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Biomedical subjects

A Y Kaufman

Publications and source records attributed to A Y Kaufman.

At least 19 recordsLinked to original sources

Determination of location of root perforations by electronic apex locators.

OBJECTIVES: This study was conducted to evaluate the accuracy of two electronic apex locators, the Sono Explorer Mark 2 Junior (Hakusui, Osaka, Japan) and Apit 2 (Osada, Tokyo, Japan) in detecting root perforations. The adequacy of radiographs for identifying root perforations was also assessed. STUDY DESIGN: Thirty-two extracted human teeth were perforated in the middle third of the root and embedded in alginate. Determination of all perforations were carried out with K-files no. 25 attached to the apex locators tested. Two radiographs were taken at two angulations after each electronic measurement. The actual location of the file tip in relation to the perforation was determined with a stereomicroscope. A total of 512 radiographs were evaluated to attempt to identify root perforations. RESULTS: The mean distance of the file tip from the external outline of the root surface was short for both instruments. A statistical difference (p < 0.05) was found between the two apex locators in dry canals or if saline solution was present. There was no significant difference between the two instruments in the presence of sodium hypochlorite. Evaluators radiographically identified 45% of the root perforations when located in buccal-lingual directions. CONCLUSION: Under the in vitro conditions of this study, both devices determined the location of the perforations in an acceptable clinical range short of the root surface. Radiographs were found to be less reliable in identification of perforation locations.

Chi-Square Distribution

Root invagination treatment: a conservative approach in endodontics.

The occurrence of dens invaginatus, a developmental anomaly, is reported to be 0.04 to 10%. Treatment modalities, such as extraction, endodontic surgery, and conventional instrumentation of the defect and/or the pulp canal, have been reported. Most suggested treatment modalities are based on the assumption that the tissue inside the invagination communicates with the pulp tissue. However, histological studies show that depending on the type of invagination, the entrapped tissue is mostly connective tissue which may or may not contain pulp tissue components. In situations where the invaginated tissue is contaminated and yet no communication with the pulp cavity exists, it is possible to instrument and disinfect the invagination without affecting the pulp and sacrificing tooth vitality. Such treatment will be referred to as "root invagination treatment." A case is described where tooth vitality was preserved when only the invagination was treated.

Adult

Tooth length determination: a review.

Tooth length determination is a crucial step in endodontic treatment. Until the late 1970s, tooth length determination was based mainly on radiographic interpretation. The advent of apex locators, which identify the difference in the electrical resistance between the root canal and the periodontal membrane, ushered in a new era for measuring tooth length. However, the accuracy of these devices has been questioned. Pertinent literature is discussed with the aim of providing information on the development of the concept, techniques, and devices for tooth length determination.

Dental Pulp Cavity

Developmental anomaly of permanent teeth related to traumatic injury.

A case is presented where a 4-year-old girl was injured in an automobile accident. The dental injury, intrusive luxation of the maxillary deciduous incisors, seemed unimportant at the time, since the child was in critical condition. The situation was first evaluated 5 years later, when the child was referred for treatment of an apical periodontitis originating from the right central incisor. The present case reflects several important aspects that were overlooked at the time of injury: the potential of intruded luxated deciduous teeth to cause developmental anomalies to the permanent dentition; the necessity of a longer follow-up period to detect such anomalies; and the need to develop effective treatment methods.

Child

The efficiency and reliability of the Dentometer for detecting root canal length.

The accuracies of an analog-indicating electronic device, the Dentometer, and of an audio-indicating device, the Sono-Explorer, were compared to each other and to the radiographic method of tooth length determination. Readings obtained by the Dentometer were shorter, an average of 0.28 +/- 0.64 mm than those obtained by the Sono-Explorer (p less than 0.001) and 0.32 +/- 0.63 mm shorter than the results obtained by the calculated working length (p less than 0.001). No statistically significant difference was found between the readings of the Sono-Explorer and the calculated radiographic working length. The results indicate that the measurements calculated by the radiographic method were longer than those obtained by the electronic method of tooth length determination. The statistically significant difference found between the two devices indicates that to determine the accuracy of electronic devices, they should be tested and compared to other methods or devices.

Dental Pulp Cavity

Life and AH26 as sealers in thermatically compacted gutta-percha root canal fillings: leakage to a dye.

Calcium hydroxide-containing root canal sealers may encourage apical obturation by cementum. Hard-setting bases with calcium hydroxide induce calcification, but set too quickly to permit lateral condensation of gutta-percha. Since thermatic compaction requires less time than lateral condensation, the possibility of using this method with Life as a sealer was investigated. Seventy roots were prepared and filled with gutta-percha using the Engine Plugger for thermatic compaction. In one group of 20 Life was used as a sealer. AH26 was used in another group of 20. The remainder served as controls. Leakage was tested by linear penetration of Procion B Blue dye measured after clearing the teeth. In the Life group the mean dye penetration was 0.575 mm versus 1.025 mm in AH26, but the difference was not statistically significant. The results indicated that Life could be used in thermatic compaction of gutta-percha and that it provided a seal comparable to that obtained with AH26.

Bismuth

Conservative treatment of root perforations using apex locator and thermatic compactor--case study of a new method.

Endodontic perforation, a serious complication in dental practice, is among the most common problems associated with endodontic procedures. Recommended methods of treatment are surgical or conservative using calcium hydroxide paste. A method in which perforations can be obturated immediately after their detection is described. The method utilizes an apex locator for measurement and detection of the perforation and a two-step treatment of thermatic compaction for filling the root canal as well as the perforation. A number of cases with a long follow-up are presented.

Adult

Hypersensitivity to sodium hypochlorite.

Sodium hypochlorite (NaOCl), the most commonly used irrigant in endodontics, is known to produce allergic reactions. This fact, however, is rarely mentioned in endodontic texts. Until now, only two cases of adverse reaction describing accidental injection of NaOCl have been reported. In the current study a case is presented in which hypersensitivity to household bleach was proven with skin patch tests. The clinician was warned of the possible health hazard from using NaOCl in this patient by the past medical history. Endodontic therapy was carried out with an irrigant not containing NaOCl after the allergy to NaOCl was verified. Treatment was uneventful. It is suggested that before any endodontic treatment in which sodium hypochlorite is to be used, the patient should be asked about hypersensitivity to household bleaching materials.

Adolescent

Reduction of dental plaque formation by chlorhexidine dihydrochloride lozenges.

The effect of chlorhexidine dihydrochloride (chlorhex HCl) in lozenges on plaque growth was assessed on 21 subjects with fresh plaque of 7 days duration. The lozenges, which contained 5 mg chlorhex HCl, were sucked three times daily after meals, for 2 weeks. The study was a single-blind crossover. Placebo lozenges had all the ingredients except chlorhex HCl. These were used as a control. Results indicated that lozenges containing chlorhex HCl were a potent plaque inhibitor. The mean plaque score was reduced by 62.8% from an initial mean plaque score (DO) of 2.38 +/- 0.48 to (D7) 0.89 +/- 0.26 (p less than 0.0001), after 1 wk of usage. A further reduction to plaque score (D14) of 0.56 +/- 0.27 (p less than 0.0001) was recorded by the end of the 2nd wk. Usage of the placebo during the same time period did not show significant differences in the plaque score (DO = 2.38; D7 = 2.33; D14 = 2.42). Inhibition of plaque formation to the 1104 test surfaces revealed a total elimination of the higher levels of plaque (scores 4 and 5), a considerable reduction of the middle levels (scores 2 and 3) and a significant increase (44.7%) of low level plaque (score 1). Total elimination of plaque (score 0) was observed in 50.3% of the test group surfaces. Lozenges containing 5 mg chlorhexidine dihydrochloride, taken three times daily, were an efficient, comfortable and potent agent for reducing and inhibiting plaque formation. These lozenges are a more convenient alternative to chlorhexidine mouthrinses and may prove to be superior to these.

Adolescent

An enigmatic sinus tract origin.

Diagnosis of the origin of a sinus tract is very complex. In this case report, a sinus tract stoma appeared above the left maxillary incisor, but the causative tooth was the right maxillary incisor. Incorrect diagnosis led to endodontic treatment of a healthy tooth followed by apicoectomy, which was also ineffective. An endodontic consultation revealed the true origin of the sinus tract. Five days after completing conservative endodontic treatment of the right maxillary incisor, the sinus tract disappeared. This case confirms the need to include a diagnostic tracing radiograph as part of routine diagnostic procedures.

Adult

Comparative study of the configuration and the cleanliness level of root canals prepared with the aid of sodium hypochlorite and bis-dequalinium-acetate solutions.

Bis-dequalinium acetate (BDA), a quaternary ammonium compound, was introduced as a bactericidal and chemotherapeutic agent for endodontic use. This study was undertaken to compare the efficacy of this compound to 5.25% sodium hypochlorite in the cleansing and shaping of root canals. One hundred twenty freshly extracted teeth were divided into three groups. Each group was treated with the aid of the test material; saline solution was used as a control. After completion of the endodontic preparation, a silicone imprint of the canals was performed and the teeth were decalcified. The imprints were examined three-dimensionally to determine the amount of debris and canal configuration due to defective preparation and anatomic variation. No significant difference could be observed between the tested materials with respect to cleanliness and the shape of the canals. At the apical third, however, the BDA-treated canals showed more favorable results with respect to cleanliness. On the basis of the present and previous findings, it was concluded that BDA might be a favorable replacement for sodium hypochlorite as an irrigation solution.

Dental Pulp Cavity

The influence of bis-dequalinium acetate on bone regeneration induced by grafts of combined inorganic heterologous bone and autologous marrow.

The present study was undertaken in order to determine the influence of BDA on bone regeneration and remodeling. Pieces of Kiel bone soaked with autologous bone marrow were implanted in the axial area of rats. The implantation sites were injected with 0.3 cc of 0.005% BDA 3 to 14 days after grafting; the control group was injected with Hartmann solution. Results indicated that BDA does not interfere with the bone-remodeling process. It does, however, have an inhibitory effect on the early stage of mesenchymal cell proliferation, that is, the development of osteoblasts from bone marrow stromal cells. Extrapolation of these findings to earlier evidence regarding the mode of action of this material is currently being investigated.

Animals

Vitality preservation of an anomalous maxillary central incisor after endodontic therapy.

Endodontic treatment of a case of fused immature central incisor with a supernumerary tooth with dens in dente is described. Although a chronic dentoalveolar abscess was diagnosed, vitality test signs were positive. Treatment consisted of pulpotomy with calcium hydroxide paste; after 2 1/2 months a permanent root canal filling was placed in the amputated part. Follow-up 2 years postoperatively indicated that the tooth has maintained its vitality. The periapical area is completely healed, and apical closure is evident.

Child