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[Partsch's chronic granulomatous inflammation, the cutaneous manifestation of a dental cause].

Dentogenous inflammatory diseases can lead to typical dermatological facial symptoms with formation of cutaneous sinuses. Partsch's chronic granulomatous inflammation can result from conducted inflammation of a nonvital tooth via a chronic apical inflammation. In this rare disease, the granulomatous tissue perforates the bone, channels through the overlying skin, and drains via cutaneous or oral sinuses. A frequent localization of the cutaneous sinus is the skin inferior to the body of the mandible, and it is caused by an inflammation of the lower molars. Treatment consists of identifying the responsible teeth and eliminating the focus of infection. Chronically progressive periradicular granuloma and/or radicular cysts can be present with impressive dermatological symptoms. Therefore, X-ray examinations are necessary to exclude possible dentogenic causes in cases of badly healing processes of the face or neck.

Adult↗

Oral assessment of the "risk" patient.

Certain patients may be considered as being at "risk" with respect to the possibility of development of significant diseases of either a local or a systemic nature as a direct result of the presence of oral infection. The problems relating to the development of bacteremia subsequent to surgery in the patient with cardiovascular disease are well appreciated. Thought should be given to the possibilities of such developments in relation to the presence of periapical pathosis. It is demonstrated that a definitive evaluation of the status of the nonvital tooth cannot be made by the presently accepted methods of clinical and radiographic examination.

Disease↗

Esthetic enhancement of ceramic crowns with zirconia dowels and cores: a clinical report.

There has been an increase in the use of esthetic metal-free ceramic crowns in restoring endodontically treated teeth or teeth with severe coronal destruction. Tooth-colored dowels and cores are used to enhance the esthetic result. This report describes the treatment of a patient with bilateral maxillary supernumerary lateral incisors, a severe malocclusion, and maxillary anterior tooth discoloration. Treatment included heat-pressed, metal-free ceramic crowns supported by zirconia ceramic dowel-and-core foundations.

Adult↗

Median palatine cyst.

Median palatine cysts are rare, nonodontogenic lesion of the hard palate that do not involve the palatine papilla or incisive canal and that usually present as asymptomatic, fluctuant swellings. They may involve the floor the nasal cavity but are treated by simple enucleation, without recurrence. They are composed histologically of a fibrous collagenous tissue wall, with infiltration of chronic inflammatory cells, and lined by stratified squamous and/or respiratory epithelium. They are differentiated from the nasopalatine and other anterior maxillary cysts by the following diagnostic criteria: Appears grossly to be symmetrical along the midline of the hard palate. Located posterior to palatine papilla. Radiographically ovoid or circular in appearance. Not intimately associated with a nonvital tooth or found to have any communication with the incisive canal. Shows no histologic evidence of nerve trunks, large vascular spaces, hyaline cartilage, or accessory salivary gland tissue in the cyst wall.

Adult↗

Root-end induction.

A root-end induction procedure was used to treat a nonvital tooth with an open apex. This procedure was relatively fast and simple and did not require special instruments or medicaments. The procedure improved the prognosis of the involved tooth and reduced the trauma associated with surgical endodontic treatment.

Calcium Hydroxide↗

Inflammatory follicular cyst associated with an endodontically treated primary molar: a case report.

This is a case study of an inflammatory follicular cyst associated with an endodontically treated deciduous molar with radiographic and microscopic diagnosis. This cystic lesion represents a typical follicular cyst that arose in association with periapical inflammation from a non-vital deciduous molar and involved the follicle of the unerupted successor premolar. This paper describes the case and discusses diagnosis, histogenesis, and controversies regarding terminology.

Abscess↗

Orthodontic and periodontal considerations in managing teeth exhibiting significant delay in eruption.

AIM: Significant delay in tooth eruption may be observed in many orthodontic patients. This delay may lead to complications, such as devitalization, ankylosis, external root resorption, injury to the adjacent teeth, and mucogingival problems. These complications may result in prolonged treatment time, esthetic deformities, damage to the periodontal tissues, and tooth loss. This report investigates the special considerations needed in treating such cases. METHODS: Combined orthodontic and surgical treatment can be used in managing teeth exhibiting significant delay in eruption. RESULTS: A high rate of success can be achieved in terms of esthetics, occlusion, and periodontal health. CONCLUSION: Nontraumatic surgery, adequate control of gingival inflammation, and use of minimal orthodontic forces may ensure a higher percentage of success and prevention of problems associated with teeth exhibiting significant delay in eruption.

Dental Occlusion↗

Differential diagnosis of periapical radiolucent lesions.

When a clinician is confronted with an apical radiolucent lesion he must follow an organized thought process and diagnostic technique prior to therapy. This technique employs the collection of data, called the diagnostic data base, and radiographic data. The diagnostic data base and radiographic data combined with the results of the vitality tests will provide the clinician with an appropriate working diagnosis. If the data support a diagnosis of radiolucent lesion associated with a nonvital tooth then endodontic therapy should be provided and the patient should be seen on a routine follow-up basis. Dr. H. M. Worth has most elequently summarized the responsibilities of the clinician as follows: "The endodontist cannot content himself with sufficient knowledge to deal with apical infections only, for he encounters a great number of diseases; it is necessary for him to be reasonably well informed on the radiographic appearances of most of the abnormalities and diseases that occur in the jaws."

Diagnosis, Differential↗

Yttrium-partially stabilized zirconium dioxide posts: an approach to restoring coronally compromised nonvital teeth.

In the pursuit of esthetic restorations for nonvital teeth, the introduction of a tooth-colored intraradicular post system is described. Conventional metallic posts can corrode and may cause inflammatory reactions and discoloration of the periodontium. Zirconium dioxide is a chemically stable ceramic with physical and optical properties that make it an ideal choice for the construction of esthetic, life-like restorations. The purpose of this study was to describe the composition, properties, and practical applications of zirconia posts in clinical practice.

Ceramics↗

Retrieval of a foreign object from the palatal root canal of a permanent maxillary first molar: A case report.

A 12-year-old boy presented with a fractured sewing needle within the palatal root canal of a nonvital permanent maxillary first molar. The patient admitted that he had often placed a sewing needle in the tooth to relieve discomfort associated with it. A minimal amount of tooth structure was removed around the foreign object to facilitate access for K-type files. Under copious irrigation, the files were worked around the object to loosen it. The fractured needle was removed with a tweezers that had long, narrow beaks. Use of this simple technique allowed the object to be removed from the root canal with minimal damage to internal tooth structure.

Child↗

An up to 15-year longitudinal study of 515 metal-ceramic FPDs: Part 1. Outcome.

PURPOSE: This study reports on the outcome of 515 metal-ceramic fixed partial dentures (FPD) involving 1,209 abutments and 885 pontics placed by one operator in a specialist prosthodontic practice between January 1984 and December 1997. MATERIALS AND METHODS: Clinical and laboratory protocol was kept constant as much as was practical. Each FPD and abutment was given a subjective prognostic rating at the time of cementation. Patients were recalled in 1993 (review 1) and 1998 (review 2). Clinical examination by the author covered 85% of 342 FPDs at review 1 and 82% of 515 FPDs at review 2. At review 2, 37% had been in clinical service for 5 to 10 years (group b), and 34% had been in service for 10 to 15 years (group c). An objective classification protocol was used to assess outcome. RESULTS: At review 2, the FPDs had failure rates of 2%, 7%, and 11% in groups a, b, and c, respectively. There was a significant increase in the failure rate of group c at review 2 (11%) compared with review 1 (5%). Cumulative survival analysis indicated that FPDs have an expected survival rate of 96%, 87%, and 85% at 5, 10, and 15 years, respectively. The applied prognostic rating proved more accurate as clinical service time increased. Outcome was not related to number of units. Cantilevered FPDs, nonvital abutments, and anterior abutments had significantly greater failure rates. Of initially vital abutments, 2% were subsequently endodontically treated. CONCLUSION: Tooth-supported FPDs have an expected survival rate of 85% at 15 years when the described clinical and laboratory protocol is applied.

Adult↗