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At least 235 records · Page 13Linked to original sources

PubMed1998

Histopathological study of the use of freeze-dried allogenic dentin powder and True Bone Ceramic as apical barrier materials.

The biocompatibility of freeze-dried allogenic dentin powder and True Bone Ceramics (TBC), the latter prepared by incineration of bovine bone, as apical barrier materials was evaluated histopathologically in dogs. After pulpectomy, 80 root canals of 53 dog premolar teeth were prepared, and each material was tightly packed to the apical stop area. The remainder of the canal was filled with guttapercha by the lateral condensation method. Control teeth were filled by the lateral condensation method using gutta-percha without constructing apical barriers. In both the teeth filled with the dentin powder and those filled with TBC, multinucleate giant cells appeared on the bone resorption surface and the surface of the root canal wall, and marked bone resorption and positive tartrate-resistant acid phosphate staining were observed. Hard tissue had formed on the root canal wall and the filling material after 3 months. These findings suggest that the test materials are nonirritative and compatible with periapical tissue, and that they may be useful and clinically applicable as apical barrier materials.

Animals↗

PubMedDate not supplied

[Value of a LHRH agonist (Zoladex) in hormonotherapy of advanced cancers of the prostate. Apropos of 22 patients].

Twenty-two patients with metastatic cancer of the prostate were treated with ZoladexR, an LHRH analogue. In all cases plasma testosterone levels decreased to post-surgical castration values. This inhibitory effect of Zoladex on testicular steroid production had a favourable influence on the course of the malignancy, since 75 p. 100 of objective responses were obtained after 3 months of treatment. The functional symptoms were distinctly improved, and the drug was well tolerated, notably by the cardiovascular system. This immediate effectiveness seemed to last for several months, one-half of the patients still being in remission after 3 to 15 months. The beneficial effects of LHRH agonists, similar to those of pulpectomy or oestrogen therapy, are limited by the susceptibility of the tumour to hormones. In view of their effectiveness and good tolerance, LHRH agonists are useful in the management of advanced prostatic cancer, either as initial therapy or to replace a poorly tolerated oestrogen therapy. Further studies are needed to clarify their indications and the possible value of their association with anti-androgens or antimitotic drugs.

Aged↗

PubMed2000

Apical terminus location of root canal treatment procedures.

The apical termination of root canal treatment is considered an important factor in treatment success. The exact impact of termination is somewhat uncertain; most publications on outcomes are based on retrospective findings. After vital pulpectomy, the best success rate has been reported when the procedures terminated 2 to 3 mm short of the radiographic apex. With pulpal necrosis, bacteria and their byproducts, as well as infected dentinal debris may remain in the most apical portion of the canal; these irritants may jeopardize apical healing. In these cases, better success was achieved when the procedures terminated at or within 2 mm of the radiographic apex (0 to 2 mm). When the therapeutic procedures were shorter than 2 mm from or past the radiographic apex, the success rate for infected canals was approximately 20% lower than that when the procedures terminated at 0 to 2 mm. Clinical determination of apical canal anatomy is difficult. An apical constriction is often absent. Based on biologic and clinical principles, instrumentation and obturation should not extend beyond the apical foramen.

Dental Pulp Cavity↗

PubMed2003

Oral biology and disorders of tusked mammals.

Tusked mammals can be terrestrial or aquatic. Many of these magnificent animals are kept in captivity all over the world. Functions of tusks vary as much as the species in which they occur. Dental anomalies and disorders of tusks and the rest of the dentition in these mammals were discussed, with an emphasis on the elephant. The tusk anatomy, with its large, conically-shaped pulp, makes it an ideal tooth for partial pulpectomy treatment in trauma cases where the pulp is exposed. Surgical techniques for tusks have been developed and were discussed. Oral tumors occur, but are rare.

Animals↗

PubMed2000

A retrospective study of treatment provided in the primary and secondary care services for children attending a dental hospital following complicated crown fracture in the permanent dentition.

OBJECTIVES: To investigate treatment provision in primary and secondary dental care following complicated crown fracture of permanent teeth. DESIGN AND METHODS: Retrospective observational survey of dental records of all patients attending a dental hospital trauma clinic during a 2-year period with complicated crown fracture. RESULTS: Eighty children (70% male) aged 6-16 years (mean age 10.3 years) with 98 complicated crown fractures were identified. Of these children, 54% were seen for emergency treatment on the day of their injury, 75% within 48 h. Of the 98 injured teeth, 60% were seen initially in general dental practice but only 56% of these 59 cases were provided with emergency treatment in practice, the others being referred immediately to the trauma clinic for treatment. The main cause of fractures was transport, in particular, bicycles. Radiographs were available for 96 teeth; for the 43 open apex teeth, the definitive treatment was pulp capping (44% of cases) and pulpotomy (30%), with vitality maintained in five cases up to 4.8 years after trauma. The 53 closed apex cases were treated definitively with pulp capping (38%) and pulpectomy (36%) and six teeth had maintained their vitality up to 4.3 years after trauma. Sixty-seven per cent of the pulp caps and 47% of the 19 pulpotomies provided relied on a doubtful coronal seal. This was primarily due to the extensive use of a conventional glass ionomer cement as an emergency bandage. The use of an etched or bonded material at initial presentation extended the Median Survival Time for vitality in open apex teeth from 188 to 377 days and in closed apex teeth from 15 to 64 days. CONCLUSIONS: Emergency treatment of complicated crown fractures, particularly in primary care services is often inappropriate or inadequate with regard to emergency management of the exposed pulp and provision of a hermetic coronal seal.

Adolescent↗

PubMed2001

Endodontic decisions based on radiographic appearance.

Endodontic disease or disease that affects the internal portion of the tooth is a frequently encountered oral problem of the cat and dog. There are many etiologies that can cause the tooth's health and longevity to be adversely affected. Trauma, tooth malformations of either congenital or acquired origin, and bacterial periodontal ascending infections all can lead to pulpal inflammation, necrosis, and tooth death. One must correlate history, physical exam and radiographic impressions of the tooth, and its supporting structures and adjacent teeth in determining proper treatment options and aftercare. Based on extent, timing, and involvement of adjacent structures, resulting pathology of the tooth may be endodontically treated with either a vital pulpectomy, standard root-canal therapy, surgical root-canal therapy, or when the disease is too extensive by extraction. Through a case presentation, we will discuss some of the decisions that enter into the therapy used to treat presenting pathology. It is the authors' intent to present a thought process for deriving a treatment plan to promote healing. There are many ways to achieve this healing, and therefore, there is no right or wrong plan, but rather one that is based on all the presenting factors.

Animals↗

PubMed2004

Effects on periradicular periodontal tissues of root canal irradiation with Er:YAG laser in rats.

OBJECTIVE: The effects of Er:YAG laser irradiation on the periodontal region during root canal preparation were evaluated using rats histopathologically. BACKGROUND DATA: The effects on periodontal tissues along the root surface and apical area during root canal preparation using Er:YAG laser irradiation in vivo are not clear. METHODS: One hundred mesial root canals of mandibular first molars in rats were divided into four groups. In three of these groups, root canals were irradiated using an Er:YAG laser at 2 Hz and 34, 68, and 102 mJ/pulse for 30 sec. Non-irradiated canals served as controls. The effects of laser irradiation on the periodontal tissues along the root surface and apical area were evaluated at 0, 2 days, 1, 2, and 4 weeks after irradiation under light microscopy. RESULTS: At 4 weeks after treatment, no inflammation or resorption was observed in any cases in the control or 34 mJ/pulse-irradiated groups. However, moderate to severe inflammation with resorption of root surface was observed in four of five cases (80%) in the 102 mJ/pulse-irradiated group, which was significantly different from the control (p < 0.01). CONCLUSIONS: These results suggest that the effects on periodontal tissues during root canal preparation by Er:YAG laser irradiation after pulpectomy are minimal, if appropriate parameters are selected, and this is a potential therapy for human root canals of teeth.

Animals↗

PubMed1991

Setting up an MSc programme in endodontics.

The course has been designed to provide a suitable foundation for academic and general practice careers. Emphasis has been placed on developing diagnostic and practical skills. Students are encouraged to review their clinical practice critically in the light of recent advances in knowledge. The course begins with an intensive period of lectures and seminars covering general aspects of endodontics, and is generously supplemented by practical demonstrations and classes on a variety of procedures performed on laboratory models. The course continues with lectures and seminars designed to stimulate group discussion. These are complemented by supervised clinical sessions encompassing assessment, planning and treatment of a comprehensive range of conventional and surgical endodontic problems. The syllabus includes relevant basic sciences, pathology, differential diagnosis, pharmacology and therapeutics. The biological basis for endodontics is stressed and covers the following: maintenance of pulp vitality; effects of pulp capping pulpotomy and pulpectomy; the management and treatment of traumatic injuries to teeth; the management of medically compromised patients; the effect of various methods of instrumentation of root canals; radiology; restorative treatment of the endodontically treated tooth; the interface between endodontics and periodontics, prosthetics or orthodontics. Each student is required to undertake a research project and write a report.

Education, Dental, Graduate↗

PubMed1992

The role of intracanal medication in root canal treatment.

The role of intracanal medication as a root canal dressing is re-examined. In pulpectomy and some root canal treatments, where the root canal contains vital pulp tissue, it is doubtful whether a routine intracanal medicament is needed. In infected root canals, intracanal medication has been advocated for many purposes. An intracanal medicament is used to: (i) eliminate any remaining bacteria after canal instrumentation; (ii) reduce inflammation of periapical tissues and pulp remnants; (iii) render canal contents inert and neutralize tissue debris; (iv) act as a barrier against leakage from the temporary filling; (v) help to dry persistently wet canals. However, most of the indications for intracanal medicaments are questionable. Intracanal medicaments should only be used for root canal disinfection as part of controlled asepsis in infected root canals, and their role is secondary to cleaning and shaping of the root canal. Thorough canal debridement and adequate canal preparation are more pertinent, and their importance is emphasized. Bacteriological sampling may be necessary if a tooth does not respond to treatment, to help in the choice of intracanal medicament.

Adrenal Cortex Hormones↗

PubMed2004

The efficacy of pain control following nonsurgical root canal treatment using ibuprofen or a combination of ibuprofen and acetaminophen in a randomized, double-blind, placebo-controlled study.

AIM: To compare ibuprofen, to an ibuprofen/acetaminophen combination in managing postoperative pain following root canal treatment. It is hypothesized that the drug combination will provide more postoperative pain relief than the placebo or ibuprofen alone. METHODOLOGY: Patients presenting at the Texas A&M Baylor College of Dentistry's graduate endodontic clinic, experiencing moderate to severe pain, were considered potential candidates. Fifty-seven patients were included based on established criteria. Following administration of local anaesthesia, a pulpectomy was performed. The patients were administered a single dose of either: (i) placebo; (ii) 600 mg ibuprofen; or (iii) 600 mg ibuprofen and 1000 mg of acetaminophen. Patients recorded pain intensity following treatment on a visual analogue scale and a baseline four-point category pain scale as well as pain relief every hour for the first 4 h then every 2 h thereafter for a total of 8 h. A general linear model (GLM) analysis was used to analyse the outcome. RESULTS: Based upon the GLM analysis, there was a significant difference between the ibuprofen and the combination drug group, and between placebo and combination drug groups. There was no significant difference between the placebo and the ibuprofen. CONCLUSION: The results demonstrate that the combination of ibuprofen with acetaminophen may be more effective than ibuprofen alone for the management of postoperative endodontic pain.

Acetaminophen↗

PubMed1989

Periapical reactions to calcium hydroxide-containing sealers and AH 26 in monkeys.

The long-term effect on periapical healing (8-14 months) of CRCS and Sealapex was compared with that of AH 26. Vital pulpectomy and root canal filling by the hybrid thermomechanical method were performed in teeth of 3 young monkeys. Ten roots with CRCS, 10 with Sealapex and 7 roots with AH 26 were examined after demineralization and routine histological processing. Hematoxylin and eosin and Brown & Brenn staining for micro-organisms were employed. Mild to severe inflammatory lesions were found at the apical foramina of the roots filled with AH 26 and CRCS. Most of the Sealapex specimens showed no inflammatory cells, except macrophages with sealer particles. A striking finding was a tendency towards apical obliteration with calcified tissue in roots filled with Sealapex, apparently following resorption of the sealer. Such a tendency was seldom observed with the other sealers. However, both AH 26 and Sealapex were irritating for a long time when pushed into bone. Despite the interesting results with Sealapex, additional research is needed before its use can be unconditionally recommended. This sealer has not yet been tested in infected cases and its ability to be resorbed, which is an advantage when it precedes replacement by calcified tissue, may become a disadvantage if it is not followed by apical obliteration.

Animals↗

PubMed1999

A comparison of laser Doppler flowmetry with other methods of assessing the vitality of traumatised anterior teeth.

Laser Doppler flowmetry is a non-invasive electrooptical technique which allows the semi-quantitative recording of pulpal blood flow. This study aimed to determine the reliability (measured as the sensitivity and specificity) of laser Doppler flowmetry as a method of assessing the vitality of traumatised anterior teeth, and to compare it with standard pulpal diagnostic tests. Recordings of pulpal blood flow were taken from 67 non-vital anterior teeth (55 patients), where the pulpal status was confirmed by pulpectomy. For comparison, recordings were also taken from 84 vital anterior teeth (84 patients). Analysis of the recordings allowed diagnostic criteria to be developed which gave the technique a sensitivity and specificity of 1.0 for this sample. None of the other standard pulpal diagnostic methods tested was as reliable. This was usually due to low sensitivities, which ranged between 0.92 for sensibility testing with ethyl chloride down to 0.36 for periapical radiolucency and 0.16 for a history of pain. Laser Doppler flowmetry was found to be a reliable method of assessing the pulpal status of traumatised anterior teeth, although it is technique-sensitive and time-consuming to use.

Adolescent↗

PubMed2002

Involvement of the NMDA-nitric oxide pathway in the development of hypersensitivity to tactile stimulation in dental injured rats.

To investigate mechanisms in pathological pain conditions as the hyperalgesia and allodynia observed after dental surgery, we employed a rat dental-injury model involving the simultaneous pulpectomy to a lower incisor and extraction of an ipsilateral upper incisor. We found that hypersensitivity to tactile stimulation developed on both ipsilateral and contralateral sides in the dental-injured rats 5 days after the surgery and that this lasted for at least 30 days. Recovery from hypersensitivity to tactile stimulation was achieved by the intraperitoneal (i.p.) administration of MK-801 (0.05 mg/kg) or N(G)-monomethyl-L-arginine monoacetate (L-NMMA: 10 - 100 mg/kg), but not attained by N(G)-monomethyl-D-arginine monoacetate (D-NMMA: 100 mg/kg). This recovery effect of L-NMMA (50 mg/kg) was inhibited by pretreatment with L-arginine (600 mg/kg). In the trigeminal nucleus caudalis (SpVc), the changes in nitric oxide (NO) levels invoked by the intravenous (i.v.) administration of N-methyl-D-aspartate (NMDA; 10 mg/kg) were found to be significantly larger in the dental-injured rats than in sham-operated rats. The number of neuronal NO synthase (nNOS)-positive neurons increased in layers I-II and III-IV in the SpVc on both sides of the dental-injured rats. These results suggest that hypersensitivity to tactile stimulation developed following dental injury, and that NMDA receptor/NOS/NO production pathways in the SpVc may be involved in pathological conditions.

Animals↗

PubMedDate not supplied

Dentine bond strength of a composite resin polymerized with conventional light and argon laser.

The use of argon laser (488 nm) has been suggested as a new alternative for polymerizing adhesive materials. This study aimed to evaluate the tensile bond strength of a microfilled composite (A110, 3M) inserted by incremental technique (3 increments of 1 mm) and by single increment (3 mm) polymerized by argon laser for 10, 20 and 30 seconds and halogen light for 40 seconds. Eighty (8 groups of 10 teeth) freshly extracted bovine teeth were stored in a freezer in distilled water for one week. The crowns were cross-sectioned from the roots. Pulpectomy was performed and the pulp chambers were sealed with wax. The buccal surfaces of the teeth were ground with wet sandpaper (grains: 120, 400, and 600) to expose the surface dentin, and the teeth were then included in acrylic resin. A metal device was used to fix each sample and a black propylene matrix25 (3 mm high with an internal millimetric delimitation) was used to insert the material according to the groups studied. The polymerization intervals were of 10, 20 and 30 seconds for the laser polymerization and 40 seconds for the conventional polymerization. Tensile tests were performed by a Universal Testing Machine 4442 (Instron) at a speed of 0.5 mm/min and 500 N load. According to the methodology used, the incremental technique increased bond strength values. There was no difference between the studied polymerization techniques when resin was filled in 3 increments.

Animals↗

PubMedDate not supplied

Evaluation of a laser Doppler flowmeter to assess blood flow in human primary incisor teeth.

PURPOSE: This study determined whether the portable Advance Laser Flowmeter Model 21, a clinical instrument, would indicate significant values when pulpal blood flow was present or absent; whether the analog output of the flowmeter was time-linked to the heart rate; and whether labial and lingual crown surfaces produced different flow values. METHODS: Teeth were tested under two conditions: with the teeth in situ and extracted, or with the pulp present and removed. RESULTS: Values before and after the teeth were extracted, and those before and after pulpectomy with the tooth in situ were significantly different. These findings verified that the flowmeter measured the presence of bloodflow. Peaks of the electrocardiogram waves and the regular signal fluctuations of the flowmeter were time-linked and verified the measurement of the heart rate from the dental pulp. Differences in the values for the lingual and labial surfaces of individual teeth were not significant. CONCLUSIONS: This instrument proved a valid means of determining the presence of pulpal blood flow in primary incisors.

Child↗

PubMed1999

Pulp therapy in the primary dentition.

Pulp therapy in the primary dentition is an area undergoing continual changes. Treatment involves numerous methods and the use of a variety of dental materials. This article discusses various techniques and materials used in pulp therapy in the primary dentition. It includes a summary of the morphology, indications, contraindications, techniques for pulpotomies and pulpectomies, and contemporary treatment modalities used in the primary dentition.

Child↗

PubMed1999

Treatment options for the exposed vital pulp.

The exposure of dental pulp generally occurs as the result of accidental trauma or preparation techniques utilized during the restoration of carious lesions. While frank carious exposures are optimally treated with pulpectomy and root canal therapy, the ideal treatment of mechanically exposed pulps has remained controversial. This article describes the indications, clinical techniques, and prognosis for direct pulp capping and partial pulpotomy.

Anti-Infective Agents, Local↗

PubMedDate not supplied

[Remodelling of the crown for occlusal equilibration in partially edentulous patients].

Two clinical cases of partial edentulous patients with irregular occlusal plane and their treatment are presented. The authors emphasize the role of occlusal rehabilitation before any prosthetic treatment. Gingivectomy, osteoplastic surgery and crown reshaping are used. Occlusal relationships before fixed or removable prosthodontics is applied, are essential to insure correct mandibular movements and the dento-maxillary system homeostasis. Two clinical cases of patients with irregular occlusal plane because of teeth migrations (horizontal or vertical) after long-term edentation are presented. Both cases were by crown reshaping after pulpectomy and gingivectomy to obtain a regular occlusal plane. Prosthetic treatment was applied only after these preparations. We achieved good results concerning the dento-maxillary functions.

Adult↗