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PubMed1975

The location and incidence of accessory pulpal canals in periodontal pockets.

One hundred permanent human teeth, extracted because of periodontal disease, were studied to determine the percentage of teeth in which accessory canals were located within a periodontal pocket. Pocket depth and other data were recorded before the extractions. After extraction, the pulpal contents were removed and pulp chambers and canals filled with a radiopaque material by an injection process. The teeth were radiographed from different angles to observe the accessory canals. Ten teeth also were studied histologically to compare the results with those obtained by the injection technique. Several conclusions were drawn from this study. Two percent of the 100 teeth studied had accessory canal located within a periodontal pocket. Seventeen percent of the teeth examined had one accessory canal, 6% had two accessory canals, and no teeth had more than two accessory canals. As groups, mandibular premolars and mandibular molars had the highest percentage of teeth exhibiting accessory canals, and maxillary molars and mandibular incisors had the lowest percentage of teeth with accessory canals. The histologic evaluation and the injection technique study showed a direct correlation as to the presence or absence of accessory canals. It was impossible to make any correlation between restorations, caries, attrition, or type of periodontal bone loss and the presence of accessory canals found in periodontal pockets.

Adult↗
PubMed1976

Endodontics 1776-1976: a bicentennial history against the background of general dentistry.

During 200 years of progress in endodontics, various sciences have contributed to our understanding of the physiology and pathology of the dental pulp. Early treatment included cauterization of the pulp, the use of poultices or leeches, and tooth transplantation or replantation. Various methods of pulp devitalization are reviewed. Near the turn of the century, the discovery of X rays made diagnosis more accurate and the discovery of local anesthetics eliminated pain during endodontic treatment. Although the focal infection theory slowed the acceptance of endodontic treatment in this century, the biomechanical concept of treatment and research have recently opened new avenues for treatment and have initiated improvements in medicaments and filling materials.

Abscess↗
PubMed1979

Avoiding perforation during endodontic access.

Planning for endodontic access should be as precise as possible and the dentist should consider several factors in his preoperative evaluation of teeth to avoid perforations. Anatomical characteristics of teeth can be helpful in establishing endodontic access, and valid and invalid points for orientation have been discussed. Seven suggestions have been offered for the establishment of access on difficult teeth. The ideal in establishing endodontic access can only be achieved by the deliberate, conscious application of a thorough knowledge of dental anatomy, and of possible variations from the norm, coupled with a thorough preoperative examination of the tooth. Although a casual approach may not be unsuccessful, precision will certainly yield a higher percentage of successful cases.

Dental Pulp Cavity↗
PubMed1988

Gloved and ungloved: performance time for two dental procedures.

This study examines the time required to perform two routine dental procedures requiring fine hand manipulative skills--a pin placement procedure and an endodontic procedure. No significant time difference was noted in performing the procedures while wearing gloves or not wearing gloves. Twelve dentists who had routinely worn gloves for the past 6 months participated, each performing four procedures.

Dental Pins↗
PubMed2007

The impact of oral disease and nonsurgical treatment on bacteremia in children.

BACKGROUND: The authors examine the role of dental disease and nonsurgical dental procedures in the incidence and duration of bacteremia in children. METHODS: The authors randomized a group of children to receive amoxicillin or a placebo before dental rehabilitation in an operating room setting. They collected eight blood draws at the following times: two minutes after intubation (draw 1); after dental restorations, pulp therapy and cleaning (draw 2); 10 minutes later (draw 3); and five draws during and after dental extractions (draws 4-8). The authors compared dental disease parameters and the type of dental procedures performed with the incidence and duration of bacteremia. RESULTS: The authors enrolled 100 children (aged 1-8 years) in the study. The incidence of bacteremia from draw 2 was 20 percent in the placebo group and 6 percent in the amoxicillin group (P = .07), and the incidence from draw 3 was 16 percent in the placebo group and zero percent in the amoxicillin group (P = .03). Subjects with higher gingival scores were more likely to have a bacteremia for draw 2 (P = .01). The authors found that subjects in the group with bacteremia for draw 3 had undergone more pulpotomies than did subjects in the group without bacteremia for draw 3 (3 +/- 2.5 standard deviation [SD] versus 1.5 +/- 1.6 SD, P = .04), while they found almost no differences for draw 2. CONCLUSIONS: This study suggests that gingival disease has an impact on bacteremia after dental restorations and prophylaxis. Although antibiotics have an impact, they do not eliminate bacteremia altogether.

Amoxicillin↗
PubMed1990

An ultrastructural study of the process of hard tissue formation in amputated dental pulp dressed with alpha-tricalcium phosphate.

This study was undertaken to determine the reaction of amputated dental pulp to the capping agent, alpha-tricalcium phosphate (alpha TCP), and to reveal the exact nature of the processes involved in both the healing of, and new hard tissue formation in the pulp when dressed with alpha TCP. The dental pulps of the anterior teeth of Macaca fuscata were dressed with alpha TCP ceramic 4-10 microns in diameter. The teeth were fixed by perfusion, then observed with light and electron microscopes. At 10 and 14 days postoperatively, the phagocytosis of the alpha TCP layer by the many macrophages and multinucleated giant cells, both of which had emerged beneath it, was seen. The synthesis of collagenous matrix underlying the alpha TCP layer began at 14 or 21 days, the cells involved exhibiting morphologic characteristics similar to those seen in osteoblasts. By the 90th day, only a bone-like hard tissue remained. No inflammation was observed in the residual dental pulp at any time during the experimental period. At 14 days, needle-like crystals were seen to have formed on the surface of alpha TCP particles, and by the 21st day, these crystals had extended to the newly synthesized matrix, with the result that calcification of the matrix was initiated, a calcified layer being superficially produced in the matrix. In the region of the matrix adjacent to the superficial calcified layer, a number of matrix vesicles were also found to function as another mechanism of matrix mineralization. Thus, it was concluded that the bone-like hard tissue was induced in the pulp capped with alpha TCP, and its potential for clinical application to exposed dental pulp was confirmed.

Animals↗
PubMed2001

Clinical evaluation of the efficacy of anesthesia and patient preference using the needle-less jet syringe in pediatric dental practice.

Most dentists are aware that local anesthetic injections produce the highest incidence of disruptive behavior in children. Both psychological and physiological monitoring of the response of children to dental injection, support empirical observations of clinicians. The needle-free injector delivers local anesthesia without the use of a needle. This is accomplished by delivering the anesthetic solution under high compressive forces. One hundred children between the ages of 3 to 13 years underwent operative procedures using Madajet XL. There was a statistically significant difference in favor of the instrument. The instrument was completely successful in providing anesthesia.

Adolescent↗
PubMed2001

Pediatric dental procedures under general anesthesia at the Amiri Hospital in Kuwait.

Ninety-six patients, fifty-eight healthy patients and thirty-eight special needs patients, ranging in age from 3 to 31 yr (average age 6.9 yr) had received dental treatments under general anesthesia (GA) at Amiri Hospital. The mean number of dental procedures per child was 13.6 (SD+/-5.4) with a mean number of 15.6 procedures for healthy patients and 10.5 special needs patients. There was a statistically significantly higher number of dental procedures for healthy patients than for special needs patients (p<0.001). The number of pulpotomies and stainless steel crowns placed for healthy patients was significantly higher (3.5) than for special needs patients (1.3) with (p<0.001) The average number of extractions was similar for the two groups of patients, 2.8 for normal and 2.2 for handicapped. On the basis of these results, it was concluded that dental treatment under GA in hospital environment is beneficial for certain group of patients, such as very young children and those with special needs. Underlying medical conditions influenced the treatment provided.

Adolescent↗
PubMed2002

The application of fiber core posts in restoring badly destroyed primary incisors.

Early childhood caries (ECC) represents a challenge to pediatric dentists especially, when teeth are badly destroyed. ECC involves the upper anterior teeth early in life and by the time the dentist sees the child, most of the coronal structure is lost. Dentally, this is a very devastating situation for both the dentist and parents, as in many cases, extraction of these teeth is the only option. With the introduction of new adhesive systems and restorative materials, a new approach for treating these teeth is explained and documented by clinical cases, where fiber core posts are introduced into the root canals of primary incisors for a distance of 2 to 3 mm. It is retained in place by flowable composite, then the coronal part is reconstructed by a strip crown to restore the crown form. After a follow up period of one year, only 2 teeth out of 30 had to be extracted. The failure was attributed to failure in pulpal therapy rather than failure in the restorations, which were totally intact. A laboratory testing of the fracture load resistance of the restored teeth proved that this technique significantly improved the fracture load resistance of composite celluloid crowns, making it a valuable procedure to consider when the coronal tooth structure is not enough to support and retain a composite celluloid strip crown.

Cementation↗
PubMed2002

Apexification of primary teeth: a treatment option.

This article reports a case of apexification in a child aged 20 months, with early childhood caries, using calcium hydroxide paste in two primary upper central incisors. This method is a feasible option for treating immature deciduous teeth showing pulpal necrosis.

Calcium Hydroxide↗
PubMed2004

A simplified technique for the restoration of severely mutilated primary anterior teeth.

The restoration of severely carious primary anterior teeth is a challenge to the pediatric dentist. The introduction of new materials and technologies makes re-evaluation of existing treatment philosophies necessary. A technique involving the placement of an omega shaped stainless steel wire extension into the entrance of the root canal prior to restoring the crown with a compomer material is described. 96 restorations were placed in 25 children. After 18 months 81.2% of the 96 restorations, which were available for evaluation, 60 (79.9%) were intact. The technique for restoring primary anterior teeth was simple, quick and effective.

Child, Preschool↗
PubMed2005

Long term radiographic study of bilateral second premolars with immature root treated by apexogenesis and apexification.

A ten-year-old girl broke the central cusps of the mandibular second premolars. The mandibular right second premolar was treated with apexification and the left with apexogenesis. These methods were chosen in view of the presented clinical symptoms, radiographic findings, and outcome of bacterial cultures of root canal samples. At postoperative 2 years 8 months, disappearance of the focus, closure of the root canal, and formation of the root apex were observed in both mandibular premolars. The mandibular left second premolar demonstrated a nearly normal root formation and root apex morphology. Immediately beneath the extracted pulp, regular, uniform, and thick hard tissue was formed. Meanwhile, in the mandibular right second premolar, root growth was suspended, making the root short, and the contour was constructed in such a way that it encircled the distal apical area from the mesial side forming the root apex.

Bicuspid↗
PubMed2006

Retrospective audit of caries management techniques for children under general anesthesia over an 18-year period.

The aim of this study was to review the outcomes of dental treatment under general anesthesia and to analyze the different types of caries management techniques for children in different age groups and time periods. Seven hundred inpatient general anesthetics were administered for 656 children between 1982 and 1999 were included in the analysis. This study concluded that the treatment modality of the caries management techniques varied according to the different age groups. Furthermore, the nature of the treatment changed the relative proportion of restorative procedures increased during the period under investigation.

Age Factors↗