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PubMed1977

[Decisive factors in the indication for pulp and peridontal treatment].

The explanation of the goal of pulp-periodontium treatment is followed by guidelines concerning the indication for the methods of pulp preservation (indirect capping, direct capping, pulpitis treatment by means of anaesthetics), of partial pulp preservation (vital amputation) and for pulpectomy (vital and non-vital techniques). The different passages of the paper terminate with conclusions for practice.

Administration, Topical↗
PubMed1988

[Methohexital/alfentanil-thiopental/alfentanil for total intravenous anesthesia for direct laryngoscopy with 100% O2 jet ventilation].

For the direct laryngoscopy and microscopic examination of the larynx with exploratory excision and pulpectomy using low frequency jet-ventilation with 100% oxygen we used total intravenous anaesthesia with a strong acting opioid and a barbiturate. Because the achievement of sufficient reflexes and a high degree of vigilance postoperatively are to be aimed, Methohexitone (M) and Thiopentone (T) were investigated in the regard of the suppression of vigilance in the postoperative period. 40 patients were randomly assigned to the group M (n = 20) or T (n = 20). The evening before operation, an intelligence test and a syndrome-short-test (SST) were performed for the measurement of attention and memory (functional psychosis). The patients received 2 mg Flunitrazepam orally and transdermal Scopolamine. On the day of operation the patients received 1 mg Lormetazepam orally for premedication. Anaesthesia was induced with 2 mg Alcuronium, 1 mg Alfentanil, 1.4 mg/kg bodyweight M respectively 5 mg/kg bodyweight T and 1.4 mg/kg bodyweight Succinylcholine. Immediately before laryngoscopy the patients received 2-4 mg Alfentanil. Muscle relaxation was achieved by an infusion with Succinylcholine using relaxometry. Methohexitone respectively Thiopentone were administered by infusion depending on clinical signs indicating insufficient anaesthesia. The following parameters were measured: Blood pressure, heart rate, duration of operation and anaesthesia, parameters of vigilance 30, 60 and 120 minutes after operation (SST) and the ability of performance. The groups were comparable with respect to all data except the parameters of vigilance. The patients receiving M were significantly more vigilant 30 min., 60 min. (SST) and 120 min (SST) after the end of anaesthesia than patients receiving T (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Ultrastructural observations of the dorsal lateral geniculate nucleus following non-surgical retinal lesion of the rats].

By intravitreal injection of arsenous pentoxide (As2O5), which had been used in the pulpectomy in the dentistry, the retina, including the ganglion cell layer, fell selectively into necrosis and the lesions were uniform throughout all part of the retina. Following these non-surgically induced retinal lesions, the dorsal lateral geniculate nucleus of the rats was examined by electron microscope over varying periods of time. From 2 days after the injection, dark atrophic axon terminals appeared in the dorsal lateral geniculate nucleus and these terminals were in most instances surrounded by swollen astrocytic processes with glycogen particles. The quantity of the degenerating terminals maximized at 6 to 7 days after injection and then decreased by 60 days. It was also shown that various features of the degenerating terminals were related to the postsynaptic dendrites. In early stages these degenerating axon terminals had dense, swollen mitochondria and many synaptic vesicles in the electron dense matrix. Then these terminals were deeply indented to the apposed dendrites and by this indentation the astrocytic process seemed to insinuate into the synaptic junction. In these situations, the cytoplasm of astrocytes increased in electron density around the terminals. The postsynaptic density and the subsynaptic organellas were clearly shown to be identical through the course of the degeneration. There were also dendro-astroglial junctions, and these junctions seemed to be one of the features of degeneration of the terminals. It was suggested that there was an obvious course of the degenerating terminals separated from their post-synaptic sites without disruption of integrity of the post-synaptic membrane specialization by astrocytic cell process in Wallerian degeneration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

In vitro inhibition of bacteria from root canals of primary teeth by various dental materials.

The primary tooth pulpectomy is a common clinical procedure. The choice of filling material is important to the success rate, but antibacterial properties of such materials against organisms known to inhabit infected primary root canals have not been well documented. This study compared the antibacterial effectiveness of 10 materials: 1. Calcium hydroxide mixed with camphorated parachlorophenol (Ca(OH)2+CPC) 2. Calcium hydroxide mixed with sterile water (Ca(OH)2+H2O) 3. Zinc oxide mixed with CPC (ZnO+CPC) 4. Zinc oxide mixed with eugenol (ZOE) 5. ZOE mixed with formocresol (ZOE+FC) 6. Zinc oxide mixed with sterile water (ZnO+H2O) 7. ZOE mixed with chlorhexidine dihydrochloride (ZOE+CHX) 8. Kri paste 9. Vitapex paste 10. Vaseline (control) These materials were compared against microbial specimens obtained from 13 infected primary teeth by using an agar diffusion assay. The results suggest that the materials could be divided into three categories. Category I, with the strongest antibacterial effect included ZnO+CPC, Ca(OH)2+CPC, and ZOE+FC. Category II, with a medium antibacterial effect included ZOE+CHX, Kri, ZOE, and ZnO+H2O. Category III, with no or minimal antibacterial effect included Vitapex, Ca(OH)2+H2O, and Vaseline. There were no significant differences within each category, but there were significant differences between the categories. The one exception was the antibacterial effect of ZOE+FC which was not significantly different from ZOE+CHX, Kri, or ZOE.

Analysis of Variance↗
PubMed1996

[Antiandrogen withdrawal syndrome in the hormonal treatment of metastatic prostatic cancer in hormonal escape].

A fall in the PSA level after stopping antiandrogens has been described at the stage of hormonal escape of prostatic cancer treated by complete androgen inhibition. The authors report a new case. The patient was offtially treated by pulpectomy and nitulamide for N+ prostatic carcinoma (PSA: 165 ng/ml). At the stage of hormonal escape, discontinuation of nitulamide induced a reduction of the PSA. Replacement of nitulamide by cytoproterone acetate was followed by a renewed increase of PSA, which again decreased after stomming cyproterone acetate. Three years later, the PSDA level was 3.5 ng/mg. This syndrome is probably due to mutation of the androgen receptor. In hormonal escape, suspension of all antiandrogens apart from LHRH analogues is recommended and can be followed by a temporary fall of PSA. No other antiandrogen must be administered in the place of the previous drug.

Adenocarcinoma↗
PubMed1996

[An unusual presentation of prostate cancer].

The authors report an uncommon case of a 74-year old man with prostatic cancer revealed by pelvic mass. Ultrasound exam and CT-scan showed a bilateral laterorectal mass with high density. Presence of such a mass in an old patient is very suggestive of lymph nodes than retroperitoneal tumor. Serum prostate specific antigen (PSA) is rather helpful in such conditions. Biopsy of the mass allows confirmation of the prostatic cancer diagnosis. Bilateral Surgical pulpectomy is performed in combination with oral hormonal therapy. Follow-up after 6 months showed a good course or ultrasound exam and PSA level.

Aged↗
PubMed1998

Laser-induced thermal events in empty and pulp-filled dental pulp chambers.

BACKGROUND AND OBJECTIVE: The purpose of this investigation was to evaluate: 1. thermal events during laser irradiation @2.1 microns of the pulp; 2. whether these effects are adequately modeled using an empty pulp chamber/root canal. STUDY DESIGN/MATERIALS AND METHODS: In extracted human teeth, pulpal access was prepared and thermocouples placed 2, 3 mm apical to the center of the irradiation spot. Pulp-filled or empty pulp chambers were irradiated using a Ho:YAG laser: Spot Size: 1 mm; Power: 1, 2, 3.5, 4.5 W; PRR: 5, 12 Hz; DURATION: 10 sec. Thermal measurements were repeated 3x. RESULTS: Thermal trends did not differ significantly and correlated positively with power (P < 0.01), PRR (P < 0.01), irradiation duration (P < 0.05). No significant difference was determined between temperatures in empty and pulp-filled chambers at all parameters at 5 Hz and at 1-2 W at 12 Hz (P < 0.05, 2-tailed Student's t-test). At 12 Hz and > 3.5 W, pulp chamber temperatures exceeded those in pulpal tissue (P < 0.05). CONCLUSION: Pulp tissues must be present to ensure clinical relevance of thermal measurements.

Animals↗
PubMed1977

Electron microscopy of degenerating axons and terminals in spinal trigeminal nucleus after tooth pulp extirpations.

Following multiple tooth pulp extirpations, electron microscopic preparations show degenerating axons and synaptic terminals in the same region of the brain stem trigeminal nucleus previously demonstrating degeneration by light-optical methods. The observations confirm the phenomenon of transganglionic degeneration in this system and identify the class of central nervous system axons and synapses specifically related to innervation of the teeth.

Animals↗
PubMed1983

Ultrastructural study of transganglionic degeneration following dental lesions.

Transganglionic degeneration in the trigeminal main sensory nucleus (MSN) and pars interpolaris (PI) was studied in cats following dental lesions. At early survival times, three types of terminal alteration were seen in both MSN and PI: (1) flocculent degeneration, (2) neurofilamentous hyperplasia and, (3) glycogen accumulation. With longer survival times, the magnitude of these terminal alterations increases. Electron dense degeneration was only seen in the ventral half of PI. Phagocytosis of the altered terminals was also observed. The study suggests a plausible explanation for the variations observed in the CNS projection of primary afferents with degeneration and with HRP transport studies.

Animals↗
PubMed2001

Preparation of severely curved simulated root canals using engine-driven rotary and conventional hand instruments.

This in vitro study evaluated the efficacy and safety of six different nickel-titanium engine-driven instruments used with a torque-controlled engine device and nickel-titanium hand and stainless steel hand instruments in preparation of curved canals. A total of 80 curved (36 degrees) simulated root canals were prepared. Images before and after were superimposed, and instrumentation areas were observed. Time of instrumentation, instrument failure, change in working length and weight loss were also recorded. Results show that stainless steel hand instruments cause significantly less transportation towards the inner wall of the canal than do nickel-titanium hand instruments. No instrument fracture occurred with hand instruments, but 30-60% breakage of instruments was recorded during instrumentation with the engine-driven devices. The working length was maintained by all types of instruments. Newly developed nickel-titanium rotary files were not able to prevent straightening of the severely curved canals when a torque-controlled engine-driven device was used.

Dental Alloys↗
PubMed2026

Evaluation of oral health-related quality of life following pulp therapy or extraction in paediatric patients: a systematic review.

BACKGROUND: Treatment decision between pulp therapy and extraction for compromised teeth in paediatric patients remains a topic of debate. While both approaches address the associated pain, their long-term impact on children's well-being remains unclear. This systematic review aimed to analyse and compare the impact of pulp therapy and extraction on OHRQoL in paediatric patients. METHODS: This review was conducted in accordance with PRISMA guidelines. A comprehensive search was performed in multiple electronic databases. Methodological quality and risk of bias were evaluated using the RoB 2 tool for randomised controlled trials, ROBINS-I tool for non-randomised trials, and the Newcastle-Ottawa Scale for observational studies. RESULTS: Seven studies comprising a total of 1367 participants met the inclusion criteria. The results indicated that pulp therapy was associated with superior OHRQoL outcomes compared to extraction. Children who underwent pulp therapy reported lower anxiety, better emotional well-being, and higher parental satisfaction. Given the heterogeneity among the studies, a narrative synthesis was performed. CONCLUSION: Pulp therapy may offer better OHRQoL outcomes than extractions in paediatric patients by preserving function, reducing anxiety, and minimising long-term complications. However, these findings should be interpreted cautiously since&#xa0;the available evidence was limited and of low to very low certainty. Further well-designed randomised controlled trials are required.

Children↗