de antirretrovirales. El universo lo constituyeron 32 pacientes mayores de edad, con infección por el virus de inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida, que se presentaron con urgencias estomatológicas en la clínica "Yuri Gómez Reinoso", en La Habana, Cuba, entre el mes de enero de 2008 e igual mes de 2010. Resultó que el 68,75 % correspondieron al sexo masculino, el 31,25 % con edades de 31 a 40 años, el 25 % presentaron estomatitis aftosa recurrente, el 21,8 % absceso dentoalveolar agudo, el 15,62 % pulpitis irreversible aguda y candidiasis eritematosa y el 37,5 % xerostomía. El 46,87 % de los pacientes con infección por el virus de 6 a 10 años de diagnóstico presentaron urgencias. El 46,9 % de los pacientes, no consumían medicamentos antirretrovirales y el 53,1 % sí lo consumían. Estas diferencias no fueron estadísticamente significativas (p= 0,8026. Se concluyó que en los pacientes estudiados, predominó el sexo masculino y los mayores de 31 años. Los tipos de urgencias mayormente tratadas fueron: estomatitis aftosa recurrente, absceso dentoalveolar agudo, pulpitis irreversible y candidiasis eritematosa. En la investigación no se constaron diferencias entre la presencia de urgencias y el consumo de antirretrovirales.A cross-sectional, descriptive and observational study was conducted to identify age, sex and frequency of Stomatology urgencies and its relation to time of infection from HIV and of antiretroviral consumption drugs. Universe included 32 HIV/AIDS adult patients came with Stomatology urgencies in the "Yuri Gómez Reinoso" Teaching Clinic between January, 2008 and January, 2010. The 68.75 % corresponded to male sex, the 31.25 % aged from 31 to

  9. Management of recently traumatized maxillary central incisors by partial pulpotomy using MTA: Case reports with two-year follow-up

    Directory of Open Access Journals (Sweden)

    Abarajithan M

    2010-01-01

    Full Text Available In traumatized, young, permanent teeth, pulpotomy is classically undertaken to promote apexogenesis. The objective is to promote root development and apical closure. Once root end development and apical closure is achieved, the root canal treatment is completed. However, it has been suggested that mere pulp exposure does not cause pulpitis in the absence of bacteria. Recent studies have proposed that as long as a good seal is ensured, root canal treatment may not be necessary following pulpotomy.In this article we report two cases of traumatized, fully matured, maxillary permanent central incisors, which have been treated with mineral trioxide aggregate following partial pulpotomy, with a two-year follow-up.

  10. Clinical and computed tomographic evaluation of portland cement pulpotomy in primary molar: A case report

    Directory of Open Access Journals (Sweden)

    Kamrun Nahar

    2016-08-01

    Full Text Available The present case describes the clinical & radiographic outcome of a Portland Cement pulpotomy. The 5 years old girl presenting extensive carious exposure in her mandibular left 2nd deciduous molar and was suffering pain in her left lower jaw only on exposure to cold for last 2 days. She was ultimately diagnosed clinic-radio-graphically as a case of irreversible pulpitis. Coronal pulpotomy procedure was carried out in the responsible tooth and Portland cement (PC was applied as a medicament after pulpotomy. At the 3 & 6-months follow-up appointments, treated tooth was asymptomatic clinically and radiographic examinations revealed no sign of periradicular pathosis in the pulpotomized teeth. Additionally, the formation of a dentin bridge immediately below the PC in the treated tooth was confirmed by RVG and CBCT.

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

    Science.gov (United States)

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

    2012-05-01

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

  12. Eficacia de la moxifloxacina en infecciones odontogénicas Efficacy of moxifloxacin in odontogenic infections

    Directory of Open Access Journals (Sweden)

    C.M. Ardila Medina

    2009-08-01

    Full Text Available Las infecciones de la boca se caracterizan por ser polimicrobianas, endógenas, oportunistas, dinámicas y mixtas debido a que intervienen bacterias aerobias y especialmente anaerobias. La mayor parte de estas infecciones son odontogénicas, siendo las más frecuentes caries, periodontitis, absceso periapical, absceso periodontal, pericoronaritis, pulpitis, sinusitis, osteítis e infección de los espacios aponeuróticos. Las quinolonas presentan una alta penetración tisular y una buena absorción cuando se suministra después de dosis orales, pero solamente los compuestos desarrollados recientemente como la Moxifloxacina demuestran suficiente efectividad clínica y microbiológica. El objetivo de este artículo es presentar la eficacia in vitro e in vivo de la Moxifloxacina para el tratamiento de las infecciones de origen dental.The infections of the mouth are characterized for being polimicrobians, endogenous, opportunistic, dynamic and mixed because aerobic and specially anaerobic bacteria take part. Most of these infections are odontogenics, being the most frequent decays, periodontitis, periapical abscess, periodontal abscess, pericoronitis, pulpitis, sinusitis, osteitis and infection of the aponeurotic spaces. Quinolonas displays a high tissue penetration and a good absorption when it is provided after oral doses, but only the compounds developed recently as the Moxifloxacin demonstrates sufficient clinical and microbiological effectiveness. The aim of this article is to present the effectiveness in vitro and in vivo of the Moxifloxacin for the treatment of the infections of dental origin.

  13. 根管测量仪测定不同类型患牙工作长度准确性的探讨%Investigation of the apex locator for determining the accuracy of working length of different teeth

    Institute of Scientific and Technical Information of China (English)

    徐俊杰; 邱赛男; 沈婷

    2012-01-01

    目的:探讨不同类型患牙应用根管测量仪测量根管长度的准确性.方法:选择88例需要根管治疗的病例,共122颗患牙,均为单根牙,其中牙髓炎组62颗,根尖周炎组60颗.两组分别采用Root ZX根管测量仪测量根管工作长度并与X线法计算的根管工作长度比较,了解其应用在不同患牙时的准确性.结果:应用根管测量仪牙髓炎组的准确率优于根尖周炎组.结论:电测法测定根管工作长度快速、准确,但对较复杂的患牙,需用X线辅助校正电测法的结果.%Objective: To investigate the accuracy of the apex locater in measuring the working length of different teeth. Method: 122 single-root-canal teeth from 88 patients who need root canal therapy,62 teeth in pulpitis group,60 teeth in apical periodontitis group. The tow groups root canals were measured by Root ZX apex locator, comparing with the working length by X-ray respectively in order to know the accuracy in different dental. ResultiThe result of the pulpitis group was better than that of the apical periodontitis group. Conclusion: The electronic apex locator can measure root canal length accurately and fast.but to the complicated teeth,X-ray can assist in correction results.

  14. Outcomes of endodontic therapy in general practice

    Science.gov (United States)

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

    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

  15. The Profile of Tooth and Gingival Crevicular Fluid Matrix Metalloproteinase-1 in Different Dental Diseases

    Directory of Open Access Journals (Sweden)

    Mutlak Shaimaa S

    2017-07-01

    Full Text Available Background: Pulpitis, apical periodontitis, and chronic periodontitis are the most common dental diseases and being the leading cause of tooth loss in adults. Aims: To unravel the changes and the interrelation of the biochemical and immunohistochemical levels of matrix metalloproteinase-1 (MMP-1 in the gingival crevicular fluid (GCF and teeth specimens of patients with different dental diseases. To test the influence of these changes on disease severity. Materials and methods: The GCF and tooth specimens were collected from 20 patients with chronic irreversible pulpitis (CIP, and similar number of patients with chronic periapical lesion (CPL, and chronic periodontitis (CP in addition to 20 healthy controls. Results: Statistically significant increase were found in the mean concentration of GCF-MMP1 of the patients within the CP and CIP groups over those of CIP and CPL groups (P<0.001. Highly significant elevation (P<0.001 in the means of cell with positive expression of the MMP-1 in all patient groups compared with the mean of the control group. The highest percentages of the MMP-1 expression (P=0.000 above the median values were seen in CPL (13.3% vs 86.7% followed by both CIP and CP groups (9.1% vs 90.9%. Using Receiver Operating Characteristic (ROC curve analysis, the GCF MMP-1 was found to be an effective test in CP group at reading ≥ 0.83 pg/ml and in CPL at cut off value of ≥ 2.24 ng/ml. Conclusion: The MMP1 plays a crucial role in the demolition of periodontal tissue and the GCF analyses can be used as noninvasive method to unravel these changes.

  16. Urgencias estomatológicas en pacientes con VIH/SIDA de la Clínica Estomatológica Docente "Yuri Gómez Reinoso"

    Directory of Open Access Journals (Sweden)

    Susel Quesada Peña

    2011-09-01

    Full Text Available Se realizó un estudio observacional descriptivo transversal con el objetivo de identificar la edad, el sexo y la frecuencia de urgencias estomatológicas y su relación con el tiempo de infección por el virus de inmunodeficiencia humana y el consumo de antirretrovirales. El universo lo constituyeron 32 pacientes mayores de edad, con infección por el virus de inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida, que se presentaron con urgencias estomatológicas en la clínica "Yuri Gómez Reinoso", en La Habana, Cuba, entre el mes de enero de 2008 e igual mes de 2010. Resultó que el 68,75 % correspondieron al sexo masculino, el 31,25 % con edades de 31 a 40 años, el 25 % presentaron estomatitis aftosa recurrente, el 21,8 % absceso dentoalveolar agudo, el 15,62 % pulpitis irreversible aguda y candidiasis eritematosa y el 37,5 % xerostomía. El 46,87 % de los pacientes con infección por el virus de 6 a 10 años de diagnóstico presentaron urgencias. El 46,9 % de los pacientes, no consumían medicamentos antirretrovirales y el 53,1 % sí lo consumían. Estas diferencias no fueron estadísticamente significativas (p= 0,8026. Se concluyó que en los pacientes estudiados, predominó el sexo masculino y los mayores de 31 años. Los tipos de urgencias mayormente tratadas fueron: estomatitis aftosa recurrente, absceso dentoalveolar agudo, pulpitis irreversible y candidiasis eritematosa. En la investigación no se constaron diferencias entre la presencia de urgencias y el consumo de antirretrovirales.

  17. Development and validation of a dental pain-screening questionnaire.

    Science.gov (United States)

    Pau, Allan; Croucher, Ray; Marcenes, Wagner; Leung, Theresa

    2005-12-15

    Dental pain, estimated to affect 12-40% of community-dwelling adults, is a symptom of a wide range of clinical conditions. A population screening instrument is needed to study their prevalence. This project aimed to develop a questionnaire for classifying a sample of dental pain patients into three groups of common dental pain conditions, i.e. Group 1 (Acute periapical periodontitis and Irreversible pulpitis), Group 2 (Reversible pulpitis and Dentine hypersensitivity) and Group 3 (Pericoronitis). Initial items were generated through a literature review, individual unstructured patient interviews and consultation with experts. Items generated were administered to a sample of dental pain patients for self-completion. Responses were subjected to a series of factor and discriminant analyses to identify questions capable of differentiating the sample into three groups, originally categorized by clinical diagnosis, with high classification rates. The selected items were administered to a further sample of dental pain patients to test for its sensitivity and specificity in classifying the sample into three groups against the gold standard of clinical diagnosis. The final 16-item Dental Pain Questionnaire (DePaQ) was capable of correctly classifying 89.7% of dental pain cases initially categorized by clinical diagnoses. The sensitivity of the questionnaire was 0.80-Group z1, 0.85-Group 2 and 0.59-Group 3. Specificity was 0.83-Group A1, 0.89-Group A2 and 0.90-Group 3. The DePaQ, which can easily be administered by non-clinical personnel, may be used to collect epidemiological data on common dental pain conditions, assess dental needs for a specified population, and triage of patients seeking treatment for dental pain.

  18. Odontogenic Infections: A 1-year Retrospective Study.

    Science.gov (United States)

    Mahmoodi, Benjamin; Weusmann, Jens; Azaripour, Adriano; Braun, Benedikt; Walter, Christian; Willershausen, Brita

    2015-04-01

    The purpose of this study was to analyze the prevalence, demographic patterns and management of odontogenic infections in patients undergoing treatment in an outpatient dental emergency service of a university hospital. In a retrospective study of the year 2012, all patients suffering from odontogenic infections were included. Demographic data, diagnosis and the conducted treatment were analyzed. Odontogenic infections were defined as pulpitis, apical and marginal periodontitis, abscesses and pericoronitis. A total of 2,058 out of 4,209 emergency patients suffered from odontogenic infections. The majority (45.0%) had an apical periodontitis, 20.8% abscesses, 17.3% a marginal periodontitis, 16.3% a pulpitis and 5.8% a pericoronitis. Mean age was 37.5 ± 17.0 years standard deviation (SD) (1.2-96.4). Most patients were 20 to 29 years (24.6%), followed by the age group of 30 to 39 year old patients (21.0%). Males were affected more frequently (55.5%) than females (45.5%). Most of the patients (64.5%) of the patients received a dental or surgical treatment. Antibiotics were prescribed in 31.7% of cases. Amoxicillin was the most common prescribed antibiotic (54.5%). Odontogenic infections represent one of the main reasons for consulting the emergency service. Due to the high number of cases and the severe complications, dentists have to be familiar with the surgical management of odontogenic infections as well as the appropriate use of antibiotics. Nearly half of all patients who sought, treatment in the emergency service had an odontogenic infectious disease. This should be considered for the organization and planning of the service.

  19. Restauraciones cerámicas en molares jóvenes con endodoncia Ceramics restorations in young molars with endodontic

    Directory of Open Access Journals (Sweden)

    M. Urdaneta Quintero

    2009-12-01

    Full Text Available Objetivo: Efectuar restauraciones cerámicas Cerec (feldespática y de dióxido de circonio en molares jóvenes con endodoncia, para prevenir complicaciones en el aparato estomatognático por la pérdida de estos dientes. Material y métodos: Se describe la confección de restauraciones cerámicas a nivel de la zona molar mandibular derecha de un paciente del género femenino de 18 años de edad, a quien se le realizó radiografía periapical, por presentar dolor espontáneo en el lado derecho mandibular. Se diagnosticó una pulpitis irreversible en el primer y segundo molar que fue tratada endodónticamente. Las restauraciones cerámicas de ambos molares fueron confeccionadas con los sistemas CAD/CAM Cerec y evaluadas clínicamente a los 6 y 12 meses, de acuerdo a los criterios establecidos por el Servicio de Salud Pública de los Estados Unidos (USPHS. Resultados: La evaluación clínica evidenció que las estructuras de cerámica feldespática y de dióxido de circonio ofrecen en el lapso evaluado, adecuada forma anatómica, adaptación marginal, estabilidad en el color, ausencia de caries recidiva a nivel de dientes del sector posterior con tratamiento endodóntico y aceptación del paciente.Purpose: Make a ceramic restoration (feldsphatic and zirconium dioxide in young molars with endodontic treatment, to prevent further complications in the stomatognathic apparatus for the loss of these teeth. Material and methods: It describes the making of ceramic restorations in the right mandibular molar area to a female patient of 18 years old, to whom it was made a periapical radiography, for presenting spontaneous pain on the mandibular right side. It was diagnosed as an irreversible pulpitis at the first and second molar, that were treated endodontically. The ceramic restorations of both molars were made with the Cerec CAD/CAM system and were examined after 6 and 12 months in accordance with the US Public Health Service (USPHS criteria at baseline

  20. 牙源性牙痛误诊误治68例分析%An analysis of 68 cases of misdiagnosed and mistreated toothache patients

    Institute of Scientific and Technical Information of China (English)

    吴胜

    2011-01-01

    AIM: To analyze the factors influencing the diagnosis of odontogenic toothache. METHODS:Patients with toothache in Guangzhou Haizhu District Dental Hospital in 2005 - 2008 were included. Sixty-eight misdi-agnozed and mistreated patients who recovered after a successful retreatment were studied retrospectively. Clinical data and descriptive statistics were recorded. The main symptoms and signs were analyzed. RESULTS: Pulpitis in which the majority was treated as deep caries without pulp treatment accounted for the largest proportion of misdiagnosis in toothache, followed by hidden caries, cracked, wedge-shaped defects, periodontal pulp joint disease, severe wear and abnormal wear of the central tip. In addition, gingival papillitis and root fracture were also prone to misdiagnosis and mistreatment. CONCLUSION; Generally, atypical symptoms of acute pulpitis, difficulty in locating of toothache source and carelessness of doctors were the main reasons of misdiagnosis and mistreatment.%目的:分析引起牙源性牙痛误诊误治的相关影响因素,以期提高牙痛的正确诊断率.方法:选择2005-2009到广州市海珠区口腔医院就诊的牙痛病例中,对误诊误治并经再次诊治疼痛缓解的病人68例进行回顾性研究,记录病人临床资料信息,统计、分析其主要症状、体征.结果:牙痛误诊中牙髓炎占最大比例,牙髓炎又以深龋已充填未做牙髓治疗者占多数,其余依次为隐蔽龋、隐裂、楔形缺损、牙周牙髓联合病变、重度磨耗及畸形中央尖磨损等.此外龈乳头炎、牙根折也易出现误诊误治.结论:部分牙髓炎急性发作体征不典型,定位困难及医生询问病史、检查不仔细是牙痛误诊、误治主要原因.熟悉各种牙痛的临床表现及体征,抓住引发牙痛几个重要原因以及正确阅读X线片有助于提高牙痛病人的诊治成功率.

  1. Antiinflamatorios no esteroideos (AINES.: Consideraciones para su uso estomatológico

    Directory of Open Access Journals (Sweden)

    Andrés A. Pérez Ruiz

    2002-08-01

    Full Text Available Se realiza una revisión extensa y actualizada sobre los antiinflamatorios no esteroideos (AINEs, con el fin de actualizar al estomatólogo en su uso. Para ello se revisan aspectos importantes del proceso inflamatorio en estructuras de la boca que como las pulpitis, presentan sus peculiaridades. Se identifica a una de las 2 familias de autacoides provenientes de los fosfolípidos de membrana celular, es decir, los eicosanoides derivados a partir de algunos ácidos grasos polisaturados, en particular, ácido araquidónico, que tras la acción de enzimas da lugar a la formación de prostaglandinas, prostaciclinas, tromboxeno A2 y leucotrienos. Conocidos estos antecedentes, nos ocupamos de fármacos usados para combatir los síntomas y signos de la inflamación. Casi todos los antiinflamatorios no esteroideos utilizados en la actualidad, casi todos, inhiben las actividades de la ciclooxigenasa 1 constitutiva y la ciclooxigenasa 2, inducida en el sitio de la inflamación y con ello, la síntesis de prostaglandinas y tromboxanos. Se alude a la ventaja terapéutica de los inhibidores de la COX-2 que aparecen hoy en el mercado. Se expone las dosis y frecuencias de los AINEs, sus interacciones, así como las reacciones adversas al medicamento y contraindicaciones, y se proponen aquellos que son de interés en la práctica estomatológica.Non-steroidal anti-inflammatory drugs. Considerations about their dental use. An extensive updated review of non-steroidal anti-inflammatory agents (NSAIN was made to give an updated information to the dentist about their use. To this purpose, important aspects of the inflammatory process in mouth structures like pulpitis that present with their own peculiarities are reviewed. We identified one of the two autacoid families from cell membrane phospholipids, that is, eicosanoids derived from some polysaturated fatty acids, in particular, arachidonic acid, which, after the action of enzymes, give rise to the formation of

  2. Assessment of pain among a group of Nigerian dental patients.

    Science.gov (United States)

    Odai, Emeka Danielson; Ehizele, Adebola Oluyemisi; Enabulele, Joan Emien

    2015-06-19

    Pain is considered a key symptom associated with possible impairment of oral-health-related quality of life and its assessment is important for the planning and evaluation of preventive and treatment effort. The tools for assessing pain must therefore be valid and consistent. The objective of this study was to assess dental patients' level of pain based on the clinical diagnosis of their dental condition and the correlation between two pain assessment scales, Visual analogue scale (VAS) and the Full Cup Test (FCT), for the assessment of pain among dental patients. A total of 185 patients presenting at the University of Benin Teaching Hospital dental outpatient clinics with various forms of orofacial pain were included in this study. The mean VAS scores and mean FCT scores for the different dental conditions were compared. Agreement between VAS and FCT was evaluated using the Intra-class correlation (ICC) coefficients and Cronbach alpha coefficient was also calculated to assess consistency of the two pain scales. Majority i.e. 95.1, 96.2 and 100% who presented with acute pulpitis, acute apical periodontitis and pericoronitis respectively, presented with moderate to severe pain levels (p < 0.05). Only 25.9 and 4% who presented with chronic marginal gingivitis and chronic pulpitis respectively presented with no pain (p < 0.05). A large proportion (75%) of patients with no pain had single diagnosis while more than half (52.1%) of those who presented with severe pain had multiple diagnoses (p = 0.025). The mean VAS and FCT scores for acute pain were 6.1 ± 2.1 and 5.9 ± 2.4 respectively and for chronic pain 3.9 ± 2.7 and 3.7 ± 2.7 respectively (P = 0.001). The interclass correlation coefficient revealed that the mean VAS and FCT scores were statistically correlated and reliable with a Cronbach alpha coefficient of 0.85. It can be concluded that patients who presented with either acute or chronic dental conditions may experience moderate to severe level of pain, with

  3. Clinical and Radiographic Assessment of the Efficacy of Calcium Silicate Indirect Pulp Capping

    Science.gov (United States)

    Hashem, D.; Mannocci, F.; Patel, S.; Manoharan, A.; Brown, J.E.; Watson, T.F.

    2015-01-01

    The aims of this study were to assess the effectiveness of calcium silicate cement (Biodentine) versus glass ionomer cement (GIC; control group) as indirect pulp capping materials in patients with reversible pulpitis and to compare the effectiveness of cone beam computed tomography (CBCT) versus periapical (PA) radiographs in detecting PA changes at baseline (T0) and at 12 mo (T12) postoperatively. Seventy-two restorations (36 Biodentine, 36 Fuji IX) were placed randomly in 53 patients. CBCT/PA radiographs were taken at T0 and T12. Two calibrated examiners assessed the presence/absence and increase/decrease in the size of existing PA radiolucencies under standardized conditions. The Kappa coefficient evaluated statistically the effectiveness of CBCT versus PA radiographs in detecting PA changes. Chi-square/Mann-Whitney tests were used to evaluate the association between PA changes in CBCT with various clinical measures. Significance was predetermined at α = 0.05. Clinical success rates for Biodentine and Fuji IX GIC were 83.3%. CBCT was significantly more effective in detecting PA radiolucencies compared with radiographs (P = 0.0069). Of the teeth, 65.4% and 90.4% were deemed healthy using CBCT and PA radiographs, respectively, at T12. Healing/healed rates were 17.3%/0%, while new/progressed radiolucency were 30.8%/9.6% with CBCT/PA radiographs, respectively. Seventy-one percent of healed lesions had received Biodentine; 88% of new/progressed lesions received Fuji IX GIC. Teeth presenting with an initial CBCT PA lesion had a failure rate of 63%, whereas teeth with no initial lesion had a failure rate of 16%. Although no statistically significant difference was detected in the clinical efficacy of Biodentine/Fuji IX when used as indirect pulp capping materials in patients with reversible pulpitis, CBCT showed a significant difference in that most healed CBCT lesions had received Biodentine while most that did not heal received Fuji IX. Longer-term follow-up is

  4. TheDiscussabouttheTreatmenttotheAscendingPulpitisonMaxillaryFirstMolar%上颌第一恒磨牙逆行性牙髓炎的治疗探讨

    Institute of Scientific and Technical Information of China (English)

    王玉华; 曹丽婷; 刘玮

    2013-01-01

    Objective To observe the therapy and curative effect of ascending pulpitis on maxillary ifrst molar. Methods 23 maxillary ifrst molars with ascending pulpitis were divided into two groups:mild case and severe case. To cure the mild case with periodontal therapy. To cure the severe case with combined periodonto-endodontic therapy. To observe the result of each treatment. Results The effective power of 10 mild case with periodontal therapy is 85.0%while the effective power of 13 mild case with combined periodonto-endodontic therapy is 92.3%after 1 year’s follow-up visit. Conclusions When the inlfammation of dental pulp ismild, periodontal therapy seem to be a effective method, while the combined periodonto-endodontic therapy could be used to cure the acute inlfammation to gain optimistic effect. We could choose different treatment according to the pathogenetic condition in clinical.%目的探究上颌第一恒磨牙逆行性牙髓炎的治疗方法及效果。方法对23例上颌第一恒磨牙逆行性牙髓炎患者根据病情分轻型,重型两组,分别进行单纯牙周治疗和牙周牙髓联合治疗,观察疗效。结果经1年随访,23例患者中进行单纯牙周治疗的10例有效率为85.0%。牙周牙髓联合治疗的13例有效率达92.3%。结论当逆行性牙髓炎的牙髓炎症为亚急性或充血状态时,单纯牙周治疗即可取得较好疗效;为急性炎症时,牙周牙髓联合治疗可以取得较好疗效,临床上可以根据病情选择治疗方式。

  5. 重度牙周炎病例牙周牙髓联合治疗与单纯牙周治疗的临床对比研究%Clinical Comparison and Study of Combined Periodonto-Endodontic Therapy and Periodontal Treatment Alone for Severe Periodontitis Cases

    Institute of Scientific and Technical Information of China (English)

    刘学

    2014-01-01

    目的观察重度牙周炎病例牙周牙髓联合治疗与单纯牙周治疗的临床效果对比。方法从我院口腔科就诊的重度牙周炎患者中选取48例,随机分为实验组和对照两组,实验组给予牙周牙髓联合治疗,对照组给予单纯牙周治疗。结果实验组有效率为91.66豫;对照组有效率为75豫,差异有统计学意义(<0.05);实验组并发牙髓炎1例,牙周炎复发2例,其它0例;对照组并发牙髓炎5例,牙周炎复发6例,其它1例,差异有统计学意义(<0.05)。结论采用牙周牙髓联合治疗重度牙周炎临床效果较单纯牙周治疗效果更好,临床并发症较少,前者较后者可能更有利于牙周骨组织再生,在临床上值得推广应用。%Objective To observe and compare the clinical ef ects of combined periodondo-endodntic therapy and periodontal treatment alone for severe periodontitis cases. Methods 48 patients with severe periodontitis were randomly divided into experimental group and control group. Experimental group was given combined periodondo-endodntic therapy while control group was given periodontal treatment alone. Results Ef ective rate of experimental group was 91.66%and control group was 75% ( <0.05). Complications of experimental group: 1 case of pulpitis, 1 case of recurrence of periodontitis; complications of control group: 5 cases of pulpitis, 1 case of recurrence of periodontitis and 1 case of other disease ( <0.05). Conclusion Combined periodondo-endodntic therapy has a bet er clinical ef ect than periodontal treatment alone for severe periodontitis cases. It has fewer complications and is more favorable to regeneration of periodontal tissue, so is worth of being popularized in clinical work.

  6. The Safety Assessment and Clinical Countermeasure of the Elderly Hypertensive Patients with ECG Monitoring Dental Treatment%老年高血压患者监护治牙安全评估及临床对策

    Institute of Scientific and Technical Information of China (English)

    郑立娟; 汤晨; 赵旭

    2014-01-01

    观察在心电监护下局麻治疗急性牙髓炎,对老年高血压患者的影响,为其安全治疗提供参考。监测522名老年高血压患者在急性牙髓炎治疗前后及过程中的血压、心率等变化,将测量结果进行分析。患者血压在麻醉即刻及术中比治疗前明显升高(P<0.05),其中收缩压较舒张压变化更为明显。心率在麻醉即刻及治疗中均明显高于治疗前(P<0.05)。病情稳定的老年高血压患者可在心电监护下治牙,Ⅱ、Ⅲ级高血压,可据情况,静脉给药控制性降压,避免高血压危象的发生,严格掌握老年高血压患者治牙适应症,可明显降低治疗中并发症发生的风险,可提高老年高血压患者治牙的安全系数。%ECG monitoring was observed under local anesthesia treatment of acute pulpitis, the impact on elderly hypertensive patients, and to provide for their safe treatment. Monitoring 522 elderly hypertensive patients’ blood pressure, heart rate and other changes in the treatment of acute pulpitis before and during, the measurement results were analyzed. Patient's blood pressure in anesthetized instantly and intraoperative significantly higher than before treatment (P<0.05), the change of systolic blood pressure than diastolic blood pressure was more obvious (P<0.05). In a stable condition of elderly patients with high blood pressure can be dental treatment under ECG monitor, II and III high blood pressure, can according to the situation, intravenous dosing control step-down, avoid the happening of hypertensive crisis, strictly grasp the indications in elderly patients with hypertension treated teeth, can obviously reduce the risk of complications in the treatment, can improve the elderly cardiovascular disease cure tooth safety coefficient.

  7. Involvement of trigeminal transition zone and laminated subnucleus caudalis in masseter muscle hypersensitivity associated with tooth inflammation.

    Directory of Open Access Journals (Sweden)

    Kohei Shimizu

    Full Text Available A rat model of pulpitis/periapical periodontitis was used to study mechanisms underlying extraterritorial enhancement of masseter response associated with tooth inflammation. Periapical bone loss gradually increased and peaked at 6 weeks after complete Freund's adjuvant (CFA application to the upper molar tooth pulp (M1. On day 3, the number of Fos-immunoreactive (IR cells was significantly larger in M1 CFA rats compared with M1 vehicle (veh rats in the trigeminal subnucleus interpolaris/caudalis transition zone (Vi/Vc. The number of Fos-IR cells was significantly larger in M1 CFA and masseter (Mass capsaicin applied (M1 CFA/Mass cap rats compared with M1 veh/Mass veh rats in the contralateral Vc and Vi/Vc. The number of phosphorylated extracellular signal-regulated kinase (pERK-IR cells was significantly larger in M1 CFA/Mass cap and M1 veh/Mass cap rats compared to Mass-vehicle applied rats with M1 vehicle or CFA in the Vi/Vc. Pulpal CFA application caused significant increase in the number of Fos-IR cells in the Vi/Vc but not Vc on week 6. The number of pERK-IR cells was significantly lager in the rats with capsaicin application to the Mass compared to Mass-vehicle treated rats after pulpal CFA- or vehicle-application. However, capsaicin application to the Mass did not further affect the number of Fos-IR cells in the Vi/Vc in pulpal CFA-applied rats. The digastric electromyographic (d-EMG activity after Mass-capsaicin application was significantly increased on day 3 and lasted longer at 6 weeks after pulpal CFA application, and these increase and duration were significantly attenuated by i.t. PD98059, a MEK1 inhibitor. These findings suggest that Vi/Vc and Vc neuronal excitation is involved in the facilitation of extraterritorial hyperalgesia for Mass primed with periapical periodontitis or acute pulpal-inflammation. Furthermore, phosphorylation of ERK in the Vi/Vc and Vc play pivotal roles in masseter hyperalgesia after pulpitis or

  8. Statistical Analysis of 8951 Night-time Dental Emergency Cases in General Hospital%综合性医院口腔科夜间急诊病例8951例回顾分析

    Institute of Scientific and Technical Information of China (English)

    欧阳明

    2013-01-01

      目的通过回顾性分析综合性医院口腔科夜间急诊病例,探讨综合性医院口腔科夜间急诊病例构成特点等。方法对2011年1月至2011年12月上海市中医药大学附属普陀医院口腔科收治的8951例口腔急诊病例进行回顾分析。结果我院口腔科夜间急诊病例分类构成以颌面部外伤最多见,占急诊病例的25.36%,其他依次为急性根尖周炎,冠周炎,急性牙髓炎、牙周炎,拔牙后出血等。颌面部外伤中又以面部皮肤黏膜软组织损伤常见。结论口腔急诊病种范围广,急诊医师除需掌握口腔急诊病种的鉴别诊断外,还需重点掌握颌面部外伤、根尖周炎、牙髓炎等病种的应急处理方法。%Objective To investigate the characteristics of night-time dental emergency diseases in a general hospital by statistical analysis of cases of night-time dental emergency diseases in a general hospital. Methods 8951 cases of night-time dental emergency patients from the dental department of Shanghai university of traditional chinese medicine affiliated Putuo hospital were analyzed. Results Most of the night-time dental emergency diseases were oral and maxillofacial injury, which is 25.36%of emergency cases. The others were acute apicial periodontitis and Pericoronitis, acute pulpitis, periodontitis, postextraction hemorrhage. Facial skin and mucous membranes soft tissue injury is the most common in oral and maxillofacial injury. Conclusion Most of the routine oral diseases could be observed in dental emergency. Emergency dentist must master differential diagnosis of dental emergency diseases and the emergent treatments of oral and maxillofacial injury, apical periodontitis and pulpitis.

  9. 氢氧化钙在年轻恒牙牙髓治疗中的疗效探析%Efficacy of Calcium Hydroxide in Endodontic Therapy for Immature Per-manent Teeth

    Institute of Scientific and Technical Information of China (English)

    宋林操

    2015-01-01

    目的:探析氢氧化钙在年轻恒牙牙髓治疗中的疗效。方法整群选取2012年1月-2015年6月该院收治的52例(54颗)第一磨牙牙髓炎和根尖周炎年轻恒牙患者作为研究对象,均给予氢氧化钙进行牙髓治疗,对其临床治疗效果进行分析。结果21颗深龋导致的意外穿髓采用盖髓术和活髓切断术进行治疗后,成功19颗,成功率为90.5%,33颗牙髓炎和根尖周炎采用根管治疗后成功30颗,成功率为(90.9%)。结论氢氧化钙在年轻恒牙牙髓治疗中的疗效确切,安全可靠,值得临床选择和积极推广使用。%Objective To analyze the efficacy of calcium hydroxide in endodontic therapy for immature permanent teeth. Methods 52 patients (54 teeth) with immature permanent teeth suffering from pulpitis and periapical periodontitis in first molar teeth admitted to our hospital from January 2012 and June 2015 were included in this study and given endodontic therapy using calcium hydroxide. The clinical efficacy was analyzed. Results 21 teeth of unexpected pulp canalization in deep dental caries were treated by pulp capping and pulpotomy and 19 were treated successfully with a success rate of 90.5%. 33 teeth of pulpitis and periapical periodontitis were treated by root canal therapy and 30 were treated successfully with a success rate of 90.9%. Conclusion Calcium hydroxide in endodontic therapy for immature permanent teeth has exact efficacy and is safe and reliable, therefore this method is worthy of application and active promotion in clinical practice.

  10. Magnetic resonance tomography and dental radiology (Dental-MRT); Die Magnetresonanztomographie in der Dentalradiologie (Dental-MRT)

    Energy Technology Data Exchange (ETDEWEB)

    Gahleitner, A. [Wien Univ. (Austria). Abt. fuer Osteologie; Wien Univ. (Austria). Abt. fuer Orale Chirurgie; Solar, P.; Ertl, L. [Wien Univ. (Austria). Abt. fuer Orale Chirurgie; Nasel, C.; Homolka, P. [Wien Univ. (Austria). Inst. fuer Biomedizinische Technik und Physik; Youssefzadeh, S.; Schick, S. [Wien Univ. (Austria). Abt. fuer Osteologie

    1999-12-01

    Purpose: To demonstrate the usefulness of Dental-MRT for imaging of anatomic and pathologic conditions of the mandible and maxilla. Methods: Seven healthy volunteers, 5 patients with pulpitis, 9 patients with dentigerous cysts, 5 patients after tooth transplantation and 12 patients with atrophic mandibles were evaluated. Studies of the jaws using axial T1- and T2-weighted gradient echo and spin echo sequences in 2D and 3D technique have been to performed. The acquired images were reconstructed with a standard dental software package on a workstation as panoramic and cross sectional views of the mandible or maxilla. Results: The entire maxilla and mandibula, teeth, dental pulp and the content of the mandibular canal were well depicted. Patients with inflammatory disease of the pulp chamber demonstrate bone marrow edema in the periapical region. Dentigerous cysts and their relation to the surrounding structures are clearly shown. After contrast media application marked enhancement of the dental pulp can be found. Conclusion: Dental-MRT provides a valuable tool for visualization and detection of dental diseases. (orig.) [German] Ziel dieses Beitrags ist die Vorstellung der Untersuchungsmoeglichkeiten des Ober- und Unterkiefers mittels Magnetresonanztomographie (Dental-MRT) und ihre Anwendung bei der Diagnose zahnmedizinischer Erkrankungen. Sieben gesunde Probanden, 5 Patienten mit Pulpitis, 9 Patienten mit dentogenen Zysten, 5 Patienten nach Zahntransplantationen und 12 Patienten mit atrophem Unterkiefer wurden untersucht. Axiale T1- und T2-gewichtete Gradientenecho- und Spinecho-Sequenzen in 2D und 3D-Technik wurden durchgefuehrt. Nach der Untersuchung wurden zusaetzliche Panoramaschnitte und orhoradiale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebraeuchlichen Dental-Software, angefertigt. Der gesamte Ober- oder Unterkiefer, Zaehne, Pulpa und der Inhalt des Mandibularkanals koennen gut dargestellt werden. Patienten mit einer Entzuendung der

  11. 一次性根管充填在临床应用的体会%Experience in Clinical Root Canal Filling

    Institute of Scientific and Technical Information of China (English)

    高娜

    2014-01-01

    目的方法结果结论利用根管测量仪对一次性根管治疗术在牙髓炎,无根尖症状及叩痛的慢性根尖周炎及改变就位方向的活随牙治疗中的可行性。方法院对140颗患牙髓炎进行一次性根管充填,术后X线检查均无欠充或超充情况,随访1w和1年,通过临床和X线检查,评价其疗效。结论院适应症选择正确,遵守无菌操作,利用根管测量仪进行一次根管充填减少了根管因反复封药而造成的继发感染,也减少了患者反复上医院的次数,因此一次性根管充填是可行的。%Objective The use of root canal measuring instrument of one-time root canal therapy to pulpitis, periapical symptom free and percussion pain chronic periapical periodontitis and change in the direction of live with the feasibility of the treatment of tooth. Methods 140 teeth with pulpitis were one-time root canal fil ing, postoperative X-ray examinations showed no charge less or over fil ing, fol owed up for 1 weeks and 1 years, the clinical and X-ray examination, evaluation of its ef icacy. Conclusion Indications correctly, obey the aseptic operation, use the root of a root canal filling reduces secondary root canal sealing caused by repeated infection pipe measurement instrument, also reduced the number of patients with recurrent hospital, so the one-time root canal filling is feasible.

  12. Endodoncia regenerativa: utilización de fibrina rica en plaquetas autóloga en dientes permanentes vitales con patología pulpar. Revisión narrativa de la literatura*

    Directory of Open Access Journals (Sweden)

    Tatiana Ramírez Giraldo

    2014-07-01

    Full Text Available Actualmente una de las mayores controversias en el tratamiento de dientes permanentes con diagnóstico de pulpitis está en la decisión de realizar una Terapia Pulpar Vital (TPV o un tratamiento convencional de conductos. Diferentes estudios han reportado que se pueden obtener resultados previsibles mediante la realización de una TPV. El éxito del tratamiento dependerá de una adecuada comprensión de la  biología pulpar, un estricto protocolo de tratamiento y una adecuada selección del caso. Con este fin, diferentes materiales han sido sugeridos. Recientemente se ha utilizado la Fibrina Rica en Plaquetas, biomaterial que cumple con propiedades biológicas para lograr una mayor rapidez y adecuada cicatrizacion del tejido. Es necesario desarrollar tratamientos dirigidos a preservar la vitalidad de la pulpa, evitando recurrir como primera opción al tratamiento convencional de conductos, teniendo como objetivo conservar o regenerar el complejo dentino pulpar.

  13. Comparison of fibroblast cell regeneration in three different concentrations of Wharton’s Jelly mesenchymal stem cells conditioned medium (WJMSCs-CM)

    Science.gov (United States)

    Untoro, E. G.; Asrianti, D.; Usman, M.; Meidyawati, R.; Margono, A.

    2017-08-01

    Wharton’s Jelly-derived mesenchymal stem cells (WJMSCs) have gained interest as an alternative source of stem cells for regenerative medicine. Although many studies have characterized Wharton’s Jelly biologically, the effects of different concentrations in a cultured medium have not yet been compared. Damaged fibroblasts, the primary components of irreversible dental pulpitis, irreversibly impair the ability to regenerate and lead to the disruption of extracellular matrix. This study was performed to evaluate the potency of three WJMSCs-CM concentrations in improving serum-starved fibroblasts. Fibroblasts were cultivated in five passages, and divided into four groups. The first group (the control group) consisted of fibroblast cells that had been treated using starvation methods. The other groups (the treatment groups) were treated with various concentration of WJMSCs-CM (50%, 25% and 12.5%). Proliferative ability was evaluated using a cell count method and analyzed with a one-way ANOVA. Cultivation of serum-starved fibroblasts produced significantly higher cell counts in 12.5% WJMSCs-CM compared to the 50% group. It can be concluded that 12.5% WJMSCs-CM is the most efficient concentration for fibroblast proliferation.

  14. A nonsurgical endodontics relational research database: the initial six years of experience.

    Science.gov (United States)

    Iqbal, Mian K; Shukovsky, Deborah Gortler; Wong, Steven; Vohra, Gayatri

    2008-09-01

    The purpose of this study was to report results of the initial six years of experience utilizing a nonsurgical root canal treatment (NSRCT) database; to compare patient characteristics, operative procedures, and patient outcomes observed in the database to those observed in other studies; and to discuss the potential benefits of a clinical endodontic database. A total of 7,372 NSRCT cases performed by endodontic residents at the University of Pennsylvania from 2000 to 2006 were evaluated. The odds ratio (OR) for caries and trauma being causative agents for NSRCT in pulpitis were two times greater than for their older counterparts, who were more likely to present with a diagnosis of pulp necrosis. The reasons necessitating NSRCT were most often caries (57.8 percent) and, second, inadequate prior root canal treatment (22.8 percent). The tooth most commonly treated was the mandibular first molar (20.1 percent). Procedural errors were found in 6.1 percent of cases and were more likely to occur in mandibular molars vs. maxillary molars.

  15. SDF-1/CXCR4 axis induces human dental pulp stem cell migration through FAK/PI3K/Akt and GSK3β/β-catenin pathways.

    Science.gov (United States)

    Li, Mingwei; Sun, Xuefei; Ma, Liang; Jin, Lu; Zhang, Wenfei; Xiao, Min; Yu, Qing

    2017-01-09

    SDF-1 (stromal cell derived factor-1) has been found to be widely expressed during dental pulp inflammation, while hDPSCs (human dental pulp stem cells) contribute to the repair of dental pulp. We showed that the migration of hDPSCs was induced by SDF-1 in a concentration-dependent manner and could be inhibited with siCXCR4 (C-X-C chemokine receptor type 4) and siCDC42 (cell division control protein 42), as well as drug inhibitors such as AMD3100 (antagonist of CXCR4), LY294002 (inhibitor of PI3K) and PF573228 (inhibitor of FAK). It was also confirmed that SDF-1 regulated the phosphorylation of FAK (focal adhesion kinases) on cell membranes and the translocation of β-catenin into the cell nucleus. Subsequent experiments confirmed that the expression of CXCR4 and β-catenin and the phosphorylation of FAK, PI3K (phosphoinositide 3-kinase), Akt and GSK3β (glycogen synthase kinase-3β) were altered significantly with SDF-1 stimulation. FAK and PI3K worked in coordination during this process. Our findings provide direct evidence that SDF-1/CXCR4 axis induces hDPSCs migration through FAK/PI3K/Akt and GSK3β/β-catenin pathways, implicating a novel mechanism of dental pulp repair and a possible application of SDF-1 for the treatment of pulpitis.

  16. A quantitative study of bone repair after endodontic therapy on digital subtraction radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1997-08-15

    This study was performed to prepare the quantitative method of judging the sensitive prognosis of chronic apical periodontitis as early as possible. The subjects were 25 cases with periapical radiolucencies of which were treated with endodontic treatment. Serial radiographs were taken by standardized method longitudinally. The density slice function of digital radiographic system were employed for quantitative and longitudinal assessment of the radiolucent area and the condensing osteitis simultaneously. Obtained results were as follows: 1. The amount of bone repair after endodontic treatment could be detected quantitatively by the density slice function of digital radiographic system. 2. Within the 6-week period after root canal filling, the prognosis could be evaluated by assessment both radiolucent area and condensing osteitis on digital radiographic system. 3. The pattern of bone repair showed peripheral type in most cases from the 6th week after root canal filling. 4. In longitudinal change, bone repair showed two patterns; the succeeding reduction of radiolucent area showing the increase of condensing osteitis in size till 6th week and following by static state or reduction tendency and the reduction following the initial increase of both areas. 5. Cases with pulpitis by trauma showed initial increase of condensing osteitis at 2nd week, marked reduction of radiolucent area and condensing osteitis at 6th week, and approximately normal bone state at 8th week after root canal filling.

  17. Nano-odontology: nanostructured assemblies for endodontic regeneration.

    Science.gov (United States)

    Fioretti, F; Mendoza-Palomares, C; Avoaka-Boni, M C; Ramaroson, J; Bahi, S; Richert, L; Granier, F; Benkirane-Jessel, N; Haikel, Y

    2011-06-01

    The vitality of the pulp is so fundamental to the functional life of the tooth that new strategies are required to avoid the removal of the whole pulp following irreversible pulpitis and to regenerate the lost endodontic tissues. Nano-odontology would provide suitable solutions for pulp tissue conservative and regenerative approaches. In our group, we have shown that when covalently coupled to Poly-Glutamic Acid (PGA) the incorporation of an anti-inflammatory hormone (melanocortin, a-MSH) into the multilayered films Poly-L-Lysine (PLL)/PGA increases the anti-inflammatory reaction of pulp fibroblasts and macrophages stimulated by LPS (Lipo-Polysaccharides). Recently, usual linear PLL polymers have been chemically grafted for making new Dendrigraft polymers (DGLG4) whose higher branching ratios can give useful properties. The objective is to use nanostructured assemblies containing DGLG4 and PGA-alpha-MSH to design a new nanomaterial. These nanostructured assemblies (DGLG4-PGA-alpha-MSH)n constitute a thick reservoir of the anti-inflammatory peptide and promote adhesion and proliferation of pulp fibroblast on the biomaterial surface. These nanostructured films could be adapted for an endodontic regeneration application to target pulp connective tissue regeneration. Firstly, the crucial reduction of inflammation could be helpful by using PGA-alpha-MSH and secondly the initiation of the regeneration of the connective tissue will be promoted by the whole nanostructured film of which allows pulp cells colonisation.

  18. Regenerative Endodontics for Adult Patients.

    Science.gov (United States)

    He, Ling; Kim, Sahng G; Gong, Qimei; Zhong, Juan; Wang, Sainan; Zhou, Xuedong; Ye, Ling; Ling, Junqi; Mao, Jeremy J

    2017-09-01

    The goal of endodontics is to save teeth. Since inception, endodontic treatments are performed to obturate disinfected root canals with inert materials such as gutta-percha. Although teeth can be saved after successful endodontic treatments, they are devitalized and therefore susceptible to reinfections and fractures. The American Association of Endodontists (AAE) has made a tremendous effort to revitalize disinfected immature permanent teeth in children and adolescents with diagnoses including pulp necrosis or apical periodontitis. The American Dental Association (ADA) in 2011 issued several clinical codes for regenerative endodontic procedures or apical revascularization in necrotic immature permanent teeth in children and adolescents. These AAE and ADA initiatives have stimulated robust interest in devising a multitude of tissue engineering approaches for dental pulp and dentin regeneration. Can the concept of regenerative endodontics be extended to revitalize mature permanent teeth with diagnoses including irreversible pulpitis and/or pulp necrosis in adults? The present article was written not only to summarize emerging findings to revitalize mature permanent teeth in adult patients but also to identify challenges and strategies that focus on realizing the goal of regenerative endodontics in adults. We further present clinical cases and describe the biological basis of potential regenerative endodontic procedures in adults. This article explores the frequently asked question if regenerative endodontic therapies should be developed for dental pulp and/or dentin regeneration in adults, who consist of the great majority of endodontic patients. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. [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.

  20. Comparison of 2% chlorhexidine and 5.25% sodium hypochlorite irrigating solutions on postoperative pain: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Bashetty Kusum

    2010-01-01

    Full Text Available Aim: To compare the levels of postoperative pain after cleaning and shaping of root canals using two different root canal irrigants for debridement. Materials and Methods: Forty patients with irreversible pulpitis, pulp necrosis and non-vital teeth exhibiting acute apical periodontitis requiring root canal treatment were included. At random, canals were cleaned and shaped with the following protocols. 2% chlorhexidine solution in group I and 5.25% sodium hypochlorite solution in group II were used as an irrigants. Access cavities were closed with a sterile cotton pellet and cavit. The patients recorded degree of pain at various time intervals after cleaning and shaping on a visual analogue scale for 1 week. Results: The mean pain score for group I was between 0.65 and 3.35 and for group II was between 0.95 and 4.50. There was significant difference in the pain level between the two groups only at 6 th hour postoperatively (P<0.05 and the pain was more in sodium hypochlorite group. Conclusions: More pain was present in teeth irrigated using 5.25% sodium hypochlorite when compared to that in teeth irrigated using 2% chlorhexidine solution. Significant difference in pain level was present only at 6th hour postoperatively, and at all other periods (24 th hour, 4 th and 7 th days there was no significant difference in pain level between the two groups.

  1. A clinical and histological report of a tooth with an open apex treated with regenerative endodontics using platelet-rich plasma.

    Science.gov (United States)

    Torabinejad, Mahmoud; Faras, Hadi

    2012-06-01

    In patients, the outcomes of teeth with necrotic pulps and open apexes that have been treated with regenerative endodontics have always been evaluated clinically and radiographically. The purpose of this case report is to present the clinical, radiographic, and histological findings of a regenerative procedure using platelet-rich plasma (PRP) 14 months after the procedure. A 12-year-old boy whose maxillary second premolar tooth had been treated with regenerative endodontics was seen with a chief complaint of pain and sensitivity to cold. After clinical and radiographic examinations, a pulpal diagnosis of reversible pulpitis and normal periapical tissues was made for this tooth. Because of the patient's complaint and his guardian's insistence on either a root canal treatment or an extraction, a root canal treatment was performed in this tooth. After entry into the root canal, the soft tissue present in the canal was removed with the aid of a large barbed broach and examined histologically. Examination of the tissue removed from the root canal of this tooth revealed the presence of a vital pulp-like vital connective tissue. There was no evidence of bone in the specimen. Very few inflammatory cells were noted in the periphery of the specimen. Based on these findings, it appears that pulp-like tissue can be generated in a human tooth with the use of PRP as a scaffold in regenerative endodontic procedures. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Endodontic treatment of mandibular molar with root dilaceration using Reciproc single-file system.

    Science.gov (United States)

    Meireles, Daniely Amorin; Bastos, Mariana Mena Barreto; Marques, André Augusto Franco; Garcia, Lucas da Fonseca Roberti; Sponchiado, Emílio Carlos

    2013-08-01

    Biomechanical preparation of root canals with accentuated curvature is challenging. New rotatory systems, such as Reciproc, require a shorter period of time to prepare curved canals, and became a viable alternative for endodontic treatment of teeth with root dilaceration. Thus, this study aimed to report a clinical case of endodontic therapy of root with accentuated dilaceration using Reciproc single-file system. Mandibular right second molar was diagnosed as asymptomatic irreversible pulpitis. Pulp chamber access was performed, and glide path was created with #10 K-file (Dentsply Maillefer) and PathFile #13, #16 and #19 (Dentsply Maillefer) up to the temporary working length. The working length measured corresponded to 20 mm in the mesio-buccal and mesio-lingual canals, and 22 mm in the distal canal. The R25 file (VDW GmbH) was used in all the canals for instrumentation and final preparation, followed by filling with Reciproc gutta-percha cones (VDW GmbH) and AH Plus sealer (Dentsply Maillefer), using thermal compaction technique. The case has been receiving follow-up for 6 mon and no painful symptomatology or periapical lesions have been found. Despite the difficulties, the treatment could be performed in a shorter period of time than the conventional methods.

  3. Evaluation of oral and periodontal status of leprosy patients in Dindigul district

    Science.gov (United States)

    Jacob Raja, S. A.; Raja, J. Johnson; Vijayashree, R.; Priya, B. Meena; Anusuya, G. Sai; Ravishankar, P.

    2016-01-01

    Aim: After the introduction of the multidrug therapy, the incidence of leprosy is decreasing every year. However, periodontal complaints are commonly seen in these patients due to compromised immunity and impaired oral hygiene. The aim of the present study is to assess the oral and periodontal status of the leprosy patients in Dindigul district. Materials and Methods: The study was conducted on 62 patients treated in a leprosy center at Dindigul district. Among these, 22 (35.5%) were female patients and 40 were male patients (64.5%). Age ranges between 40 and 70 with the mean age being 52. Facial changes, periodontal status, dental caries, attrition, tooth loss, plaque index (Silness and Loe), and calculus component of oral hygiene index-simplified were assessed. Results: Majority of the patients presented with loss of eyebrows and eyelashes, saddle nose, ocular involvement, and leonine facies. Gingival recession (54.8%) was a predominant finding followed by tooth loss (69.5%), mobility (60.86%), attrition (56%), chronic pulpitis (34.7%), and dental caries (26%). Most of the patients had severe periodontitis. Conclusions: Compromised immunity and altered autonomy pave way for many dental complaints such as periodontitis and deposits in tooth with poor oral hygiene. Awareness about the oral health problems and reinforcement of oral hygiene should be insisted to the leprosy patients to prevent further morbidity. PMID:27829761

  4. Experimental grounds for YAG:Er laser application to dentistry

    Science.gov (United States)

    Bol'shakov, E. N.; Dolgikh, Robert A.; Zazulevskaya, Lidiya Y.; Zubov, Boris V.; Lobachyov, V. A.; Murina, T. M.; Prokhorov, Alexander M.

    1990-09-01

    Stornatologic service is most popular of all kinds of medical aid, since up to 90% of people suffer from caries, parodontosis holds the second place after such a widespread disease as cardiovascular pathology. The treatment of the tooth hard tissue, intervention into pulp and parodontium using conventional methods are accompanied with painfulness and unpleasant sensation. A lack of efficient methods of anesthesia and pulp devitalization, a high percentage of complica tions after pulpitis treatment made it necessary to search for new methods of treatment which exclude these negative aspects. Application of laser radiation may be one of the ways in resolving this problem. Such attempts have been made repeatedly with the development of laser technology.'3 However, not all of them turned out to be successful. The greatest difficulties occurred on surgical intervention into hard tooth tissue. The best results have been so far attained when using pulsed CO2 laser operated at the wavelength A =1O.61um. For instance, at pulse width 1O1us and frequency 10-20 Hz, the tooth channel drilling was efficient at energy density in pulse P . 10 JIcm2. 4'5 The electron-microscopic investigations have proved the tooth microstructure to be preserved for this laser operation mode. The traces of graphitization were observed only in the vicinity of the lateral walls of the channel.

  5. Simultaneous Occurrence of Dens Invaginatus and Fusion

    Directory of Open Access Journals (Sweden)

    Amit Mhapuskar

    2013-01-01

    Full Text Available Although Dens invaginatus and fusion are well-known and well established dental anomalies, they are rarely seen in supernumerary teeth. In this article, simultaneous occurrence of Dens invaginatus and fusion between maxillary lateral incisor and a supernumerary tooth is described. Dens invaginatus is clinically significant due to the possibility of the pulpal involvement; pulpitis, necrotic pulps and chronic periapical lesions are often associated with this anomaly without clinical symptoms. Fusion has a negative impact on the aesthetics, especially when it occurs in maxillary anterior teeth. It is difficult to clinically make differential diagnosis between fused teeth and geminated teeth, especially when these anomalies take place together with hypodontia or supernumerary tooth. It has been found that sequel of such teeth may result in delayed eruption, ectopic eruption or even impaction of permanent teeth; hence proper diagnosis by clinical and radiographic methods and intervention at appropriate time is of paramount importance. The accurate knowledge of variations in morphology of tooth and pulp cavity greatly assists the dentist in planning successful treatment options.

  6. Comparison of digital radiography and apex locator with the conventional method in root length determination of primary teeth

    Directory of Open Access Journals (Sweden)

    I E Neena

    2011-01-01

    Full Text Available Aim: The purpose of this study was to compare the Working length in primary teeth endodontics using intra oral digital radiovisiography and apex locator with conventional method for accuracy. Materials and Methods: This in vivo study was conducted on 30 primary teeth which were indicated for pulpectomy in the patients of the age group of 5-11 years All experimental teeth had adequate remaining tooth structure for rubber dam isolation and radiographicaly visible canals. Endodontic treatment was required due to irreversible pulpitis or pulp necrosis. A standardized intraoral periapical radiograph of the tooth was taken using conventional method by paralleling technique. The distance between the source and the tooth, tooth and the films were standardized using X-ray positioning device. During the pulpectomy procedure, the working length was determined by digital radiograph and apex locator. The measurements were then compared with the conventional method of root canal measurement technique for accuracy Result: From the results obtained we can conclude that Working length determined in primary molars using digital radiography and Apex locator did not show any significant difference in the mean working length measurements when compared with the conventional radiographic method. Conclusions: Apex locator is comparable to conventional radiograph in determining the working length without radiation in the primary teeth. Intraoral digital radiography is the safest method in determining the working length with significant reduction in radiation exposure.Hence, both the techniques can be safely used as alternatives to conventional radiographic methods in determining working length in primary teeth.

  7. Comparison of Pulp Regeneration with Absorbable Gelatin Sponge Stent Combined MTA and Calcium Hydroxide Cover%可吸收明胶海绵支架联合三氧化矿物凝聚体与氢氧化钙覆盖诱导体内牙髓再生的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张宇; 魏灼丽; 赵彪; 任延秀

    2016-01-01

    目的:比较可吸收明胶海绵支架联合三氧化矿物凝聚体( MTA)与氢氧化钙覆盖诱导体内牙髓再生的疗效。方法选取重庆三峡中心医院收治的122例(130颗患牙)不可复性牙髓炎患者,采用随机数字表法将其分为观察组61例(66颗患牙)和对照组61例(64颗患牙)。其中观察组采用可吸收明胶海绵支架联合MTA封闭治疗,对照组采用氢氧化钙覆盖治疗,经3个月随访,观察比较两组患者的治疗效果、牙龈活力变化情况。结果术后1周,观察组总的初步成功率为50.0%(33/66),明显高于对照组[12.5%(8/64)],差异有统计学意义(P<0.01);其中观察组急性牙髓炎、慢性闭锁性牙髓炎成功率均高于对照组,差异有统计学意义( P<0.01)。术后1个月,观察组总的阶段成功率为62.1%(41/66),明显高于对照组[18.8%(12/64)],差异有统计学意义(P<0.01);其中观察组急性牙髓炎、慢性闭锁性牙髓炎、慢性增生性牙髓炎成功率均高于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组总的最终成功率为66.7%(44/66),明显高于对照组[21.9%(14/64)],差异有统计学意义(P<0.01);且观察组各型牙髓炎成功率均高于对照组,差异有统计学意义(P<0.05)。结论可吸收明胶海绵支架联合MTA可有效诱导体内牙髓再生,对各型不可复性牙髓炎均有较好的效果,值得推广应用于临床。%Objective To compare the efficacy of pulp regeneration induced by absorbable gelatin sponge stent combined mineral trioxide aggregate(MTA) and calcium hydroxide cover.Methods Total of 122 patients (130 sick teeth) with irreducible pulpitis in Chongqing Three Gorges Central Hospital were chosen,and were randomly divided into observation group 61 cases (66 sick teeth) and control group 61 cases(64 skck

  8. Vital Pulp Therapy with Calcium-Silicate Cements: Report of Two Cases

    Science.gov (United States)

    Ashraf, Hengameh; Rahmati, Afsaneh; Amini, Neda

    2017-01-01

    This article describes successful use of calcium-enriched mixture (CEM) cement and Biodentine in apexogenesis treatment in two 8-year-old patients, one with immature permanent molar diagnosed primarily with irreversible pulpitis and the other with partially vital maxillary central incisor. After access cavity preparation, partial pulpotomy in molar and full pulpotomy in central was performed, and the remaining pulps was capped with either Biodentine or CEM cement, in each tooth. The crowns were restored with composite filling material at the following visit. The post-operative radiographic and clinical examinations (approx. average of 16 months) showed that both treated teeth remained functional, with complete root development and apex formation. A calcified bridge was produced underneath the capping material. No further endodontic intervention was necessary. Considering the healing potential of immature vital pulps, the use of CEM cement and Biodentine for apexogenesis might be an applicable choice. These new endodontic biomaterials might be appropriate for vital pulp therapies in an immature tooth. However, further clinical studies with longer follow-up periods are recommended. PMID:28179936

  9. Procesos pulpares y periapicales agudos como urgencias estomatológicas. Holguín 2009

    Directory of Open Access Journals (Sweden)

    Carmen Graña Dorta

    2009-01-01

    Full Text Available Aborda un estudio observacional descriptivo de corte transversal en días comprendidos en Mayo y Junio del 2009. Se desarrolló en las consultas de urgencias de las clínicas ¨Manuel Angulo Farrán¨ y ¨Mario Pozo Ochoa¨ de la Provincia Holguín. La muestra estuvo constituida por 70 pacientes que presentaron patologías pulpares y periapicales agudas. Se Planteó como objetivo determinar las patologías más frecuente según grupos de edad y sexo, identificar las causas principales de estas afecciones y evaluar la conducta diagnóstica y terapéutica inmediata en las consultas de urgencia. Como resultado arrojó una mayor afectación por patologías pulpares y periapicales agudas en el sexo femenino y en el grupo de edad de 35 a 59 años. La pulpitis reversible fue la patología pulpar más frecuente. La causa principal de afecciones fue la caries dental. Se evaluó de regular la conducta diagnóstica y terapéutica en las consultas de urgencias objeto de estudio.

  10. Clinical analysis of cardiac toothache%心源性牙痛的临床分析

    Institute of Scientific and Technical Information of China (English)

    石建军

    2016-01-01

    The pain from the angina pectoris of coronary heart disease sometimes can be delivered to neck, face, mandibular or maxillary teeth, which tend to be easily misdiagnosed by the pulpitis pain. This case report stated how to diagnosis and treat the toothache caused by cardiac origin, and provided the clinical reference for the differential diagno-sis of the toothache from the cardiac originor odontogenic origin.%冠心病患者心绞痛或心肌梗死发作时,疼痛可放射至颈部、颊部、上下颌、牙齿,其牙痛性质与牙髓炎疼痛类似,临床容易误诊而延误治疗。本文通过报道1例心源性牙痛的诊断和治疗过程,分析心源性牙痛的发生机制和鉴别诊断要点,供同行借鉴。

  11. Rare Root Morphology of a Maxillary Central Incisor Associated With Gingival Hyperplasia

    Science.gov (United States)

    Monea, Monica; Moldovan, Cosmin

    2016-01-01

    Abstract Dilaceration is a developmental disturbance characterized by the angulation of the crown or root of a permanent tooth, which is often related to trauma of primary dentition. We report a case of a dilacerated root in a maxillary central incisor associated with gingival hyperplasia in a patient under fixed orthodontic treatment, a combination of pathological conditions that had never been mentioned before in the scientific literature. A 10-year-old female patient presented to the Department of Odontology and Oral Pathology with tenderness to palpation and bleeding from the oral aspect of the central incisor, alerted by the proliferation of the gingiva. During clinical examination, the palpation performed with a dental probe revealed a carious lesion with dental pulp exposure on the distal aspect of right central incisor and the presence of a sessile mass of inflamed gingival tissue that proliferated inside the defect. On the preoperative radiograph a dilacerated root canal was noted, without periapical bone resorption. The main diagnosis was irreversible pulpitis and gingival hyperplasia and the treatment option was surgical removal of the inflamed tissue with histopathological examination and root canal treatment. Successful endodontic treatment with a good prognosis was recorded. The measurement of the root curvature proved to be extremely helpful in choosing the right endodontic technique and made the treatment easier than expected. An important observation was that, despite the rare clinical and radiographic aspect of this dilacerated tooth, the endodontic treatment proved to be relatively easy to perform and, therefore, the prognosis was considered favorable. PMID:27149498

  12. Pengambilan Lentulo Patah Pada Perawatan Saluran Akar Gigi Molar Satu Kiri Bawah Nekrosis Pulpa

    Directory of Open Access Journals (Sweden)

    Muhammad Syafri

    2013-06-01

    Broken Lentulo Removal During Root Canal Treatment On The First Molar Mandible Sinistra With Pulp Necrosis. During root canal preparation procedure, there is always potential for instrument breakage. Nowadays, broken instruments can be removed using ultrasonic instruments such as a needle miller connected to endo ultrasonic tip, but it needs good access and visibility in order to make it easier for the operator to remove the broken instruments. The aim of this case report is to present the successful removal of a broken lentulo left in a root canal by using smooth broach connected to a ultrasonic endo tip combined with an hedstroem file no 25. This paper reports a case of molar root canal treatment of the lower left irreversible pulpitis in 20 year-old female patient, but the incident of broken lentulo occured while applying root canal medicament. The effort to remove lentulo was successful on the second visits using a needle miller connected to endo ultrasonic tip and headstrom file no 25. Visibility was obtained by using a coronal flaring of micro mega hero shaper associated with the rotary tool. In the following week, the teeth was obturated with single cone technique on the distal root canal applying the lateral condensation technique on mesiolingual and mesiobuccal root canal. In the next visit, the teeth were restored with composite resin with dowel dentatus screw. After 2 months of being observed radiographically and clinically, there is no more complaint from the patient

  13. Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

    Science.gov (United States)

    Martiniano, Eli Carlos; Monteiro, Larissa Raylane Lucas; Valenti, Vitor E.; Sorpreso, Isabel Cristina Esposito; de Abreu, Luiz Carlos

    2017-01-01

    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. PMID:28182118

  14. Restorasi Resin Komposit dengan Pasak Fiber Reinforced Composite untuk Perbaikan Gigi Insisivus Sentralis Maksila Pasca Trauma

    Directory of Open Access Journals (Sweden)

    Mella Synthya Dewi

    2011-06-01

    Full Text Available Latar belakang. Trauma pada gigi dapat menyebabkan injuri pulpa dengan atau tanpa kerusakan mahkota atau akar. Pulpektomi menjadi pilihan perawatan pada fraktur mahkota yang membutuhkan restorasi kompleks. Gigi pasca perawatan saluran akar biasanya telah kehilangan struktur jaringan keras yang cukup banyak sehingga membutuhkan retensi intrakanal berupa pasak untuk mendukung restorasi akhir. Pasak Fiber Reinforced Composite (FRG memiliki flexure dan fatigue strength yang lebih besar, modulus elastisitas yang mendekati dentin, kemampuan untuk membentuk monoblok (kompleks akar-pasak dalam saluran akar, dan meningkatkan estetik jika dibandingkan dengan pasak logam. Resin komposit memiliki warna dan translusensi yang menyerupai dentin dan email sehingga mampu menghasilkan estetik yang baik pada gigi anterior. Tujuan. Melaporkan restorasi resin komposit dengan pasak FRG untuk memperbaiki gigi insisivus sentralis maksila yang mengalami fraktur mahkota kompleks pasca trauma. Kasus dan penanganan. Perempuan 20 tahun, gigi insisivus sentralis kanan dan kiri maksila mengalami Fraktur Ellis klas III akibat kecelakaan. Gigi 11 pulpitis ireversibel dan gigi 21 nekrosis pulpa. Kedua gigi malposisi. Dilakukan pulpektomi atau perawatan saluran akar multi kunjungan. Resin komposit dengan pasak FRG customized digunakan sebagai restorasi akhir. Kesimpulan. Restorasi resin komposit dengan pasak FRG customized memberikan hasil yang memuaskan secara estetik dan fungsional untuk merestorasi gigi insisivus sentralis pasca trauma dan perawatan saluran akar.

  15. Emergency pulpotomy in relieving acute dental pain among Tanzanian patients

    Directory of Open Access Journals (Sweden)

    Simon Elison NM

    2006-01-01

    Full Text Available Abstract Background In Tanzania, oral health services are mostly in the form of dental extractions aimed at alleviating acute dental pain. Conservative methods of alleviating acute dental pain are virtually non-existent. Therefore, it was the aim of this study to determine treatment success of emergency pulpotomy in relieving acute dental pain. Methods Setting: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania. Study design: Longitudinal study. Participants: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001. Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute. Results Of the patients with treated premolars, 25 (13.9% patients did not experience pain at all while 19 (10.6% experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31% did not experience any pain, 76 (42.2% experienced mild pain and the other 4 (2.2% suffered acute pain. Conclusion The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.

  16. Postoperative Pain after Root Canal Treatment: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    M. Gotler

    2012-01-01

    Full Text Available Aim. To evaluate the incidence and severity of postendodontic treatment pain (PEP subsequent to root canal treatment (RCT in vital and necrotic pulps and after retreatment. Methodology. A prospective study. Participants were all patients (=274 who underwent RCT in teeth with vital pulp, necrotic pulp, or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment, by one clinician, during an eight-month period. Exclusion criteria were swelling, purulence, and antibiotic use during initial treatment. A structured questionnaire accessed age, gender, tooth location, and pulpal diagnosis. Within 24 h of treatment, patients were asked to grade their pain at 6 and 18 hours posttreatment, using a 1–5 point scale. Results. RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP (63.8%; 2.46 ± 1.4, resp. than RCT of teeth with necrotic pulp (38.5%; 1.78 ± 1.2, resp. or of retreated teeth (48.8%; 1.89 ± 1.1, resp.. No statistical relation was found between type of pain (spontaneous or stimulated and pulp condition. Conclusion. RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth.

  17. Comparison of Single Visit Post Endodontic Pain Using Mtwo Rotary and Hand K-File Instruments: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohamad Kashefinejad

    2016-08-01

    Full Text Available Objectives: Pain is an unpleasant outcome of endodontic treatment that can be unbearable to patients. Instrumentation techniques may affect the frequency and intensity of post-endodontic pain. This study aimed to compare single visit post endodontic pain using Mtwo (NiTi rotary and hand K-file instruments.Materials and Methods: In this randomized controlled trial, 60 teeth with symptomatic irreversible pulpitis in 53 patients were selected and randomly assigned into two groups of 30 teeth. In group A, the root canals were prepared with Mtwo (NiTi rotary instruments. In group B, the root canals were prepared with hand K-file instruments. Pain assessment was implemented using visual analog scale (VAS at four, eight, 12 and 24 hours after treatment. The acquired data were analyzed using chi-square, Mann-Whitney U and Student’s t-test (P<0.05.Results: Patients treated with rotary instruments experienced significantly less post-endodontic pain than those treated with hand instruments (P<0.001.Conclusion: The use of Mtwo (NiTi rotary instruments in root canal preparation contributed to lower incidence of postoperative pain than hand K-files.

  18. Histological evaluation of pulp tissue from second primary molars correlated with clinical and radiographic caries findings

    Directory of Open Access Journals (Sweden)

    Vellore Kannan Gopinath

    2014-01-01

    Full Text Available Background: Managing dental caries in young children is demanding due to the elusions present on the right diagnostic criteria for treatment. The present study evaluated the histological status of pulp tissues extracted from primary second molar with caries involvement. Histological findings are correlated with clinical and radiographic assessment. Materials and Methods: Simple experimental study was conducted on upper or lower second primary molars with occlusal (22 teeth or proximal (22 teeth dental caries. Selected children were below 6 years of age. Percentage of caries involvement, residual dentin thickness (RDT, radiographic assessment of interradicular and periapical areas, clinical caries depth and signs and symptoms are the parameters considered for comparing with the histological findings. The specimens were grouped based on the nature of the inflammatory process as acute or chronic. The data were analyzed by Student t-test to compare histological types of inflammation with clinical parameters. P value < 0.05 was considered as significant. Results: Four cases revealed severe acute inflammation in coronal and relatively mild acute inflammation in radicular pulp. In the rest of the specimen coronal and radicular pulp had similar acute or chronic inflammatory changes. Histological evidence of pulpitis correlated with dental caries depth of ≥80%, RDT of ≤1 mm, radiographic rarefactions in the interradicular regions and symptoms of pain. Conclusion: Primary second molars with more than two-third caries involvement with symptoms of pain histologically showed inflammation of both coronal and radicular pulp tissues in all cases.

  19. Endodontic treatment of mandibular molar with root dilaceration using Reciproc single-file system

    Directory of Open Access Journals (Sweden)

    Daniely Amorin Meireles

    2013-08-01

    Full Text Available Biomechanical preparation of root canals with accentuated curvature is challenging. New rotatory systems, such as Reciproc, require a shorter period of time to prepare curved canals, and became a viable alternative for endodontic treatment of teeth with root dilaceration. Thus, this study aimed to report a clinical case of endodontic therapy of root with accentuated dilaceration using Reciproc single-file system. Mandibular right second molar was diagnosed as asymptomatic irreversible pulpitis. Pulp chamber access was performed, and glide path was created with #10 K-file (Dentsply Maillefer and PathFile #13, #16 and #19 (Dentsply Maillefer up to the temporary working length. The working length measured corresponded to 20 mm in the mesio-buccal and mesio-lingual canals, and 22 mm in the distal canal. The R25 file (VDW GmbH was used in all the canals for instrumentation and final preparation, followed by filling with Reciproc gutta-percha cones (VDW GmbH and AH Plus sealer (Dentsply Maillefer, using thermal compaction technique. The case has been receiving follow-up for 6 mon and no painful symptomatology or periapical lesions have been found. Despite the difficulties, the treatment could be performed in a shorter period of time than the conventional methods.

  20. Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

    Directory of Open Access Journals (Sweden)

    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.

  1. Intraoperative discomfort associated with the use of a rotary or reciprocating system: a prospective randomized clinical

    Directory of Open Access Journals (Sweden)

    Aline Cristine Gomes

    2017-05-01

    Full Text Available Objectives The aim of this randomized, controlled, prospective clinical study was to evaluate patients' intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo or single-file reciprocating (Reciproc systems were used. Materials and Methods Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS, ranging from ‘least possible discomfort’ (1 to ‘greatest possible discomfort’ (10. The Wilcoxon signed-rank test was used to determine significant differences at p< 0.05. Results Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660. Conclusions Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients' intraoperative discomfort.

  2. Mineral trioxide aggregate as a pulpotomy agent in primary molars: An in vivo study

    Directory of Open Access Journals (Sweden)

    Naik S

    2005-03-01

    Full Text Available The retention of pulpally involved deciduous tooth in a healthy state until the time of normal exfoliation remains to be one of the challenges for Pedodontists. A scientific noise has been generated about several materials some of which have been popular pulpotomy medicaments. Concerns have been raised about the toxicity and potential carcinogenicity of these materials, and alternatives have been proposed to maintain the partial pulp vitality, however to date no material has been accepted as an ideal pulpotomy agent. Mineral trioxide aggregate (MTA is a biocompatible material which provides a biological seal. MTA has been proposed as a potential medicament for various pulpal procedures like pulp capping with reversible pulpitis, apexification, repair of root perforations, etc. Hence the present study was done to evaluate the efficacy of MTA as a pulpotomy medicament. A clinical and radiographic evaluation was done on children where MTA was used as pulpotomy medicament in primary molars for a period of 6 months and it was found to be a successful material.

  3. Evaluation of oral and periodontal status of leprosy patients in Dindigul district

    Directory of Open Access Journals (Sweden)

    S A Jacob Raja

    2016-01-01

    Full Text Available Aim: After the introduction of the multidrug therapy, the incidence of leprosy is decreasing every year. However, periodontal complaints are commonly seen in these patients due to compromised immunity and impaired oral hygiene. The aim of the present study is to assess the oral and periodontal status of the leprosy patients in Dindigul district. Materials and Methods: The study was conducted on 62 patients treated in a leprosy center at Dindigul district. Among these, 22 (35.5% were female patients and 40 were male patients (64.5%. Age ranges between 40 and 70 with the mean age being 52. Facial changes, periodontal status, dental caries, attrition, tooth loss, plaque index (Silness and Loe, and calculus component of oral hygiene index-simplified were assessed. Results: Majority of the patients presented with loss of eyebrows and eyelashes, saddle nose, ocular involvement, and leonine facies. Gingival recession (54.8% was a predominant finding followed by tooth loss (69.5%, mobility (60.86%, attrition (56%, chronic pulpitis (34.7%, and dental caries (26%. Most of the patients had severe periodontitis. Conclusions: Compromised immunity and altered autonomy pave way for many dental complaints such as periodontitis and deposits in tooth with poor oral hygiene. Awareness about the oral health problems and reinforcement of oral hygiene should be insisted to the leprosy patients to prevent further morbidity.

  4. The Anti-Inflammatory Effect of Human Telomerase-Derived Peptide on P. gingivalis Lipopolysaccharide-Induced Inflammatory Cytokine Production and Its Mechanism in Human Dental Pulp Cells

    Directory of Open Access Journals (Sweden)

    Yoo-Jin Ko

    2015-01-01

    Full Text Available Porphyromonas gingivalis is considered with inducing pulpal inflammation and has lipopolysaccharide (LPS as an inflammatory stimulator. GV1001 peptide has anticancer and anti-inflammation activity due to inhibiting activation of signaling molecules after penetration into the various types of cells. Therefore, this study examined inhibitory effect of GV1001 on dental pulp cells (hDPCs stimulated by P. gingivalis LPS. The intracellular distribution of GV1001 was analyzed by confocal microscopy. Real-time RT-PCR was performed to determine the expression levels of TNF-α and IL-6 cytokines. The role of signaling by MAP kinases (ERK and p38 was explored using Western blot analysis. The effect of GV1001 peptide on hDPCs viability was measured by MTT assay. GV1001 was predominantly located in hDPC cytoplasm. The peptide inhibited P. gingivalis LPS-induced TNF-α and IL-6 production in hDPCs without significant cytotoxicity. Furthermore, GV1001 treatment markedly inhibited the phosphorylation of MAP kinases (ERK and p38 in LPS-stimulated hDPCs. GV1001 may prevent P. gingivalis LPS-induced inflammation of apical tissue. Also, these findings provide mechanistic insight into how GV1001 peptide causes anti-inflammatory actions in LPS-stimulated pulpitis without significantly affecting cell viability.

  5. REAKSI RADANG

    Directory of Open Access Journals (Sweden)

    Ratna Farida

    2015-07-01

    Full Text Available Inflammatory respone is a non-specific response to an injurious stimulus in vascularized tissue. The purpose of this response is to destruct noxious agent, limitation of its spread, and preparation for reconstitution or repair of injured area. Inglammation is classified into acute and chronic types. The classical features of redness, swelling, warmth, pain and loss of function, all of which reflect the effects of cytokines and other inflammatory mediators on the local blood vessels in acute inflammation. The cellular response is mainly of neutrophil polymorphonuclear leukocytes. Furthermore, chronic mononuclear cells-macrophages, lymphocytes, and plasma cells. A proliferation of blood vessels also occurs. There is also associated collagen production by fibroblasts resulting fibrosis. Cytokines secreted by macrophages play prominent roles in inflammation. However, other soluble factors, such as vasoactive amines, lipid mediators, complement fragments C5a, C3a, and C4a, prostacyclin and nitric oxide are also major players in inflammation. The inflammatory reactions in the mouth and teeth are identical to inflammatory reactions anywhere else in the body. Such as pulpitis is similar to inflammation in other connective tissue anywhere in the body.

  6. Perawatan Saluran Akar Satu Kunjungan Disertai Ekstrusi dan Mahkota Jaket Porselin Fusi Metal dengan Fraktur Ellis Kelas III Subgingiva (Pada Gigi Insisivus Sentralis Kanan Maksila

    Directory of Open Access Journals (Sweden)

    Yulita Kristanti

    2011-06-01

    Full Text Available Latar Belakang dan Tujuan. Laporan kasus ini dibuat dengan tujuan untuk menginformasikan hasil perawatan saluran akar, ekstrusi gigi dan restorasi mahkota jaket porselin fusi metal dengan penguat inti pasak tuang pada gigi insisivus sentralis kanan maksila yang mengalami fraktur Ellis klas III subgingiva dengan pulpitis irreversibel. Kasus dan Penanganannya. Pasien laki-Iaki umur 20 tahun mengalami fraktur Ellis klas III subgingiva akibat keeelakaan satu minggu sebelum periksa. Cara perawatan yang dilakukan adalah dengan melakukan perawatan saluran akar satu kunjungan pada gigi insisivus kanan atas maksila. Setelah dilakukan kontrol pasea perawatan saluran akar dan menunjukkan tanda-tanda menuju kesembuhan, dilakukan ekstrusi. Ekstrusi dilakukan dengan terlebih dahulu mengambil sebagian guta perea disaluran akar untuk meletakkan kawat dengan coi/ di ujungnya. Selanjutnya bracket dan insisal bar dipasang pada 5 gigi anterior dan dihubungkan dengan kawat dengan coil diujungnya yang telah disementasikan dalam saluran akar dengan semen ionomer kaea tipe I. Setelah gigi terekstrusi, dan melewati periode stabilisasi selama 1 bulan dengan tidak terjadi relaps, perawatan dilanjutkan dengan preparasi pembuatan inti pasak tuang dan dilanjutkan dengan pembuatan mahkota jaket porselin fusi metal. Hasil. Hasil perawatan ini menunjukkan ekstrusi telah tereapai dalam waktu 1 bulan dan perawatan dilanjutkan dengan pembuatan inti pasak tuang dan mahkota jaket porselin fusi metal warna A2 (vitapan dengan kontur, embrasur dibuat ideal, area kontak proksimal pada bagian sepertiga insisal. Kesimpulan. Perawatan saluran akar satu kunjungan disertai ekstrusi dan mahkota jaket porselin fusi metal efektif untuk menangani kasus gigi insisivus sentralis kanan maksila dengan fraktur Ellis Kelas III subgingiva.

  7. A prospective clinical trial on the influence of a triamcinolone/demeclocycline and a calcium hydroxide based temporary cement on pain perception

    Directory of Open Access Journals (Sweden)

    Willershausen Brita

    2012-03-01

    Full Text Available Abstract Introduction The aim of this clinical trial was to compare the degree of short term post-operative irritation after application of a triamcinolone/demeclocycyline based or a calcium hydroxide based provisional cement. Methods A total of 109 patients (55 female and 54 male; mean age: 51 ± 14 years with primary or secondary dentinal caries were randomly assigned to the two treatment groups of this biomedical clinical trial (phase III. Selection criteria were good systemic health and treated teeth, which were vital and showed no symptoms of pulpitis. Up to three teeth were prepared for indirect metallic restorations, and the provisional restorations were cemented with a triamcinolone/demeclocycyline (Ledermix or a calcium hydroxide (Provicol based material. The intensity of post-operative pain experienced was documented according to the VAS (4, 12, 20, 24, and 82 h and compared to VAS baseline. Results A total of 159 teeth were treated (Ledermix: 83 teeth, Provicol: 76 teeth. The minor irritation of the teeth, experienced prior to treatment, was similar in both groups; however, 4 h after treatment this value was significantly higher in the Provicol group than in the Ledermix group (p Conclusions The patients had no long term post-operative pain experience in both groups. However, within the first hours after cementation the sensation of pain was considerably higher in the Provicol group than in the Ledermix group.

  8. Dental care provided to sickle cell anemia patients stratified by age: A population-based study in Northeastern Brazil

    Science.gov (United States)

    Costa, Cyrene Piazera Silva; Aires, Bárbara Tamires Cruz; Thomaz, Erika Bárbara Abreu Fonseca; Souza, Soraia de Fátima Carvalho

    2016-01-01

    Objective: To assess differences in the dental care provided to sickle cell anemia (SCA) patients depending on age. This retrospective study used secondary data from the dental records of the Center of Hematology and Hemotherapy in Maranhão (HEMOMAR). Materials and Methods: Data were obtained from 574 dental records of patients with SCA treated or under treatment in the Dental Department of HEMOMAR from 2000 to 2011. Data on the gender, age, duration of dental treatment, number of patients submitted to periodontal treatment (PT), number of filled teeth (FT), teeth extracted (EX), endodontically treated teeth (ET), and reason for the dental procedures were collected. The Kruskal–Wallis test together with Dunn's post hoc test, Chi-square test, and Spearman's correlation was used for statistical analysis. An alpha error of 5% was considered acceptable. Results: Significant differences were found for FT, EX (P dental caries (100%) and irreversible pulpitis (55.6%), respectively. The main reasons for teeth extractions were residual roots (21.3%), chronic apical periodontitis (19.7%), and crown destruction (19.3%). There were positive correlations between age and EX (r = 0.93; P = 0.025) and ET (r = 0.92; P = 0.028). Conclusions: FT, ET, EX, and PT procedures become more common in older patients. Tooth decay is the main reason for dental treatment in SCA patients. PMID:27403053

  9. Comparison of Postoperative Pain after Root Canal Preparation with Two Reciprocating and Rotary Single-File Systems: A Randomized Clinical Trial

    Science.gov (United States)

    Mollashahi, Narges Farhad; Saberi, Eshagh Ali; Havaei, Seyed Rohollah; Sabeti, Mohammad

    2017-01-01

    Introduction: Root canal preparation techniques may cause postoperative pain. The aim of the present study was to compare the intensity of postoperative pain after endodontic treatment using hand files, single file rotary (OneShape), and single file reciprocating (Reciproc) systems. Methods and Materials: In this single-blind, parallel-grouped randomized clinical trial a total of 150 healthy patients aged between 20 to 50 years old were diagnosed with symptomatic irreversible pulpitis of one maxillary or mandibular molars. The teeth were randomly assigned to three groups according to the root canal instrumentation technique: hand files (control), OneShape and Reciproc. Treatment was performed in a single visit by an endodontist. The severity of the postoperative pain was assessed by the visual analogue scale (VAS) after 6, 12, 24, 48 and 72 h. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: The patients in control group reported significantly higher mean postoperative pain intensity at 12, 24, 48, and 72 h compared to the patients in the two other groups (P0.05). Conclusion: The instrumentation kinematics (single-file reciprocating or single-file rotary) had no impact on intensity of postoperative pain. PMID:28179917

  10. Application of partial pulpotomy in vital pulp conservation of young permanent tooth%部分活髓切断术在年轻恒牙保髓治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    卢伟; 解光明

    2013-01-01

    年轻恒牙急性牙髓炎是一类常见的急性牙髓感染病症,是否保留生活牙髓是尚存争议的问题.作者在严格掌握适应证的基础上,选择由龋齿和外伤所引起的急性牙髓炎年轻恒牙46例,通过开随引流、控制感染后,在局麻下行部分活髓切断加直接盖髓的方法以保存大部分活髓组织.经2年随访,成功38颗,占82.6%,失败8颗,占17.4%.%Acute pulpilis of young permanent teeth is a kind of common acute pulp infeclion disease, whelher or not conserve vtlal pulp was still a conlroversial problem. On the basis of slricl selection of appropriate indications, 46 young permanent teeth with acute pulpitis caused by dental caries and trauma were selected. After control of infection by open drainage, partial pulpotomy and direct pulp capping were used to conserve the majority of vital pulp tissues under local anesthesia. After 2 year-follow-up, 38( 82.6%) teeth were cured and 8( 17.4%) failed.

  11. Human Pulp Response to Direct Pulp Capping and Miniature Pulpotomy with MTA after Application of Topical Dexamethasone: A Randomized Clinical Trial

    Science.gov (United States)

    Mousavi, Seyed Amir; Ghoddusi, Jamileh; Mohtasham, Nooshin; Shahnaseri, Shirin; Paymanpour, Payam; Kinoshita, Jun-Ichiro

    2016-01-01

    Introduction: The aim of this randomized clinical trial was to compare the histologic pulp tissue response to one-step direct pulp capping (DPC) and miniature pulpotomy (MP) with mineral trioxide aggregate (MTA) after application of dexamethasone in healthy human premolars. Methods and Materials: Forty intact premolars from 10 orthodontic patients, were randomly chosen for DPC (n=20) or MP (n=20). In 10 teeth from each group, after exposure of the buccal pulp horn, topical dexamethasone was applied over the pulp. In all teeth the exposed/miniaturely resected pulp tissue was covered with MTA and cavities were restored with glass ionomer. Teeth vitality was evaluated during the next 7, 21, 42, and 60 days. Signs and/or symptoms of irreversible pulpitis or pulp necrosis were considered as failure. According to the orthodontic schedule, after 60 days the teeth were extracted and submitted for histological examination. The Kruskal-Wallis and Fisher’s exact tests were used for statistical analysis of the data (P=0.05). Results: Although dexamethasone specimens showed less inflammation, calcified bridge, pulpal blood vasculature, collagen fibers and granulation tissue formation were not significantly different between the groups (P>0.05). Conclusion: Topical dexamethasone did not hindered pulp healing but reduced the amount of underlying pulpal tissue inflammation after DPC and MP in healthy human premolars. PMID:27141213

  12. Barodontalgia among flyers: a review of seven cases.

    Science.gov (United States)

    Holowatyj, R E

    1996-07-01

    Once referred to as "flyer's toothache," barodontalgia is defined as tooth pain occurring with changes in ambient pressure. It usually occurs in people who fly or dive. It can develop in conjunction with sinusitis, and in teeth experiencing pulpitis after restorative treatment, new and recurrent caries, intra-treatment endodontic symptoms, dental and periodontal cysts, or abscesses. Although the causal process of barodontalgia is not well understood, it may be related to pulpal hyperemia, or to gases that are trapped in the teeth following incomplete root canal treatment. Patients who are frequently exposed to changes in ambient pressure should be encouraged to follow good oral health practices, attend regularly-scheduled dental recall examinations and accept the timely completion of restorative treatment to minimize the possibility of developing barodontalgia. By employing a classification system to document cases of barodontalgia, dentists will be better prepared to provide appropriate and successful treatment. Seven case reports of barodontalgia are presented and compared to previously documented cases. The author also reviews the reasons why military flyers are more likely to develop barodontalgia than others, although the passengers and crews of commercial airliners may also suffer from this condition.

  13. Pulp-Capping with Mineral Trioxide Aggregate

    Directory of Open Access Journals (Sweden)

    Peycheva Kalina

    2015-11-01

    Full Text Available There are two considerations for direct pulp capping - accidental mechanical pulp exposure and exposure caused by caries. Mineral trioxide aggregate (MTA was used as pulp-capping material to preserve the vitality of the pulpal tissues. Follow-up examinations revealed that treatment was successful in preserving pulpal vitality and continued development of the tooth. On the basis of available information, it appears that MTA is the material of choice for some clinical applications. Material and methods: Cases 18 - 8 teeth with grey MTA, 10 teeth with white MTA; diagnose: Pulpitis chronica ulcerosa, Electro pulpal test (EOD - 30-35 μA, pre-clinical X-ray - without changes in the structures, follow ups for 4 years. Successful treatments: without clinical symptoms and changes in the X-rays: 5 teeth with grey MTA, 8 teeth with white MTA for period of 4 years. Unsuccessful treatments: Clinical symptoms and sometimes changes in the X-ray: 3 with grey MTA, 2 with white MTA. MTA is an appropriate material for pulp-capping and follow-up examinations revealed that the treatment was successful in preserving pulpal vitality.

  14. Comparison of Anaesthetic Efficacy of 4% Articaine Primary Buccal Infiltration Versus 2% Lidocaine Inferior Alveolar Nerve Block in Symptomatic Mandibular First Molar Teeth.

    Science.gov (United States)

    Zain, Muhammad; Rehman Khattak, Shakeel Ur; Sikandar, Huma; Shah, Shafqat Ali; Fayyaz

    2016-01-01

    To evaluate success of pulpal anaesthesia of mandibular 1st molar by using 4% articaine in buccal infiltration versus 2% lidocaine in inferior alveolar nerve block. Randomized control trial. Department of Operative Dentistry, Sardar Begum Dental College, Gandhara University, Peshawar, from March to August 2014. One hundred and fifty-six emergency patients, who had 1st molar diagnosed with irreversible pulpitis, participated in the study. Subjects were divided into two groups by random allocation. One group received 4% articaine buccal infiltration and the other group received inferior alveolar nerve block of 2% lidocaine. Subjects’self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anaesthetic administration during access cavity preparation and pulp extirpation. Mean age of subjects was 31.46 ±10.994 years. The success rate of 4% buccal infiltration was 76.9%; whereas the success rate of 2% lidocaine inferior alveolar nerve block was 62.8%. There was no statistically significant difference between the two groups. 4% articaine buccal infiltration can be considered a viable alternative to 2% lidocaine inferior alveolar nerve block in securing successful pulpal anaesthesia for endodontic therapy.

  15. The clinical meaning of external cervical resorption in maxillary canine: transoperative dental trauma

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    2014-12-01

    Full Text Available External Cervical Resorption in maxillary canines with pulp vitality is frequently associated with dental trauma resulting from surgical procedures carried out to prepare the teeth for further orthodontic traction. Preparation procedures might surgically manipulate the cementoenamel junction or cause luxation of teeth due to applying excessive force or movement tests beyond the tolerance limits of periodontal ligament and cervical tissue structures. Dentin exposure at the cementoenamel junction triggers External Cervical Resorption as a result of inflammation followed by antigen recognition of dentin proteins. External Cervical Resorption is painless, does not induce pulpitis and develops slowly. The lesion is generally associated with and covered by gingival soft tissues which disguise normal clinical aspects, thereby leading to late diagnosis when the process is near pulp threshold. Endodontic treatment is recommended only if surgical procedures are rendered necessary in the pulp space; otherwise, External Cervical Resorption should be treated by conservative means: protecting the dental pulp and restoring function and esthetics of teeth whose pulp will remain in normal conditions. Unfortunately, there is a lack of well-grounded research evincing how often External Cervical Resorption associated with canines subjected to orthodontic traction occurs.

  16. Inflamed dental pulp stem cells:initial research and future development%炎症牙髓干细胞:起步研究与未来发展

    Institute of Scientific and Technical Information of China (English)

    赵华翔; 赵珊梅; 辛欣; 张博; 马宁虎; 李沐嘉; 张梦琦; 李昂

    2014-01-01

    BACKGROUND:Inflamed dental pulp stem cells are a new kind of dental pulp stem cells, and there is no systematic review on the cells by now. OBJECTIVE:To systematical y review the research progress in inflamed dental pulp stem cells. METHODS:A computer-based online search in PubMed, Web of Science, CNKI, WanFang and VIP databases was performed for related articles published from the establishment of the databases to February 2014. The keywords were“(pulptis or inflam*dental pulp*or human dental pulp with irreversible pulpitis) and stem cel*”in English and Chinese, respectively. Hand searching was also done to obtain further information or papers about the studies. The results were qualitatively analyzed to comprehensively summarize the progress in the research of inflamed dental pulp stem cells. RESULTS AND CONCLUSION:Total y 11 papers were involved in result analysis that comprehensively review the research progress in inflamed dental pulp stem cells at the fol owing aspects:the research of history, material origin, cellculture, cel-surface markers, proliferation ability, multi-directional differentiation potential, animal models and clinical use. Researches of inflamed dental pulp stem cells are stil in the initial stage, and cultivating conditions and the establishment of animal models are stil in the exploratory phase. Controversies stil exist in the capacity of proliferation and multi-directional differentiation of the inflamed dental pulp stem cells. And fewer studies have been done in the characteristics of immunity, subpopulation and clinical use of the inflamed dental pulp stem cells.%背景:炎症牙髓干细胞是近年来新发现的一类牙髓干细胞,目前尚无对其研究进展的系统评价。目的:系统评价炎症牙髓干细胞的研究进展。方法:以“(Pulptis OR Inflam* Dental Pulp* OR Human Dental Pulp with Irreversible Pulpitis)AND Stem Cel*/(牙髓炎OR炎症牙髓OR不可逆性牙髓炎)AND干细胞

  17. Indirect pulp capping in primary molar using glass ionomer cements

    Directory of Open Access Journals (Sweden)

    Murtia Metalita

    2014-12-01

    Full Text Available Background: Indirect pulp capping in primary teeth, however, is more rarely conducted than permanent teeth, since it thought to have low impact and most suggestion is for taking caries lesion aggressively on primary teeth. Purpose: The study was aimed to evaluate the subjective complaint, clinical symptom, and radiographic appearance of indirect pulp capping treatment using glass ionomers cements in primary molar. Methods: Sixteen children in range of age 6 to 8 years old, who visited Clinic of Pediatric Dentistry Universitas Airlangga Dental Hospital, Surabaya Indonesia, were the subject of study. They had one occlusal dental caries on one side of maxillary or mandibular primary molar with the diagnose of pulpitis reversible. The experimental group, had indirect pulp capping treatment with glass ionomer cements (GC Fuji VII®, while the control group, had indirect pulp capping treatment with calcium hydroxide (Metapaste. Each group was filled with GC Fuji IX® as permanent restoration. After one week, one month, and three months later, the observations were made on subjective complaint, clinical symptom, and radiographic appearance. Results: The results showed no subjective complaint such as pain or problem on mastication; no negative clinical symptoms such as pain on palpation, gingivitis or periodontitis, and abnormal tooth mobility; no negative radiographic appearance such as pathological apical radioluscency, internal or external resorbtion, and change of ligament periodontal widthafter the treatment. Conclusion: The study suggested that indirect pulp capping treatment using glass ionomer cement materials on primary teeth might be considered to be the treatment choice.Latar belakang: Indirect pulp capping pada gigi sulung lebih jarang dilakukan dibandingkan gigi permanen, karena dianggap memiliki dampak yang rendah dan sebagian besar menyarankan untuk mengambil lesi karies secara agresif pada gigi sulung. Tujuan: Penelitian ini bertujuan

  18. The expressions of NF-kb and TGFb-1 on odontoblast-like cells of human dental pulp injected with propolis extracts

    Directory of Open Access Journals (Sweden)

    Ira Widjiastuti

    2014-03-01

    Full Text Available Background: Propolis is known to have beneficial effects, namely anti- bacterial, anti-viral, anti-inflammatory, antioxidant, and immunomodulatory. Propolis extracts with anti-inflammatory properties are expected to be useful in treating inflamed pulp tissue with a diagnosis of reversible pulpitis. The inflammation of pulp tissue is caused by bacteria, namely Lactobacillus acidophilus. This research used odontoblast like cells derived from pulp tissue of human third molars. Odontoblast like cells exposed to Lactobacillus achidophilus were used as a model of proinflammatory cytokine signaling. This research examined the effects of propolis extracts on odontoblast like cells exposed to Lactobacillus acidophilus. Purpose: This research was aimed to determine the effectiveness of propolis extracts on the activities of odontoblast-like cells exposed to Lactobacillus acidophillus by measuring the expressions of NFkb and TGF- b1. Methods: First, pulp odontoblast cultures were derived from human dental pulp tissues of impacted third molars removed by using digestion method. Next, odontoblast-like cells exposed to inactive Lactobacillus acidophilus bacteria were given propolis extract. Finally, the activities of odontoblast-like cells were monitored by measuring the expressions of NF-kb and TGFb-1 with immunocytochemistry technique. Results: A decline NF-kb expression and on increase of TGFb-1 expression on odontoblast like cells exposed to inactive Lactobacillus acidophilus. Conclusion: Propolis extracts inhibit the expression of NF-kb, and increase the expression of TGF-b1 in pulp odontoblast-like cells exposed to inactive Lactobacillus acidophillus.Latar belakang: Propolis dilaporkan mempunyai efek menguntungkan yaitu bersifat anti bakteri, anti virus, anti inflamasi, anti oksidan, dan imunomodulator. Ekstrak propolis dengan sifat anti inflamasi diharapkan bermanfaat untuk mengobati jaringan pulpa yang mengalami inflamasi dengan diagnosis pulpitis

  19. The increasing of odontoblast-like cell number on direct pulp capping of Rattus norvegicus using chitosan

    Directory of Open Access Journals (Sweden)

    Widyasri Prananingrum

    2010-12-01

    Full Text Available Background: Pulpal perforation care with direct pulp capping in the case of reversible pulpitis due to mechanical trauma was performed with chitosan which has the ability to facilitate migration, proliferation, and progenitor cell differentiation. Purpose: The purpose of this study was to determine the increasing number of odontoblast-like cells in direct pulp capping dental care of Rattus norvegicus using chitosan for seven and fourteen days. Methods: Samples were molars of male Rattus norvegicus strain wistar, aged between 8–16 weeks, divided into two treatment groups, namely group I given chitosan and group II as a control group given Ca(OH2. Those Rattus norvegicus’ occlusal molar teeth were prepared with class I cavity, and then chitosan and Ca(OH2 were applied as the pulp capping materials. Afterwards, glasss ionomer cement type IX was used as a restoration material. Their teeth and jaw were then cut on the seventh day and the fourteenth day. Next, histopathological examination was carried out to observe the odontoblast like cells. All data were then analyzed by t test. Degree of confidence obtained, finally, was 95%. Results: The results obtained showed that the significant differences of odontoblast like cells on the seventh day observation was 0.001 (p = 0.001, and on the fourteenth day observation was 0.002 (p = 0.002. Conclusion: The number of odontoblast-like cells in direct pulp capping dental care of rattus norvegicus using chitosan is higher than the one using Ca(OH2 for seven and fourteen days.Latar belakang: Perawatan perforasi pulpa pada kasus pulpitis reversible karena trauma mekanis bur dilakukan direct pulp capping dengan cara pemberian bahan secara topikal pada daerah perforasi. Kitosan memiliki kemampuan untuk memfasilitasi migrasi, proliferasi dan diferensiasi sel progenitor pulpa. Tujuan: Tujuan penelitian ini adalah untuk menentukan jumlah peningkatan odontoblas-like cell pada perawatan direct pulp capping gigi

  20. Expression of minaralization-related genes in normal and inflamed human dental pulp tissues%人正常和感染牙髓组织中矿化因子表达的研究

    Institute of Scientific and Technical Information of China (English)

    王海婧; 白玉; 王亚飞; 蒋文凯; 贾谦; 倪龙兴

    2013-01-01

    AIM: To investigate the expression of minaralization-related genes in normal and inflamed hu- man dental pulp tissues. METHODS:Dental pulp from freshly extracted teeth for orthodontic reasons was collected. Total RNA of human dental pulp was extracted. Expression of minaralization-related genes, including alkaline phos-phatase (ALP) , osteocalcin (OCN) and runt-related transcription factor (Runx)-2 in normal and inflamed dental pulp tissues were detected respectively by RT-q PCR. RESULTS: Higher expression of ALP was observed in the dental pulp of the teeth with moderate and deep caries ( ompared with the normal group, P 0. 05) . However, the mRNA expression of the three genes decreased in pulp tissures with irreversible pulpitis ( P < 0. 05 ). CONCLUSION: The mineralization refated genes expresse in normal dental pulp tissues. ALP may have a potential role in the early stage of reparative dentin formation, while OCN may be related to pulp reaction in the middle and late stage of pulpitis. At late stage of infection the fuction of mineralization - related genes may decrease.%目的:观察不同状态牙髓组织矿化相关基因表达情况,以探讨矿化相关基因在牙髓损伤修复过程中的变化.方法:收集临床新鲜拔除的成人恒牙牙髓,荧光实时定量检测正常、浅龋、中龋、深龋、牙髓炎时牙髓组织中碱性磷酸酶(alkaline phosphatase,ALP)、骨钙蛋白(osteocalcin,OCN)、转录因子(runt-related transcription factor 2,Runx2)各基因的相对表达量.结果:与正常组织相比ALP mRNA在中龋及深龋组牙髓中表达量升高(P <0.05);OCN mRNA在深龋牙髓中表达量高(P<0.05);Runx2 mRNA在浅、中、深龋牙髓中的表达无明显变化(P>0.05).但以上3种基因在牙髓炎牙髓中的表达均较正常组明显下降(P<0.05).结论:在正常牙髓组织中矿化相关因子均有表达,ALP参与牙髓组织防御修复反应,OCN参与中晚期牙髓修复反应,牙髓炎后期,矿化因子作用减弱.

  1. The Effect of the Dental Operating Microscope on the Outcome of Nonsurgical Root Canal Treatment: A Retrospective Case-control Study.

    Science.gov (United States)

    Khalighinejad, Navid; Aminoshariae, Anita; Kulild, James C; Williams, Kristin A; Wang, Jeannie; Mickel, Andre

    2017-05-01

    The aim of the current investigation was to assess the effect of the use of a dental operating microscope on the outcome of nonsurgical root canal treatment (NS RCT) while treating the mesiobuccal (MB) root of the maxillary first molar. This retrospective investigation included endodontically treated maxillary first molars (ETMs) with apparent adequate previous NS RCT and restorations referred for endodontic retreatment at the endodontic graduate clinic. Inclusion criteria were ETMs that were diagnosed with irreversible pulpitis and normal periapical tissues before the initial NS RCT and ETMs that presented with a minimum of 1 identifiable periapical lesion (PAR) at 1 of the roots at the time of retreatment. One hundred ninety-five ETMs were included and divided into 2 groups: (1) the initial NS RCT had been performed using a microscope (n = 83) and (2) NS RCT had been performed without the use of a microscope (n = 112). Data extracted were whether the second MB (MB2) canal was located initially and the presence of an MB PAR at the time of retreatment. Data were statistically analyzed using binary logistic regression (α = 0.05). The MB root was 3 times more likely to present with a PAR at the time of retreatment if the initial NS RCT was performed without the use of a microscope (P microscope (P microscope, a missed MB2 canal was not associated with the presence of an MB PAR. With proper education, dentists can gain further insight into recognizing limitations in treating cases that require advanced training and advanced optics such as a microscope. Based on this strategy, it would appear that the outcome of NS RCT can be improved. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  2. Invasion of dentinal tubules by oral bacteria.

    Science.gov (United States)

    Love, R M; Jenkinson, H F

    2002-01-01

    Bacterial invasion of dentinal tubules commonly occurs when dentin is exposed following a breach in the integrity of the overlying enamel or cementum. Bacterial products diffuse through the dentinal tubule toward the pulp and evoke inflammatory changes in the pulpo-dentin complex. These may eliminate the bacterial insult and block the route of infection. Unchecked, invasion results in pulpitis and pulp necrosis, infection of the root canal system, and periapical disease. While several hundred bacterial species are known to inhabit the oral cavity, a relatively small and select group of bacteria is involved in the invasion of dentinal tubules and subsequent infection of the root canal space. Gram-positive organisms dominate the tubule microflora in both carious and non-carious dentin. The relatively high numbers of obligate anaerobes present-such as Eubacterium spp., Propionibacterium spp., Bifidobacterium spp., Peptostreptococcus micros, and Veillonella spp.-suggest that the environment favors growth of these bacteria. Gram-negative obligate anaerobic rods, e.g., Porphyromonas spp., are less frequently recovered. Streptococci are among the most commonly identified bacteria that invade dentin. Recent evidence suggests that streptococci may recognize components present within dentinal tubules, such as collagen type I, which stimulate bacterial adhesion and intra-tubular growth. Specific interactions of other oral bacteria with invading streptococci may then facilitate the invasion of dentin by select bacterial groupings. An understanding the mechanisms involved in dentinal tubule invasion by bacteria should allow for the development of new control strategies, such as inhibitory compounds incorporated into oral health care products or dental materials, which would assist in the practice of endodontics.

  3. 牙髓状态影响TRR1根尖定位仪准确性的临床评价%The influence of pulp status on the accuracy of TRR1 electronic apex locator

    Institute of Scientific and Technical Information of China (English)

    李焱; 唐继伟; 陆兆威

    2009-01-01

    Objective To investigate the influence of pulp status on the accuracy of determining root canal length by TRR1 electronic apex locator in clinic.Methods Two hundred and fifty-seven root canals of 87 teeth were divided into two groups, teeth in group A were diagnosed as pulpitis, and teeth in group B were apical periodontitis. All these root canals' working length were measured by TRR1 electronic apex locator, then measured the distance between the K-file tip and the radiographs(L), when 0 mm≤L≤2 mm,the data were considered accuracy. Results The accuracy rate of group A was lower than that of group B, but there was no significant difference in these data between two groups. Conclusion The accuracy of TRR1 electronic apex locator wasn't influenced by the pulp status in this study.%目的 探讨TRR1根尖定位仪在不同牙髓活力状态下测量根管长度的准确性.方法 由指定的临床主治医师使用TRR1根尖定位仪对诊断为牙髓炎和尖周炎的两组患牙分别作根管长度测量,根据X线插针定位片测定K锉尖距根尖的距离(L),以0 mm≤L≤2 mm为测量准确.结果 牙髓炎组(A组)测量准确率较根尖周炎组(B组)低,但两组准确率无显著性差异.结论 TRR1根尖定位仪的准确性不受牙髓活力状态的影响.

  4. Immunolocalization of fibronectin during reparative dentinogenesis in rat molor teeth after pulp capping with mineral trioxide aggregate or calcium hydroxide.

    Science.gov (United States)

    Bal, Cenkhan; Oztas, Nurhan; Cincik, Mehmet; Baris, Emre

    2011-11-01

    The aim of this study was to evaluate the immunolocalization of fibronectin during reparative dentinogenesis in rat teeth after pulp capping with mineral trioxide aggregate (MTA) or calcium hydroxide (Ca(OH)2). The pulps of 72 upper and lower first molar teeth from 18 male Wistar rats were experimentally exposed. The pulps were capped with MTA or (Ca(OH)2); final restoration followed with zinc oxide and eugenol cement. The animals were euthanized at, respectively, one, three, seven and fourteen days postoperatively. At day one, all groups showed varying degrees of inflammation, from mild to severe. There was no positive reaction for fibronectin at day one. After three days, a partial acute pulpitis was observed in the Ca(OH)2 group. There was less inflammation in the MTA group (p<0.05), and a layer of fibrin barrier was observed along the pulp walls of the MTA material. The layer of fibrodentin formation showed positive reaction for fibronectin. At seven days, the Ca(OH)2 group showed mild inflammation and demonstrated more immunostaining for fibronectin than the Ca(OH)2 group (p<0.05) at three days. Pulps capped with MTA at seven days showed thicker fibrin barrier formation than the MTA group at three days and more immunostaining for fibronectin in whole groups (p<0.05). At fourteen days, there was no positive reaction for fibronectin in either the MTA or Ca(OH)2 group. It seems MTA showed better biocompability properties with the dental pulp tissue, inducing the expression of reparative molecule fibronectin compared with Ca(OH)2. Therefore, MTA may be a better choice for pulp capping procedures.

  5. A Self-Administered Method of Acute Pressure Block of Sciatic Nerves for Short-Term Relief of Dental Pain: A Randomized Study

    Science.gov (United States)

    Wang, Xiaolin; Zhao, Wanghong; Wang, Ye; Hu, Jiao; Chen, Qiu; Yu, Juncai; Wu, Bin; Huang, Rong; Gao, Jie; He, Jiman

    2014-01-01

    Objectives While stimulation of the peripheral nerves increases the pain threshold, chronic pressure stimulation of the sciatic nerve is associated with sciatica. We recently found that acute pressure block of the sciatic nerve inhibits pain. Therefore, we propose that, the pain pathology-causing pressure is chronic, not acute. Here, we report a novel self-administered method: acute pressure block of the sciatic nerves is applied by the patients themselves for short-term relief of pain from dental diseases. Design This was a randomized, single-blind study. Setting Hospital patients. Patients Patients aged 16–60 years with acute pulpitis, acute apical periodontitis, or pericoronitis of the third molar of the mandible experiencing pain ≥3 on the 11-point numerical pain rating scale. Interventions Three-minute pressure to sciatic nerves was applied by using the hands (hand pressure method) or by having the patients squat to force the thigh and shin as tightly as possible on the sandwiched sciatic nerve bundles (self-administered method). Outcomes The primary efficacy variable was the mean difference in pain scores from the baseline. Results One hundred seventy-two dental patients were randomized. The self-administered method produced significant relief from pain associated with dental diseases (P ≤ 0.001). The analgesic effect of the self-administered method was similar to that of the hand pressure method. Conclusions The self-administered method is easy to learn and can be applied at any time for pain relief. We believe that patients will benefit from this method. PMID:24400593

  6. Depth and activity of carious lesions as indicators for the regenerative potential of dental pulp after intervention.

    Science.gov (United States)

    Bjørndal, Lars; Demant, Sune; Dabelsteen, Sally

    2014-04-01

    Studies on dental regeneration involving interventions for pulp therapy such as regeneration and revascularization procedures are promising for the injured tooth; however, a complete replication of the original pulp tissue does not seem to take place. In cases in which we wish to preserve or maintain parts of the pulp during treatment, it is apparent that the effectiveness of healing or biological regeneration is dependent on the degree of inflammation of the pulp tissue. Thus, the control or prevention of a pulp infection is still a major issue for the clinicians. Data indicate that the typical reason for performing endodontic treatment is deep caries. The biological concept of vital pulp therapy associated with deep caries takes the treatment and evaluation of the unexposed as well as the exposed pulp into account. Interestingly, the clinical diagnosis is typically the same. Deep caries with reversible pulpitis may receive differing treatments such as excavation procedures aiming to avoid pulp exposure or more pulp invasive treatments such as pulp capping or pulpotomy. This should not be the case. Consequently, huge treatment variation is noted among clinicians based on the same caries diagnosis. Which treatment should be selected? High-quality trials are needed, and it is important to obtain information on the actual lesion depth and an estimate of the lesion activity before treatment. These may be basic indicators for the regenerative potential of dental pulp. Recent clinical trials dealing with the treatment of deep caries lesion are discussed, including pulp invasive and noninvasive concepts, to attempt to solve the task of getting the best clinical outcome for adult patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. The application of tissue engineering to regeneration of pulp and dentin in endodontics.

    Science.gov (United States)

    Nakashima, Misako; Akamine, Akifumi

    2005-10-01

    Caries, pulpitis, and apical periodontitis increase health care costs and attendant loss of economic productivity. They ultimately result in premature tooth loss and therefore diminishing the quality of life. Advances in vital pulp therapy with pulp stem/progenitor cells might give impetus to regenerate dentin-pulp complex without the removal of the whole pulp. Tissue engineering is the science of design and manufacture of new tissues to replace lost parts because of diseases including cancer and trauma. The three key ingredients for tissue engineering are signals for morphogenesis, stem cells for responding to morphogens and the scaffold of extracellular matrix. In preclinical studies cell therapy and gene therapy have been developed for many tissues and organs such as bone, heart, liver, and kidney as a means of delivering growth factors, cytokines, or morphogens with stem/progenitor cells in a scaffold to the sites of tissue injury to accelerate and/or induce a natural biological regeneration. The pulp tissue contains stem/progenitor cells that potentially differentiate into odontoblasts in response to bone morphogenetic proteins (BMPs). There are two strategies to regenerate dentin. First, is in vivo therapy, where BMP proteins or BMP genes are directly applied to the exposed or amputated pulp. Second is ex vivo therapy and consists of isolation of stem/progenitor cells from pulp tissue, differentiation into odontoblasts with recombinant BMPs or BMP genes and finally transplanted autogenously to regenerate dentin. This review is focused on the recent progress in this area and discusses the barriers and challenges for clinical utility in endodontics.

  8. The application of lesion sterilization and tissue repair 3Mix-MP for treating rat's dental pulp tissue

    Directory of Open Access Journals (Sweden)

    Raditya Nugroho

    2015-03-01

    Full Text Available Background: Lesion sterilization and tissue repair (LSTR 3Mix-MP are three broad-spectrum antibiotics, including metronidazole, ciprofloxacin and minocycline are mixed with propylene glycol or macrogol. There is the possibility ofthe healing process that marked proliferation ofnew blood vessels and proliferation offibroblasts in the treatment ofirreversible pulpitis by pulp capping LSTR 3MixMP because of  the principle of the method LSTR 3Mix-MP is to kill bacteria. Purpose: The purpose of this study to prove the effect of LSTR 3Mix-MP on chronic inflammation and the healing process in rat dental pulp tissue in vivo. Methods: Rattus norvegicus anaesthetized by using ketamine and xylazine dissolved in sterile isotonic saline solution (0.2 ml/50gr mm on the upper right thigh. Cavity preparation class I to perforation by using a low speed tapered diamond round bur. In the treatment group, rats were treated 3Mix-MP at a dose of10 mg and then covered with glass ionomer cement for 7 days on the pulp that has been opened for 3 days. The control group treated with saline irrigation on the pulp that has been opened for 3 days. Rats were killed after seven days, and then made preparations pulp tissue to count the number oflymphocytes, macrophages, plasma cells, blood vessels, and fibroblasts Results: There is an increase in the average number ofmacrophage cells, plasma, and fibroblasts; and decreased lymphocytes and blood vessels in the treated group exposure LSTR 3Mix-MP. Conclusion:LSTR 3Mix-MP can reduce chronic inflammation process and enhance the healing process in rat dental pulp tissue.

  9. A randomized controlled study of the use of ProRoot mineral trioxide aggregate and Endocem as direct pulp capping materials.

    Science.gov (United States)

    Song, Minju; Kang, Minji; Kim, Hyeon-Cheol; Kim, Euiseong

    2015-01-01

    The purpose of the present study was to evaluate and compare the short-term clinical outcomes of direct pulp capping using ProRoot MTA (Dentsply, Tulsa, OK) or Endocem (Maruchi, Wonju, Korea) as capping materials in a prospective randomized controlled study. This study was conducted with subjects who were recruited from the pool of patients from the Department of Conservative Dentistry at the Dental College of Yonsei University, Seoul, Korea, between January and May 2013. Of the 48 teeth confirmed to be eligible for direct pulp capping, a total of 46 teeth were randomly assigned to either the ProRoot MTA or the Endocem group (23 teeth per group). Direct pulp capping was performed using these 2 materials, and clinical and radiographic evaluations were performed at 1, 2, 4, and 12 weeks after the treatments. Teeth with no response to pulp vitality test and those exhibiting clinical or radiographic signs and/or symptoms of irreversible pulpitis or pulp necrosis were considered to be failures. Thirty-two patients (43 teeth) were examined at the 3-month follow-up (patient recall rate = 91.4%); 22 of these teeth were in the ProRoot MTA group, and 21 were in the Endocem group. The overall success rate was 93%, and the success rates in the ProRoot MTA and Endocem groups were 95.5% (21/22 teeth) and 90.5% (19/21 teeth), respectively. Statistical analyses of these success rates did not reveal any significant difference between the groups (P = .522). In this randomized controlled study, no significant difference in the short-term clinical outcomes of direct pulp capping using ProRoot MTA or Endocem as the capping material was found. Furthermore, the favorable short-term outcome success rate of 93% indicates that direct pulp capping may be a reliable treatment for pulp exposure in adult teeth. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  10. Hand and ultrasonic instrumentation for orthograde root canal treatment of permanent teeth

    Directory of Open Access Journals (Sweden)

    Vinícius Pedrazzi

    2010-06-01

    Full Text Available Root canal treatment is a frequently performed dental procedure and is carried out on teeth in which irreversible pulpitis has led to necrosis of the dental pulp. Removal of the necrotic tissue remnants and cleaning and shaping of the root canal are important phases of root canal treatment. Treatment options include the use of hand and rotary instruments and methods using ultrasonic or sonic equipment. OBJECTIVES: The objectives of this systematic review of randomized controlled trials were to determine the relative clinical effectiveness of hand instrumentation versus ultrasonic instrumentation alone or in conjunction with hand instrumentation for orthograde root canal treatment of permanent teeth. MATERIAL AND METHODS: The search strategy retrieved 226 references from the Cochrane Oral Health Group Trials Register (7, the Cochrane Central Register of Controlled Trials (CENTRAL (12, MEDLINE (192, EMBASE (8 and LILACS (7. No language restriction was applied. The last electronic search was conducted on December 13th, 2007. Screening of eligible studies was conducted in duplicate and independently. RESULTS: Results were to be expressed as fixed-effect or random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confdence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. No eligible randomized controlled trials were identifed. CONCLUSIONS: This review illustrates the current lack of published or ongoing randomized controlled trials and the unavailability of high-level evidence based on clinically relevant outcomes referring to the effectiveness of ultrasonic instrumentation used alone or as an adjunct to hand instrumentation for orthograde root canal treatment. In the absence of reliable research-based evidence, clinicians should base their decisions on clinical experience, individual circumstances and in conjunction with patients

  11. Prevalence of persistent pain 3 to 5 years post primary root canal therapy and its impact on oral health-related quality of life: PEARL Network findings.

    Science.gov (United States)

    Vena, Donald A; Collie, Damon; Wu, Hongyu; Gibbs, Jennifer L; Broder, Hillary L; Curro, Frederick A; Thompson, Van P; Craig, Ronald G

    2014-12-01

    The frequency of persistent pain 3-5 years after primary root canal therapy and its impact on the patient's perceived oral health-related quality of life was determined in a practice-based research network. All patients presenting to participating network practices who received primary root canal therapy and restoration for a permanent tooth 3-5 years previously were invited to enroll. Persistent pain was defined as pain occurring spontaneously or elicited by percussion, palpation, or biting. The patient also completed an oral health-related quality of life questionnaire (Oral Health Impact Profile-14). Sixty-four network practices enrolled 1323 patients; 13 were ineligible, 12 did not receive a final restoration, and 41 were extracted, leaving 1257 for analysis. The average time to follow-up was 3.9 ± 0.6 years. Five percent (63/1257) of the patients reported persistent pain, whereas 24 of 63 (38%) exhibited periapical pathosis and/or root fracture (odontogenic pain). No obvious odontogenic cause for persistent pain was found for 39 of 63 (62%). Teeth treated by specialists had a greater frequency of persistent pain than teeth treated by generalists (9.3% vs 3.0%, respectively; P tooth type, type of dentist, and arch were not found to be associated with nonodontogenic persistent pain; however, ethnicity and a preoperative diagnosis of pulpitis without periapical pathosis were. Patients reporting pain with percussion tended to experience pain with other stimuli that negatively impacted quality of life including oral function and psychological discomfort and disability. These results suggest that a small percentage (3.1%) of patients experience persistent pain not attributable to odontogenic causes 3-5 years after primary root canal therapy that may adversely impact their quality of life. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  12. 牙科电子麻醉在窝洞制备和开髓治疗中的应用%The analgesic effect of electronic dental anesthesia in cavity preparation and pulp treatment

    Institute of Scientific and Technical Information of China (English)

    兰俊; 赵俊

    2001-01-01

    的:评价牙科电子麻醉在窝洞制备和开髓过程中的镇痛效果。 方法:对60例窝洞制备患者和15例开髓患者应用电子麻醉进行局部镇痛,另对60例窝洞制备患者和15例开髓患者应用传统局部麻醉作为对照,计算有效率,并对所得数值进行统计学处理(χ2检验)。 结果:窝洞制备组中,电子麻醉有效率为93.33%,局部麻醉有效率为98.33%,二者差异不显著(P>0.05);开髓治疗组中,电子麻醉有效率为26.67%,局部麻醉有效率为93.33%,二者差异显著(P0.05).For patients with pulpitis in need of pulp treatment ,the effective rates in EDA group and LA group were 26.7% and 93.33% respectively(P<0.01). Conclusions: EDA can be an effective analgesic method for cavity preparation, but not for pulp treatment.

  13. OCT4B1 Regulates the Cellular Stress Response of Human Dental Pulp Cells with Inflammation

    Directory of Open Access Journals (Sweden)

    Lu Liu

    2017-01-01

    Full Text Available Introduction. Infection and apoptosis are combined triggers for inflammation in dental tissues. Octamer-binding transcription factor 4-B1 (OCT4B1, a novel spliced variant of OCT4 family, could respond to the cellular stress and possess antiapoptotic property. However, its specific role in dental pulpitis remains unknown. Methods. To investigate the effect of OCT4B1 on inflammation of dental pulp cells (DPCs, its expression in inflamed dental pulp tissues and DPCs was examined by in situ hybridization, real-time PCR, and FISH assay. OCT4B1 overexpressed DPCs model was established, confirmed by western blot and immunofluorescence staining, and then stimulated with Lipopolysaccharide (LPS. Apoptotic rate was determined by Hoechst/PI staining and FACS. Cell survival rate was calculated by CCK8 assay. Results. In situ hybridization, real-time PCR, and FISH assay revealed that OCT4B1 was extensively expressed in inflamed dental pulp tissues and DPCs with LPS stimulation. Western blot and immunofluorescence staining showed the expression of OCT4B1 and OCT4B increased after OCT4B1 transfection. Hoechst/PI staining and FACS demonstrated that less red/blue fluorescence was detected and apoptotic percentage decreased (3.45% after transfection. CCK8 demonstrated that the survival rate of pCDH-OCT4B1-flag cells increased. Conclusions. OCT4B1 plays an essential role in inflammation and apoptosis of DPCs. OCT4B might operate synergistically with OCT4B1 to reduce apoptosis.

  14. Treatment approaches and antibiotic use for emergency dental treatment in Turkey

    Directory of Open Access Journals (Sweden)

    Kaptan RF

    2013-11-01

    Full Text Available Rabia Figen Kaptan,1 Faruk Haznedaroglu,2 Fatima Betul Basturk,3 Mehmet Baybora Kayahan11Department of Endodontics, Yeditepe University, 2Department of Endodontics, Istanbul University, 3Department of Endodontics, Marmara University, Istanbul, TurkeyAbstract: The purpose of this study was to gather information about Turkish general dental practitioners' treatment approaches towards endodontic emergencies, antibiotic-prescribing habits, and their participation in lifelong learning programs. Questionnaires were given to dentists who attended the 16th National Congress organized by the Turkish Dental Association. From 1,400 questionnaires distributed, 589 (43% were deemed usable in this study. This survey dealt with questions that were subdivided into two main topics: dental emergency treatment approaches, and antibiotic prescription and information on lifelong learning program participation. The statistical analysis was conducted with a Χ2 test at a significance level of P<0.05. For irreversible pulpitis cases in vital teeth, most of the dental practitioners (65.3% preferred single-visit root canal treatments. For teeth presenting a periapical lesion, the preferred treatment approach was root canal treatment (91.5%. The rate of prescription of analgesics and antibiotics was 21.7% in untreated acute apical periodontitis cases and 41% in acute apical abscess cases. Frequently prescribed antibiotics were amoxicillin–clavulanate (61.8% and amoxicillin (46.5%. There was a tendency for practitioners to attend congresses as their years of professional practice increased (P<0.0001. There have been discrepancies between taught and observed practice. Educational initiatives are needed to prevent inappropriate prescription of antibiotics.Keywords: antibiotic prescription, endodontic emergency, survey, Turkey

  15. Comparison of the effect of ibuprofen and slow-released Diclofenac Sodium in controlling post endodontic pain

    Directory of Open Access Journals (Sweden)

    Saatchi M

    2010-01-01

    Full Text Available "nBackground and Aims: Despite the significant improvement in dentistry, pain after endodontic therapy is still of concern for patients. Non-steroidal anti-inflammatory drugs are the most commonly prescribed oral analgesics used for dental pain relief after root canal treatment. The purpose of this study was to compare the effectiveness of Ibuprofen versus slow-released Diclofenac Sodium in controlling pain following root canal treatment. "nMaterials and Methods: In this randomized clinical trial, mandibular molars with irreversible pulpitis in 90 patients were selected. The patients were divided into three groups (Ibuprofen, slow-released Diclofenac Sodium and placebo. After examination patients filled in the consent form. Then they received one of the mentioned drugs. After inferior alveolar nerve block, access cavity was prepared and the root canals were prepared using passive step back method. The canals were dried and temporary filling material was placed. Then the pain evaluation form (visual analog scale was explained and delivered to the patients. Data were analyzed using Repeated Measurement ANOVA, Kruskal-wallis and Man-Whitney U tests. "nResults: The mean pain intensity in slow-released Diclofenac Sodium group was 0.87 0.95, 1.17 1.10 for Ibuprofen group, and 2.14  1.70 for placebo group. The differences between groups were statistically significant (P<0.001. The effect of Ibuprofen in controlling post endodontic pain in the first 2 hours was more than slow-released Diclofenac Sodium (P=0.01, but in 10, 18, and 36 hours after treatment, slow-released Diclofenac Sodium was more effective than Ibuprofen (P<0.001. "nConclusion: Premedication with single dose of slow-released Diclofenac Sodium can control post endodontic pain for a longer period of time compared with Ibuprofen. "n.

  16. A new analgesic method, two-minute sciatic nerve press, for immediate pain relief: a randomized trial

    Directory of Open Access Journals (Sweden)

    Zhang Fenglin

    2008-01-01

    Full Text Available Abstract Background Current analgesics have drawbacks such as delays in acquisition, lag-times for effect, and side effects. We recently presented a preliminary report of a new analgesic method involving a two-minute sciatic nerve press, which resulted in immediate short-term relief of pain associated with dental and renal diseases. The present study investigated whether this technique was effective for pain associated with other disease types, and whether the relief was effective for up to one hour. Methods This randomized, placebo-controlled, parallel-group trial was conducted in four hospitals in Anhui Province, China. Patients with pain were sequentially recruited by participating physicians during clinic visits, and 135 patients aged 15 – 80 years were enrolled. Dental disease patients included those with acute pulpitis and periapical abscesses. Renal disease patients included those with kidney infections and/or stones. Tumor patients included those with nose, breast, stomach and liver cancers, while Emergency Room patients had various pathologies. Patients were randomly assigned to receive a "sciatic nerve press" in which pressure was applied simultaneously to the sciatic nerves at the back of both thighs, or a "placebo press" in which pressure was applied to a parallel region on the front of the thighs. Each fist applied a pressure of 11 – 20 kg for 2 minutes. Patients rated their level of pain before and after the procedure. Results The "sciatic nerve press" produced immediate relief of pain in all patient groups. Emergency patients reported a 43.5% reduction in pain (p th minutes, and the relief decreased 47% by the 60th minutes. Conclusion Two minutes of pressure on both sciatic nerves produced immediate significant short-term conduction analgesia. This technique is a convenient, safe and powerful method for the short-term treatment of clinical pain associated with a diverse range of pathologies. Trial registration Current

  17. The effect of watermelon frost on prostaglandin E2 (PGE2 in inflamed pulp tissue (in vitro study

    Directory of Open Access Journals (Sweden)

    Dennis Dennis

    2009-06-01

    Full Text Available Background: Pulp inflammation can be marked by the increase of prostaglandin E2(PGE2 level compared to normal pulp. The increase of PGE2 may lead to vasodilatation, increase of vascular permeability, pain and bone resorption. Watermelon frost has been well known in Chinese society for pain relief and inflammation in oral cavity and teeth. Purpose: The aim of this study was to investigate that watermelon frost can be used to decrease the PGE2 level. Method: 27 samples of pulp tissues used in this in-vitro study, were extirpated from the patients’ teeth with symptomatic irreversible pulpitis referred to clinic of Conservative Dentistry, RSPGM Faculty of Dentistry, USU. Trial materials were applied to 27 samples i.e. watermelon frost as a trial material and commercial watermelon frost and eugenol to observe their effect on PGE2. PGE2 level of each material was detected through ELISA method by measuring and comparing the absorbance reading of the wells of the samples against standards with a micro plate reader at W1 = 650 nm and W2 = 490 nm. Result: The result showed the biggest effect was found in the third group (eugenol, mean 4.6933, followed by the first group (watermelon frost as a trial material, mean 18,1578 then the second group (commercial watermelon frost, mean 82,2689. OneWay ANOVA revealed that there were significant differences among all trial materials (p < 0.001 on PGE2 level. Conclusion: This study demonstrated that watermelon frost can be used to decrease the PGE2 level in inflamed pulp tissue and led to the acceptance of traditional medicine and natural products as an alternative form of dental care.

  18. Contribution of the Collagen-Binding Proteins of Streptococcus mutans to Bacterial Colonization of Inflamed Dental Pulp.

    Directory of Open Access Journals (Sweden)

    Ryota Nomura

    Full Text Available Streptococcus mutans is a major pathogen of dental caries. Collagen-binding proteins (CBPs (approximately 120 kDa, termed Cnm and Cbm, are regarded as important cell surface antigens related to the adherence of S. mutans to collagenous tissue. Furthermore, CBP-positive S. mutans strains are associated with various systemic diseases involving bacteremia, such as infective endocarditis. Endodontic infection is considered to be an important cause of bacteremia, but little is known regarding the presence of S. mutans in dental pulp tissue. In the present study, the distribution and virulence of S. mutans in dental pulp tissues were investigated by focusing on CBPs. Adhesion and invasion properties of various S. mutans strains were analyzed using human dental pulp fibroblasts (HDPFs. CBP-positive strains had a significantly higher rate of adhesion to HDPFs compared with CBP-defective isogenic mutant strains (P<0.001. In addition, CBP-positive strains induced HDPF proliferation, which is a possible mechanism related to development of hyperplastic pulpitis. The distribution of S. mutans strains isolated from infected root canal specimens was then analyzed by PCR. We found that approximately 50% of the root canal specimens were positive for S. mutans. Approximately 20% of these strains were Cnm-positive, while no Cbm-positive strains were isolated. The Cnm-positive strains isolated from the specimens showed adhesion to HDPFs. Our results suggest that CBP-positive S. mutans strains exhibit high colonization in dental pulp. This could be a possible virulence factor for various systemic diseases.

  19. Regeneration of dental pulp/dentine complex with a three-dimensional and scaffold-free stem-cell sheet-derived pellet.

    Science.gov (United States)

    Na, Sijia; Zhang, Hao; Huang, Fang; Wang, Weiqi; Ding, Yin; Li, Dechao; Jin, Yan

    2016-03-01

    Dental pulp/dentine complex regeneration is indispensable to the construction of biotissue-engineered tooth roots and represents a promising approach to therapy for irreversible pulpitis. We used a tissue-engineering method based on odontogenic stem cells to design a three-dimensional (3D) and scaffold-free stem-cell sheet-derived pellet (CSDP) with the necessary physical and biological properties. Stem cells were isolated and identified and stem cells from root apical papilla (SCAPs)-based CSDPs were then fabricated and examined. Compact cell aggregates containing a high proportion of extracellular matrix (ECM) components were observed, and the CSDP culture time was prolonged. The expression of alkaline phosphatase (ALP), dentine sialoprotein (DSPP), bone sialoprotein (BSP) and runt-related gene 2 (RUNX2) mRNA was higher in CSDPs than in cell sheets (CSs), indicating that CSDPs have greater odonto/osteogenic potential. To further investigate this hypothesis, CSDPs and CSs were inserted into human treated dentine matrix fragments (hTDMFs) and transplanted into the subcutaneous space in the backs of immunodeficient mice, where they were cultured in vivo for 6 weeks. The root space with CSDPs was filled entirely with a dental pulp-like tissue with well-established vascularity, and a continuous layer of dentine-like tissue was deposited onto the existing dentine. A layer of odontoblast-like cells was found to express DSPP, ALP and BSP, and human mitochondria lined the surface of the newly formed dentine-like tissue. These results clearly indicate that SCAP-CSDPs with a mount of endogenous ECM have a strong capacity to form a heterotopic dental pulp/dentine complex in empty root canals; this method can be used in the fabrication of bioengineered dental roots and also provides an alternative treatment approach for pulp disease. Copyright © 2013 John Wiley & Sons, Ltd.

  20. 157例妊娠期妇女口腔疾病的回顾性分析%Retrospective analysis on 157 cases of oral disease in pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘华

    2015-01-01

    目的:总结分析妊娠期女性口腔疾病的临床特点和治疗方法,探索治疗方法。方法通过回顾性分析2009年1月至2014年12月口腔科治疗的157名妊娠患者临床资料,对疾病病因、诊断、治疗等进行分析。结果妊娠期牙周炎73例;妊娠期牙龈炎10例;冠周炎32例;牙髓炎和根尖炎患者42例。结论妊娠期口腔疾病以牙周炎比例最高,以冠周炎临床症状较重。孕妇口腔疾病容易引起早产,应重视孕前检查。%To analyze the clinical features and treatment of oral disease in pregnancy and to explore preventive methods. 157 patients from January 2009 to December 2014 were retrospectively reviewed. Etiology, diagnosis, treatment and outcome were analyzed. There were 73 cases of pregnancy periodontitis; 10 cases of pregnancy gingivitis; 32 cases of pericoronitis; 42 cases of pulpitis and papicitis. During pregnancy, there is the highest proportion of periodontitis, and the heaviest symptom of pericoronitis in oral disease. Oral disease may cause pre-mature birth easily, pregnant women should attach importance to pre-pregnancy check.

  1. Direct pulp capping of permanent teeth in New Zealand general dental practice--a practice based research study.

    Science.gov (United States)

    Friedlander, L; McElroy, K; Daniel, B; Cullinan, M; Hanlin, S

    2015-06-01

    This study aimed to investigate treatment protocols and opinions towards direct pulp capping (DPC) amongst New Zealand (NZ) general dental practitioners (GDP) through a Practice Based Research Network (PBRN) study. Mixed-methods approach using qualitative thematic and quantitative analysis. An on-line survey containing Likert scale items and open-ended questions was distributed to GDPs on the Dental Council of New Zealand (DCNZ) register (2012) to collect information on practitioner demographics, treatment protocols, continuing professional development (CPD) and philosophies towards DPC. RESULTs: Two hundred and ten GDPs from North and South Islands providing care in main centres and rural areas engaged with the PBRN and participated in the study. Almost all performed DPC treatment although it was not a common procedure. DPC was perceived as 'successful' or 'very successful' by 95% of respondents, mostly for cases of reversible pulpitis. Most provided DPC for patients of all ages but younger patients were perceived to have the best clinical outcomes. Calcium hydroxide and MTA were the most commonly used materials for DPC. MTA was believed to have the best outcome but cost and handling properties were barriers to its use. The majority of respondents had participated in CPD related to vital pulp therapy and regarded this treatment as conservative and providing time and financial benefits compared with more invasive treatment. Clinicians' timeframes for assessing healing were variable, and combined clinical and radiographic findings were considered most useful. New Zealand dentists perceive DPC as a successful and conservative treatment in selected cases. The findings have provided insights into engagement of NZ dentists in using research to inform everyday clinical practice through a PBRN study.

  2. 水激光在牙体牙髓病治疗中的应用%Application of Er,Cr,YSGG laser in restorative and endodontic treatment

    Institute of Scientific and Technical Information of China (English)

    刘宁宁(综述); 何文喜(审校)

    2016-01-01

    The first ruby laser machine was invented in 1960 and laser was first applied to dental treatment in 1971.Afterward,extensive studies have been conducted on laser application in dentistry.In 2002,Er,Cr,YSGG laser/Waterlaser was approved by US Food and Drug Administration.Since then,Er,Cr,YSGG laser has been widely used for the treatment of dental diseases including dental caries,dentin hypersensitivity,pulpitis and apical periodonti-tis.It is used for the removal of caries,pulp capping or pulpotomy and root canal therapy.In this review,the applica-tion of Er,Cr,YSGG laser in restorative and endondontic treatment is summarized.%自1960年第一台红宝石激光器问世,1971年开始了激光在牙科中的应用。2002年美国FDA批准了水激光牙科治疗系统的临床应用。随着各种不同激光器的进一步研发,激光在口腔疾病治疗方面的应用研究也不断深入,其应用范围也越来越广泛。其中以治疗龋病、牙本质过敏症、盖髓术、牙髓切断术、根管治疗术以及牙周疾病的研究较多。为此,本文就水激光在牙体牙髓病治疗中的应用研究作一综述。

  3. HUBUNGAN PENGETAHUAN, SIKAP, DAN PERILAKU TENTANG KARIES GIGI TERHADAP INDEKS DMF-T PADA SISWA SD KELAS VI DI DAERAH KUMUH DAN TIDAK KUMUH KECAMATAN PENJARINGAN JAKARTA UTARA

    Directory of Open Access Journals (Sweden)

    Ratih Ariningrum

    2012-11-01

    Full Text Available In Indonesia town people are being increase almost twofold. Than many people have to stay in the slum areas. The health of teeth and mouth service in health centres (puskesmas is given toothache for low income people and specially for anxious people to toothache. The percentage of the toothache, pulpitis and periapical membrane diseases for people took the fourth rank from nine non contagious diseases at Kecamatan Penjaringan are 2.9% in 1999. The objectives of the research were to determine the relations of knowledge, attitude, and behavior aspect about dental caries with DMF-T index. The other objecllves were to determine the classification of slum and non­ slum areas regarding  the knowledge, attitude, and behavtor about caries on the elementary school students 6th class. Results by simple linear regression showed that DMF-T index were influenced by variables of knowledge (p = 0.041. Results by multiple linear regression showed that DMF-T index is influenced by variable of knowledge and attitude about dental (p knowledge = 0.010 and p attitude = 0.046. Results by t test proved there were the significant differences in the knowledge and attitude between elementary school students 6th class in the slum and non-slum area (p knowledge= 0.001 and p attitude= 0.029. Dental healthy of elementary school students 6th class were mfluenced by knowledge. If the variables of knowledge, attitude, and behavior were analyzed together, just variables of knowledge and attitude that influenced caries dentis (DMF-T index. The classification slum and non-slum areas influenced the knowledge and attitude of the students about dental caries.   Key words:  knowledge, attitude, practice, index DMF- T. slum and non-slum area

  4. 笑气/氧气吸入镇静在儿童口腔科的临床应用%Clinical application of nitrous oxide/oxygen inhalation sedation in pediatric dentistry.

    Institute of Scientific and Technical Information of China (English)

    姜秋; 杨秀玲

    2011-01-01

    Objective: To test the sedation effect of root canal treatment of children by inhaling N2O / O2. Method: N2O / O2 were inhaled by 54 patients of dental anxiety who were diagnosed pulpitis or apical periodontitis in our department and all the parents have agreed with it. To assess the effect of N2O / O2 inhalation sedation by comparing the difference of the heart rate、respiration rate、 blood pressure、calm score. Result: 50 patients finished root canal treatment snccessfully,4 patients quited the experiments. No obvious diffrence of respiration rate、blood pressure were found before、after inhaling N2O / O2 and during the process of root canal treatment,besides there were no statistics significance according three times mensuration of sedation scores. Conclusion: It is a safe、useful approach with inhalation N2O / O2 for the root canal treatment of children.%目的:观察笑气/氧气吸入在儿童根管治疗过程中的镇静效果.方法:选取患有牙髓炎或根尖周炎牙科焦虑患儿54例经患儿家长同意采取笑气/氧气吸入,通过患儿心率(HR)、呼吸频率(RR)、血压(Bp)变化,镇静程度差异评定笑气/氧气吸入对儿童根管治疗过程中的镇静效果.结果:50例患儿根管治疗顺利进行,4例患儿退出实验.吸入笑气前、后、根管治疗时脉搏、呼吸频率、血压均无明显变化,镇静评分三次测量均无统计学意义.结论:笑气/氧气吸入安全、有效,对于儿童根管治疗具有很好的辅助效应.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Effects of Prenatal Care for the Mother on Dental Caries in Preschool children%母亲孕期保健对学龄前儿童龋齿的影响研究

    Institute of Scientific and Technical Information of China (English)

    杜娟

    2016-01-01

    Objective To investigated the relationship between caries of preschool child and maternal related factors in pregnancy. Methods 2168 preschool children in 21 kindergartens of the whole city were collected in the study. 1084 children suf-fered caries served as study group;The other 1084 children with on caries served as control group. Maternal related factors in preg-nancy were investigated. Results There were significant differences between two groups(P<0. 05)with following related factors to affect caries of preschool child:dental caries,gingivitis,maternal pulpitis,to add calcium and protein,smoking or passive-smoking in pregnancy and preterm. Conclusion Caries of preschool child and maternal related factors in pregnancy were relevant. To pro-tect children teeth and promote the healthy growth of children,the mother during pregnancy should add nutrition and strengthen oral and general health.%目的:探究学龄前儿童发生龋齿与母亲孕期相关因素的关系。方法全市范围内选取21所幼儿园中的2168名学龄前儿童进行研究,对照组1084例儿童均未患龋齿,观察组1084例儿童均患有龋齿。对全部儿童的母亲孕期相关因素进行调查分析。结果母亲怀孕期间患龋齿、牙龈炎、牙髓炎、孕期补充钙和蛋白质、吸烟或被动吸烟及早产等因素与儿童龋齿患病率相关(P<0.05)。结论学龄前儿童龋齿与母亲怀孕期间的多种因素具有相关性,为保护儿童乳牙,促进儿童的健康成长,应该在母亲怀孕期间注意增加营养,做好口腔及全身的保健。

  7. 变形链球菌诱导牙髓细胞MMP-8mRNA的表达及意义%The expression and significance of MMP-8 mRNA induced by streptococcus mutans in dental pulp cells

    Institute of Scientific and Technical Information of China (English)

    孙淑芬; 张影杰; 姜新朋; 张颖丽

    2011-01-01

    目的 采用变形链球菌诱导体外培养的人牙髓成纤维细胞,观察变形链球菌对人牙髓成纤维细胞中MMP-8影响,探讨MMP-8在牙髓炎症过程中的作用机制.方法 采用组织块法体外培养人牙髓成纤维细胞,通过变形链球菌上清液诱导建立牙髓细胞损伤实验模型,利用RT-PCR方法检测经变球链球菌诱导人牙髓成纤维细胞中MMP-8的表达.结果 经变形链球菌诱导后的人牙髓成纤维细胞中MMP-8的表达增强.结论 变形链球菌能够促进人牙髓成纤维细胞中MMP-8的合成和分泌,从而导致牙髓中细胞外基质的降解,产生不可逆性牙髓损伤.%Objective  Cultivate human pulp fibroblasts in vitro induced by streptococcus mutans ,observe the influence of streptococcus mutans on MMP-8 in human pulp fibroblasts ,and investigate the mechanism of action of MMP-8 in pulpitis .Methods  Cultivate human pulp fibroblasts with architecture method ,establish the experimental model of human pulp cells induced by streptococcus mutans supernatant ,and then detect the expression of MMP-8 in pulp fibroblasts by RT-PCR .Results  The expression of MMP-8 is significantly increased in human pulp fibroblasts induced by streptococcus mutans .Conclusion  Streptococcus mutans can induce the synthesis and expression of MMP-8 mRNA in human pulp fibroblasts ,resultin degradation of the extracellularm atrix ,which can cause the inconvertible pulp injuries .

  8. The clinical efficacy of Xipayigingiva consolidation gargle for root canal flushing%西帕依固龈液用于根管冲洗的疗效

    Institute of Scientific and Technical Information of China (English)

    林彤; 程百祥; 李昂; 侯立鹏; 胡娜

    2016-01-01

    Objective To explore the efficacy of Xipayigingiva consolidation gargle for root canal flushing. Methods 543 teeth in 543 patients with acute or chronic pulpitis or apical periodontitis who needed root canal treatmentwere divided into three groups by completely randomized design. The three groups wereXipayigingiva consolidation gargle group, hydrogen peroxide group, and sodium hypochlorite group. Conventional pulp chamber incision, pulpectomy and root canals preparation were used for the affected teeth. Three different rinsing solutions were applied to flush root canal. One week later , signs and symptoms were observed , and success rate was assessed in patients by comparing among the three groups. Results Regardless of duration of disease course and patients′ oral health situation, the success rate did not differ significantly among the three groups (P > 0.05). Conclusions Xipayi gingiva consolidation gargle has the same effect as sodium hypochlorite and hydrogen peroxide. It can be used as an alternative for flushing root canal.%目的:探讨西帕依固龈液用于根管冲洗的疗效。方法:选取因急慢性牙髓炎及根尖周炎而需要行根管治疗的543例患者的543颗患牙,采用完全随机设计,分为西帕依固龈液组、双氧水组及次氯酸钠组。3组患牙均采用常规开髓、拔髓及根管预备,采用3组不同的根管冲洗液冲洗,1周后复诊,观察患者症状体征,计算成功率,并进行组间比较。结果:无论病程长短以及患者口腔卫生状况好与差,3种药物的根管冲洗的成功率差异均无统计学意义(P >0.05)。结论:西帕依固龈液与次氯酸钠、双氧水的冲洗效果相同,可作为替代品用于根管冲洗。

  9. 脉冲Nd:YAG激光用于乳牙活髓切断术的临床试验研究%Clinical and experimental study of pulsed Nd:YAG laser for amputation of the pith of live teeth

    Institute of Scientific and Technical Information of China (English)

    杨春丽; 曾明昌; 李芳

    2015-01-01

    目的:通过临床试验,研究Nd:YAG激光用于乳牙活髓切断术的有效性,为临床行乳牙活髓切断术提供一种有效的新方法。方法选择3~6岁乳牙深龋及早期牙髓炎患儿189例,将实验牙随机分为激光组和对照组。激光组给予40 Hz,2 W,50 mJ的能量照射乳牙切髓断面,对照组给予生理盐水、双氧水冲洗牙髓断面,消毒棉球压迫止血。治疗后,分1,3,6个月三个时间段随访并行X片复查。结果激光组在每个时间点的口内检查和X线表现均优于对照组。结论 Nd:YAG激光照射乳牙切髓断面,能有效地杀菌、止血。同时可有效地应用于乳牙活髓切断术中。%ObjectiveThe purpose of this study was to compare clinical effects of Nd:YAG laser pulpotomy to formocresol pulpotomy on human primary teech. An effective new method for pulpotomy was applied.Methods189 cases of primary teeth with deep caries or early pulpitis were selected for this study. These teeth were divided into the laser group and the control group randomly. After pulpotomy, every stump of laser group was exposed to Nd:YAG laser with output of 40 Hz, 2 W, 50 mJ. And each of the control group was irrigated with Stroke-physiological caline solution(SPSS) and Hydrogen Peroxide,then staunched with pressure. 189 teeth in two groups were to be followed up clinically and radiographicaly at 1, 3, 6 months. ResultsThe rapeutical effects of the experimental group were better than that of the control group in clinical and radiographic examination at each time point.ConclusionNd:YAG laser,can effectively sterilize and staunch. Nd: YAG laser is an effective method for primary teeth pulpotomy.

  10. Clinical study on root canal therapy for calcified teeth with reciprocal instrument clamping K file%回旋手机夹持K型锉治疗钙化根管

    Institute of Scientific and Technical Information of China (English)

    何泽红; 程超; 金树人

    2015-01-01

    AIM:To evaluate the clinical outcome of reciprocal instrument clamping K file in the negotiation of calcified root canals. METHODS:167 calcified root canals of 112 teeth from 96 patients with pulpitis or apical periodontitis were negotiated with reciprocal instrument clamping K file and the outcome were evaluated. RESULTS:131(78. 44%) calci-fied root canals were successfully negotiated. Correlation was found between the success rate and tooth location, the success rate of the anterior teeth group was higher than that of the molar group (P<0. 05);the success rate of the canals with calci-fication of coronal to the bend position was significantly higher than that of apical to the bend position(P<0. 05). CON-CLUSION:The reciprocal instrument clamping K file is safe and effective in the treatment of calcified root canal, but it has certain limitation in negotiating the calcification of the root canals at apical to the bend position.%目的::评价回旋手机夹持K型锉疏通钙化根管的临床效果。方法:选择牙髓炎或根尖周炎患者96例112个患牙,共167个钙化根管,用回旋手机夹持K型锉进行疏通,评价根管疏通效果。结果:167个钙化根管,成功疏通131个(78.44%)。其中前牙组成功率高于磨牙组(P<0.05);钙化位于弯曲部位以上的成功率高于钙化位于弯曲部位以下的根管(P<0.05)。结论:回旋手机夹持K型锉疏通钙化根管安全、有效,但疏通钙化位于弯曲部位以下的根管方面尚有一定的局限性。

  11. Clinical study of patients with persistent orofacial pain Estudo clínico de pacientes com dor orofacial persistente

    Directory of Open Access Journals (Sweden)

    José Tadeu Tesseroli de Siqueira

    2004-12-01

    Full Text Available OBJETIVE: To evaluate a sample of patients with persistent facial pain unresponsive to prior treatments. METHODS: Hospital records of 26 patients with persistent facial pain were reviewed (20 female and 6 male. RESULTS: Patients were classified into three groups according to their presenting symptoms: aGroup I, eight patients (30.7% with severe, diffuse pain at the face, teeth or head; bGroup II, eight patients (30.7% with chronic non-myofascial pain and; cGroup III, ten patients with chronic myofascial pain (38.4%. We find 11 different diagnoses among the 26 patients: pulpitis(7, leukemia(1, oropharyngeal tumor(1, atypical odontalgia(1, Eagle's syndrome(1, trigeminal neuralgia(4, continuous neuralgia(1, temporomandibular disorders (9, fibromyalgia (2, tension-type headache(1, conversion hysteria(2. After the treatment program all patients had a six-month follow-up period with pain relief, except the patient with tumor. CONCLUSION: The wide variability of orofacial pain diagnosis (benign to life-threatening diseases indicates the necessity to reevaluate patients presenting recurrent pain that is refractory to the usual treatments.OBJETIVO: Avaliar uma amostra de doentes com dor facial persistente. MÉTODO: Foram revisados 26 prontuários de doentes com dor facial persistente (20 mulheres e 6 homens. RESULTADOS: Classificação dos doentes, após o diagnóstico: aGrupo I, oito pacientes (30,7% com dor facial difusa de fortíssima intensidade; bGrupo II, oito pacientes (30,7% com dor crônica de natureza não-miofascial e; cGrupo III, dez pacientes com dor crônica miofascial (38,4%. Foram encontrados 11 diagnósticos diferentes entre os 26 pacientes: pulpites(7, leucemia(1, tumor de orofaringe(1, odontalgia atípica(1, síndrome de Eagle(1, neuralgia idiopática do trigêmeo(4, neuralgia atípica(1, disordens temporomandibular (9, fibromialgia(2 cefaléia tipo-tensão(1, histeria de conversão(2. O acompanhamento dos doentes, após receberem a

  12. Cost differentials of dental outpatient care across clinical dentistry branches

    Directory of Open Access Journals (Sweden)

    Jovana Rančić

    2015-03-01

    Full Text Available Background: Dental care presents affordability issues in Central & Eastern European transitional economies due to lack of insurance coverage in most countries of the region and almost complete out-of-pocket payments by citizens.Objective: Real world estimates on cost differentials across clinical dentistry branches, ICD-10 diagnostic groups and groups of dental services.Methods: Prospective case-series cost analysis was conducted from the patient perspective. A six months time horizon was adopted. Sample size was 752 complete episodes of treatment in 250 patients, selected in 2012/2013 throughout several specialist state- and private-owned dental clinics in Serbia. All direct costs of dental care were taken into account and expressed in Euros (€.Results: Mean total costs of dental care were € 46 ± 156 per single dentist visit while total costs incurred by this population sample were € 34,424. Highest unit utilization of services belongs to conservative dentistry (31.9%, oral surgery (19.5% and radiology (17.4%, while the resource with the highest monetary value belongs to implantology € 828 ± 392, orthodontics € 706 ± 667 and prosthetics € 555 ± 244. The most frequently treated diagnosis was tooth decay (33.8% unit services provided, pulpitis (11.2% and impacted teeth (8.5%, while most expensive to treat were anomalies of tooth position (€ 648 ± 667, abnormalities of size and form of teeth (€ 508 ± 705 and loss of teeth due to accident, extraction or local periodontal disease (€ 336 ± 339.Conclusion: Although the range of dental costs currently falls behind EU average, Serbia’s emerging economy is likely to expand in the long run while market demand for dental services will grow. Due to threatened financial sustainability of current health insurance patterns in Western Balkans, getting acquainted with true size and structure of dental care costs could essentially support informed decision making in future

  13. 心理干预加无痛麻醉对降低去髓术患者牙科焦虑症的疗效观察%Effect of psychological intervention and single tooth anesthesia on the dental anxiety of patient with pulpectomy treatment

    Institute of Scientific and Technical Information of China (English)

    尤苏霞; 范晓敏; 刘玺; 李芬; 杨媛; 郭翠红; 周丹

    2012-01-01

    目的:探讨减轻慢性牙髓炎患者去髓术治疗过程中牙科焦虑症(Dental anxiety,DA)的方法.方法:200例慢性牙髓炎患者,书面告知去髓术方法,疗效以及可能出现的并发症等后,随机分为4组.A组:在碧兰麻醉下行去髓术;B组:无痛麻醉(Single tooth anesthesia,STA)下行去髓术;C组:进行心理干预后在碧兰麻醉下行去髓术;D组:心理干预后在STA无痛麻醉下行去髓术.采用改良牙科焦虑量表(Modified dental anxiety scale,MDAS)测量4组患者不同治疗时期DA水平的变化,并对去髓术治疗前后测量数据进行统计学分析.结果:复诊时4组患者的DA值均呈下降趋势,其中以D组下降最为明显,其次为B、C组.同一组内治疗前后DA值均有显著性差异(P<0.05).结论:心理干预与STA无痛麻醉同时应用可显著降低去髓术治疗中的牙科恐惧.%AIM: To explore the method of decreasing dental anxiety (DA) on pulpectomy. METHODS:Two hundred patients with chronic pulpitis were given written notice about the method, effects and complications of pulpectomy. They were then randomly divided into 4 groups. Patients in each group received pulpectomy under anesthesia ( group A) , under single tooth anesthesia ( STA) ( group B) , psychological intervention plus anesthesia ( group C) and psychological intervention plus STA (group D) respectively. Modified dental anxiety scale (MDAS) was used to measure the DA levels before and after pulpectomy. RESULTS: DA levels decreased in all four groups. Group D showed the most decrease, followed by group B, C and A (P <0. 05). CONCLUSION: Psychological intervention plus single tooth anesthesia can significantly decrease dental anxiety during pulpectomy.

  14. Clinical Analysis of Common Complications and Countermeasures of Porcelain Tooth Restoration%烤瓷牙修复的临床常见并发症分析及对策

    Institute of Scientific and Technical Information of China (English)

    江鹏

    2015-01-01

    Objective To study the clinical complications of porcelain tooth restoration measures for prevention and control.Methods Of 90 patients in our hospital were porcelain dental restoration of patients,the clinical data of al patients were retrospectively analyzed.Results Al the patients teeth after repair,the patients were folowed,including porcelain dental restoration success in 73 cases,accounting for 81.1%; effective repair in 10 cases, accounting for 11.1%; repair invalid in 7 cases,accounting for 7.8%. The emergence of crown shedding,pulpitis,abutment tooth pain.Conclusion Porcelain dental restoration can effectively ensure the appearance of the teeth,natural color,form more realistic,with non deformation,but also can effectively promote the masticatory function,in the process of porcelain tooth restoration,the doctors need to pay attention to the details of the clinical operation,control effectively the complications occur,may obtain the good the effect of treatment.%目的:研究分析烤瓷牙修复的临床常见并发症的防治措施。方法选择我院收治的90例进行烤瓷牙修复的患者,对所有患者的临床资料进行回顾性分析。结果所有患者的牙齿修复之后,对患者进行随访,其中烧瓷牙修复成功的有73例,占81.1%;修复有效的有10例,占11.1%;修复无效的有7例,占7.8%。其中出现牙冠脱落、牙髓炎、基牙疼痛等并发症。结论烧瓷牙修复可以有效的确保牙齿的美观,色泽天然,形态比较逼真,具有不变形的特点,还可以有效的促进咀嚼功能的恢复,在烧瓷牙修复的过程中,医生需要注意临床操作中的细节,有效的控制并发症的发生,可以取得较好的治疗效果。

  15. Clinical evaluation of fractured immature anterior permanent teeth after immediate restoration%年轻恒前牙冠折后即刻冠修复的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈永丰; 马兆峰; 李石

    2012-01-01

    目的:通过21例(29颗)年轻恒前牙外伤冠折实例,讨论外伤冠折牙的即刻临床处理方法及效果.方法:对29 颗年轻恒前牙冠折,根据不同情况分别进行了间接盖髓术、活髓切断术、根尖诱导术.术后即刻或1周内采用断冠再接、直接树脂修复、活动义齿对缺损牙行临时冠修复,缺损牙修复后经过至少1年的临床观察.结果:冠折的年轻恒前牙经过相应的牙髓治疗与冠修复治疗,绝大多数患牙取得了良好的治疗效果.结论:年轻恒前牙外伤性冠折,在尽可能促进牙根继续发育的同时,即刻冠修复对于儿童身心健康具有重要意义.%Objective The objective of this study is to discuss the clinical effect of immediate restoration of fractured 29 immature permanent anterior teeth from 21 patients. Methods 21 cases including 29 fractured anterior teeth were treated by indirect pulp capping, partial pulpotomy and apexification respectively.Then.the fractured teeth were restored with esthetic light-cured resin, patients' natural crown and removable prosthesis.AII the provisional restorations were observed at least for 1year. Results Fractured permanent anterior teeth were treated endodontically.including 7 indirect pulp capping, 19 partial pulpotomy and 3 apexification.During the period of observation.pulpitis occurred from 1 tooth of indirect pulp capping and 2 teeth of partial pulpotomy.and apexification was performed for the 3 teeth.Fracture occurred from 2 light-cured resin restored teeth.The rest restoration presented satisfied appearance and function. Conclusion It is suggested that immediate restoration is important to the fractured immature permanent anterior teeth in prerequisite of maintaining root continuous growth.

  16. Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon

    Directory of Open Access Journals (Sweden)

    Naidoo Sudeshni

    2011-01-01

    Full Text Available Abstract Background The majority of Cameroonians depend on traditional medicines for their health care needs and about seven per cent of the average household health budget is spent on traditional medicines irrespective of their incomes. The aim of the present study was to determine the oral care knowledge and practices of Traditional Healers (TH on oral health delivery in the urban and rural areas of Bui Division of Cameroon and the objectives to determine the cost of treatment and reasons why people visit TH. Methods The present study was cross sectional and utilized semi-structured questionnaires to collect data. Results The sample consisted of 21 TH and 52 clients of TH. Sixty two percent of the TH's were above 40 years and 90% male. The mean age was 46 years (range 20-77 years. Twenty four percent of the TH practiced as herbalists and the remainder both divination and herbalism. Sixty seven percent of people in the Bui Division, who patronize TH for their oral health needs, fall within the 20-40 year age group. There is little collaboration between the oral health workers and TH and only 6% of all patients seen by TH are referred to the dentist. Socio-cultural and economic factors affect the oral health care seeking behavior of patients in this area and only 6.5% of patients visit dental clinics. Reasons for not attending dental clinics included high cost, poor accessibility, superstition and fear. TH's are not experienced in the treatment of pulpitis - the majority of patients who presented with toothache had temporary or no relief, but despite this 67% reported being satisfied with their treatment. Sixty nine percent of the patients visited TH because of low cost - the average cost of treatment with TH (approximately $5 is very low, as compared to conventional treatment ($50. Conclusions Traditional healers are willing to co-operate with oral health workers in improving oral health. Since they have a vital role to play in health care

  17. 活髓状态对电子根尖定位仪测量准确性影响的研究%THE STUDY ON VITAL PULP EFFECT ON THE ACCURACY OF ELECTRONIC APEX LOCATORS

    Institute of Scientific and Technical Information of China (English)

    王子; 牛一山

    2015-01-01

    目的::在临床根管治疗过程中,分析活髓状态对DENTAPORT ZX,RAYPEX 5,PROPEXⅡ三种根尖定位仪测量根管工作长度的准确性的影响。方法:收集因急慢性牙髓炎、牙髓坏死、根尖周炎需行根管治疗的恒牙活髓根管50个。用三种根尖定位仪分别测量根管工作长度并记录数据,再测量并计算根管实际工作长度。比较根管实际工作长度与根尖定位仪所测长度的差值,并进行统计学分析。结果:活髓状态下, DENTAPORT ZX与RAYPEX 5、PROPEXⅡ之间的测量差别有统计学意义,而RAYPEX 5与PROPEXⅡ之间的测量差别无统计学意义。结论:活髓牙DENTAPORT ZX的测量更准确。%Objective:In the process of clinical root canal treatment, analyzed the vital pulp of influence the accuracies of DENTAPORT ZX,RAYPEX 5 and PROPEX Ⅱ for measuring the working length of the root canal. Methods:Collect 50 vital teeth and permanent root canals which need root canal treatment because of the acute and chronic pulpitis,pulp necrosis,and periapical periodontitis. Three electronic apex locator in root canal working length were measured and recorded data. And then Measurement and calculation of root canal working length. Compare the difference between the root canal working length and the measured length of root apex locator, and statistical analysis. Results:although there is no significant difference between RAYPEX 5 and PROPEX measured,the significant difference can be found between DENTAPORT ZX,RAYPEX 5 and PROPEX measured. Conclusion:DENTAPORT ZX is more accurate measurement under the vital teeth status.

  18. Curative effect observation of two kinds of root canal preparation for root canal filling on posterior teeth%两种根管预备方法对后牙根管充填的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李江; 张恺

    2014-01-01

    目的:评价机用ProTaper镍钛锉根备后对根管充填(简称根充)的影响。方法将30例磨牙、30例前磨牙的牙髓炎和根尖炎患者平均分为两组,A组30例用机用Pro T aper镍钛锉进行根管预备,B组30例用普通K锉改良的逐步后退法进行根管预备。比较两组器械根备对根充的影响,分别从根充的时间、根备的主尖锉和根充的主牙胶尖的匹配度、根充的恰填率、根充的术后反应进行比较。结果在根充时间上A组平均前磨牙为1分30秒,磨牙为4分25秒;B组平均前磨牙为5分30秒,磨牙为11分41秒,差异有统计学意义( P<0.05)。A组前磨牙主尖锉和主牙胶尖的匹配度为86.37%,磨牙为88.89%;而B组前磨牙为62.50%,磨牙为26.67%,差异有统计学意义( P<0.05)。根充恰填率在X线片上前磨牙A组为72.73%,B组为70.83%;磨牙A组为80.00%,B组为77.78%,差异无统计学意义( P>0.05);根充的术后疼痛反应上两者都很低且弱,差异无统计学意义(P>0.05)。结论机用ProTaper镍钛锉根备后能加快根充速度,提高主尖锉和主牙胶尖的匹配度,简化根充治疗程序。%Objective To evaluate the influence of ProTaper rotary nickel-titanium files root preparation on root canal filling . Methods 30 cases of molars pulpitis and 20 cases of premolars pulpitis or periapical periodontitis were equally divided into two groups .The group A(30 cases) used the ProTaper rotary nickel-titanium files in root canal preparation and the group B (30 cases) adopted the common K files modified step-back technique for root canal preparation .The influence of the root preparation by 2 sets of apparatus on the effect of root canal filling ,and the several aspects of the root canal filling time ,the matching degree of main root canal file and master gutta-percha ,proper filling rate ,postoperative reaction of root canal

  19. Manejo clínico de la resorción dental interna utilizando agregad o trióxido mineral como material de obturación intracanal

    Directory of Open Access Journals (Sweden)

    Alvaro Francisco Negrete Barbosa

    2013-10-01

    Full Text Available ResumenLa resorción dental interna es una patología poco común, asintomática, que por lo general es detectada accidentalmente en una radiografía de rutina; su etiología es desconocida pero se cree que puede ser producida por trauma, persistencia de una pulpitis crónica, aparatología ortodóntica, entre otras causas. Aunque esta patología es poco frecuente, el endodoncista no puede pasar por alto el conocimiento de esta y mucho menos su tratamiento, ya que de este, depende que la patología se detenga o siga avanzando, debido a que la acción resortiva está ligada a cierto grado de vitalidad pulpar; después de la eliminación del tejido pulpar en órganos dentarios con este tipo de patología, se debe pensar que material es el ideal para poder obturar la cavidad de forma elíptica o redondeada que origina este tipo de resorción. Desde la salida del MTA (agregado trióxido mineral ya hace tiempo, este asume múltiples usos en la práctica endodontica, debido a sus grandes ventajas y propiedades en comparación con otros materiales presentes en el mercado, es por esto que se convierte en un material de elección para la obturaciónde estas cavidades de tipo resortivo, junto con una copiosa irrigación con hipoclorito de sodio y la conformación biomecánica de los conductos. En el siguiente artículo mostraremos el manejo clínico de un premolar superior con dos conductos subobturados y una resorción dental interna, en el cual se utiliza agregado trióxido mineral como material obturador intracanal. (DUAZARY 2010, 239 - 246Palabras clave: Diente premolar; endodoncia; resorción dentaria; obturación del conducto radicular; MTA.AbstractThe internal dental resorption is a rare disease, asymptomatic, which is usually detected accidentally on a radiograph routine; its etiology is unknown but is believed to be produced trauma, persistent chronic pulpits, orthodontic, among other causes. Although this condition is rare, the endodontist

  20. 脂多糖上调人牙髓细胞B细胞淋巴瘤-2蛋白及其相关X蛋白的表达%Lipopolysaccharides upregulated the expression of B-cell lymphoma-2 and its associated X protein in human dental pulp cells

    Institute of Scientific and Technical Information of China (English)

    朱玉婷; 刘江峰; 李晓星; 杨会肖; 黄江勇; 于淼; 陈秉勋; 李艳利

    2015-01-01

    目的:探讨脂多糖(LPS)作用于人牙髓细胞后,B细胞淋巴瘤-2(Bc1-2)蛋白、Bcl-2相关X蛋白(Bax)在正常人牙髓和炎症牙髓中的表达,探讨其在牙髓炎症过程中的作用机制。方法在体外用不同质量浓度LPS刺激人牙髓细胞后,采用免疫细胞化学染色方法在不同的时间点检测Bcl-2、Bax的表达,用图像分析系统Simple PCI version 5.1分析。结果正常人牙髓细胞中Bcl-2、Bax表达量不高,而在牙髓炎症过程中两者均增强,但是随着LPS质量浓度的增加,Bcl-2的表达量开始下降,而Bax的表达则持续增强。结论内毒素能使人牙髓细胞膜上的Bcl-2、Bax表达增强,但Bax的表达强于Bcl-2,内毒素可能通过两者介导的信号传导途径引起细胞凋亡。%Objective   To study the effects of lipopolysaccharides(LPS) on B-cell lymphoma-2(Bcl-2) protein and Bcl-2-associated X protein(Bax) expression of human dental pulp cells. Methods  In vitro model of human dental pulp cells apoptosis was established by LPS. The protein expression of Bcl-2 and Bax in human dental pulp cell(HDPC) after induction of LPS with different concentrations at different times was determined by immunocytochemical method. The result was analyzed using Simple PCI version 5.1. Results   A small number of Bcl-2 and Bax positive cells were observed in normal dental pulp. By contrast, Bcl-2 and Bax showed enhanced expression in inflammatory dental pulp and some pulp cells in the inflammatory area. Bax was furtherexpressedas the LPS increased, whereas Bcl-2 showeda weakened shift. Conclusion  The apoptosis in dental pulp induced by Bcl-2 and Bax may play a role in pulpitis

  1. 锥形束 CT 对根管治疗前后病变区域变化的评估作用%Evaluation of lesion area with CBCT before and after root canal treatment

    Institute of Scientific and Technical Information of China (English)

    杨婕

    2016-01-01

    目的:分析锥形束 CT(CBCT)对患牙根管治疗前后病变区域变化的评估作用。方法选择接受根管治疗患者110例为研究对象,回顾性分析患者临床资料,患者均采取 CBCT 扫描和数字化根尖片诊断,分析根管填充效果,比较治疗前后病变区域变化。结果两种方法评价中,42根根管意见不统一,X 线片和 CBCT 对根管充填长度评价存在显著差异( P ﹤0.05),X 线片和 CBCT 对根管充填密实度评价也存在显著差异( P ﹤0.05)。治疗前70颗牙髓炎,52颗根尖周病,其中根尖周病患牙采用 X 线片诊断24颗有根尖阴影,CBCT 诊断52颗有根尖阴影,回访后 X 线片诊断和CBCT 诊断根管治疗后疾病存在显著差异( P ﹤0.05)。CBCT 检测结果显示12例新增根管周病变,36颗未愈合。结论CBCT 能够准确评估根管治疗程度和效果,对治疗后疾病诊断有重要价值。%Objective To assess the role of cone beam CT(CBCT)in the evaluation of lesion area before and after root canal treatment. Methods The clinical data of 110 patients with root canal therapy were retrospectively analyzed. All the patients were diagnosed with both CBCT and digital periapical radiograph. Root canal filling effect was analyzed. Changes of the lesion area before and after treatment were compared. Re-sults There were different evaluations in root canal filling length and root canal filling density in 42 root canals between CBCT and X - ray(all P﹤ 0. 05). Before treatment 70 teeth were pulpitis,52 teeth were periapical disease;of the 52 teeth with periapical diseases,24 teeth showed api-cal shadow by X - ray,while 52 teeth showed apical shadow by CBCT. After root canal treatment,CBCT diagnosis and X - ray diagnosis showed significant difference( P ﹤ 0. 05). CBCT indicated new periapical disease in 12 cases,and 36 teeth were not healed. Conclusion CBCT can accurately assess the extent and effects of root canal

  2. Characterization and analysis of matrix metalloproteinases 8 and 20 in the human crown and root dentin%人牙冠及根部牙本质内基质金属蛋白酶8,20的测定及分析

    Institute of Scientific and Technical Information of China (English)

    朱梓园; 周恬; 张保卫

    2012-01-01

    BACKGROUND: In recent years, matrix metalloproteinases (MMP)-mediated collagen degradation in dentin has been widely studied. Recent studies have shown that MMPs play an important role in the progress of periodontal disease, dentin caries, pulpitis and failure in dentin adhesive interface.OBJECTIVE: To determine the contents and distribution features of MMP-8 and -20 in the human crown and root dentin.METHODS: Dentin powder was extracted by guanidine hydrochloride, then subjected to ethylene diamine tetraacetic acid demineralization in four cycles, and finally extracted by guanidine hydrochloride again. Extracts were analyzed by Western blot and enzyme linked immunosorbent assay (ELISA) for MMP-8 and -20 detection.RESULTS AND CONCLUSION: MMP-8 and MMP-20 in the extracted materials were confirmed by western blot and ELISA. MMP-8 and -20 were mostly extracted from the mineralized compartment of the dentin (E1). These two MMPs presented overall lower levels in G1 and the lowest levels in G2. Both Western blot analysis and ELISA detected that MMP-8 and -20 equally distributed in the crown and root dentin. MMP-8 and MMP-20 proteins have been found in the extracted materials from the human crown and root dentin. They are mostly presented in mineralized dentin, both in the crown and root dentin.%背景:基质金属蛋白酶被激活后可降解细胞外基质,其对牙本质胶原的破坏对于牙周病、牙本质龋病、牙髓炎的进展及牙本质黏结的失败有重要影响.目的:检测冠根部牙本质内基质金属蛋白酶的含量及其分布特点.方法:牙本质粉经盐酸胍提取,然后经EDTA循环脱矿,再经盐酸胍提取.采用免疫印迹与免疫酶联吸附反应检测提取物中基质金属蛋白酶8,20的含量,对比二者在牙冠部和牙根部内的分布特点.结果与结论:免疫印迹结果及免疫酶联吸附检测结果均显示,提取物中含有基质金属蛋白酶8,20.未矿化牙本质提取蛋白G1

  3. In vitro study of demineralization resistance and fluoride retention in dental enamel irradiated with Er,Cr: YSGG laser; Estudo in vitro da resistencia a desmineralizacao e da retencao de fluor em esmalte dental irradiado com laser de Er, Cr: YSGG

    Energy Technology Data Exchange (ETDEWEB)

    Ana, Patricia Aparecida da. E-mail: patriciadaana@yahoo.com.br

    2007-07-01

    This study aimed to establish irradiation conditions of Er,Cr:YSGG laser ({lambda} of 2.79 {mu}m) which could propitiate changes on human dental enamel and increase its resistance to demineralization, when associated or not with topical application of acidulated phosphate fluoride (APF). Fluences of 2,8 J/cm{sup 2}, 5,6 J/cm{sup 2} e 8,5 J/cm{sup 2} were selected; they were associated or not with previous application of a photo absorber (coal paste) and then APF was applied or not after laser irradiation. In a first step, the morphological findings, the surface temperatures, and the pupal temperatures were evaluated during laser irradiation. After that, the treated samples were submitted to a a ten-day pH-cycling model. After producing the incipient white-spots lesions, the following aspects were evaluated: the mineral loss, the loosely bound fluoride and the firmly bound fluoride. All the demineralizing and remineralizing pH-cycling solutions were evaluated with respect to their calcium (Ca), inorganic phosphorous (Pi) and fluoride (F{sup -}) concentrations. The data had their normality and homogeneity distribution statistically evaluated, and it was chosen an appropriated statistical test for each performed analysis according to the obtained results, considering 5% significant level. The fluences selected for this study created ablated surfaces; the fluences of 5.6 J/cm{sup 2} and 8.5 J/cm{sup 2} promoted increments in surface temperature above 110 deg C. The intrapupal temperature changes revealed that laser irradiation did not increase the pulpal temperatures above the critical threshold for induction of pulpitis. The coal paste did not promote any changes on surface morphology or in the intrapulpal temperature changes; however, this paste increased the surface temperatures during laser irradiation. Only laser irradiation at 8.5 J/cm{sup 2} was able to decrease the mineral loss when compared to the no-treatment group; although the association of coal paste

  4. 母亲孕期相关因素对学龄前儿童龋齿的影响%Effect of maternal pregnancy related factors on dental caries in preschool children

    Institute of Scientific and Technical Information of China (English)

    崔新华

    2016-01-01

    Objective to analyze the influence of the factors of the mother's pregnancy on the dental caries in preschool children.Methods 500 healthy children aged 3-7 years in 7 kin-dergartens were randomly selected as the research object,and 204 children with dental caries were selected as the study group,and 296 children without dental caries were selected as the con-trol group.Results through the investigation of the mother during pregnancy and perinatal factors related to the,the mother during pregnancy patients with pulpitis or periapical periodontitis, mother of the initiative smoking or passive smoking,premature birth and gingivitis are on preschool children's caries has certain ef ect(P<0.05),and the mother in pregnancy,active or passive smoking,suf ering from dental caries and periapical periodontitis is af ected the children's risk of having caries risk factors.Conclusion the factors related to maternal or perinatal is dental caries of preschool children causes adverse ef ects,mother during pregnancy should strengthen their own nutrition,oral to carry out health care,prevention of dental caries in the life,protect children's teeth,and promote the healthy growth of children.%目的:分析母亲孕期的相关因素对学龄前儿童龋齿的影响。方法随机选取本市城区内的7所幼儿园中的500名3-7岁的健康儿童作为研究对象,将204名患有龋齿的儿童作为研究组,将296名未患龋齿的儿童作为对照组,并同时调查500名儿童的母亲在孕期和围产期的相关因素。结果通过调查母亲在孕期及围产期的相关因素结果显示,母亲在孕期患牙髓炎或根尖周炎、母亲主动吸烟或被动吸烟、早产以及牙龈炎都对学龄前儿童患龋齿有一定影响(p <0.05),差异有统计学意义,通过 Logistic 回归分析,对比两组儿童的不同体征和生活方式,结果显示,母亲在孕期补充蛋白质和钙剂对学龄前儿童龋齿有保护因素,而

  5. Which mechanical and physical testing methods are relevant for predicting the clinical performance of ceramic-based dental prostheses?

    Science.gov (United States)

    Anusavice, K J; Kakar, Kunjan; Ferree, N

    2007-06-01

    The survival and performance of clinical prostheses with a ceramic component are probabilistic in nature. Only under very rare circumstances will all of the prostheses in a group exhibit either 100% successes or 100% failures over a period of 5 years or more. Prosthesis failure may be defined as any condition that leads to replacement. These conditions include secondary caries, irreversible pulpitis, excessive wear of opposing tooth surfaces, excessive erosion and roughening of the ceramic surface, ditching of the cement margin, unacceptable esthetics, cracking, chipping and fracture. A systematic review of the dental literature was performed to determine the extent to which the mechanical and physical properties of dental alloys and ceramics can predict the 5-year clinical performance of metal-ceramic and all-ceramic fixed dental prostheses (FDP) and to determine the associated quality of reported outcomes associated with these clinical studies. The review was based on clinical research studies of 5 years or greater duration that were published in English dental journals between 1980 and 2006 using the following key words and MeSH terms. Our search strategy was as follows: Search 1: Partial fixed denture OR denture, partial, fixed OR denture, partial fixed OR dental porcelain OR metal ceramic alloys OR dental ceramic Search 2: Prosthesis failure OR dental restoration failure OR time factors OR survival analysis Search 3: Meta-analysis OR evaluation studies OR review OR clinical trial OR comparative study OR follow-up studies OR prospective studies OR clinical follow-up study OR clinical trial OR longitudinal studies Inclusion of searches 1, 2 and 3 and limits placed on the publication date starting on January 1, 1980, English language, and clinical studies involving humans resulted in a total of 684 articles. By restricting the clinical studies to 5 years or more in duration, the number was reduced to 193. By eliminating resin-bonded FDPs, cantilever designs

  6. Clinical Evaluation of the Combined Application of Pathfile and Mtwo in Preparing Curved Root Canals%Pathfile和Mtwo联合应用于预备弯曲根管的临床评价

    Institute of Scientific and Technical Information of China (English)

    韩俊; 高恒; 潘卫红

    2014-01-01

    目的:评价联合使用Pathfile和 Mtwo预备弯曲根管的临床效果。方法选择2013年12月至2014年2月期间因牙髓炎或根尖周炎需进行根管治疗的90颗患牙,313个根管,随机分为3组。A组联合使用 Pathfile和 Mtwo 镍钛锉进行根管预备,B组联合使用Pathfile和ProTaper进行根管预备,C组单独使用ProTaper进行根管预备。3组均采用热牙胶连续波垂直加压充填。记录3组在根管预备时间、器械分离数、根尖偏移和充填效果方面的差异。结果 A组预备时间最短,为(6.01±1.12)min,未见器械分离和根尖偏移,恰填率高。与 B组及 C 组比较,差异均有统计学意义(均P<0.05)。结论 Pathfile和 Mtwo联合应用于预备弯曲根管快速安全,根管充填效果佳,适合临床推广应用。%Objective To evaluate the clinical efficacy of combined use of Pathfile and Mtwo in the preparation of curved root canals.Methods This study enrolled a total of 90 teeth(313 root canals)that need root canal therapy because of pulpitis or apical periodontitis from December 2013 to February 2014.All root canals were randomly divided into three groups.In group A,both Pathfile and Mtwo NiTi files were used in root canal preparation.In group B,Pathfile and ProTaper were used.ProTaper was employed alone in root canal preparation in group C.The high temperature thermaplasticized inj ectable ver-tical condensation technique was applied in all the three groups.The time of root canal preparation,the number of separated de-vices,root canal transportation and the quality of root canal filling were obtained and compared among the 3 groups.Results In group A,the time of root canal preparation was shortest,(6.01±1.12)min ;there were no instrument separation and ledge for-mation,and the filling rate was highest in group A.The differences were significantly noted in these indexes between group A and groups B,C.Conclusion Combined use of Pathfile and Mtwo for preparation of curved root

  7. The clinical comparative study of root canal treatment with TF and Protaper nickel-titanium instruments%机用镍钛器械TF和Protaper用于根管治疗的临床比较

    Institute of Scientific and Technical Information of China (English)

    王镇

    2012-01-01

    Objective: To investigate the effects of TF and Protaper nickel-titanium instruments on root canal treatment. Method: 90 teeth with pulpitis or periapical that need rootcanal treatment were divided into 3 groups: Group T were prepared by TF nickel-titanium instrument with crown-down technique. Group P were prepared by Protaper nickel-titanium instrument with crown-down technique,and the above two groups were filled with warm qutta-percha vertical condensation technique.Group k wre prepared by manual stainless steel K file with step-back technique (control group),and filled with cold lateral condensation technique. Record 3 groups of root canal preparation time and the number of broken equipment. Evaluation based on the effect of preparation and root canal treatment according before,during and after the x-ray. Result: With TF and Protaper nickel-titanium instrument were able of root canal,and the operating time was shorter than Group K. There were 3 cases of broken equipment with Protaper nickel-titanium files,but in the Group T,there wasnit. Conclusion: The shoping abilty of TF and Protaper nickel-titanium files are better than stainless steel K-files,and the time of preparation of root canal is shortened,the TF nickel-titanium files have the higher fracture resistance ,and the TF nickel-titanium files are especially suitable for the treatment of curved root canals.%目的:比较机用镍钛器械TF和Protaper用于根管治疗的临床效果.方法:随机选择牙髓炎或根尖周炎需进行根管治疗的患牙90颗,均分为3组:T组使用镍钛器械TF,冠向下技术预备根管;P组采用镍钛器械Protaper,冠向下技术预备根管,以上两组均采用热牙胶垂直加压技术充填根管;K组使用不锈钢K锉,逐步后退法预备根管,冷牙胶技术侧向加压技术充填.记录根管预备时间及器械折断数,根据治疗前、中、后的X线片评价根管预备及根充效果.结果:T组、P组均能保持根管原有走向,形态

  8. 三种根尖诱导剂的临床疗效比较%Comparison of clinical effects of three different materials used in apexification

    Institute of Scientific and Technical Information of China (English)

    王淑芳; 任吉芳

    2016-01-01

    Objective To compare the clinical effect of three different kinds of materials used in apexification. Methods Sixty immature permanent teeth with pulpitis, pulp necrosis, periapical periodontitis were selected and ran-domly assigned to 3 groups according to registration order. Group A was treated with mineral trioxide aggregate (MTA), group B with Vitapex, and the control group with calcium hydroxide. All patients were recalled 3, 6 and 12 months after initial treatment. Results Pearson Chi-square test showed that the efficacy rate of group A was significantly higher than group B and the control group (P<0.05) in the visits of 3 months and 6 months after treatment. And efficacy rate of group B is also higher than the control group, but no statistical difference was found between two groups in the final visit (12 months). The efficacy rate of group A is 94.1%, group B is 75.0%and the control group is 58.8%. The statisti-cal difference was found between group A and control group, but it was not found between group A and group B or be-tween group B and the control group. Conclusion Compared with calcium hydroxide and Viatapex, MTA for apexifica-tion has better performance in apexification.%目的:比较三种药物用于根尖诱导成形术的临床效果。方法选取8~14岁患有牙髓感染、牙髓坏死或根尖周炎的患者48例共年轻恒牙60颗,根据就诊顺序随机分为三组。分别用三氧化物多聚体(miner-al trioxide aggregate,MTA)(MTA组)、Vitapex(Vitapex组)、氢氧化钙糊剂(对照组)进行根尖诱导。术后3个月、6个月、12个月复查,比较其临床效果。结果术后3个月和6个月,MTA组有效率明显高于Vitapex组和对照组,差异具有统计学意义(P<0.05);术后12个月,MTA组有效率明显优于对照组(χ2=3.96),差异具有统计学意义(P<0.05),然而MTA组和Vitapex组、Vitapex组和对照组之间的差异无统计学意义(P>0.05)。

  9. Fijación de radioyodo en huesos maxilares simulando metástasis en pacientes con Carcinoma Diferenciado de Tiroides (CDT: False- Positive images in patients with Differentiated Thyroid Carcinoma. (DTC Uptake of 131-I in maxillary bones mimicking salivary glands

    Directory of Open Access Journals (Sweden)

    O. J. Degrossi

    2008-06-01

    , (caries, prótesis, pulpitis, granulomas periapicales y en especial se incrementa en pacientes provenientes del interior que habitaban en zonas con aguas con contenido de flúor o arsénico. Seis pacientes tratados con actividades altas de radioyodo de entre 5,55 y 11,1 MBQ (150 a 300 mCi mostraron lesiones actínicas en mucosa bucal y lingual. En 5 pacientes se efectuaron inmediatamente después del CCT con radioyodo, estudios panorámicos de Rx maxilar y de centellograma óseo coincidiendo las imágenes maxilares positivas de ambos estudios con las áreas positivas con radioyodo, confirmándose la localización de las mismas. En 13 pacientes que se sometieron a intensos tratamientos odontológicos, en estudios de CCT posteriores se apreció la disminución de intensidad de las imágenes o su desaparición. Ninguno de los pacientes presentó metástasis de CDA en las áreas activas maxilares. Estos hallazgos confirman la concentración del radioyodo en hueso maxilar en relación con alteraciones, dentales debiendo efectuarse investigaciones más profundas sobre la naturaleza de la molécula formada y los mecanismo de fijación de la misma. Deberá tenerse en cuenta el estado de salud dentario del pacientes antes de someterlo a tratamiento de metástasis o ablaciones, en especial cuando las actividades de radioyodo a utilizar sean mayores de 3,7 GBq (100 mCi y aún indicar tratamiento de las lesiones dentales en forma previa.In the whole body scans (WBS with 131I in the follow-up or treatment of patients bearing DTC it is observed frequently fixation areas of the tracer apparently in relation with salivary glands. These areas generally belong to the salivary glands and are present during the first 48/72 hours, but others are kept during more than 3 weeks. These latter ones were considered as possible uptake in ectopic thyroid cells in the mouth floor, iodized proteins, retention of salivary glands and other assertions. Valdivieso et al (Cong. Arg. Biol. Med. Nuclear, 1996

  10. The application of cone-beam computed tomography in diagnosing the lesions of apical periodontitis of posterior teeth%锥形束CT对后牙根尖周炎骨病损的评价作用

    Institute of Scientific and Technical Information of China (English)

    马兰; 詹福良; 仇丽鸿; 薛明

    2012-01-01

    PURPOSE: To evaluate the effect of periapical radiography in diagnosing the lesions of the apical periodontitis (AP) of posterior teeth,with CBCT imaging as a standard. METHODS: One hundred and six posterior teeth in 80 patients were examined by periapical radiography and CBCT, which consisted of healthy teeth (58 teeth), chronic pulpitis (11 teeth), chronic apical periodontitis (34 teeth), remnant teeth with normal apical images after root canal therapy (3 teeth). All images were measured and evaluated by two experienced dentists by using periapical index (PA1) to ensure the classifications. The results were analyzed statistically with SPSS 13.0 software package for X2 test. RESULTS: AP was identified in 39.6% and 59.4% of 106 cases by radiography and CBCT, the difference was significant (x2=8.32, P<0.01). The use of conventional radiography for detection of AP should be done with care because of the great possibility of artifacts which might lead to misdiagnosis. Because of its accuracy, CBCT is more useful for clinic diagnosis and therapy. Furthermore, the images of CBCT could show destruction of cortical bone that couldn't detect by periapical radiography. CONCLUSIONS: CBCT is more accurate than periapical radiography for AP diagnosis. CBCT can reveal the details of the lesions and adjacent structures and provide correct clinical diagnosis and scientific treatment planning with accurate evidence. Supported by University Scientific Research Project of Bureau of Education of Liaoning Province(2008856).%目的:以锥形束CT(cone-beam computed tomography,CBCT)为标准,评价X线片在诊断后牙根尖周炎骨病损中的作用.方法:收集门诊同时拍摄X线片和CBCT图像的病例80例,共106颗后牙,包括前磨牙和磨牙各53颗,其中健康牙58颗,临床诊断为慢性牙髓炎11颗,诊断为慢性根尖周炎34颗(含8颗根管治疗后的患牙),根管治疗后表现正常的牙3颗.由2名有经验的医师对CBCT图像及X线片进行

  11. 玻璃离子和流体树脂修复楔状缺损的疗效比较%Comparation of the Clinical Effects of Glass Ionomer Cement and Flowable Composite Resin on the Restoration of Dental Wedge-Shaped Defects

    Institute of Scientific and Technical Information of China (English)

    陆佳萍; 赵守亮; 徐培成

    2013-01-01

    目的:探讨玻璃离子和流体树脂用于楔状缺损的修复的临床效果.方法:选择105例中型楔状缺损患者(376颗患牙),楔状缺损深度大于1 mm且小于2 mm、仅出现牙本质过敏症状、无牙髓炎症状.将患者左右两侧同名牙采用自身对照法随机分为玻璃离子衬垫组(A组)和流体树脂衬垫组(B组),A组以玻璃离子和复合树脂充填;B组以流体树脂和复合树脂充填.采用Ryge和USPHS评价标准,比较术后1周、1个月、1年、3年的敏感发生率及充填体脱落率.结果:失访18例70牙,复查87例306牙,复查率为81.4%.A组楔状缺损充填修复后1周、1个月的术后敏感发生率分别为18.3 %(28/153)、9.2%(14/153),B组分别为35.9 %(55/153)、28.1%(43/153),差异均有统计学意义(P均<0.01);修复后1年和3年2组术后敏感发生率差异无统计学意义.A组患牙术后1年、3年充填体脱落率分别为9.8 %(15/153)、11.8 %(18/153),B组分别为2.6%(4/153)、3.3 %(5/153),差异均有统计学意义(P<0.05和0.01);修复后1周、1个月差异均无统计学意义.结论:采用玻璃离子和流体树脂作为夹层技术中的衬垫材料修复楔状缺损,对于预防术后敏感和降低充填体脱落率均有理想的疗效.但是玻璃离子作为衬垫材料在预防术后敏感方面要优于流体树脂,而流体树脂作为衬垫材料在修复体固位力方面则优于玻璃离子.%Objective:To compare the clinical effects of glass ionomer cement(GIC) and flowable composite resin(FCR) on the restoration of dental wedge-shaped defects as liners.Methods:A total of 376 teeth from 105 patients with wedge-shaped defects were studied and divided into Group A and Group B randomly with self-contrasted method.The depth of wedge-shaped defects was more than 1 mm and less than 2 mm,and the patients were with dentin hypersensitiveness and without pulpitis.Group A was restored with composite resin after applying flowable

  12. Non-specific clinical features and misdiagnosis of acute cardinal infarc-tion%急性心肌梗死非特异性临床症状与误诊分析

    Institute of Scientific and Technical Information of China (English)

    张杰文

    2015-01-01

    治。因此患者出现上述症状,特别是易患冠心病的高危患者,一定要重视并进行常规心电图和心肌酶检查,必要时动态观察,以提高以非特异性症状为主要表现的急性心肌梗死患者的诊断率,减少误诊。%Objective To analyze the acute cardinal infarction (acute cardinal infarction,AMI) non-specific clinical features and misdiagnosis. Methods A retrospective analysis of patients with myocardial infarction during January 2010 to 2014 in our hospital in January nonspecific clinical manifestations of 65 cases , clinical data were analyzed. Results 65 cases of non-specific clinical symptoms in patients with chest pain were not typical. 28 cases mainly as abdominal pain with nausea and vomiting; 18 cases showed ectopic radioactive pain (including sore throat , toothache , and neck and shoulder pain); 10 cases mainly as shortness of breath; 5 cases mainly for shock; 3 cases mainly dizziness and limb weakness; one case mainly for syncope. First diagnosed in 20 patients misdiagnosed , including 10 cases of ab-dominal pain and nausea, and vomiting as the main symptoms were misdiagnosed as acute gastritis eight cases, one case of cholecystitis, pancreatitis, 1 case;mainly for sore throat, toothache, and neck pain , four cases were misdiag-nosed as cervical spondylosis, pharyngitis one case, pulpitis one case, two cases misdiagnosed as a result of the in-vestigation of shock, one patient was misdiagnosed as acute exacerbation of chronic bronchitis; one cases of syncope patients were misdiagnosed as transient cerebral ischemia blood episodes. No line when first diagnosed 12 cases of mis-diagnosis in ECG, consider two cases of right ventricular infarction in patients with shock, ECG do not add V3R, V4R, V5R leads;two cases of posterior wall infarction without making V7, V8, V9 lead. 4 cases of myocardial infarc-tion on admission ECG change is not typical, did not pay attention, one case was normal, one case of left