Biomedical subjects
Publications and source records attributed to J E Skribner.
Endodontic treatment of a permanent mandibular first molar and a second molar presumably joined by cementum is presented. This case illustrates the difficulty in interpreting the vitality testing in such a situation. It also suggests possible irreversible pulp injury of a vital healthy tooth caused by extension of the inflammatory periapical pathosis of the adjacent tooth.
This study compared the coronal microleakage of post-prepared teeth with and without the placement of a zinc oxide-eugenol cement seal coronal to the gutta-percha. Forty single-rooted extracted teeth were prepared and obturated with sealer and gutta-percha. These teeth were divided into two groups of teeth 20 each. A post space was prepared for each tooth so that 5 to 6 mm of gutta-percha remained in one group and 3 to 4 mm in the other group. To the latter group, 2 to 3 mm of zinc oxide-eugenol cement base was placed directly coronal to the gutta-percha. The sealer was allowed to set for 48 h and the outer root surfaces of the teeth were covered with finger nail varnish and sticky wax, except for the access openings. The teeth were immersed in dye for 1 wk to allow coronal microleakage. The specimens were sectioned and measurements were made on the extent of dye penetration into the root filling. The teeth without a zinc oxide-eugenol base showed significantly greater microleakage than those protected with a zinc oxide-eugenol base.
Two hundred and thirty-six cases of endodontic treatment failures, none of which had advanced periodontal disease, postperforations, or root or crown fractures were analyzed clinically, radiographically, and histobacteriologically to determine the major factor(s) for treatment failures. It was found that there was a correlation between bacterial infection in the canal system and the presence of periradicular rarefaction in endodontic failures. This report provides evidence indicating that the major factors associated with endodontic failures are the persistence of bacterial infection in the canal space and/or the periradicular area and the presence of preoperative periradicular rarefaction. The apical extent of root canal fillings, i.e. underfilled, flush-filled, or overfilled, seems to have no correlation to treatment failures.
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