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Biomedical subjects

M L Furst

Publications and source records attributed to M L Furst.

At least 19 recordsLinked to original sources
PubMed1991

A review of aging of dental components and a retrospective radiographic study of aging of the dental pulp and dentin in normal teeth.

A review of aging of dental components is followed by a clinical radiographic study. Patients received radiographs at 5-year intervals with a 10-year minimum followup. Data obtained were age, gender, tooth, and systemic diseases. Measurements taken were tooth length, coronal length, apical length, cervical width, midroot width, and apical width. Root canal shrinkage was calculated vertically, horizontally, and as a combination (vertical and horizontal). Results showed statistically significantly more shrinkage in men, the elderly, and people with calcification-related diseases. Shrinkage increased with advancing age. With further studies, radiographically determined root canal measurements could prove useful in anthropology, forensics, and as a biomarker of aging.

Adult↗
PubMed1990

The antimicrobial effect of various endodontic sealers.

The antimicrobial activity of an endodontic sealer can be helpful in destroying any remaining root canal microbes. Therefore it was decided to test the antimicrobial activity of several commonly used endodontic sealers. The sealers used were Grossman's sealer, Tubliseal, Calciobiotic, Sealapex, Hypocal, eucapercha, Nogenol, and AH26. Also tested were dry calcium hydroxide powder, calcium hydroxide mixed with saline, and a Teflon formulation. The microbes used were Streptococcus mutans (a gram-positive microaerophile). Staphylococcus aureus (a gram-positive facultative anaerobe), and Bacteroides endodontalis (a gram-negative obligate anaerobe). The freshly mixed sealers were placed into the prepared wells of agar plates inoculated with the test microorganisms. After varying periods of incubation, the zones of inhibition of bacterial growth were observed and measured. Grossman's sealer had the greatest overall antibacterial activity. However, AH26 had the greatest activity against B. endodontalis. The zinc oxide-eugenol-based sealers had more antimicrobial activity than either the calcium hydroxide-based sealers or eucapercha.

Bacteroides↗
PubMed1990

A comparison of erythromycin and cefadroxil in the prevention of flare-ups from asymptomatic teeth with pulpal necrosis and associated periapical pathosis.

In a previous study by our group with patients having asymptomatic teeth with pulpal necrosis and an associated periapical radiolucent lesion (PN/PL), it was shown that prophylactic administration of penicillin V or erythromycin (high-dose, 1-day regimen) resulted in a low incidence of flare-up (mean = 2.2%) and a low incidence of swelling and pain not associated with flare-up. No hypersensitivity responses occurred, and gastrointestinal side effects were found primarily with the erythromycins. To ascertain whether a single-dose administration of a long-acting 1-gm tablet of the cephalosporin antibiotic cefadroxil would result in a similar outcome, the present study was undertaken with 200 patients having quiescent PN/PL. The patients were randomly given either cefadroxil or erythromycin (base or stearate). Evaluations of flare-up were done 1 day, 1 week, and 2 months after endodontic treatment. A 2.0% flare-up incidence was found, with no statistically significant differences for cefadroxil (1.0%), stearate (2.0%), or base (4.0%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (19.0%). The results showed that a 1-gm, single-dose regimen of cefadroxil was as effective as erythromycin and penicillin in preventing flare-ups and serious sequelae. A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last three investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment of asymptomatic PN/PL (p less than 0.001).

Acute Disease↗
PubMed1990

Comparison of prophylactic and on-demand diflunisal for pain management of patients having one-visit endodontic therapy.

To determine whether the posttreatment prophylactic use of diflunisal (Dolobid 500) would be more effective than the on-demand use of diflunisal in reducing endodontic posttreatment pain, the current open-label, randomized study was undertaken. After one-visit nonsurgical endodontic therapy, 100 patients with asymptomatic teeth having either vital-inflamed pulp, pulpal necrosis, or pulpal necrosis with periapical radiolucent lesion were randomly given either prophylactic diflunisal (two tablets immediately at the conclusion of the visit, then four tablets to be taken in the schedule of one every 8 to 12 hours for pain if needed) or on-demand diflunisal (same dosage schedule; pills to be taken only if needed). The outcome showed that compared to the on-demand usage, the posttreatment prophylactic administration of diflunisal resulted in a statistically significant reduction in the number of episodes of endodontic posttreatment pain that required analgesic intervention. It appears from the results of this study that the posttreatment prophylactic use of diflunisal is significantly more effective than the on-demand usage of diflunisal in reducing endodontic posttreatment pain for one-visit endodontic therapy with all types of originally asymptomatic endodontic conditions. Further studies are necessary to determine whether pretreatment prophylactic deflunisal would be more effective, and also the effectiveness of prophylactic diflunisal in reducing posttreatment pain in presenting symptomatic cases and for cases treated in multiple visits.

Adolescent↗
PubMed1989

A prospective randomized double-blind trial on efficacy of dexamethasone for endodontic interappointment pain in teeth with asymptomatic inflamed pulps.

To determine whether a relatively large dose of oral dexamethasone given for a short period of time would be effective in reducing endodontic interappointment pain, the current double-blind, placebo-controlled study was undertaken. After the visit for instrumentation, 40 patients with asymptomatic teeth having vital-inflamed pulps were randomly given either dexamethasone (3 tablets of 4 mg each) or a dextrose placebo identical in appearance (same dosage schedule). The outcome showed that the oral administration of dexamethasone resulted in a statistically significant reduction in endodontic interappointment pain at all three time periods evaluated, that is, at 8 hours, 24 hours, and 48 hours (p less than 0.01). It appears from the results of this study that this dosage schedule of oral dexamethasone is sufficient to significantly reduce endodontic interappointment pain for teeth with asymptomatic vital-inflamed pulps. Further studies are needed for teeth with other endodontic pulpal-periapical conditions and for symptomatic teeth.

Clinical Trials as Topic↗
PubMed1989

An evaluation of tricalcium phosphate as a treatment for endodontic perforations.

In the rat, perforations of maxillary molars were created and treated with either tricalcium phosphate (Synthograft) or Cavit. At four time intervals (1 day, 1 wk, 2 wk, and 1 month), four evaluative factors (inflammation, bone resorption, cementum and dentin resorption, and epithelial proliferation) were analyzed and compared for the two materials. For the individual time periods, there were no statistically significant differences between the two materials. However, when all four time periods were combined, there was a statistically significant better result for tricalcium phosphate than for Cavit with respect to decreased inflammation (p less than 0.05).

Animals↗
PubMed1988

Prophylactic penicillin versus penicillin taken at the first sign of swelling in cases of asymptomatic pulpal-periapical lesions: a comparative analysis.

In order to ascertain whether the time of administration of an antibiotic affects the occurrence of flare-ups and non-flare-up-associated swelling and pain, an analysis of components of two prospective endodontic studies on patients having asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL) was done. In the first study, prophylactic penicillin was used. In the second study, penicillin (or erythromycin for patients allergic to penicillin) was taken by the patient at the first sign of swelling (patient controlled). For the patient-controlled group, as compared to the prophylactic penicillin group, there was statistically significantly more (1) incidence of flare-ups (p less than 0.05); (2) non-flare-up-associated swelling (p less than 0.001); (3) non-flare-up-associated pain (p less than 0.05); (4) combined moderate and severe pain (p less than 0.05); (5) combined incidence of flare-ups and swelling (p less than 0.001); (6) combined incidence of flare-ups and pain (p less than 0.01); and (7) combined incidence of flare-ups and both swelling and pain (p less than 0.001). There were statistically significantly fewer instances of (1) no patient post-treatment problems (p less than 0.001) and (2) combined mild pain and no patient post-treatment problems (p less than 0.001). Hence, for asymptomatic teeth with PN/PL, it appears that prophylactic antibiotics are preferable to antibiotics taken by the patient at the first sign of swelling.

Bacterial Infections↗
PubMed1988

A prospective randomized trial on efficacy of antibiotic prophylaxis in asymptomatic teeth with pulpal necrosis and associated periapical pathosis.

A recent study from a private endodontic practice compared "prophylactic" antibiotic (high-dose, 1-day) regimens of penicillin V and erythromycin (base or stearate) for patients who had asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL). A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred, and gastrointestinal side effects were found primarily with the erythromycins (12.4%). To ascertain whether or not similar results would occur with student operators in a dental school clinic population, the current study was undertaken. One-hundred ninety-five patients with quiescent PN/PL were randomly given either penicillin V or erythromycin (base or stearate). A 2.6% flare-up incidence was found, with no statistically significant differences for penicillin (3.1%), base (1.5%), and stearate (3.1%). No hypersensitivity responses occurred, and GI side effects were found primarily with the erythromycins (17.7%). As can be seen, the results were very similar to those of the recent endodontic practice study. Hence, it can be concluded that the results of the previous endodontic practice study were not unique to any one clinician or method. A comparison was also made between the "prophylactic" penicillin group of the current study and the placebo control group of our previous dental school clinic, student operator study (in which the methods, population, and regimen were almost identical to those of the current study). The results showed that the "prophylactic" penicillin group had significant fewer flare-ups and non-flare-up-associated swelling and pain than did the placebo group. In view of these findings and those from studies from the literature in which "prophylactic" antibiotics were not used, it is our opinion that the antibiotic regimens used in the current study should be a component of clinical endodontic therapy for quiescent PN/PL.

Adolescent↗
PubMed1987

Infectious flare-ups and serious sequelae following endodontic treatment: a prospective randomized trial on efficacy of antibiotic prophylaxis in cases of asymptomatic pulpal-periapical lesions.

Without peritreatment antibiotics, infectious flare-ups (about 15% incidence) and serious sequelae follow endodontic treatment of asymptomatic teeth with necrotic pulps and associated periapical lesions. Antibiotics administered after endodontic treatment (4-day regimen) reduce the flare-up incidence to about 2%, but hypersensitivity responses, sensitization, resistant microbes, and drug-taking compliance are potential problems. To ascertain whether a specific prophylactic antibiotic (high-dose, 1-day regimen) would preferentially maintain this low flare-up incidence while overcoming antibiotic-related problems, 315 patients with quiescent pulpal necrosis and an associated periapical lesion were randomly given either penicillin V or erythromycin (base or stearate). Evaluations of flare-up after endodontic treatment were done at 1 day, 1 week, and 2 months. A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (12.4%). A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last two investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment (p less than 0.001).

Adolescent↗
PubMed1987

A prospective randomized trial comparing periapical instrumentation to intracanal instrumentation in cases of asymptomatic pulpal-periapical lesions.

To clarify the divergent viewpoints with respect to method of instrumentation in asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL), this prospective study was undertaken. The subjects were 106 patients with quiescent cases of PN/PL. Alternately, 53 had periapical instrumentation and 53 had intracanal instrumentation. Prophylactic antibiotics were not administered but the patients were told to take an antibiotic at the first sign of swelling. Flare-ups, non-flare-up-associated swelling and pain, and cases in which there were no postoperative problems were evaluated at 1-day, at 1 week, and at 2 months. A 6.6% incidence of flare-up was found with no statistically significant difference between periapical instrumentation (7.5%) and intracanal instrumentation (5.7%). A 27.4% incidence of swelling was found with no statistically significant difference between periapical instrumentation (24.5%) and intracanal instrumentation (30.2%). A 43.4% incidence of pain was found, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (47.2%). When moderate pain and severe pain were combined, the incidence was 21.7%, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (28.3%). An incidence of patients having no postoperative problems of 41.5% was found, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (35.8%). When flare-ups were combined with swelling, the incidence was 34.0%, with no statistically significant difference between periapical instrumentation (32.1%) and intracanal instrumentation (35.8%). When flare-ups were combined with pain, the incidence was 50.0%, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (52.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Comparison of diflunisal and an aspirin-codeine combination in the management of patients having one-visit endodontic therapy.

One hundred seventy-nine patients with asymptomatic or mildly symptomatic endodontic disease had single-visit therapy and were given either diflunisal (n = 94) or aspirin with codeine (n = 85) to control posttreatment pain. In this open-label, randomized study, diflunisal was judged superior to the aspirin-codeine combination in all major categories evaluated. Of patients receiving diflunisal, 93.6% needed the medication for only one day. In contrast, 77.7% of patients receiving aspirin with codeine needed the medication for only one day. Almost 64% of patients receiving diflunisal needed only one dose, while 32.9% of patients using aspirin with codeine needed only one dose. Four or more doses were required by 5.3% of patients receiving diflunisal and by 23.5% of patients receiving the aspirin-codeine combination. In patients receiving diflunisal, 20.2% experienced side effects. In contrast, 29.4% of patients receiving aspirin with codeine reported side effects. Thirty-five percent of patients receiving diflunisal rated the analgesic as excellent; 5.3% rated it as fair or poor. In contrast, 12.9% of patients receiving aspirin with codeine rated the analgesic combination as excellent; another 12.9% rated it as fair or poor. Diflunisal was found to be generally effective and well-tolerated, and superior to aspirin with codeine in the management of pain from endodontic treatment.

Adolescent↗