Combined periapical and periodontal surgery. Report of a case.
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Adult↗
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Results for “Periapical Periodontitis”
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[Changes of prostaglandin E2 levels in periapical exudates after root canal treatment].
OBJECTIVE: The aim of this study was to examine the levels of prostaglandin E2 in periapical exudates before and after root canal treatment. METHODS: Periapical exudates specimens were quantitatively sampled from root canals of 25 teeth at consecutive treatment visits, and the concentration of prostaglandin E2 in each sample was determined using a commercial kit. RESULTS: The mean prostaglandin E2 levels significantly decreased after the endodontic therapy. Significant correlations between the levels of prostaglandin E2 and the clinical features of periapical periodontitis were also found in this study. CONCLUSION: The results suggest that the level of prostaglandin E2 in periapical exudates reflects the state of periapical periodontitis.
Adolescent↗
Microbiologic studies on the periapical and periodontal abscesses of Egyptian patients.
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Egypt↗
[Anaerobes in infected canals: a preliminary study].
Anaerobes of 17 infected canals with periapical periodontitis were studied. Most of root flora were not only anaerobes but also aerobes. Anaerobes were predominant in chronic periapical periodontitis. Major anaerobes isolated from canals were peptostreptococcus, B. melaninogenicus and B. oralis. The chi-square results indicated that the peptostreptococcus were significantly related to apical radiolucency and B. melaninogenicus were significantly related to percussion or foul smell. Animal experiment results showed that rats inoculated with mixed flora developed many abscesses. But the monoinfected rats had infiltration of PMNs, dilation and hypermia of vessels. B. melaninogenicus, B. oralis and mixed flora had liquefied gelatin and indicated these bacteria had collagenase which could dissolve collagen fibers and significantly related to destroy of collagen fibers and bone in periapical tissues.
Adolescent↗
Caries, periodontal disease, and periapical changes.
Conventional radiography is the standard for diagnosis of dental disease, although it lacks the sensitivity to demonstrate the earliest changes of diagnostic significance. Imaging techniques such as direct digital radiography and subtraction help to better demonstrate subtle changes in diagnostic information.
Dental Caries↗
Correction of mucosal defects of periapical origin with periodontal surgical techniques.
Periapical lesions usually heal after successful root canal therapy. Persistent apical-oral communications may be due to anatomic and pathologic features that were originally linked to the endodontic cause of the lesion. One such factor is close proximity of the root apex to the oral mucosa. These defects necessitate corrective surgical intervention similar to techniques used in periodontal surgery. Four cases involving young female patients are described. These defects occurred in teeth that did not complete their maturation before necrosis of the pulp set in.
Adolescent↗
[Treatment of advanced periodontal and periapical lesion caused by malformed lingual groove with guided tissue regeneration: report of one case].
This paper reported one case with severe periodontal lesions caused by malformed lingual groove treated by guided tissue regeneration. The periodontal lesion was exposed palatally after the tooth had been treated with root canal therapy, the alveolar bone and the root surface was prepared, an unabsorbable member of e-PTFE was placed into the wound,and removed after 4 weeks, the patient was followed up for 3 years. The lesion recovered well three years after the operation, all of the periodontal tissue was in a healthy condition. It is advisable that guided periodontal tissue regeneration can be used as a new method to treat periodontal destruction induced by malformed lingual groove.
Alveolar Bone Loss↗
[Clinical observation of one-visit root canal therapy by microwave instrument]
OBJECTIVE:To analysis post-treatmental reaction and long-term effect of one-visit root canal therapy by microwave instrument. METHODS:Applying heat effect and the other ones of microwave,the changes of dentine tissue of extracted teeth were observated by SEM examination.48hs and 1 year post-treatmental effect of 47 patients of periapical periodontitis treated by one-visit root canal therapy were observated and compared with the results of 54 cases treated with common method.RESULTS:In the cases of acute and chronic periapical periodontitis microwave applied in root canal therapy can close the openings of dentine,enhance the effects of sterilization and decrease times of treatment.CONCLUSION:Microwave applied in one-visit root canal therapy is competent.
Journal Article↗
Histopathological observations of periapical repair in teeth with radiolucent areas submitted to two different methods of root canal treatment.
Dogs' teeth with induced chronic periapical periodontitis were treated endodontically by two different methods, and the results were compared. A total of 40 root canals from the upper and lower premolars of two dogs were prepared chemomechanically. In method 1, a high-concentration (5.25%) hypochlorite solution was used during the instrumentation of the root canal, and an antibacterial dressing was applied between sessions, followed by filling of the root canal. In method 2, a low-concentration (0.5%) sodium hypochlorite solution was used as an adjunct to mechanical debridement, and the root canal was filled during the same session. The histopathological results showed that method 1 led to better periapical repair than method 2.
Animals↗
Expression of inflammatory cytokine genes in vivo by human alveolar bone-derived polymorphonuclear leukocytes isolated from chronically inflamed sites of bone resorption.
Alveolar bone-derived polymorphonuclear leukocytes (PMNs) were characterized for their ability to produce inflammatory cytokines such as interleukin-1 alpha (IL-1 alpha), IL-1 beta, tumor necrosis factor alpha (TNF alpha), and IL-6 in vivo. Periapical exudates (PE) were collected from periapical lesions with chronic periapical periodontitis through root canals. Cells and noncellular supernatants were then isolated by centrifugation. The concentration of cytokines present in the noncellular supernatants were determined by ELISA. High concentrations of IL-1 alpha, IL-1 beta, and IL-6 were detected in PE, however, TNF alpha was not. PE contains predominantly PMNs ( > 95% of residing cells) with a few percent of lymphocytes and/or macrophages. These alveolar bone-derived PMNs were purified by the Ficoll-Hypaque gradient method and were analyzed for cytokine mRNA expression using the cytokine-specific reverse-transcription polymerase chain reaction. Highly purified PMNs ( > 99.5%) isolated from PE expressed significant levels of mRNA for IL-alpha, IL-1 beta, and TNF alpha. IL-6 mRNA was not detected, although a high concentration of IL-6 was detected in supernatants of PE by ELISA. The IL-6 secretion in PE could be derived from macrophages, T lymphocytes, osteoblasts, or fibroblasts around periapical lesions. These data strongly suggest that human PMNs derived from alveolar bone can spontaneously produce IL-1 alpha, IL-1 beta, and TNF alpha at sites of inflammation, and probably initiate inflammation and regulate augmentation of bone resorption in vivo.
Adolescent↗
[Odontogenic foci--possible etiology of urticaria?].
Recent studies have shown that chronic odontogenic infections could pose a risk for myocardial infarction, cerebral ischemia, and arteriosclerosis. However, the correlation between urticaria and dental infections has rarely been examined so far. Therefore, we performed a case-control study using a standardized questionnaire and examination. We investigated 66 patients suffering from an acute or chronic urticaria and 65 age- and sex-matched healthy patients as a control group. Dental status was determined by a so-called total dental index (TDI) which primarily reflects caries, periodontitis, periapical lesions, and nonvital and missing teeth. All 66 patients were referred from the department of dermatology. After their treatment in hospital, all patients received a questionnaire with questions on intensity and localization of the urticaria. The TDI of the urticaria patients was slightly better ( n=66; 2.6+/-1.98) than that of the control group ( n=65, TDI=3.3+/-1.86). Subsequently, it was determined if the urticaria had receded after dental treatment. In conclusion, chronic dental infections do not seem to correlate with an increased risk for urticaria.
Adult↗
Periodontal disease, periapical lesions and caries were, in that order, the causes of overdenture abutment loss.
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Comment↗
[Experimental study on the effect of replantation of immature permanent teeth on the periapical and periodontal tissues].
Replantation and semi-rigid fixation were performed on canine immature permanent teeth, and one week after replantation the teeth were treated by root filling with calcium hydroxide. The root apex and periodontium of the teeth with replantation were examined for changes regularly during the experiment by microradiographic, fluorescence microscopic, polarizing microscopic and X-ray observation of undecalcified horizontal continual ground sections. The results obtained were as follows: 1) Immediately after replantation, root formation was observed, but its formation was found to cease at a relatively early time. No site of the root showed any inflammatory resorption. 2) The dentine of the teeth with replantation was narrow, and the whole tooth substance showed discoloration due to penetration of calcium hydroxide. 3) the periodontal space surrounding the teeth with replantation was decreased daily by new bone actively formed from the alveolar bone proper and by a thin cementum layer added on the periodontal surface. This change occurred from one week after replantation. 4) The width of the periodontal space of the teeth with replantation, which had been wider than that of a control tooth, was increased and decreased daily at the cervix and root apex and the central part of the root, respectively. 5) Collagen fibers of the periodontal membrane were present in the periodontal space of the teeth with replantation, together with regeneration of the periodontal membrane that had been cut by extraction. 6) There were no changes due to replantation in the two teeth adjacent to the tooth with replantation or the lateral jaw.
Cuspid↗
[Aspects of bone regeneration, applied to fractures, extractions, and periapical and periodontal lesions].
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Bone Regeneration↗
[Odontogenic focus as the etiology of cerebral ischemia].
Recent studies have shown that acute infections, especially of the respiratory tract, are an important risk factor for cerebral ischemia. Additionally we know that chronic dental infections may be a risk for myocardial infarction and artherosclerosis. However, the connection between stroke and dental infections has hardly been examined so far. Therefore we performed a case-control study using a standardized questionaire and examination. We investigated 66 patients consecutive to a acute cerebral ischemia/stroke and 60 age- and sex-matched nonstroke neurological patients as a control group. Dental status was determined by a so called total dental index (TDI) which reflects primarily caries, periodontitis, periapical lesions, devital and missing teeth as well as by a panoramic index (PI). Specifically, older patients with cerebrovascular ischemia tended to have a significantly worse dental status and had more severe periodontitis and periapical lesions than control subjects. A predefined poor dental status was associated with cerebrovascular ischemia independent from other vascular risk factors and social status. In conclusion, poor dental health, mainly resulting from chronic dental infections, may be associated with an increased risk for cerebrovascular ischemia. The results must now be verified in larger studies. As chronic dental infections are a common and also easily treatable factor, their identification as a risk factor for stroke would be quite important in the field of preventive medicine.
Adult↗
Endodontic retreatment of an autotransplanted lower first premolar: a case report.
A 24-year-old female with no contributory medical history had been treated by orthodontic alignment and transplantation of the lower left first premolar to the upper left first premolar site to correct for congenitally missing upper premolars. Subsequently, the transplanted premolar was treated by conventional endodontics and apical surgery for persistent periapical periodontitis over a span of 12 years. A combination of conventional endodontic retreatment and periapical surgery resulted in periapical healing. This case outlines the need for careful preoperative case assessment.
Adult↗
Dental radiographic findings in the elderly in Helsinki, Finland.
A total of 169 dentate persons, aged 76, 81, and 86 years, living at home in Helsinki, Finland, were examined by means of panoramic radiography supplemented by intraoral radiographs. The older the age group, the fewer teeth remained. Altogether 75% of the subjects had radiographically detectable caries. A high proportion of the carious teeth (62%) was found in a relatively small number (24%) of subjects. The number of carious teeth and their percentage of the total number of teeth were greater in the older age groups. The proportion of endodontically treated teeth was 19% in the 76-year-olds and 26% in the 86-year-olds. Of the subjects 41% had periapical periodontitis, which was commoner in root-filled teeth (18%) than in other teeth (4%). Caries and periapical radiolucent and radiopaque findings were commoner in men. Vertical bone pockets (3 mm or deeper) were found in 51% and furcation lesions in 28% of the subjects. Compared with earlier Finnish studies, the results indicate an improving oral health status among elderly Finns.
Age Factors↗
Neutrophil elastase levels in periapical exudates of symptomatic and asymptomatic teeth.
The aim of this study was to determine neutrophil elastase levels (NE) in periapical exudates and to evaluate its relationship with clinical signs and symptoms of endodontically involved teeth. A total of 42 teeth with periapical periodontitis of 37 patients were clinically examined and spontaneous pain, swelling, pain on palpation or percussion, sinus tract formation and pus discharge were recorded. Additionally, periapical lesion size was measured on periapical radiographs. Periapical exudate samples were obtained during routine root canal treatment by using paper points. Enzyme levels were determined by spectrophotometric assays using the NE specific substrate N-methoxysuccinil-Ala-Ala-Pro-Val-p-nitroanilide. The teeth with signs and symptoms showed higher NE levels than the teeth without symptoms (p<0.05). The differences were significant when NE levels were presented as total amounts instead of concentration. This study demonstrated that NE in periapical lesions related with clinical symptoms and total enzyme amount may be more reliable mode of data presentation.
Adult↗