Biomedical subjects
Publications and source records attributed to S Taschieri.
We did apicectomies of 30 teeth with periradicular lesions in 23 patients, using a 3 mm endoscope. Two patients failed to attend for postoperative assessment and of the remaining 21 patients who had 28 teeth treated the operation was judged after 1 year to be a success in 26 (93%).
AIM: To evaluate the apical seal of canals filled with a core-carrier obturator following root-end resection with and without a root-end filling. METHODOLOGY: Thirty single-rooted human teeth with single canals were used. Root canal treatment was performed and canals filled with a core-carrier obturation technique. The teeth were then randomly assigned to three groups (n = 10). In the first group root canal filling only was performed. After orthograde filling, the teeth of the second group were resected apically, perpendicular to the major axis of the root. In the third group after apical resection, a root-end cavity was prepared using ultrasonic diamond retrotips and the cavities filled with Super-EBA cement. During a period of 3 h and with a headspace pressure of 0.12 atm, methylene-blue solution was forced through a tube that was connected to the apical end of each tooth specimen. The coronal end of the tooth was connected to a capillary tube containing an air bubble. Leakage was evaluated by observing the distal displacement of the air bubble. The roots were then sectioned along their long axis. Using a stereomicroscope, linear dye infiltration at the dentine-cement interface was determined. Kruskal-Wallis and Mann-Whitney tests were used to compare the three groups. RESULTS: Linear dye infiltration was significantly greater in root canals filled with the core-carrier obturators and resected apically (0.9 +/- 0.9 mm) when compared with those that had root-end fillings (0.2 +/- 0.4 mm). Air bubble displacement was not observed. CONCLUSION: Root-end filling improves the sealing of roots with core-carrier obturation following root-end resection.
Apical resection is fundamental in obtaining a correct apical seal. The purpose of this study was to evaluate how the apical root resection angle and the cavity made by ultrasonic retrotips may influence the apical seal. A total of 48 extracted teeth were endodontically treated and sealed by guttapercha vertical compaction: 24 were resected with a 45 degrees angle and 24 with a 90 degrees one. An ultrasound source (P.M. 400 EMS) and a CT5 Scaler were used to make the retrograde cavity that was filled afterwards with EBA-zinc oxide-eugenol alumina-added cement. Apical leakage was determined using fuchsin and assessed after the roots were sectioned longitudinally. Linear dye penetration in dentin and at the interface between dentin and cement was measured with a stereomicroscope (x 12 magnification), and the results were statistically analyzed. Results showed that there was less infiltration both in dentin and in the space between the filling and the dentinal wall in the group with the 90 degrees angle, but this difference was statistically significant (p < 0.0001) only for the dentin. None of the samples showed leakage greater than the depth of the preparation. An apical cavity of 3 mm or more along the vertical axis can produce a safe and effective seal.
BACKGROUND/AIMS: Surgical treatment of primary liver tumors has undergone significant changes in recent years because of improved surgical and anesthesiological techniques and better pre- and post-operative care. We review our personal series from 1987-1995. METHODOLOGY: Of 31 cases of hepatocellular carcinoma (HCC) observed in the years 1987-1995, 23 underwent curative resective surgery for a total of 24 liver resections: 6 hepatectomies; 10 segmentectomies; 4 atypical subsegmentectomies; 2 extended resections, with excision of neoplastic thrombi within the portal vein; 1 orthotopic liver transplantation in another institution, and 1 limited segmental resection for tumor recurrence. In 7 recent cases, pre-operative transcatheter arterial chemoembolization (TAE) was used. RESULTS: The mean survival of the 13 patients that are known to be deceased is 27 months (range: 7-114 months). Perioperative mortality was nil. Actuarial 5-year survival rate is 27%. Pre-operative TAE was used in 7 patients: 4 out of 7 lesions were significantly reduced at computed tomography (CT) scan control 21 days following TAE, while in 3 the tumor size was unchanged. CONCLUSIONS: Liver surgery, even major resections, has become safe with no perioperative mortality in our series. In our experience, pre-operative TAE has often produced significant reduction of the mass, but its real efficacy is still the subject of debate. TAE and percutaneous ethanol injection (PET) should be evaluated as part of combined multimodality treatment in the therapy of large lesions previously considered inoperable.