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The case history of a six-year-old girl who underwent endodontic treatment by a non recommended technique. It was decided to perform integral treatment anew, this time with techniques and materials adequate for the restoration and renewal of temporary dentition.
The authors analyze the functional value of pulpless teeth. A pulpless tooth retains its structure, shape, and function for a long time and, in authors' opinion, effectively performs.
In a prospective, randomized study it was researched whether epinephrine-free Articain 2%-solution is suitable for dental surgery. The estimated local anesthetic effect was subjective considering a dental operation an in comparison with the usual Articain 4% solution with an epinephrine addition of 1:200,000 (Ultracain D-S). The local anesthetic effect of the 2% solution was clearly lower than that of the 4% solution. However, in many cases even the lower doses of the 2% solution was sufficient for dental treatment including surgery. The higher efficiency of the 4% solution is more a result of a higher concentration than of anesthesia. In principle, the epinephrine-free 2% Articain solution is suitable for dental surgery, although, due to a shorter anesthetic duration and an unsure effect additional injections have to be given more often.
Rheoparodontographic findings evidence more profound and manifest shifts in periodontal circulation of pulp-free teeth as against intact teeth after preparation for artificial crowns. Vascular elasticity and distensibility are reduced in pulp-free teeth, vascular tonic tension and periodontal tissue blood content are elevated (according to the inflammatory arterial hyperemia type), peripheral vascular resistance is reduced, and venous blood flow from the periodontal tissues deteriorated.
Periapical tissue reaction to root canal filling with zinc-eugenol paste (complete or incomplete filling) was studied in 15 teeth of 5 mongrel dogs after total or subtotal pulp extirpation. Inflammatory reaction developed in all the cases. It was more intensive in cases with total extirpation of the pulp followed by complete or incomplete filling of the root canal than after subtotal extirpation of the pulp followed by root canal filling 1-2 mm below the anatomical apical foramen.
The reasons why is it sometimes necessary to resort in paediatric dentistry to the use of conscious sedation with N2O/O2 are explained together with clinical indications and applications. The excellent results obtained with this technique lead to greater cooperation of the child, to a positive emotional contact with dental treatment and the possibility of performing the necessary therapies with greater precision.
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Histological examination was carried out of milk molars involved by physiological or pathological resorption, i.e. accelerated, during treatment of pulp diseases by amputation using formocresol, and delayed in case of persisting milk teeth. The results showed that the histological pattern of accelerated resorption due to formocresol was not different from physiological resorption. Delayed resorption was associated with an evident repairing reaction in the resorption sinuses.
The method of immediate root canal filling following vital pulp extirpation involves many problems to be solved clinically. Therefore, the present study was performed to increase the clinical usefulness by applying formalin medicine in the root canal before immediate root canal filling after vital pulp extirpation. Group 1 (the group of applying formalin tricresol or formalin guaiacol on the intentionally exposed pulp tissue) Group 2 (pulp extirpation). This study is based upon 95 human permanent teeth with noninfected pulps in patients ranging in age from 16 to 43 years. Under local anesthesia the experimental teeth were isolated with cotton rolls. The pulp was intentionally exposed during the preparation of the Ingle's cavity with diamond instruments mounted on a high speed air turbine. The cavity and exposed pulp surface were cleaned with Neo-cleaner (10% Hypochlorite) and oxydol, and then dried using an absorbent material. One of the experimental medicines, which had been saturated into phi 2mm cotton pellet, was applied on the exposed pulp tissue. The cavity was filled with gutta-percha and amalgam. Under local anesthesia, the pulp was intentionally exposed in the same way as mentioned above. After removal of pulp tissue, root canals were cleaned with oxydol. Root canals were filled with Calvital (CV) in 15 cases. Following insertion of sterilized paper point soaked in the solution of formalin guaiacol (FG) or formalin tricresol (FC) for 5 minutes, root canal filling with Calvital was carried out in 20 cases. The experimental teeth were clinically observed at various intervals, and then extracted. After fixation in 10% formalin solution, the teeth were decalcified using nitric acid and embedded in celloidin. The serial sections were stained with hematoxylin and eosin and observed histopathologically. Group 1. 1. Kinds of clinical discomfort observed in this investigation were as follows. FG: Spontaneous pain (25.0%), Percussion discomfort (5.0%). FC: Spontaneous pain (35.0%), Percussion discomfort (35.0%). 2. Clinical results were as follows. FG: 14 cases (70.0%) out of 20 were evaluated as good, 6 cases (30.0%) as fairly good, and none as bad. FC: 11 cases (55.0%) out of 20 were evaluated as good, 9 cases (45.0%) as fairly good, and none as bad. 3. Histopathological changes observed in this investigation were as follows. 1) Hyperemia, 2) Hemorrhage, 3) Round cell infiltration, 4) Suppurative inflammation, 5) Coagulation necrosis, 6) Atrophy, 7) Cicatrization. Group 2. 1. Kinds of clinical discomfort observed in this investigation were as follows. CV: Spontaneous pain (20.0%), Percussion discomfort (20.0%). FG: Spontaneous pain (30.0%), Percussion discomfort (15.0%). FC: Spontaneous pain (30.0%), Percussion discomfort (30.0%). 2. Clinical results were as follows.
In endodontic treatment of teeth, partial or "conservative" crown reconstructions are clinically acceptable where loss of substance is limited and recourse to radicular pivots is contraindicated. Such reconstructions bring into play a variety of currently available biomaterials, including those inserted in the plastic phase. They make it possible to delay a prosthetic solution (full crown restoration) without impinging on the conservation of the devitalized tooth.
The general principles governing the choice of materials for reconstruction of devitalized teeth are determined on the basis of mechanical and biological imperatives as well as degradation phenomena. In describing the various techniques for clinical implementation, particular emphasis is placed on the imperatives and limitations of each protocol. A decisive factor in the durability of restorations is their homogeneity, as well as the clinical conditions under which they are performed.
1. Seven cases of pulpal lesions due to accidental trauma in young individuals anterior permanent teeth are studied clinically and histologically. 2. Etiopathogenic concepts of the specific lesions under study are synthesized. 3. Characteristics of the material and utilized methods are established. 4. By means of a detailed description of the cases, the histopathological and clinical qualities are coordinated, formulating commentaries. 5. Synoptic charts of the results obtained are included and the total analysis of all the material studied is completed with a general clinical-histopathological commentary.
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Above all the treatment of fractured juvenile frontal teeth doesn't represent a restoration problem but a problem of conservation of the tooth. In cases of uncomplicated crown-fractures the covering of all opened dentin tubuli must be recommended. In complicated crown-fractures the method of partial pulpotomy is preferred instead of pulp amputation regarding special indication. A closed cooperation with the orthodontist should be in the treatment of juvenile frontal teeth with a vital pulp.
Pulp stump and periapical tissue reaction to root canal filling with material containing calcium hydroxide and potassium nitrate after subtotal vital extirpation of the pulp was studied in 12 teeth of 6 green monkeys. Use of the material containing potassium nitrate was found to result on the 90th day of the experiment in the formation of a biologic barrier of secondary cement at the dental root apex. Such result was not achieved with calcium hydroxide-containing material. Other advantages of potassium nitrate-containing material were detected, consisting in a more rapid recovery of structural shifts in the pulp stump and periapical tissues.
Twenty-four radix dentis fractures were managed using both standard and original techniques. Treatment variants are suggested able to produce optimal long-term results.