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Results for “Periapical Periodontitis”

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PubMed1996

Detailed tomography of periapical and periodontal lesions. Diagnostic accuracy compared with periapical radiography.

OBJECTIVE: To compare the diagnostic accuracy of detailed tomography using the Scanora system with that of conventional periapical radiography for detecting periapical and periodontal lesions. METHODS: We selected for comparison 243 periapical and 322 periodontal sites in 177 patients. Five observers independently assessed radiographs for the presence or absence of the following lesions: periapical bone changes, widening of apical and marginal ligament space, crestal erosion, vertical bone loss, furcation involvement and calculus. RESULTS: ROC analysis demonstrated no significant differences in the overall interpretation of either disease. Periapical radiography was superior (p < 0.05) to tomography for the detection of calculus. The sensitivity of tomography for periapical pathology was 87%, and 70% for periapical radiography. Sensitivities for periodontal diseases were 84% and 77%. Specificities were 81%, 90%, 77% and 79%, respectively. Differences for sensitivity and specificity were significant (p < 0.05) in relation to periapical pathology. The energy imparted during tomography was 0.92 mJ. CONCLUSION: Detailed tomography and periapical radiography performed equally well for the overall diagnosis of periapical and periodontal lesions. Tomograms differed substantially from periapical radiographs in both sensitivity and specificity for detecting periapical lesions in posterior regions. The energy imparted during detailed tomography is similar to that from two D-speed films.

Adult↗
PubMed1995

A bacteriologic aid in the differential diagnosis of periapical and periodontal abscesses.

The aim of the present investigation was to determine whether spirochaetal count could help differentiate between periodontal and periapical abscesses. 23 draining abscesses were included, where 15 were diagnosed as periodontal and 8 as periapical, based on clinical and radiographic data. Exudate samples were collected aseptically and examined by both darkfield microscopy and Gram-stained smear. The results revealed a statistically high increase in spirochaetal count in periodontal abscesses compared to periapical ones. The obvious difference appeared adequate to differentiate both lesions and establish a rapid chairside diagnostic aid.

Colony Count, Microbial↗
PubMed1990

Differential localization of type I and type III procollagen messenger ribonucleic acids in inflamed periodontal and periapical connective tissues by in situ hybridization.

Inflammatory lesions of periodontal and periapical connective tissue were studied by in situ hybridization to detect cells responsible for type I and type III collagen production. Formalin-fixed and paraffin-embedded tissue specimens from patients with oral lesions of various stages of inflammation were hybridized with cDNA probes specific for human pro alpha 1(I) and pro alpha 1(III) collagen mRNAs, and with bacteriophage lambda DNA as a control probe. This technique permitted us to localize fibroblasts active in type I collagen synthesis in the vicinity of inflammatory infiltrates in all the samples studied. Cells containing high levels of type III collagen mRNA were seen in early abscess formation and they were particularly abundant in pyogenic granuloma and irritation fibroma. Type I collagen mRNA was prominent in gingival fibrosis. In the infrabony lesions with active inflammatory infiltrations the production of collagen was confined mostly to the periphery of the lesions. These findings give indirect evidence that cytokines liberated during the early stages of the inflammatory process stimulate expression of the type III collagen gene by fibroblasts. In chronic lesions a gradual switch from type III to type I collagen gene expression occurs. The change in collagen types appears to underlie the observed isolation of the inflammation by a collagenous capsule. In all the samples studied fibroblasts exhibited marked variation in their levels of procollagen mRNAs, supporting previous views about their heterogeneity in connective tissues. The approach presented here offers new possibilities to study cellular interactions and metabolic activities in inflammatory lesions.

Adolescent↗
PubMed1990

[Effect on the development of permanent successors due to the extraction and non-extraction of infected deciduous teeth].

The purpose of this study was to clarify the effects on the eruption and root formation of the permanent successors of deciduous teeth affected by periapical periodontitis. Materials used were forty-one healthy infant dogs about two months old. Standardized X-ray films were taken every two weeks. The period of study ran from the age of ten weeks to twenty eight weeks until the roots of the permanent successors were completed. A total of 328 mandibular teeth were used and classified as P2 and P3 with their preceding deciduous teeth being Dp2 and Dp3. The following four groups were used in this experiment. 1) Extraction group with infected deciduous teeth: The infected deciduous teeth were extracted after being left for four weeks following pulpectomy. 2) Extraction group with healthy deciduous teeth: Healthy deciduous teeth were extracted from fourteen-week olds. 3) Left-alone group with infected deciduous teeth: After pulpectomy the infected deciduous teeth were left until they were shed naturally. 4) Healthy group (control): Untreated teeth were observed which represented the opposites of all the teeth examined in the previous three groups. A study was made of the changes in location, eruption and root formation of the permanent successors of deciduous teeth in affected with periapical periodontitis and the condition of eruption and root formation of the permanent successors. The result were as follows. 1. Appearance rate of periapical periodontitis: 1) DP2: Two weeks after pulpectomy, periapical periodontitis was observed in eleven out of twenty-one teeth (52.4%), and after four weeks in seventeen out of twenty-one teeth (81.0%). 2) Dp3: Two weeks after pulpectomy, periapical periodontitis was observed in eighteen out of twenty-one teeth (85.7%), and after four weeks in all of the experimental teeth. The appearance rate of periapical periodontitis in Dp3 was higher than in Dp2. 2. Eruption of permanent successors: 1) Extraction group with infected deciduous teeth: (1) The eruption of permanent successors was accelerated more than the other experimental groups. This tendency was stronger in P3 than in P2. (2) There were changes in location in the upper and lower directions of P2 before extraction of Dp2, in the lower direction for P3 before extraction of Dp3, and in the upper direction for P2 and P3 after extraction of Dp2 and Dp3. 2) Extraction group with healthy deciduous teeth: (1) Eruption of P2 appeared to be almost the same as the control group, but the eruption of P3 was delayed slightly at the eruption from the alveolar bone.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1987

Periodontal repair of periapical lesions: the borderland between pulpal and periodontal disease.

A series of cases demonstrating the destruction of periapical periodontal structures, without pulpal involvement has been presented. Treatment using both surgery and antibiotics resulted in extensive healing without any concommitant endodontic therapy. The results suggest that lesions affecting the apical periodontium are either periodontal or pulpal in origin. Careful diagnosis allows the maintenance of pulp vitality in cases where apical destruction has a source other than an infected pulp. The commonly held belief that lateral and accessory canals are a significant source of pulpal contamination from deep periodontal pockets has been questioned.

Adult↗
PubMed2005

[Clinical observation of CP and iodoform for intracanal medication].

To evaluate and compare the clinical effect of camphophenic (CP) and iodoform used as intracanal medication in root canal therapy for periapical periodontitis, 305 teeth suffering from periapical periodontitis in 245 subjects were divided into two groups. The experimental group of 163 teeth was treated with CP and iodoform, while the control group of 142 teeth was treated with CP alone. The clinical effect after 10 days was observed. The result showed that the response rate in the teeth treated with CP and iodoform was 92.64%, significantly higher than that in the teeth treated with CP alone (79.58%), P<0.01.

Camphor↗
PubMedDate not supplied

[Endodontic treatment of chronic apical periodontitis without periapical medication].

The aim of this research was to evaluate the clinical course of chronic apical periodontitis (CAP), treated only endodontically, without periapical medication. Chronic apical periodontitis cases of pulpal origin were used as a material and treated endodontically as individual clinical cases. Clinical and statistical procedures were applied. The percentage of efficient or non-efficient cases was evaluated on the basis of radiographic comparison of treated CAP immediately after obturation, and six months later. Influences of various factors on therapy effect were analysed: radiographic condition and type of periapical lesions, apical level of canal obturation, group of teeth and jaws as well as age. Radiographic conditions were assessed as status quo, improvement or deterioration. Final results were: 67.3% of improvement, 27.2% of status quo and 5.5% deterioration.

Chronic Disease↗
PubMed2005

Incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures.

OBJECTIVE: The aim of this study was to determine the incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures. METHODS: A total of 237 patients who underwent oral and maxillofacial surgery were included in this study. Blood samples were obtained for bacteriological examination immediately after the essential steps of the surgical procedure had been performed. RESULTS: Bacteremia was detected in patients who underwent surgery for tumor, infection and trauma, and surgical reconstruction of jaw. In particular, decortication for osteomyelitis and tooth extraction resulted in a higher incidence of bacteremia compared with other surgical procedures. The incidence of bacteremia was not affected by oral hygiene, gingival inflammation, blood loss, and duration of surgery. Furthermore, concerning tooth extraction, there was no statistical difference in the incidence of bacteremia with respect to the number of teeth extracted and the method of extraction. Extraction of teeth with odontogenic infection (periodontitis, periapical infection, and pericoronitis) did however produce a significantly increased incidence of bacteremia compared with infection-free teeth (P < .01). Viridans streptococci were the predominant group of bacteria isolated from the bacteremias. CONCLUSION: Oral and maxillofacial surgery involving transoral incision produces bacteremia, regardless of the extent and degree of surgical invasion. In particular, surgical procedure at infected sites is more likely to result in bacteremia compared with infection-free sites.

Adult↗
PubMed2005

A novel exopolysaccharide from a clinical isolate of Prevotella nigrescens: purification, chemical characterization and possible role in modifying human leukocyte phagocytosis.

Prevotella nigrescens, a gram-negative black-pigmented anaerobic rod, has frequently been isolated from periodontitis and periapical periodontitis lesions. We have isolated an exopolysaccharide-producing P. nigrescens, strain 22, from a chronic periodontitis lesion. The purpose of this study was to determine the chemical composition and function of the exopolysaccharide associated with this clinical isolate. The chemical composition and structure of the purified exopolysaccharide from strain 22 were determined by high performance liquid chromatography and methylation analysis. To define the biological function of this exopolysaccharide, a chemically induced exopolysaccharide nonproducing mutant, strain 328, which was derived from strain 22, was established. The biological effects of exopolysaccharide were determined by comparing the ability of strain 22, strain 328 or heat-killed strain 22 to form abscesses in mice and to interfere with the phagocytic activity of peripheral blood polymorphonuclear leukocytes. Chemical analysis showed that isolated exopolysaccharide consisted of mannose (521.6 microg/mg), glucose (25.6 microg/mg), fructose (65.8 microg/mg), galactose (12.5 microg/mg), arabinose (6.2 microg/mg), xylose (3.2 microg/mg), rhamnose (6.1 microg/mg), and ribose (0.6 microg/mg). Methylation analysis of exopolysaccharide indicated that the linkages of mannose were primarily (1-->2, 1-->6) (1-->2) (1-->6), and (1-->3). Strain 22 and, to a lesser extent, its heat-killed counterpart induced greater abscess formation in mice than strain 328, even though the enzymatic profile of strain 22 was similar to that of strain 328. The ability of strain 328 to induce abscess formation was restored by adding the purified exopolysaccharide isolated from strain 22 to the cell suspension of strain 328. Exopolysaccharide alone failed to induce abscess formation in mice. Further, strain 328 but not the untreated or heat-killed strain 22, was phagocytosed by polymorphonuclear leukocytes both in the presence and in the absence of opsonic factors. The results suggest that these polysaccharides isolated from strain 22, which primarily consisted of mannose, may play a key role in the development of the chronic inflammatory lesion from which this strain was isolated.

Abscess↗
PubMed2004

[Effect of tinidazole-dexamethasone-iodoform paste on controlling endodontic interappointment emergencies].

PURPOSE: To compare the clinical effect of tinidazole-dexamethasone-iodoform paste on intracanal dressing medication for teeth with chronic periapical periodontitis with that of formocresol. METHODS: 520 permanent teeth with chronic periapical periodontitis were selected and divided randomly into tinidazole-dexamethasone-iodoform paste group (A group) and formocresol group (B group). The periapical signs and symptoms were recorded, radiographs were taken. After root canal preparation, the tinidazole-dexamethasone-iodoform paste was used as an intracanal dressing medication for one week in A group and the formocresol paper point was used in B group. During the course of canal treatment, the clinical findings were assessed with clinical periapical index (CPI), the cases were followed up for two years. RESULTS: There was significant difference between A and B group (P<0.01), group A was better than group B. There was no significant difference between two groups of the success rate after following up two years (P>0.05). CONCLUSION: As an intra-canal sterilization medication,tinidazole-dexamethasone-iodoform can reduce the occurrence of endodontic interappointment emergencies in teeth with chronic periapical periodontitis and has a good long-term result.

Adult↗
PubMed2003

Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: results after 12 months.

OBJECTIVE: The aim of the present study was to evaluate the periapical and periodontal healing of apicomarginal defects 12 months after periradicular surgery and guided tissue regeneration in a series of consecutively treated patients. STUDY DESIGN: Patients with apicomarginal defects who were referred for periradicular surgery were included. Apicomarginal defects were grafted with Bio-Oss bone mineral and covered with a Bio-Gide membrane. Periodontal probing depths (PPDs) and relative attachment levels were measured preoperatively and 12 months postoperatively with a manual force-controlled probe. Periapical healing was assessed clinically and radiographically. RESULTS: Of the 23 defects in 22 patients for whom follow-up data were available, 19 were considered clinically and radiographically successful, 2 were doubtful, and 2 were failures. Overall, the baseline median PPD decreased from 9.0 mm to 3.0 mm, corresponding to a median relative attachment level gain of 2.8 mm. In the case of periodontic-endodontic lesions, the median baseline PPD decreased from 9.8 mm to 4.0 mm, corresponding to a median relative attachment level gain of 4.2 mm. Defects that involved a proximal root surface had a significantly higher residual PPD than did defects not involving a proximal root surface. CONCLUSIONS: Guided tissue regeneration treatment of apicomarginal defects yields good results in terms of periapical and periodontal healing after 12 months and should be considered as an adjunct to periradicular surgery in such cases.

Adolescent↗
PubMed1990

Histologic reactions to a newly developed calcium phosphate cement implanted in the periapical and periodontal tissues.

A newly developed calcium phosphate cement (CPC), basically composed of tetracalcium phosphate, Ca4(PO4)2O and dicalcium phosphate dihydrate, CaHPO4.2H2O or anhydrous calcium phosphate, CaHPO4, was tested in this study. When combined with water, the cement hardens and produces hydroxylapatite resembling the principal mineral of teeth and bones. Therefore, the CPC should be highly compatible with the body. However, before its clinical application in dentistry, the biocompatibility of CPC in the potential environments of implantation needs confirmation. Eight monkeys were used in our study to test the material in the periapical and marginal periodontal regions. Surgically created periodontal defects were implanted with CPC and hydroxylapatite (HA) (Calcitite 4060). In another application, CPC was pushed into the periapical areas via overfilling of the root canals. Sargenti N2 served as the control material in the periapical test. Generally, only a limited inflammatory response to CPC was found after 6 weeks of implantation in the periodontal area. In the 16-week specimens, the adverse reaction was negligible, and bone regeneration was marked and directly surrounding the CPC. The bone formation activity and biocompatibility in general were found to be even better in the periapical region. The results suggest that the CPC may have a good potential in future clinical applications, although many issues remain to be investigated.

Animals↗
PubMed1997

The change of periapical exudate prostaglandin E2 levels during root canal treatment.

We have previously demonstrated that detectable levels of prostaglandin E2 exist in periapical exudates (PE-PGE2) from root canals of periapical periodontitis. Our data from a cross-sectional study also suggested the association of PE-PGE2 concentrations with the active phase of periapical lesions. The objective of this study was to investigate the longitudinal changes of PE-PGE2 levels during root canal treatment. Periapical exudate specimens were quantitatively sampled from root canals of 20 nonvital teeth at consecutive treatment visits to measure PGE2 concentrations. The mean PE-PGE2 levels significantly decreased following the endodontic therapy (158.0 +/- 54.1 pg/microliter in the first samples versus 48.4 +/- 37.9 pg/microliter in the second samples). A significant correlation was also found between the changes in PE-PGE2 levels and the clinical disease expression of periapical periodontitis (p < 0.01). Decreased PGE2 production is considered to reflect the remission of disease activity. These results suggest the central roles of PGE2 in regulatory mechanisms for the expression of periapical disease.

Dental Pulp Cavity↗
PubMed1993

Relationship between periapical and periodontal status. A clinical retrospective study.

The purpose of the present investigation was to explore possible relationships between clinical periodontal status in periodontally involved teeth with and without endodontic infection. The investigation was conducted as a retrospective study on a consecutive referral population. The periapical conditions in endodontically-involved single-rooted teeth from a selected patient sample were evaluated and correlated to their periodontal status. There was a significant correlation between periapical pathology and vertical bony destructions. An intra-individual comparison between pocket depth in teeth with and without periapical pathology showed that periapical pathology was significantly correlated to an increased pocket depth in the absence of a vertical bony destruction. It was concluded that an endodontic infection, evident as a periapical radiolucency, promotes periodontal pocket-formation on an instrumented marginal root surface and, consequently, should be regarded as a risk factor in periodontitis progression and be given appropriate consideration in periodontal treatment planning.

Adult↗
PubMed2004

[A comparison of the effect between Vitapex paste and antibiotic paste in apexification.].

PURPOSE: To study the effects of two root canal filling material in the apexification. METHODS: 172 juvenile permanent teeth,including 62 teeth with pulpitis, 32 teeth with necrotic pulp and 78 teeth with periapical periodontitis, were divided into two groups.The root canal was filled with Vitapex paste and antibiotic paste.Every patient was examined once three months.The treatment lasted 6-30 months.The outcome of treatment was investigated for three years following treatment. RESULTS: The effective rate in the group of Vitapex paste and antibiotic paste group were 86.0% and 91.9% (P>0.05).In periapical periodontitis group,the effective rate of antibiotic paste group was significantly higher than the other (P<0.05). CONCLUSION: Both Vitapex paste and antibiotics paste were good filling materials in apexification. Antibiotic paste was better than the other in periapical periodontitis group.

Anti-Bacterial Agents↗
PubMed2005

Identification and localization of extraradicular biofilm-forming bacteria associated with refractory endodontic pathogens.

Bacterial biofilms have been found to develop on root surfaces outside the apical foramen and be associated with refractory periapical periodontitis. However, it is unknown which bacterial species form extraradicular biofilms. The present study aimed to investigate the identity and localization of bacteria in human extraradicular biofilms. Twenty extraradicular biofilms, used to identify bacteria using a PCR-based 16S rRNA gene assay, and seven root-tips, used to observe immunohistochemical localization of three selected bacterial species, were taken from 27 patients with refractory periapical periodontitis. Bacterial DNA was detected from 14 of the 20 samples, and 113 bacterial species were isolated. Fusobacterium nucleatum (14 of 14), Porphyromonas gingivalis (12 of 14), and Tannellera forsythensis (8 of 14) were frequently detected. Unidentified and uncultured bacterial DNA was also detected in 11 of the 14 samples in which DNA was detected. In the biofilms, P. gingivalis was immunohistochemically detected in all parts of the extraradicular biofilms. Positive reactions to anti-F. nucleatum and anti-T. forsythensis sera were found at specific portions of the biofilm. These findings suggested that P. gingivalis, T. forsythensis, and F. nucleatum were associated with extraradicular biofilm formation and refractory periapical periodontitis.

Adult↗