Biomedical subjects
Publications and source records attributed to D J Kleier.
The continuous locking suture technique is described for use in endodontic surgery. The technique is an effective way to close Ochsenbein-Luebke flaps. The importance of the assistant's role is described. The technique's advantages and disadvantages are discussed.
Endodontic therapy is becoming an increasingly routine facet of general dental practice. Advances in technology and techniques have made endodontics in the contemporary clinical environment more pleasant and predictable for both the patient and the provider. The development of rotary instrumentation with nickel-titanium files has revolutionized the cleaning and shaping aspects of treatment. A sequenced model is discussed that has been shown to have encouraging outcomes in both predoctoral and continuing education experiences. The protocol may use more instruments than some other approaches, but has evolved as a technique that provides reliable and predictable outcomes.
Titanium and titanium alloy posts are currently being used in complex dental restorations. Titanium posts have been shown to be less radiopaque than stainless steel and to have a radiographic density similar to gutta-percha. This radiographic similarity can make detection of a titanium post difficult. Failure to identify the presence of a titanium post before the initiation of retreatment could cause significant complications for the treating endodontist. Five cases are presented to describe the radiographic subtleties that can be used to detect the presence of a titanium post.
This case report documents the treatment of an endodontic patient who experienced a type 1 hypersensitivity reaction to latex. The dental, medical, and environmental aspects of treating latex allergic patients are reviewed. Because gutta-percha and latex rubber are similar compounds, the possible cross-reactivity of these materials is discussed.
The removal of metallic filling materials and posts is necessary before endodontic retreatment. Retreatment in such cases can require considerable time and effort. This article presents a technique to facilitate the removal of metallic obstructions from root canals using tungsten carbide needle holders. Clinical cases demonstrate the effectiveness of this technique.
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Tomograms taken before endodontic surgery can demonstrate the location of root apices relative to adjacent anatomic structures. This buccolingual perspective is not depicted on conventional periapical or panoramic radiographs. Accurate length determination from the root apex to the inferior alveolar canal is simplified, and the relationship of root surfaces to the buccal and lingual plates is well visualized on the tomographic images.
This study was undertaken to determine the clinical and radiographic success of calcium hydroxide apexification in a group of 48 patients requiring endodontic therapy because of pulpal necrosis prior to root-end closure. The study examined tooth number, etiology of pulpal necrosis, age, sex, size of root-end opening, size of radiolucency, crown discoloration, interappointment symptoms, and total treatment time from initial instrumentation to completion of apexification. Apexification required an average of 1 year +/- 7 months. A statistically significant relationship was found between: the presence of a radiolucency and development of interappointment symptoms (p less than 0.04); and the size of apex opening and development of interappointment symptoms (p less than 0.02). If symptoms did develop, apexification was delayed an additional 5 months when compared to patients who did not have symptoms. Calcium hydroxide apexification was found to be statistically highly successful regardless of the clinical variables encountered.
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This study investigated the difference between Ektaspeed and Ultraspeed dental x-ray film in detecting incipient interproximal carious lesions, in vitro. Molars and premolars were radiographed with 60, 70, or 90 kVp and 15 mA. Time was varied, so the density of all films was closely matched. The radiographs were viewed by ten dentists who judged the presence and extent of caries according to a predetermined scale. Inter-rater reliability was determined for each film type and tooth surface by using Pearson's Product-Moment Correlation Test. Results showed that inter-rater reliability was high and significant at p less than 0.01. Differences in kilovolt (peak) exposure had no significant effect on Ektaspeed and Ultraspeed film correlation. This study suggests no statistically significant difference in caries-detection ability for Ektaspeed or Ultraspeed radiographic film.
The purpose of this study was to evaluate the effectiveness of high frequency neural modulation as a substitute for traditional local anesthesia in various dental procedures. This double-blinded study was done to evaluate patient comfort and degree of satisfaction as well as manageability of pain control by the operator during the dental procedures. Procedures included restorations, tooth extractions, root planing, pulp extirpation, and temporomandibular joint therapy. In the experimental group, favorable responses ranged from 0.0% to 92.8%, depending on the procedures. An overall favorable rating of 71.8% was given by the experimental group, and an overall favorable response of 8.5% was given by the placebo group.
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Four groups of patients were selected during various phases of endodontic therapy to receive two comparable radiographic exposures. One exposure was made with Kodak Ultraspeed dental x-ray film and the second exposure was made with Kodak Ektaspeed dental x-ray film. The films were coded and mounted in a side-by-side format to be judged by thirty raters. A double-blind clinical protocol was followed. Ultraspeed film was judged superior to Ektaspeed film in terms of contrast, image quality and rater satisfaction.