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Biomedical subjects

L K Bakland

Publications and source records attributed to L K Bakland.

11 recordsLinked to original sources

Anatomical relationship of the mandibular canal to its surrounding structures in mature mandibles.

A lack of agreement exists in the literature regarding the anatomical relationship of the mandibular canal to its surrounding structures such as the root apices. The purpose of this investigation was to study the spatial relationship of the mandibular canal to the posterior teeth in dried human mandibles. Twenty-two mature dried mandibles were sectioned through the root apices of the first and second premolars and molars. Second premolars and second molars had the closest distances to the canal with a mean of 4.7 mm and 3.7 mm, respectively. With a mean of 6.9 mm, the apices of the mesial roots of the first molars were farthest from the canal. The canal pathway in mature mandibles followed in S-shaped curve in 31% of the cases. In 41% of the cases it was located lingual (19%), buccal (17%), or directly inferior (5%) to the apices of the posterior teeth. In 28% of the cases the canal could not be identified clearly in the second premolar and first molar regions. In a typical S-shaped configuration the canal was located buccal to the distal root of the second molar, crossed to the lingual below the second molar mesial root, ran lingual to the first molar, and crossed back to the buccal apical to the apex of the second premolar. Based on our results it appears that the mandibular second premolar and second molar are the most likely teeth to be involved in accidental damage to the mandibular canal during root canal therapy.

Bicuspid

Root resorption.

Several types of resorption affect teeth: internal, external, invasive, pressure, and idiopathic resorption. Diagnosis depends on an accurate medical and dental history, and radiographic and clinical examination. Because trauma appears to be a major factor associated with resorption, questions regarding past traumatic events may provide good leads to a likely cause. Treatment is determined based on a correct diagnosis. Root canal therapy is very beneficial in cases of internal resorption and external, inflammatory resorption. In cases of invasive resorption, it may or may not be necessary, whereas in replacement and pressure resorption, root canal therapy is not indicated at all (unless unrelated pulpal conditions necessitate endodontic intervention). Prevention of resorption includes appropriate treatment of traumatically injured teeth with frequent evaluation visits during the first year following an injury. Early detection of pressure-producing agents such as cysts, tumors, and impacted teeth can allow timely treatment to minimize the resorptive destruction.

Humans

Trauma to the oral cavity.

Sports events, particularly those in which mouth protectors are not commonly used, can be associated with injuries to the oral structures. While the incidence of sports-related orofacial injuries is not as high as for other traumatic events, the incidence could be reduced further by increased use of mouth and face protection. When injuries occur, quick action by primary health care providers can significantly improve the final outcome of the definitive treatment. Also important is appropriate follow-up evaluation and care since the effect of trauma on teeth is not always immediately apparent. Destructive resorption, unnecessary tooth loss, and possible alveolar infections may be prevented by referral to appropriate health care providers for evaluation following the initial urgent care of trauma patients.

Athletic Injuries

Treatment of endodontic urgent care cases.

This article describes treatment for urgent care cases involving the dental pulp and periradicular tissues: acute pain of pulpal or periradicular origin, acute pain from endodontic procedures, and management of traumatically injured teeth.

Acute Disease

Immunopathogenesis of chronic periapical lesions. A review.

The pathogenesis of periapical lesions has not been fully elucidated. Currently, the possibility of its being an immunologic phenomenon is receiving much attention. This article presents a review of the literature concerning immunologic reactions which may involve periapical lesions. It appears that antigen-antibody complexes and IgE-mediated reactions can initiate preliminary changes in periapical tissues. It is also likely that delayed hypersensitivity participates in the perpetuation and progression of periapical disease.

Antibodies