PubMed · 4501731
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C H Fischer. 1972. [Endodotics, (fundamentals, reflections, instructions)].. https://pubmed.ncbi.nlm.nih.gov/4501731/
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KEEP EXPLORING
Tooth luxations are relatively common. In case of concussion or subluxation the tooth is not displaced. The treatment will consist of relief of the tooth. Most frequent complications are pulp necrosis and obliteration of pulpal tissues. In case of extrusive luxation pulpal tissues and the periodontal ligament are injured. When tooth mobility is increased flexible splinting should be considered. Endodontic treatment is necessary after extrusive luxation of a tooth with completed root formation. Teeth with open apex often show pulpal obliteration after extensive luxation. Lateral luxation is more complex than extrusive luxation since the alveolar bone is also damaged. Repositioning and splinting of the tooth are necessary. When the apical foramen in closed, endodontic treatment will be necessary. Teeth with incomplete root formation will develop pulp obliteration. Following lateral luxation, external root resorption and loss of marginal bone are not infrequent. Intrusive luxation is the type of trauma with most unfavorable prognosis. All intruded teeth will become necrotic and external root resorption and marginal bone loss are frequent. There is no consensus regarding the therapeutic approach. Orthodontic extrusion or surgical mobilisation are possible options. In case of avulsion, both the pulpal tissues and the periodontal ligament are disrupted. Preservation of the vitality of the periodontal ligament covering the root will determine the prognosis of the reimplanted tooth. Therefore the tooth will be repositioned as soon as possible. When this is not possible, milk or a specific solution are most appropriate for tooth conservation. When the reimplanted tooth has complete root formation, devitalization will be performed one week after after repositioning. In case of a tooth with open apex revascularisation can be awaited. Healing of the periodontal ligament will determine prognosis. When a normal ligament is obtained during healing or when surface resorption is obtained, the tooth can be preserved for a long period. When progressive replacement resorption (ankylosis) develops, most teeth can remain in position for about 10 years. When inflammatory resorption develops, the tooth will be lost within a short time.
Factors affecting the negotiability of MB2 canals were evaluated by studying 87 extracted maxillary molars that had undergone previous endodontic treatment in the endodontic technique laboratory. The mesiobuccal roots were resected and radiographed, after which a #08 file was used in an attempt to negotiate those roots with the potential for a second mesiobuccal canal. The file was then intentionally separated in the MB2 canals that could be negotiated. The roots were decalcified, cleared, and observed under a stereomicroscope. Several factors that could interfere with the total or partial negotiation of MB2 canals were identified and included accumulation of debris and sealer that blocked access to these canals, dentinal debris produced with the pathfinding instrument, the presence of anatomical variations, diffuse calcifications, and pulp stones.
Root canal calcification represents a serious problem which often occurs in clinical practice. Calcified root canals are difficult or even impossible to find and treat conservatively. In this paper, a technique is proposed which may be helpful in detecting and locating calcified root canal(s) and properly treating them. The proposed technique is simple and easy to perform in posterior and anterior teeth, and it may be useful in everyday clinical practice.