[3 clinical cases. Root canal therapy].
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A case of bilateral inferior dental nerve paraesthesia following accidental introduction of root canal filling material into the canal is described. The significance of early recognition of the complication and prompt surgical intervention is highlighted.
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In order to find a simple and effective method for endodontic treatment of recalcitrant cases, the efficacy of ammoniacal silver nitrate was re-evaluated. The modified serial tube dilution method was conducted to determine the effective antimicrobial concentration of ammoniacal silver nitrate on selected test microorganisms and clinical isolates. The effective antimicrobial concentration for the most resistant microorganism, Streptococcus faecalis, was 5.0 X 10(-10) g/ml and the effectiveness persisted for several days. The diffusion ability of 4% ammoniacal silver nitrate into the dentinal tubules from root canal wall was also tested with freshly extracted teeth treated as in routine procedure for root canal therapy. The diffusibility was evident and the extent of infiltration was various, with more infiltration at cervical dentin than at apical one.
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Due to natural or artificial clustering, multivariate survival data often arise in biomedical studies, for example, a dental study involving multiple teeth from each subject. A certain proportion of subjects in the population who are not expected to experience the event of interest are considered to be "cured" or insusceptible. To model correlated or clustered failure time data incorporating a surviving fraction, we propose two forms of cure rate frailty models. One model naturally introduces frailty based on biological considerations while the other is motivated from the Cox proportional hazards frailty model. We formulate the likelihood functions based on piecewise constant hazards and derive the full conditional distributions for Gibbs sampling in the Bayesian paradigm. As opposed to the Cox frailty model, the proposed methods demonstrate great potential in modeling multivariate survival data with a cure fraction. We illustrate the cure rate frailty models with a root canal therapy data set.
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This retrospective study of 118 teeth receiving root canal treatment was conducted to determine the frequence and complications of delayed root canal treatment. Teeth were categorised into prompt treatment group and delayed treatment group according to the length time of treatment; prompt treatment group was defined as a group where root canal treatment was achieved within a period of 4 months or less, and delayed treatments group, a group where period of treatment was greater than 4 months or where canals were never obturated. Two types of complications were studied: postobturation pain and fracture involving tooth extration. The results of this study have shown that 34.5% of treatments were delayed. In this group we found also a higher rate of fractures involving tooth extraction, but the difference was not significant. The results have also shown that disappearance of pain was the essential factors in the frequence of delayed treatment, but the dental chair breakdown had some responsability. As well as in the two groups, the first reason of extractions was fracture and not pain. These results emphasize the necessity of focusing the patient's motivation on the risk of losing the tooth.
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