Three nonvital teeth associated with chorio-epithelioma: report of a case.
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Carcinoma↗
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Results for “Tooth, Nonvital”
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A technique for bleaching nonvital teeth: inside/outside bleaching.
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Carbamide Peroxide↗
Vertical root fractures: clinical and radiographic diagnosis.
BACKGROUND: Early detection and management of vertical root fractures, or VRFs, remain a vexing issue that has caused needless suffering for patients as well as for dentists. The authors present techniques to aid the dentist in recognizing VRFs. METHODS: During a five-year period, the authors examined 36 patients who had VRFs. Absent control subjects and a larger number of patients, the authors did not design this investigation for statistical analysis. They diagnosed VRFs through dental histories and clinical and radiographic examinations. RESULTS: The study revealed VRFs in 36 teeth, two of which were vital and 34 of which were nonvital (that is, endodontically treated). The 34 VRFs resulted from excessive operative procedures performed in the root canal after endodontic therapy. Thirty-one of these 34 VRFs were caused by poorly designed dowels (too long, too wide or both) or inappropriate selection of the tooth as a bridge abutment; two VRFs were caused by a restoration that exerted lateral pressure on the axial walls of the preparation; and one VRF was caused by overzealous endodontic forces. The VRFs in the two vital teeth were in men who had a history of bruxism or clenching. CONCLUSIONS AND CLINICAL IMPLICATIONS: VRFs can be detected early by listening to the patient's chief complaints, carefully examining periapical and bitewing radiographs and performing a thorough clinical examination.
Adult↗
The shear bond strengths of stainless steel and ceramic brackets used with chemically and light-activated composite resins.
Since the introduction of ceramic brackets to orthodontic therapy, a need has arisen to test the manufacturer's claims regarding these brackets. Forty-eight noncarious human canine teeth were divided equally into groups A to D. Brackets were bonded to these teeth with the use of the acid-etch technique and a composite resin according to the manufacturer's instructions. The combination within each group was as follows: A = stainless steel brackets and chemically cured resin; B = ceramic brackets and chemically cured resin; C = ceramic brackets and light-cured resin; D = stainless steel brackets and light-cured resin (via transillumination). After curing, the teeth were stored for 1 week in distilled water at 37 degrees C. The Instron machine was used to test the shear bond strengths of the brackets to the teeth. The brackets were individually tested to failure of the bond, which was recorded along with the site of fracture. The conclusions are as follows: (1) all combinations produced shear bond strengths that were greater than those that are considered clinically acceptable, (2) the ceramic groups exhibited a significantly higher bond strength than that of the stainless steel group, and (3) enamel fractures occurred among the B group in 40% of the samples tested in that group. It is thus apparent that a fracture of enamel is a real possibility during therapy or at debonding of the ceramic brackets, especially if the tooth is nonvital.
Analysis of Variance↗
A four-year clinical follow-up of nonvital root resection in maxillary molar teeth.
The aim of the study was to evaluate the success of non-vital root resected maxillary molar teeth over a period of four years. Fourteen root resected maxillary molar teeth were evaluated for mobility and probing depth in the area of root resection. Only one failure was observed over a period of four years follow-up. It was observed that removal of one root neither increase the tooth mobility nor the probing depth in most of the cases. It is concluded that non-vital root resection should be considered before molar extraction, because this treatment can provide good results with long term success, provided appropriate patient selection. This procedure can be practised by general dentists with little effort.
Adult↗
Sealing capacity of a photochromatic flowable composite as protective base in nonvital dental bleaching.
AIM: To evaluate microleakage of a flowable composite used as a protective isolating base, applied with different adhesive systems. METHODOLOGY: Seventy root-filled teeth were divided into seven groups. A flowable composite base (Tetric Flow Chroma) was used with three adhesive techniques (Syntac, Excite, Excite DCS; in the three cases with and without acid etching) and in a control group without dentine conditioning or adhesive placement. A 30% hydrogen peroxide solution was applied for 24 h in the pulp chambers, followed by the placement of a dye (silver nitrate) for 4 h. Each tooth was sectioned longitudinally, and examined under 4x magnification to assess the tooth/restoration dye leakage following a four-degree scale. Percentage of dye penetration was registered. Statistical analysis was made through the Tukey and Mann-Whitney U-tests. RESULTS: Maximum leakage (100% of specimens) was recorded in the control group without an adhesive system. In the groups subjected to acid etching, the percentage of leakage corresponded to Excite DSC (10%), followed by Syntac (20%) and Excite (30%). In the groups in which only an adhesive system was used, 50% of the teeth demonstrated dye leakage. Statistically significant differences in terms of leakage were observed between the control group and the experimental groups (P < 0.05). There were no significant differences among the experimental groups, but comparing the leakage percentages obtained between the groups in which the teeth were subjected to prior acid etching, and those in which no etching was carried out, observed differences were significant (P = 0.04). CONCLUSIONS: There were no significant differences between the adhesive systems in terms of leakage. Acid etching significantly reduced leakage.
Acid Etching, Dental↗
Clinical accuracy of a new apex locator with an automatic compensation circuit.
A new circuit was designed to automatically compensate for measurement errors of an electronic apex locator in various electrolytes. Thirty-one root canals were clinically tested for accuracy. A file was inserted into the canal until the apex signal was obtained, at which point the file was immobilized with glass-ionomer cement. After extraction, the apical area was exposed and the position of the file tip was examined under an operating microscope. Distances from the major foramen and cemento dentinal junction (CDJ) were recorded. The average distance from the major foramen was -0.13 mm with a range of -1.28 mm and +0.46 mm. The average distance in 26 detectable CDJ samples was +0.18 mm with a range of -0.98 mm and +0.65 mm. The measurements, which were within +/- 0.5 mm, were 94% (29/31) from the major foramen and 92% (24/26) from the CDJ. Measurement consistencies within one SD were 81% for the major foramen and 65% for the CDJ, respectively. Measurements within two SD were 97% for the major foramen and 92% for the CDJ. There were no differences between the smaller (< # 25) and larger apical foramens (< or = 25) or vital and nonvital pulps.
Adult↗
Dentoalveolar trauma in a patient with chronic idiopathic thrombocytopenic purpura: a case report.
A case is presented of a 13-year-old boy with chronic idiopathic thrombocytopenic purpura (ITP) who sustained traumatic labial luxation of both lower central incisors, with partial alveolar fracture resulting in displacement of the labial alveolar plate. Intravenous immunoglobulin (Fleibogamma, 1 g/kg body weight x 2 days) was administered, resulting in the patient's platelet count rising from 15,000/mm3 to 70,000/mm3. Under general anesthesia, the displaced lower labial alveolus and luxated teeth were repositioned and splinted 2 days following trauma. Healing was uneventful. Subsequently, both lower central incisors became nonvital and were endodontically treated. The dental treatment of this patient with ITP is discussed in terms of emergency management, and subsequent care.
Adolescent↗
Bleaching of vital and nonvital teeth.
Although tooth bleaching has been known to the dental profession for over 100 years, new knowledge is continually surfacing. This review discusses the 1990 to 1991 literature on two nonvital bleaching techniques (thermocatalytic and walking) and three classes of vital bleaching techniques (in-office; dentist-prescribed, home-applied; and over-the-counter kits). The choice for nonvital bleaching is the walking bleach technique, with the use of sodium perborate alone having less potential for cervical resorption. The choices for vital bleaching techniques are either the dentist-prescribed, home-applied technique, the in-office technique, or a combination of the two. Bonding should be delayed 2 weeks after bleaching. Microabrasion is a possible second choice for certain discolorations. These chosen bleaching techniques, when used in a professionally appropriate manner, seem as safe as other commonly used dental treatments.
Borates↗
Dentigerous cysts of inflammatory origin. A clinicopathologic study.
The exact histogenesis of dentigerous cysts remains unknown, but most authors favor a developmental origin from the tooth follicle. The aim of this article is to report a series of 15 dentigerous cysts that we believe to be of inflammatory origin. These inflammatory dentigerous cysts occurred in the first and early part of the second decades of life. Males were affected more frequently, and there did not appear to be any racial predilection. All of the cases involved permanent teeth: premolars in nine cases, canines in four cases, and second molars in two cases. The mandible was affected twice as frequently as the maxilla. In 13 cases, nonvital grossly carious or heavily restored deciduous teeth were associated with the cysts. Some of these teeth had been extracted before the cysts were diagnosed. In the remaining two cases, both of which involved the second permanent molars, there were no nonvital deciduous teeth, however both had concomitant proliferative periostitis. All of the cysts were moderately or intensely inflamed and were lined predominantly or entirely by nonkeratinized stratified squamous epithelium that in some cases was markedly hyperplastic and exhibited anastomosing rete ridges mimicking radicular cysts. In the majority of cases, parts of the cysts were lined with a 2 to 3 cell layer thick cuboidal epithelium that we believe was derived from reduced enamel epithelium. Rests of odontogenic epithelium frequently were evident in the cyst walls. We suggest that these cysts arose as a result of periapical inflammation from any source but usually from a nonvital deciduous tooth and spreading to involve the follicles of the unerupted permanent successors. The inflammatory exudate causes separation of the reduced enamel epithelium from the enamel with resultant cyst formation. This study proposes the existence of two types of dentigerous cysts: one developmental and the other inflammatory in nature.
Bicuspid↗
Subjective sensation and objective neural discharges recorded from clinically nonvital and intact teeth.
The aim of this study was to compare subjective sensation with objective neural discharges recorded by microneurography. We examined human teeth that did not respond to pulp vitality testing, but that responded to cavity preparation for endodontic treatment (pathophysiological). Intact teeth and endodontically obturated teeth were used as controls. Pulpal blood flow in the clinical crown and histological examination were also used. Most teeth, both in normal and pathophysiological conditions, did not respond to all pulp vitality tests. Even when teeth in the pathophysiological group showed spike discharges evoked by pulp vitality tests or from spontaneous activity no sensation was elicited. These results confirmed the usefulness of microneurography for research on pulpal sensation and the significance of summation in the perception of sensation in chronically inflamed tooth pulp.
Action Potentials↗
Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis.
OBJECTIVE: The purpose of this study was to use meta-analysis statistics to determine the influence of factors such as apical limit (short vs. overextension), status of the pulp (vital vs. nonvital), and periapical status (presence or absence of radiolucency) on endodontic prognosis. Study design The study-list was obtained by using a MEDLINE search and Japana Centra Revuo Medicina search. Only those papers in which the criteria for success or failure was exactly described were accepted. RESULTS: The cumulative success rate of 82.8 +/- 1.19% (average +/-95% confidence interval) was obtained for vital pulp; and 78.9 +/- 1.05%, for nonvital ones. There was a significant difference between the 2 groups.The cumulative success rates with overextension, flush, and underextension in vital teeth were 70.8 +/- 1.44, 86.5 +/- 0.88, and 85.5 +/- 0.98% respectively. There was a significant difference between flush and overextension and between flush and underextension. The rates for nonvital pulp were similar to those for vital ones. CONCLUSION: The root canal should be filled to within 2 mm of the radiographic apex.
Adult↗
Five-year follow-up of internal bleaching.
A 5-year clinical follow-up study was conducted to determine the longevity of originally acceptable results for internal bleaching. The "walking internal bleaching" method is an acceptable technique of lightening discolored anterior teeth to provide an esthetically pleasing match with adjacent teeth. This follow-up study revealed a success rate of 79% for all indications after 5 years. If the indication is limited to one palatal endodontic opening, the total success rate can reach 91%. However, a 98% success rate is common when subjective evaluation of patients is considered. The results clearly indicated that internal bleaching provides long-term success for treatment of discolored nonvital anterior teeth over a period of years and does not have any detrimental effect on dental hard tissue. In ideal cases, if the procedure is performed precisely, the success rate can exceed 90% after five years.
Adolescent↗
Evaluation of fiber-composite laminate in the restoration of immature, nonvital maxillary central incisors.
The purpose of this study was to evaluate the use of fiber-composite laminate, a reinforcement ribbon embedded throughout a composite restoration, to reinforce immature maxillary central incisors. Twenty-six mature maxillary central incisors were prepared a minimum of 3 mm below the facial cementoenamel junction to simulate immature nonvital teeth. They were separated into 3 groups: group 1 was unfilled and served as a control; group 2 was filled to the depth of the preparation with composite; and group 3 was filled with composite and Connect Reinforcement Ribbon. The specimens were subjected to class I loading in an Instron Testing Machine until catastrophic failure occurred. The results indicate a highly significant difference between the groups (p < or = 0.003). Group 1 fractured at an average load of 31.08 kg, group 2 at 51.00 kg, and group 3 at 37.93 kg. These findings suggest that composite alone increases fracture resistance of the immature tooth model more than composite with Reinforcement Ribbon.
Analysis of Variance↗
The odontogenic keratocyst: a potential endodontic misdiagnosis.
Odontogenic keratocysts manifest themselves as radiolucencies that can appear anywhere in the maxilla or mandible, including periradicular areas; they may thus masquerade as lesions of endodontic origin. This retrospective study examined 239 odontogenic keratocysts received by the Oral Pathology Laboratory at Temple University School of Medicine over a 3-year period. Twenty-one (9%) of the cysts received were located periradicularly; of these 21, 12 (57%) were associated with nonvital or endodontically treated teeth and thus mimicked lesions of endodontic origin. Because of its aggressive nature and tendency to recur, the periradicular odontogenic keratocyst should be included in the differential diagnosis of lesions that are refractory to endodontic treatment.
Adult↗
Comparative evaluation of endodontic management of teeth with unformed apices with mineral trioxide aggregate and calcium hydroxide.
PURPOSE: The purpose of this study was to compare mineral trioxide aggregate (MTA) and calcium hydroxide (Ca(OH)2) for their efficacies and time taken for formation of apical biological calcific barriers and resolution of periapical radiolucencies, if present at baseline, in teeth with unformed apices. METHODS: Twenty nonvital permanent maxillary incisors with unformed apices, stratified according to the size of periapical radiolucencies and stage of root development, were equally allocated to MTA and Ca(OH)2 groups. In group 1 (MTA group), after 7 days of disinfection with Ca(OH)2, MTA was packed into the apical one third of the root canals and obturation with gutta percha (GP) was performed in 90% (9/10) of cases within 15 to 30 days. In group 2 (Ca(OH)2 group), obturation was performed following clinical and radiographic depiction of the apical stop. RESULTS: The mean time taken for apical biological barrier formation was 3 +/- 2.9 months for group 1 and 7 +/- 2.5 months for group 2 (P=.008). The periapical radiolucencies were resolved in 4.6 +/- 1.5 months for group 1 and 4.4 +/- 1.3 months for group 2 (P=.83). The total treatment was completed in 0.75 +/- 0.4859 months and 7 +/- 2.5 months for groups 1 and 2, respectively. CONCLUSION: The 2 materials were found to be equally efficacious in the management of nonvital teeth with unformed apices. Time taken to complete the treatment and the biological barrier formation in group 1 was significantly less than that for group 2. The healing time for periapical radiolucencies was almost identical.
Adolescent↗
Clinical study of a halogen light-activated bleaching agent in nonvital teeth: case reports.
Clinical experience with an innovative, dual-action, in-office bleaching regimen that has both chemical and photoactivated mechanisms is described. This internal bleaching procedure was performed in three patients, each with different characteristics. In general, the results obtained were satisfactory. In the 6-month period of follow-up, no adverse effects related to the application of the bleaching agent were found. The different factors that may have influenced the results achieved are discussed.
Adult↗
Apical bridging in association with regular root formation following single-visit apexification: a case report.
A case report is presented in which continuing root formation occurred in a carious nonvital and immature mandibular second premolar after single-visit calcium hydroxide apexification treatment. An apical hard tissue barrier was formed, accompanied by a separate, mesioapically growing root, 7 months posttreatment. Treatment was concluded with gutta-percha root canal restoration. The success of this single-visit apexification treatment supports the contention that frequent changing of the calcium hydroxide dressing is not always required to induce apical closure.
Calcium Hydroxide↗