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The purpose of this paper is to present two case reports of dental trauma with middle-apical level root fractures and pulp necrosis. The treatment consisted of programmed applications of calcium hydroxide until a calcified barrier was formed at the fracture level. The technique presented here proved efficient in treating horizontal fractures at the middle and apical thirds of the root.
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Most endodontists use ultrasonic instruments for retrograde root-end cavity preparations even though they have been found to produce cracks. In this laboratory study, thirty-six randomly chosen roots had root-end cavity preparations made with the Waterlase laser and only one questionable intra-canal crack was found. It was concluded that the Waterlase laser when used to make endodontic root-end cavity preparations produces either no cracks, or a very low percentage (2.8%) of cracks.
Two hundred and fifty-three patients treated for dental emergencies at the University Hospital dental clinic over a three-month period were surveyed by telephone 24 to 48 hours and one year after treatment. The purpose was to investigate the success of treatment in resolving the chief complaint of pain and to determine the compliance with further dental care for the original dental problem. The results of the telephone survey showed that: patients available for questioning totaled 49.1% at 24 to 48 hours and 28.9% at one year; an 80.7% success rate was recorded in resolving pain within 24 to 48 hours; and the original emergency problem did not motivate a large number of these patients to seek further dental care.
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The purpose of this project was to observe the amount of apical and mid-curve transportation produced by a range of nickel titanium (NiTi), titanium alloy and stainless steel (SS) files. Tests were carried out in simulated curved root canals produced in epoxy resin blocks. Seven commercially available file types were tested using sizes 15 to 40. Instrumentation was carried out to 1 mm beyond the apex. Changes in canal dimensions were measured at 10x magnification under a shadowgraph. There were substantial differences in the amount and the pattern of apical and mid-curve transportation produced. The amount of transportation increased with each subsequent size of file. Under the same conditions, nickel titanium files produced significantly less transportation than stainless steel files. The least apical transportation was obtained with the NiTi Mity Turbo and the most by the SS K file and SS Hedstrom file. The least mid-curve transportation was produced by the NiTi Mity Turbo and the most by the SS Hedstrom file.
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Cementum regeneration on exposed dentinal root surfaces of replanted teeth not subjected to replantation. The implication was that secondary reattachment of replanted teeth was largely dependent on the status of supporting alveolar tissues. The role of the replant appeared essentially passive, reacting as a substrate for cementum deposition that may be more or less acceptable to the regenerating periodontal tissues as dictated by the extraoral history. Although the pattern of cementum deposition was unaltered by replantation, the quantity of new cementum deposited on exposed dentin did appear to be affected by pulpal treatment; thus, an indication was given that survival of replanted teeth may be influenced by pulpal procedures.
Dental pulp cells have the potential to differentiate into odontoblasts. The molecular mechanisms underlying differentiation are not clear. Demineralized dentin matrix is osteoinductive and contains bone morphogenetic protein (BMP) activity. BMPs have been implicated in embryonic odontogenic differentiation and hence may play a role in the differentiation of adult pulp cells into odontoblasts during pulpal healing. This study examined the hypothesis that BMPs induce dentin formation on amputated canine pulp. Recombinant human BMP-2 and BMP-4 were capped with inactivated dentin matrix on amputated pulp. At two months, the amputated pulp was filled with tubular dentin in the lower part and osteodentin in the upper part. The amount of dentin formed was markedly diminished when dentin matrix alone was implanted. These findings imply that recombinant human BMP-2 and BMP-4 induce differentiation of adult pulp cells into odontoblasts. Thus, BMPs may have a role in dentistry as a bioactive pulp-capping agent to induce dentin formation.
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