[The discovery of accessory root canals].
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Dental Pulp Cavity↗
Biomedical subjects
M Hülsmann
Publications and source records attributed to M Hülsmann.
[Preparation of root canals].
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Dental Cavity Preparation↗
Eicosanoid-mediated increase in glucose and lactate output as well as decrease and redistribution of flow by complement-activated rat serum in perfused rat liver.
Rat serum, in which the complement system had been activated by incubation with zymosan, increased the glucose and lactate output, and reduced and redistributed the flow in isolated perfused rat liver clearly more than the control serum. Heat inactivation of the rat serum prior to zymosan incubation abolished this difference. Metabolic and hemodynamic alterations caused by the activated serum were dose dependent. They were almost completely inhibited by the cyclooxygenase inhibitor indomethacin and by the thromboxane antagonist 4-[2-(4-chlorobenzesulfonamide)-ethyl]-benzene-acetic acid (BM 13505), but clearly less efficiently by the 5'-lipoxygenase inhibitor nordihydroguaiaretic acid and the leukotriene antagonist N-(3-[3-(4-acetyl-3-hydroxy-2-propyl-phenoxy)-propoxy]-4-chlorine-6-meth yl- phenyl)-1H-tetrazole-5-carboxamide sodium salt (CGP 35949 B). Control serum and to a much larger extent complement-activated serum, caused an overflow of thromboxane B2 and prostaglandin F2 alpha into the hepatic vein. It is concluded that the activated complement system of rat serum can influence liver metabolism and hemodynamics via release from nonparenchymal liver cells of thromboxane and prostaglandins, the latter of which can in turn act on the parenchymal cells.
Animals↗
Delayed endodontic and prosthetic treatment of two traumatized incisors.
This case report describes the delayed endodontic and prosthetic treatment of two maxillary central incisors in a 16-year-old patient. Both teeth had been traumatized eight years previously. The examination revealed arrested root formation with wide open apices, periapical inflammation and inflammatory resorption. Endodontic treatment with calcium hydroxide led to formation of hard tissue barriers in both teeth so that definite obturation could be performed. One tooth was lost due to a deep crown-root-fracture and replaced by an intraosseous implant, whereas the other incisor was retained for nearly four years.
Adolescent↗
[Studies on the incidence and quality of root fillings. Evaluation by orthopantomograms].
Incidence, distribution and quality of endodontic treatment were investigated using panoramic radiographs of 200 patients of the Department of Periodontology. The results were compared to those of similar epidemiological investigations published in the recent literature. 3.2% of all teeth showed to be root-canal-fillings, which is less than in any other investigation. 87% of all root-canal-fillings ended more than 2 mm from the apex and more than 60% exhibited insufficient obturation. Periapical lesions were detected in 60% of all root-canal-fillings teeth.
Adolescent↗
[Efficiency of mechanically aided vs. manual root canal irrigation. In vitro comparison].
This in vitro study shows that the cleaning of root canals can be decisively improved in terms of fluid mechanics by using mechanized instruments as opposed to conventional manual irrigation.
Humans↗
[Determination of working length in endodontics. 1. Radiographic method].
Incomplete instrumentation and faulty obturation are the main reasons for endodontic failures. Exact determination of working length is one of the basic principles of a successful endodontic therapy. In this paper technique, benefits and problems of radiographic determination of endodontic working length are described.
Adolescent↗
[Determination of working length in endodontics. 2. Endometric determination of canal length].
Electronic determination of endodontic working length has become very popular in the past few years. Nevertheles it has shown that the use of electronic apex locators cannot replace radiographic length determination, but can be a useful additional device in endodontics. Indication, benefits and limits of electronic length determination are described in this paper.
Dental Pulp Cavity↗
[Physical characteristics of endometric instruments].
A method for measuring and documentation of the physical characteristics of electronic root canal length determination instruments is presented and illustrated by evaluation of ten different devices. Important parameters such as the influence of the capacitive component in alternating current resistances are presented by means of impedance-charts. All devices examined worked with alternating current; regarding frequency, signal form and resistances, which the devices interpreted as "Apex", the measurements obtained varied. The advantages of this method for clinical and experimental studies are discussed by the author.
Dental Instruments↗
Removal of silver cones and fractured instruments using the Canal Finder System.
Removal of fractured instruments and silver cones was undertaken experimentally and clinically using the automated Canal Finder System. In all cases manual retrieval had been tried and had failed. Fifteen of 50 fragments could be removed completely and 11 fragments could be bypassed using the Canal Finder System. In 24 teeth the use of the Canal Finder was not successful, in 7 teeth the root canal was perforated or the fragment was pushed through the apical foramen. Removal of silver cones was undertaken in 38 root canals with 40 cones. Eighteen of them could be removed using the Canal Finder. Two cones could be bypassed only. Eight of the remaining 20 cones which could not be removed initially, finally could be removed after combined use of the Canal Finder and an ultrasonic device. The results of this study indicate that the Canal Finder System may be used as an auxillary device in difficult cases of removal of silver cones and fractured instruments.
Dental Instruments↗
Retrieval of silver cones using different techniques.
Three different techniques of silver cone retrieval were investigated in 41 teeth containing 91 silver cones. The techniques used for retrieval were as follows: (i) hand instrumentation with files, spoon excavators and forceps; (ii) the automated Canal-Finder-System; (iii) ultrasonic devices. In all teeth, these techniques were used in the same sequence, starting with hand instrumentation, followed by the Canal-Finder-System, and ending with ultrasonic devices. Fifty-two of the 91 cones (57 per cent) could be removed with hand instruments. Of the remaining 39 cones, 19 were removed after using the Canal-Finder-System. An additional 10 cones could be removed after the use of ultrasonics. Two cones could only be bypassed by the Canal-Finder-System but were not removed with any of the techniques investigated in this study. Eight silver cones (9 per cent) could neither be bypassed nor removed. It was concluded that silver cone retrieval in more than half the cases could be performed easily with hand instruments, particularly spoon excavators. The automated Canal-Finder-System and ultrasonics proved to be helpful devices in many difficult cases, but did not guarantee success in every case.
Humans↗
Mandibular first premolar with three root canals.
This report presents a case of endodontic treatment of a mandibular first premolar with 3 root canals and a review of the literature concerning root canal anatomy of lower premolars. It is stressed that, even in teeth with a low frequency of abnormal root canal anatomy, the possibility of additional root canals has to be considered in the clinical and radiographic examination of the patient.
Adult↗
[Patient with high risk of caries. Definition, epidemiology and clinical aspects].
Epidemiological studies have shown that there is a small group of patients with high caries prevalence. This survey illustrates the clinical picture of caries-active patients on the basis of exemplary cases and defines a number of terms which are important in this context. In addition to this, possible causes of an increased caries risk are discussed.
Adolescent↗
[Removal of fractured root canal instruments using the Canal Finder System].
Retrieval of fractured instruments from the root canal by means of the Canal-Finder-System was studied in 22 extracted teeth and in 26 clinical cases. In vitro the fragment could be removed in 6 cases and bypassed in 6 cases. In 10 cases the use of the automated device remained without success. In vivo 8 of 26 fragments were removed completely, 4 fragments were bypassed, and in 14 teeth the fragment could neither be removed nor bypassed. In 7 cases the root canal was perforated, in one tooth the fragment was pushed through the apical foramen. The Canal-Finder-System may be used as an auxilliary device for the retrieval of fractured instruments.
Dental Instruments↗
[Test of an electronic fissure caries detector].
The reliability of an electronic detector for caries in pits and fissures was tested by means of physical measurements, histological sections and clinical evaluation. The device measures the ohmic resistance of the tooth, technical data are given. First we compared measurements and histological sections of teeth due for extraction. The results indicated a high sensitivity of the device for caries, false positive diagnoses did not occur. Based on this, a clinical evaluation on 179 teeth was performed. Under practical conditions the sensitivity of the electronic detector (0.77) was lower than in the first part of the study; conventional diagnosis revealed more carious lesions in dentine (sensitivity: 0.82).
Dental Fissures↗
[Root canal preparation with Canal-Finder system. Scanning electron microscopy and clinical studies].
Root canal preparation was performed with the new Canal-Finder-System in extracted teeth and in simulated root canals in resin blocks. The results of SEM- and stereomicroscopic investigation showed severe alterations of root canal morphology in the apical part of the canal in many cases. Excellently cleaned and shaped canal walls were found as well as parts, which were not instrumented at all or covered with smear layer and debris. The Canal-Finder-System was found to be a good and suitable device for the initial instrumentation of narrow and severely curved canals, but cannot replace hand instrumentation as the standard method of root canal preparation.
Dental Pulp Cavity↗
[Preparation of curved root canals using hand instruments and mechanical aids].
Root canal preparation in curved canals was performed with handinstruments and three automated devices (Enac-Ultrasonic, Canal-Finder-System, Endolift). Ten curved roots canals in extracted teeth and 10 simulated curved canals in resin blocks were prepared with each device. The extracted teeth were cracked and investigated under the scanning electron microscope. Preparation with the ultrasonic system showed the best results in cleaning the middle and coronal part of the canal walls. The Canal-Finder-System gave the best results in maintaining the curvature of the canal. Hand preparation resulted in the best apical preparation. The use of the Endolift led to fractures of the instruments in four cases and to the worst results in cleaning the walls. With no method the canal preparation was perfect in form and cleanliness. Hand preparation should remain the standard method of root canals preparation. Nevertheless the use of automated devices such as Ultrasonics or the Canal-Finder-System may be helpful in certain strongly limited cases.
Dental Pulp Cavity↗
[Clinical verification of measuring accuracy of an electronic apex localizer].
Root canal length was determined with an electronic apex locator in 253 root canals and compared to the results obtained by radiographic length determination. After electronic measurement the tip of the instrument only in 56.6% was 0-1 mm from the roentgenographic apex. The electronic device gave better results after pulpectomies than in nonvital cases. Even worse results were obtained in revision cases.
Dental Instruments↗