Restorative endodontics: anatomy of a failure.
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Biomedical subjects
Publications and source records attributed to M Kellert.
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When a periapical lesion communicates with a deep periodontal pocket, the etiology can be either endodontic or periodontal. This article clarifies the relationship between pulpal and periodontal disease and presents a systematic approach to the diagnosis and management of endodontic-periodontal lesions. It also presents a case that demonstrates the successful treatment of teeth that appear to be hopelessly diseased.
Membrane barriers used in conjunction with periodontal surgery have promoted regeneration of lost marginal attachment. Membrane barriers also may be indicated during surgical endodontics, in selected cases, where primary apical lesions are complicated by the loss of marginal attachment. The indications for using guided tissue regeneration in endodontic surgery are discussed and two cases are presented.
Apical surgery is known to be an effective and practical way of treating endodontic failures. However, in spite of seemingly proper root end management, surgical failures may occur as a result of lateral canal, dentinal tubule, end retrograde leakage. Since surgical retreatment of such failures would likely result in failure, the alternative of a nonsurgical retreatment should be carefully considered. An understanding of the relationship which exists between the quality of the orthograde treatment and the surgical prognosis is necessary to properly direct the course of treatment.
A review of external resorption is presented with an emphasis on a wide range of etiological factors. This case report details the possible pitfalls in basing the diagnosis solely on radiographic interpretation.
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A method for the determination of 5-methoxypsoralene in suntan-cosmetics is described. After liquid chromatographic clean-up, the final extract is screened by twodimensional thin layer chromatography. For positive extracts 5-methoxypsoralene is analysed quantitatively by capillary gas chromatography, using 5-alpha-cholestane as an internal standard and flame ionization detection (FID). The results were confirmed by gas chromatography-mass spectrometry (GC-MS). The recoveries for suntan-cosmetics of emulsion type were 70% and for tanning oils 90%. Detection limits of the method were 0,1 to 0,5 mg/kg, depending on the sample type. By application of this method 5-methoxypsoralene was detected in 6 of the 21 cosmetic products at levels up to 28 mg/kg.
A method is described for the determination of Deoxynivalenol (DON) and Nivalenol (NV). A liquid chromatographic clean-up step is followed by silylation of the extract and the trimethylsilylether are determined by gas-chromatography-mass-spectrometry (GC-MS), monitoring the characteristic ions in the negative chemical ionisation mode. 71% of 42 food-samples were contaminated with DON and 38% with NV. The highest contamination detected was 2000 micrograms/kg DON and 120 micrograms/kg NV in a wheat bran sample. Deoxynivalenol and Nivalenol in concentrations of 10 micrograms/kg can be detected easily by this method.
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Ultrasonic devices are capable of generating better apical preparations than rotary instruments with less sacrifice of root structure. Regardless of the technique used, good lighting and magnification are necessary to insure an adequate apical preparation.