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Biomedical subjects

R J Matusow

Publications and source records attributed to R J Matusow.

At least 19 recordsLinked to original sources
PubMed1995

Endodontic cellulitis 'flare-up'. Case report.

Endodontic cellulitis involves facial swelling which can vary from mild to severe and can occur as a primary case or a flare-up following initial treatment of asymptomatic teeth with periapical lesions. The microbial spectrum in primary cases involves a significant mixture of anaerobic and facultative aerobic microbes, chiefly streptococci. In a previous study, cultures from flare-up cases, utilizing the same anaerobic techniques as in primary cases, revealed an absence of obligate anaerobes and an 80 per cent incidence of facultative aerobic streptococci. These cases also revealed a significant time lapse from onset of symptoms to the cellulitis phase. No sex or age factors were noted in the primary or flare-up cases. The purpose of this case report is to restate a traditional theory, namely, the alteration of the oxidation/reduction potential (Eh), as a major factor for endodontic cellulitis flare-ups; to confirm the pathogenic potential of oral facultative streptococci; and that asymptomatic endodontic lesions tend to exist with mixed aerobic/anaerobic microbial flora.

Adolescent↗
PubMed1991

Acute pulpal-alveolar cellulitis syndrome. V. Apical closure of immature teeth by infection control: the importance of an endodontic seal with therapeutic factors. Part 2.

During orthodontic treatment to promote eruption of maxillary and mandibular second bicuspids, a young male patient had a severe endodontic cellulitis of a mandibular bicuspid. Apexogenesis and resolution of the periapical lesion was achieved by infection control with nonspecific intracanal medication without calcium hydroxide, as stated by Das. A mild periodontal cellulitis occurred shortly thereafter and rapidly resolved. A second endodontic cellulitis, after apexogenesis without an endodontic seal, occurred shortly after completion of orthodontic treatment. This also quickly resolved, and the canal was effectively sealed. This case indicates the importance of an effective endodontic seal shortly after apexogenesis is induced by infection control. This report and others on the subject indicate that apexogenesis of nonvital permanent immature teeth by infection control is a predictable endodontic treatment procedure.

Acute Disease↗
PubMed1991

Acute pulpal-alveolar cellulitis syndrome V. Apical closure of immature teeth by infection control: case report and a possible microbial-immunologic etiology. Part 1.

Das with Matusow and Goodall previously noted the rapid clinical apexogenesis of nonvital immature permanent teeth that are involved with an acute endodontic cellulitis. This apexogenesis was achieved by control of infection and by nonspecific intracanal medication without the use of calcium hydroxide. The case report confirms the clinical observations. The experimental canine endodontic cellulitis in a Cebus primate was induced as an immunologic pulp infection with a facultative Streptococcus species. The noted epithelial proliferation and organization into lacelike strands and bilaminar loops, similar to Hertwig's epithelial root sheath in root development, appear to be immunologic and genetic in origin, with an acceleration of the root maturation process.

Animals↗
PubMed1988

The flare-up phenomenon in endodontics: a clinical perspective and review.

The acute endodontic cellulitis exacerbation, which can be potentially fatal, is a definitive entity in endodontic flare-ups. Aerobic microbes, particularly streptococci, are the predominant causative microbes isolated. There was a noticeable absence of obligate anaerobes. This is significant for the selection of an antibiotic for therapy. Treatment parameters were presented. An endodontic cellulitis exacerbation is most unlikely with obligate anaerobes. An endodontic flare-up perspective was attempted with some clinical parameters. The proponents of routine one-visit endodontic treatment with prophylactic drugs to prevent cellulitis exacerbations do not appear to offer any advantage to the more traditional approaches to endodontic treatment of the patient, which may be more beneficial.

Cellulitis↗
PubMed1988

Acute pulpal-alveolar cellulitis syndrome. IV. Exacerbations during endodontic treatment. Part 3. A case report.

An asymptomatic abscessed maxillary premolar, which had undergone previous endodontic treatment, was retreated. The initial attempt to remove the silver cone seal was unsuccessful. Early the next morning, the patient appeared with a severe cellulitis exacerbation. The silver cone was now loose: a lateral "blowout." Specific cultures of the silver cone and exudate revealed three aerobic microbes: a Streptococcus sp and two obligate Pseudomonas spp. Anaerobes were shown to be absent with anaerobic subcultures. This case would appear to substantiate the alteration of the tissue oxidation-reduction potential as the major factor in endodontic cellulitis exacerbations, as previously reported.

Abscess↗
PubMed1988

Resolution of fused vertical molar root bridge abutment fracture: report of case.

Vertical root fractures involving apparently successful endodontic treatment with gutta-percha may be caused by hairline root fractures that existed before root canal therapy was performed. A root stripping technique was used to restore a strategically located tooth in a 70-year-old patient. Bruxism with occlusal trauma is proposed as a significant cause of hairline vertical root fractures. The commonly held view that these fractures arise from root canal condensation techniques appears more circumstantial than factual.

Aged↗
PubMed1986

Acute pulpal-alveolar cellulitis syndrome. IV. Exacerbations during endodontic treatment: a clinical study of specific microbial isolates and their etiologic role. Part 1.

A statement has been made by Sundqvist that it has not been possible to isolate the specific bacteria that is responsible for acute exacerbations during endodontic treatment of existing periapical inflammation. This clinical study presents specific microbial isolates from 34 intact nonvital teeth involved with acute cellulitis exacerbations during endodontic therapy. No obligate anaerobes were isolated. Forty-seven aerobic and facultative microbes were isolated. Streptococci, primarily facultative, were the major group of microbes isolated (80%); alpha hemolytic streptococci and the group D enterococcus were predominant as mixed and pure culture specimens. Gram-negative microbes as strict aerobic and facultative microbes were also reported as specific isolates. The biological role of anaerobes were discussed in primary pulpal-periapical infections. The alteration of the tissue oxidation-reduction potential, (Eh) is proposed as an etiologic factor in cellulitis exacerbations during endodontic treatment. This is further substantiated in the Part 2 report. Attention is drawn to the pathogenic potential of streptococci and other microbes isolated in this study.

Acute Disease↗
PubMed1986

Acute pulpal-alveolar cellulitis syndrome. IV. Clinical parameters, demographics, and affirmation of a traditional etiologic theory. Part 2.

The Part 1 report revealed the microbiologic etiology and introduced the oxidation-reduction potential (Eh) as a major factor in acute cellulitis exacerbations during endodontic therapy. Facultative streptococci were the predominant group of microbes specifically isolated. This Part 2 study revealed a 9.5% incidence of cellulitis exacerbations in patients during endodontic treatment of 168 primarily intact nonvital teeth. These teeth were usually asymptomatic, manifesting radiographic periapical lesions without fistulous tracts and necrotic canals. This category of pulpal periapical inflammation is virtually the only type of tooth that is predisposed to cellulitis exacerbations. A frequency distribution of the 34 permanent teeth studied revealed a spectrum of mandibular and maxillary molars, premolars, and anterior teeth involved with the exacerbations. Sex and age did not appear to be factors. Further clinical evidence is cited, which support the concept of altering the tissue oxidation-reduction potential as the prime etiologic factor in favoring the growth of aerobic microbial pathogens.

Acute Disease↗
PubMed1985

Clinical observations regarding the treatment of traumatically avulsed mature teeth. Part 1.

A documented case involving the simultaneous avulsion of two maxillary incisors, intraorally and extraorally, was reported. Long-term observations following replantation treatment revealed several interesting clinical features: The prognosis of replanted teeth may be more favorable following intraoral avulsions. The intrusion phenomenon associated with replanted incisors appears to be directly related to replacement root resorption or ankylosis; occlusal forces may be a factor. Teeth extraorally avulsed for a few hours may still provide a useful function, albeit temporary, with replantation treatment. These teeth may not reveal clinical ankylosis or replacement resorption for periods of 1 to 2 years, or possibly longer, following replantation. Long-term studies can help evaluate replantation techniques.

Child↗
PubMed1985

Clinical observations regarding the treatment of traumatically avulsed mature teeth. Part 2.

Two documented cases involving avulsions of an incisor and a cuspid are reported. Long-term observations following replantations indicated factors in addition to those reported in Part 1 of this study. Endodontic metallic implants may retard the intrusive process. A fixed-bridge splint also appears to have retarded the ankylosis phenomenon. The three case reports in the two parts of this study indicated that splint time may not be a critical factor in the prognosis of replanted teeth. Calcium hydroxide failed to prevent early root resorption and eventual ankylosis in an early replantation case; the other two cases, with longer replant time, fared better without calcium hydroxide. Endodontic treatment of avulsed teeth soon after replantation is suggested; a time period of several weeks does not appear critical to the prognosis. Removal of the apical root segment prior to replantation does not appear to affect the replacement root resorption process. The reporting of long-term documented cases should be encouraged in order that replantation techniques may be evaluated.

Adult↗
PubMed1981

Acute pulpal-alveolar cellulitis syndrome. III. Endodontic therapeutic factors and the resolution of a Candida albicans infection.

An acute pulpal-alveolar cellulitis, involving a drug-resistant Candida albicans, was resolved successfully with endodontic treatment in 6 days. Effective debridement, irrigation, and intracanal medication were significant factors in obtaining a negative culture at completion of treatment. The case illustrates that clinical procedures and judgment can be major factors in the resolution of serious infection, where antibiotic therapy is not feasible. External heat compresses should be avoided in pulpal-alveolar cellulitis cases. Hot intraoral saline rinses are recommended to promote tooth drainage and the formation of fluctuant mucosal swellings. External cold compresses may help reduce facial swelling and provide relief from discomfort.

Adult↗
PubMed1981

Acute pulpal-alveolar cellulitis syndrome. II. Clinical assessment of antibiotic effectiveness against microbes isolates from intact teeth.

Ten antibiotics were comprehensively screened for effectiveness against 105 microbes, specifically isolated from seventy-eight teeth involved with acute pulpal-alveolar cellulitis. On the basis of effectiveness and compatibility, erythromycin was regarded as the drug of choice for initial therapy. Streptococci were the predominant class of microbes isolated; enterococci were the most resistant. No resistance was noted wit erythromycin; 52 percent resistance was obtained with clindamycin. Tetracycline was the most effective of the common drugs for aerobic gram-negative rods. Polyantibiotic resistance was noted among microbes of all types. A clinical perspective in drug therapy for acute oral infection is discussed.

Acute Disease↗