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Results for “Periapical Periodontitis”

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PubMed1979

Periapical surgery.

A retrospective study of 572 teeth treated with periapical surgery was undertaken in order to evaluate the influence of preoperative, operative and postoperative factors in the healing process as well as the operation method used. It was also the aim to assess whether the histophatological diagnosis of biopsies taken at the operation could be correlated to healing. Statistical analyses by the AID method and conventional cross-classification methods were performed. Factors of importance were found to be the extent of the destrucion, the operation method used, the bone surrounding the destruction, the quality of the orthograde root filling, the age of the patient, and the marginal bone buccally. The operation method was of importance in large destructions where root fillings were considered as not having properly sealed the canals, and when treating inflamed cysts. The histopathological diagnosis could not be ascribed any definite prognostic value.

Adolescent↗
PubMed1998

A histopathological study of the morphological changes at the apical seat and in the periapical region after irradiation with a pulsed Nd:YAG laser.

In this study, the effects of pulsed Nd:YAG laser irradiation on the apical seat and periapical region of instrumented root canals were investigated. One hundred and ninety-two teeth, including incisors and molars (239 root canals), in 18 healthy adult beagle dogs were used. After extirpation of the pulp under anaesthesia, each root canal was shaped up to at least a size 40 K-file, and then laser irradiated using the following parameters: 1 W, 15 pps for 2, 3, and 4 s; 2 W, 15 pps for 2 s. The effectiveness of debris removal and carbonization on the root canal walls immediately laser irradiation were examined and inflammation of the periapical region at 1, 2, and 4 weeks after laser irradiation was examined using light microscopy. Effective debris removal was observed in most cases in the laser-treated groups and was dependent on irradiated energy. Carbonization was observed in the irradiated root canals except at the parameter of 1 W for 2 s. Periapical inflammation was observed at 1 W for 2 s to the same extent as in the control group (P > 0.01). These results suggest that the pulsed Nd:YAG laser is useful for debris removal with no adverse effects immediately after extirpation of the pulp if appropriate parameters are selected.

Aluminum Silicates↗
PubMed1998

Apical limit of root canal instrumentation and obturation, part 2. A histological study.

The results of an in vivo histological study involving apical and periapical tissues following root canal therapy after different observation periods demonstrated the most favourable histological conditions when the instrumentation and obturation remained at or short of the apical constriction. This was the case in the presence of vital or necrotic pulps, also when bacteria had penetrated the foramen and were present in the periapical tissues. When the sealer and/or the gutta-percha was extruded into the periapical tissue, the lateral canals and the apical ramifications, there was always a severe inflammatory reaction including a foreign body reaction despite a clinical absence of pain.

Adolescent↗
PubMed2001

Periapical healing of mandibular molars after root-end sealing with dentine-bonded composite.

AIM: The purpose was to present the frequency of periapical healing in first and second/third mandibular molars, after root-end resections sealed with a dentine-bonded resin composite. METHODOLOGY: Root-end sealing of resected mandibular molar roots was made with dentine-bonded composite (Gluma-Retroplast) as a cover on the entire slightly hollowed root-end, in an attempt to prevent leakage. RESULTS: Out of the 834 roots recalled between 6 months and 12.5 years postoperatively, 92% showed complete apical healing, 1% uncertain healing and 7% exhibited failure. The healing result of 681 first molar roots was not significantly different (P = 0.21) from that of 153 second/third molar roots, and there was no significant difference in healing between mesial and distal roots (P = 0.32 for first molars, P = 0.86 for second/third molars) or amongst six age groups (P = 0.94). In the patient group: 71-89 years, 36 roots showed an average of 97% with complete healing. Out of 25 failures who were retreated surgically, 80% showed complete healing when examined subsequently. CONCLUSION: Root-end sealing of mandibular molars with dentine-bonded resin composite is a promising technique giving 92% complete healing in cases examined between 6 months and 12 years postoperatively.

Adolescent↗
PubMed2002

Periapical healing of endodontically treated teeth in one and two visits obturated in the presence or absence of detectable microorganisms.

AIM: The purpose of the present study is to evaluate the healing of periapical lesions of teeth with positive and negative canal cultures at the time of obturation, and to evaluate the periapical healing of teeth treated in one visit (without) or in two visits with an interappointment dressing of calcium hydroxide. METHODOLOGY: Thirty-nine patients received root-canal treatment. In the first visit, teeth were instrumented, and 18 of these teeth were filled (after microbiological sampling) with calcium hydroxide in sterile saline. The other 21 teeth were obturated with gutta-percha and AH-26 sealer after microbiological sampling. Four weeks later, the teeth with calcium hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer. Healing of periapical radiolucency was recorded over a period up to 4.5 years. RESULTS: In both the treatment groups, the size of the periapical lesions reduced significantly during the follow-up period. Complete radiographic healing was observed in 81% of the cases in the one-visit group, and in 71% of the cases in the two-visit group. The probability of success increased continuously over time for both treatment groups. Seven out of eight cases (87.5%) that showed a positive root-canal culture at the time of obturation healed. The number of colony forming units (CFU) in six out of eight positive canals was <10(2) CFU mL(-1). CONCLUSIONS: Within the limitations of this study, no significant differences in healing of periapical radiolucency was observed between teeth that were treated in one visit (without) and two visits with inclusion of calcium hydroxide for 4 weeks. The presence of a positive bacterial culture (CFU<10(2)) at the time of filling did not influence the outcome of treatment.

Adult↗
PubMed2005

The effect of endodontic therapy on periapical exudate neutrophil elastase and prostaglandin-E2 levels.

This study aimed to investigate periapical exudate neutrophil elastase (NE) and prostaglandin E2 (PGE2) levels and their relationships with clinical symptoms, and to determine the changes of their levels following first treatment visit. Periapical exudate samples were collected from the canals of 34 nonvital single-rooted teeth at two sequential treatment visits. Periapical exudate NE and PGE2 levels were found to be higher in the presence of clinical symptoms (pus discharge, swelling) (p < 0.05). The canals of teeth with larger periapical radiolucent area (>or=1 cm) contained more PGE2 levels than with smaller ones (<1 cm) (p < 0.05). Periapical exudate NE levels were significantly correlated with PGE2 levels (p < 0.05), and their levels at first treatment visit did not change following root canal therapy (p > 0.05). The periapical exudate NE and PGE2 levels may regulate periapical disease expression, but the results of this study were unable to reveal this association.

Adult↗
PubMed1990

Tissue response to glass ionomer retrograde root fillings.

The periapical tissue response to glass ionomer cement retrograde root fillings was investigated both in the presence and in the absence of fillings in the root canals of eight upper incisor teeth of four monkeys. The pulps of the teeth were extirpated and one canal in each pair was filled with laterally condensed gutta-percha immediately after canal preparation. The other canal was prepared but left open to oral contamination. Apicectomies were performed on both teeth in each pair 1 week later, and glass ionomer cement retrograde root fillings were placed. After 5 months, the teeth and surrounding tissues were removed and prepared for histological examination. All four of the teeth without root canal fillings showed severe periapical inflammation, and bacterial were present in the interface between the dentine and the retrograde root filling. The teeth with root canal fillings showed little or no periapical inflammation. This study showed that adhesive retrograde root fillings were successful when the root canal was completely filled, but in the absence of a gutta-percha canal filling they failed to provide a seal.

Animals↗
PubMed1987

The calcifying potential of the pulpless open apex in untreated teeth of dogs.

Pulpectomies were performed on 22 immature premolars (44 root canals) from 3 young dogs. The root canals remained unfilled and the access cavities were sealed with amalgam. After observation periods of 7, 15 and 45 days, the apical and periapical regions of the teeth were evaluated histopathologically. Hard tissue formation was found in 32 open apices. The apical calcification occurred only in specimens with intracanal vital tissue. The severity of periapical inflammatory response had no relationship to the presence or absence of apical hard tissue formation. No apical bridging was seen in specimens where epithelial proliferation had occurred.

Animals↗
PubMed1981

Influence on periapical tissues of indigenous oral bacteria and necrotic pulp tissue in monkeys.

In nine monkeys (Macaca fascicularis) the pulps of 78 teeth were aseptically necrotized. Twenty-six of the pulp chambers were kept bacteria-free by sealing, while 52 were infected by the indigenous oral flora. The results were recorded clinically, radiographically and microbiologically at the beginning of the experiment and after 6-7 months. The final examination also included histologic recordings. The initially noninfected root canals were all sterile at the final samplings, indicating that the risk of contamination (including hematogenous) of root canals of this animal is very slight. It was shown that noninfected necrotic pulp tissue did not induce inflammatory reactions in the apical tissues. By contrast, teeth with infected pulp tissue showed inflammatory reactions clinically (12/52 teeth) and radiographically (47/52 teeth). Facultatively anaerobic streptococci, coliform rods and obligately anaerobic bacterial strains were most frequently found. In the final samples the number of obligately anaerobic strains increased. Some microorganisms which were isolated in the initial samples were not detected in the final samples. All infected teeth histologically examined showed strong inflammatory reactions in the periapical region.

Animals↗
PubMed1996

Effect of various sealers with gutta-percha as root-end fillings on healing after replantation.

This study examined histologically the effect of three sealers used with gutta-percha as root-end fillings placed in a replantation model. A total of 14 molar teeth were used in seven monkeys. After extraction, root ends were resected, the canals contaminated with oral bacteria, root-end cavities prepared, and fillings of gutta-percha and sealer placed prior to replantation. After 8 weeks the teeth and surrounding jaw were removed and prepared for histological examination. Six roots filled with gutta-percha plus a fortified zinc oxide-eugenol cement (IRM), 13 with gutta-percha plus zinc oxide-eugenol (EP), and eight with gutta-percha plus Kloropercha, were available for examination. The tissue response to gutta-percha with either zinc oxide material was characterized by little or no inflammation of limited extent. In contrast, more severe inflammation was observed against root ends filled with gutta-percha and Kloropercha. Gutta-percha plus IRM or zinc oxide-eugenol had a much more favourable response than that to amalgam reported previously in a similar experiment.

Animals↗