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At least 127 records · Page 7Linked to original sources
PubMed2005

Pilot study of correlation of pulp stones with cardiovascular disease.

We propose that calcification of dental pulp may have a similar pathogenesis as calcified atheromas and could lead to use of routine dental radiographs as a rapid screening method for early identification of potential cardiovascular disease (CVD). Fifty-five dental patients ages 20 to 55 were chosen because pulp stones in pulpally noninflamed teeth were not expected in this age group. They completed a questionnaire regarding their CVD status and that of their parents and siblings. Entry criteria included at least one asymptomatic, minimally restored, noncarious molar and no history of gout, renal disease, or renal lithiasis. Patients' periapical radiographs of record were viewed to determine the presence of pulp stones. There was a significant relationship between pre-existing CVD and pulp stones (odds ratio of 4.4 with a 95% confidence interval of 1.1, 18.7), but no relationship was found for family history of CVD and pulp stones (odds ratio of 1.7 with a 95% confidence interval of 0.5, 5.5). Seventy-four percent (14/19) of patients with reported CVD had detectable pulp stones while only 39% (14/36) of patients without a history of CVD had pulp stones. This pilot study demonstrates that patients with CVD have an increased incidence of pulp stones in teeth with noninflamed pulps compared to patients with no history of CVD. No relationship was found between presence of pulp stones and family history of CVD. The findings suggest that dental radiographic determination of the presence or absence of pulp stones may have possibilities for use in CVD screening.

Adult↗
PubMed1996

The application of the buccal object rule for the determination of calcified root canals.

Root canal calcification represents a serious problem which often occurs in clinical practice. Calcified root canals are difficult or even impossible to find and treat conservatively. In this paper, a technique is proposed which may be helpful in detecting and locating calcified root canal(s) and properly treating them. The proposed technique is simple and easy to perform in posterior and anterior teeth, and it may be useful in everyday clinical practice.

Dental Pulp Calcification↗
PubMed1997

Pulp calcifications in traumatized primary incisors. A morphological and inductive analysis study.

The purpose of this study was to investigate histopathological changes in primary teeth following trauma, and to look for possible correlations between the morphology of pulpal calcification and clinical findings. The material consisted of 123 primary teeth from 98 Danish children aged 9-108 months (mean age 33.5 +/- 19.7 months) at the time of injury. The specimens were analyzed by means of light and scanning and transmission electron microscopy. Data from the clinical investigation and from predetermined ranked parameters from the histological analysis were processed in a computerized inductive analysis program. The results, describing patterns of co-variation, are presented as a decision tree. The most common diagnosis was intrusion luxation (54%). In 41% of all teeth, the degree of obliteration was less than 1/4 of the pulpal lumen. In most cases (79%), no denticles were visible. When present, 80% of the denticles had a bone-like appearance. Tissues occluding the pulpal lumen were either dentin-like (49%), bone-like (19%), or fibrotic (9%). It could be concluded that these varying responses could not be correlated with explicit clinical diagnoses. However, in certain combinations, histological parameters could be correlated to clinical findings.

Bone and Bones↗
PubMed2006

Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin.

AIM: To report the repair of an extensive periapical lesion of endodontic origin, following nonsurgical treatment. SUMMARY: Clinical and radiographic examination revealed an extensive periapical lesion related to tooth 22, extending from the distal surface of tooth 21 to the mesial surface of 26. The patient reported a previous history of dental trauma involving this quadrant and had been under orthodontic treatment for a year. Intraoral examination revealed an asymptomatic bony hard swelling, mainly confined to the palate. During root canal exploration irregular walls associated with 3 mm of apical calcification were noted. After apical patency was obtained 1 mL of bloody serous exudate was drained. Intracanal aspiration provided a further 2 mL of yellow serous exudate. Following biomechanical preparation, a dressing of calcium hydroxide with anaesthetic solution was applied and replaced four times over a period of 12 months. The clinical-pathological picture demonstrated resolution of the lesion during this period of time. The 14-month clinical and radiographic examinations revealed normal bony contour and a significant resolution of the maxillary radiolucency. KEY LEARNING POINTS: Periapical lesions of endodontic origin may develop asymptomatically and become large. Proper biomechanical preparation followed by calcium hydroxide medication renewed periodically represents a nonsurgical approach to resolve extensive inflammatory periapical lesions.

Adult↗
PubMed1989

Ultrastructure of initial calcification on exposed human pulp applied with autogenous dentin fragments.

Initial calcification in human dental pulp has been studied with electron microscopy in 20 human teeth over a period of 21 days following pulp exposure and capping with autogenous dentin fragments. Five days after operation, dentin fragments were surrounded by degeneration cells and inflammatory cells. Occasionally a macrophage that had phagocytosed a dentin fragments was observed. Fourteen days after operation, osmiophilic needle-like crystalline structures were found in spherical bodies in the collagen fibrils or on the dentin surface. Ca and P were detected in these needle-like crystalline structures by energy dispersive X-ray analysis. They tended to increase in size and to fuse together to form mineralizing globules with the passage of time. Initial calcification around the dentin fragments developed various patterns, including spherical bodies in the collagen fibrils and direct apposition of needle-like crystals on the dentin fragments.

Adolescent↗
PubMed1998

Microorganisms in closed periapical lesions.

The purpose of this study was to investigate the microorganisms of strictly selected closed periapical lesions associated with both refractory endodontic therapy and pulpal calcification. Definitive criteria were established that assured complete clinical isolation of the periapical lesion from the oral and periodontal environment. A total of 13 criteria-referenced lesions were selected from 70 patients with endodontic surgical indications. A well controlled culturing method was used in all cases and samples were taken by one clinician at three separate sites during each surgery. Samples taken at the surgical window and within the body of the lesion served as controls, whilst a third sample was taken at the apex. In all 13 cases, samples taken from the apex yielded microorganisms comprising 63.6% obligate anaerobes and 36.4% facultative anaerobes. Prevalence of the isolated species was 31.8% for Actinomyces sp., 22.7% Propionibacterium sp., 18.2% Streptococcus sp., 13.6% Staphlyococcus sp., 4.6% Porphyromonas gingivalis, 4.6% Peptostreptococcus micros and 4.6% Gram-negative enterics. The results of this investigation indicate that closed periapical lesions associated with calcified teeth or those resistant to root canal treatment harbour bacteria. The inability to eradicate all root canal microorganisms during root canal treatment, along with anatomical factors, may allow further bacterial colonization of the root apex and surrounding periapical tissues, and consequently prevent healing.

Bacteria, Anaerobic↗
PubMed1998

Dentinogenesis imperfecta: endodontic implications. Case report.

Dentinogenesis imperfecta is a hereditary disorder resulting in defective dentin in both the primary and secondary dentitions. The complications of dentinogenesis imperfecta are difficult to manage and provide a challenge to the dentist. This case report concerns treating an African American patient with dentinogenesis imperfecta who appeared for treatment with endodontic pathosis. It illustrates the need for appropriate and timely restorative treatment to prevent pulpal pathosis. Also demonstrated is the difficulty of endodontically treating dentinogenesis imperfecta teeth because of pulpal obliteration and abnormal dentin mineralization. Early and correct diagnosis of dentinogenesis imperfecta is imperative to enable appropriate preventive interventions and optimal dental treatment. Although pulpal pathosis is rarely reported with dentinogenesis imperfecta, endodontic treatment is occasionally necessary and has a guarded prognosis if initiated after pulp canal obliteration has occurred.

Adult↗
PubMed2003

Coronal pulp size in molars: a study of bitewing radiographs.

AIM: To: (i) study coronal pulp dimensions in human first molar teeth; (ii) investigate the effects of restorations on pulp size; (iii) determine differences in dimensions between teeth of Mongoloid patients and teeth of other ethnic groups; and (iv) record the presence of pulp stones. METHODOLOGY: Bitewing radiographs of 121 subjects (mean age, 20.9 years) were taken under standardized conditions. The films were digitally scanned and nine measurements were made from the image of each first molar. The data were analysed in terms of presence or absence of restorations and in terms of racial group. Differences were examined using Student's t-test, Pearson correlations and Levene's test. RESULTS: A total of 445 teeth were analysed. Large crowns were correlated to large pulps. Teeth restored with occlusal and proximal restorations had significantly smaller pulps (P = 0.044 and 0.004, respectively), but no difference was found in pulp area in the clinical crown between the restoration types. Mongoloid crowns were shorter and more bulbous. Pulp areas of maxillary molars and pulp widths at the cervix of mandibular molars were significantly larger in Mongoloids. The pulp area in the clinical crown correlated to pulp horn height for Mongoloids and others and for maxillary and mandibular teeth. No differences were found between the heights of pulp horns in the Mongoloid and other teeth. Four of the pulp measurements demonstrated sexual dimorphism. Stones were present in almost 10% of the subjects, representing 4% of the tooth pulps examined. CONCLUSION: Even teeth with shallow occlusal restorations had reduced pulp spaces. There were significant differences in pulp and crown dimensions between the teeth of Mongoloid patients and those of other patients.

Adolescent↗
PubMed2002

Experimental evaluation of human teeth using noninvasive ultrasound: echodentography.

Anomalies present in the hard tissue of teeth are manifested in several ways such as cavities, decay, and caries. The most extensively and commonly used diagnostic modality for the assessment of these abnormalities are x-rays. Unfortunately, these rays are harmful to the human body and may be a source of health risk. This work describes the development of a new testing technique that uses ultrasound designed to complement, or even replace, existing tools used in dentistry applications. Previous studies have shown several models of acoustic field simulation, propagation, and interaction of ultrasound with the layers of several tooth structures. In this paper, experimental data is gathered for the purpose of assessing the viability of this technique in an attempt to detect cavities and fractures in extracted human teeth. A low-intensity, high-frequency ultrasonic set-up is used in all in vitro tests. Four cases have been examined: an intact tooth, a tooth containing an amalgam restoration and a natural surface fissure, a tooth containing a machine side-drilled hole that mimics a cavity, and a calcified tooth--a rare naturally occurring condition. Upon analysis of the obtained A-scans and B-scans, it is verified that these experimental measurements confirm predictions reported in earlier finite element and transmission line studies and suggest that ultrasound is a valuable tool which has the potential to be an addition to, or even an improvement upon, current dental imaging systems.

Dental Caries↗
PubMed2004

Effects of alendronate on restoration of biomechanical properties of periodontium in replanted rat molars.

OBJECTIVE: We examined the effect of the pretreatment of roots with alendronate on the restoration of the support function of the healing periodontal ligament in replanted rat molars. METHODS: The left maxillary first molars were extracted, placed in 0.9% NaCl containing 1 mm alendronate (alendronate group) or 0.9% NaCl (control group) for 5 min, and were replanted into their sockets. Groups of animals were killed at 7, 14, and 21 days after replantation. Normal control rats were also killed on the same days. The force required to extract the replanted or normal tooth from its socket was measured, and a load-deformation curve was developed and analyzed. Micro-computed tomography and histologic analyses were also made. RESULTS: The mechanical properties of the healing periodontal ligament in the alendronate group were gradually restored from 7 to 21 days. However, fractures of the roots and bones during mechanical testing occurred in most of the replanted teeth in the control group at 21 days. The rates of restoration of the mechanical strength, extensibility, stiffness, and toughness for the alendronate group at 21 days were 67, 98, 74, and 68% of the normal controls, respectively. Micro-computed tomography and histologic observations revealed that bone-like structures within the pulp and ankylosis between the roots and socket bones occurred commonly in the control group, but were uncommon in the alendronate group. CONCLUSIONS: Our findings suggest that the pretreatment with alendronate inhibits the formation of abnormal mineralized tissues and results in better restoration of the support function of the healing periodontal ligament in replanted teeth.

Alendronate↗
PubMed1995

Progressive changes in the pulpo-dentinal complex and their clinical consequences.

With changes in the age structure and oral health in the population, changes in the pulpo-dentinal complex are becoming more relevant clinically. Age-related changes in the structure of dentine and pulp are reviewed. The influence of these changes on restorative dentistry are considered with particular emphasis on endodontics and the use of adhesive restorative materials.

Adult↗
PubMedDate not supplied

Pulp-dentin biology in restorative dentistry. Part 5: Clinical management and tissue changes associated with wear and trauma.

Tooth wear occurs during normal mastication. Pathologic wear, including abrasion and erosion, may also take place. Formation of reactionary and reparative dentin and obturation of dentinal tubules are biologic responses that compensate for the loss of tissue. Physical trauma to teeth will affect the blood supply to the pulp. Extensive physical trauma may result in the formation of mineralized, often bonelike tissue in the pulp chamber. Minor trauma, such as that associated with orthodontic tooth movement, may exert transient effects on the pulp or it may result in permanent structural changes. No experimental data involving restorative work on traumatized teeth have been published, but available evidence suggests that special care may be necessary in the restoration of such teeth because their reaction patterns may differ from those in nontraumatized teeth.

Dental Deposits↗
PubMed1998

Pulpal response to intrusive orthodontic forces.

Many studies have examined the effect of orthodontic forces on supporting tissue. However, their effect on dental pulp has not been sufficiently studied. The aim of the present study was to evaluate, histologically, the pulpal response to the action of intrusive orthodontic forces. The study was performed on 40 first premolars which had to be extracted for orthodontic reasons from 11-17 year-old patients. The twenty teeth of the experimental group received, prior to extraction, an intrusive force with an initial load of 150 g over a period of 15 to 20 days. The control group comprised the 20 homologous teeth which were not submitted to intrusive forces prior to extraction. All the teeth were fixed in 10% buffered formalin, decalcified, embedded in paraffin, sectioned and stained with hematoxylin-eosin. Light microscopy observation revealed alterations in predentine, calcium deposition, fibrohyalinosis, congestion, inflammation and haemorrhage. The data were statistically analysed employing Fisher's exact probability test. Congestion, haemorrhage and fibrohyalinosis were significantly (p < 0.005) greater in the experimental group than in controls.

Adolescent↗
PubMed2001

Juvenile dermatomyositis: literature review and report of a case.

Dermatomyositis is a rare disease of unknown origin, which affects both children and adults. In the juvenile form, dermatomyositis is a multisystem disease, characterized by myositis; an erythematous rash over the bridge of the nose, around the eyes, and on the trunk and limbs; vasculitis; and dilatation of the capillaries in the nail beds and gum margin. Late development of calcinosis is seen in approximately two-thirds of the patients. This case describes a 5-year-old dental patient diagnosed with dermatomyositis. This article includes the clinical manifestations of dermatomyositis in the body and in the oral cavity as well as the considerations that should be taken when treating these patients.

Child, Preschool↗
PubMedDate not supplied

Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol.

PURPOSE: The objective of this study was to assess the effect of mineral trioxide aggregate (MTA) as pulp dressing material following pulpotomy in primary molars with carious pulp exposure and compare them to those of formocresol (FC). METHODS: Of 33 children, primary molars treated via a conventional pulpotomy technique were randomly assigned to the MTA group (33 teeth) or FC group (29 teeth). Clinical and radiographic follow-up ranged between 4 and 74 months. The mean follow-up time was 38 months, with no difference between the groups. Twenty-nine teeth were followed until uneventful shedding (mean=33 months). Failures were detected after a mean period of 16 months (range=4 to 30). RESULTS: The success rate of pulpotomy was 97% for MTA (1 failure) and 83% for FC (5 failures). Eight teeth presented internal resorption. In 4 of them (2 of each group), progress of the resorption process stopped and the pulp tissue was replaced by a radioopaque calcified tissue. Pulp canal obliteration was observed in 58% of the MTA group and in 52% of the FC group (total=55%). CONCLUSIONS: MTA showed a higher (though not statistically significant) long-term clinical and radiographic success rate than formocresol, and can be recommended as its replacement as, unlike FC, MTA does not induce undesirable responses.

Aluminum Compounds↗