A model for demonstrating an electronic canal length measuring device.
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Biomedical subjects
Publications and source records attributed to H Gerstein.
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Thirty-two cases of vertical fractures were studied in an attempt to identify the causes and diagnostic signs normally present. In all of the patients except two, osseous defects were present and could be probed. The majortiy (65.63 percent) had only mild pain or a dull discomfort. Seventy-five percent showed diffuse widening of the periodontal ligament space. This study suggests that excessive force during lateral condensation of the gutta-percha caused 84.38 percent of the fractures. A secondary cause was the forcing or tapping of inlays or dowels into place. The majority (78.13 percent) of the patients were over the age of 40. In all but nine of the cases, treatment consisted of the extraction of the involved teeth.
A case is presented of extreme loss of tooth substance, most probably as a result of dentifrice abrasion. The lesions resulted in many instances of pulpal death and periapical pathosis. In most instances, an opening into the pulp chamber could not be demonstrated using an explorer. In two instances, an opening into the pulp chamber was present and probable. This communication with the oral cavity resulted in pulpal pathosis and an accompanying periapical lesion. In most cases of dental abrasion and erosion, or both, pulpal pathosis and periapical pathosis do not occur because of the ability of the pulp to lay down dentin as the pulp recedes. The findings in this case are not typical.
Five cases in which perforations of mandibular molars into the furca occurred during endodontic instrumentation of the canal are presented. This resulted in alveolar bone loss. All were relatively asymptomatic, which could present a problem in diagnosis of the periodontal defect. The prognosis is questionable. The only tooth retained was treated surgically by an apically positioned flap and opening of the furca area to make it accessible to cleansing. The best treatment is the avoidance of the perforation. This is accomplished by considering the configuration of the canals and the size of the reamer than can follow it. Overinstrumentation with an endodontic instrument that is too large in diameter should be avoided.
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Six cases of vertical root fractures accompanied by vertical bone loss are presented. Possible causes for these fractures are suggested. Four vertical fractures probably resulted from the use of excessive pressure at the time of obturation of the canals. One vertical root fracture may have been caused by the cementation of a post, and another may have been caused by the cementation of an inlay in an endodontically treated tooth. All of the fractures resulted in alveolar bone loss to the apical extent of the fracture lines. The definitive treatment in each case was extraction of the tooth or root amputation. In one case successful treatment was accomplished by apically positioning the flap.
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