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Use of EMLA: is it an injection free alternative?

This study was conducted to evaluate the use of Eutectic Mixture of Local Anesthetics (EMLA) for various clinical procedures such as extraction of the mobile primary teeth, root stumps as well as pulpal therapy procedures in the primary teeth. Thirty children in need of routine dental procedures were selected and procedures were done under a single anesthesia of EMLA. Pain perception and the effectiveness of anesthesia were evaluated with the Eland's color scale and Lickert's scale respectively. Results showed that use of EMLA could to some extent eliminate the use of the needle in the procedures performed especially in pediatric dentistry.

Abscess↗

A radiographic study of the relationship between technical quality of coronoradicular posts and periapical status in a Jordanian population.

A radiographic study was conducted to investigate the relationship between the technical quality of coronoradicular posts and periapical status. A total of 400 periapical radiographs, including 560 posts, of patients attending the Dental Department at Jordan University Hospital were scanned and studied. It was found that maxillary teeth were more frequently restored with posts (65.36%) than mandibular teeth (34.64%). Tapered posts accounted for 73.93% of the posts used. The ratio of the mean post length to crown length was 0.8, and that to root length was 0.45. The mean length of the remaining gutta percha apical to the end of the post was 6.22 mm. In addition, 25% of the posts deviated from the line of the root canal. Periapical radiolucency was evident in 53.93% of the assessed teeth. It is concluded that inadequate root canal treatment and coronoradicular posts are associated with increased prevalence of periapical radiolucency, and that general dental practitioners should be better trained in performing endodontic treatment and restoring endodontically treated teeth.

Dental Prosthesis Design↗

Aesthetic posts and cores for metal-free restoration of endodontically treated teeth.

Utilization of contemporary post and core systems has facilitated the aesthetic restoration of endodontically treated teeth. Light transmission and biocompatibility have been enhanced by the introduction of metal-free post systems. The periodontal and endodontic status, root length, and histological structure of the devitalized teeth must be considered in order to achieve successful restoration following endodontic treatment. This article presents various restorative criteria for the aesthetic placement and buildup of post and core materials, as well as the preservation of maximum coronal and root structure.

Biocompatible Materials↗

Restoration of endodontically treated teeth: a review.

The concept of restoring a pulpless tooth with post, core and/or crown is based on the belief that the root-filled tooth becomes brittle as a result of loss of moisture content. However, recent studies revealed that the moisture content of a root-filled tooth is not significantly different from that of a vital tooth. A survey of dentist' philosophies and techniques of restoring pulpless tooth conducted in the United States of America (U.S.A.) revealed that approximately 50 per cent of the respondents believed that a post would reinforce an endodontically treated tooth, while other studies reported no statistically significant advantage to reinforcing the teeth. Therefore, the concept that all anterior teeth that have received root canal therapy require posts and crowns is not supported by recent studies. But the access cavity for the root canal treatment should be as conservative as possible so that the tooth is not weakened unnecessarily. Based on a review of the literature, this article intends to provide a guideline for the restoration of endodontically treated teeth.

Dental Materials↗

Root resorption and pulpal changes due to intrusive force.

Intrusion has been regarded as a controversial topic in the literature. It is apparent from many studies that excessive forces applied in orthodontic treatment might lead to undesirable results such as circulatory disturbances, pulp degeneration, calcification and even necrosis. This study was performed to observe the reaction of pulp and roots following tooth intrusion. Material consisted of four first premolar teeth of two adult patients. One premolar of each patient was intruded orthodontically and the other premolars were taken as controls. The palatal roots of the experimental teeth were cut and examined in scanning electron microscope (SEM) and the pulps of the teeth were examined in transmission electron microscope (TEM). At SEM examination, root surfaces of intruded teeth showed resorption cavities of different diameters and depths. At TEM examination, vascular degeneration was the main change in the pulps of experimental teeth.

Adult↗

Relationship of radiologic and histologic signs of inflammation in human root-filled teeth.

The aim of this study was to determine the relationship between histologic and radiologic signs of inflammation in human root-filled teeth. In addition, other factors with possible importance for apical inflammation were assessed. Fifty-three block sections of root-filled teeth were gathered from human cadavers. The blocks were radiographically exposed, sectioned, and stained with hematoxylin and eosin. Histologic sections were categorized as inflamed or uninflamed. Radiographically, the roots were assigned as apical lucency, widened periodontal ligament (PDL), or no lucency. Presence and contents of accessory canals were recorded (empty, tissue, or filling material). Statistical analysis was performed with the Chi-square test. All roots had accessory canals; 12 showed tissue remnants, and the others were empty. Of the cases, 49% were histologically uninflamed at the apex, and 52% appeared radiographically intact. The odds ratio of finding a histologically inflamed apex with radiologic lucency versus a radiographically intact apex was 9.2 (p = 0.002). The odds ratio of finding a histologically uninflamed apex with a radiologically tight coronal seal versus an unacceptable seal was 3.7 (p = 0.053). It may be concluded that there are relationships between radiologic and histologic signs of inflammation in human root canal-treated teeth. There appears to be a tendency that the radiologically determined quality of the coronal seal has an impact on the histologic state of the root-filled tooth. No relationship was detected between unfilled lateral or accessory canals and the status of inflammation at the periapex (51% inflamed, 49% uninflamed).

Cadaver↗

Dental caries prevalence in early Polynesians from the Hawaiian Islands.

We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.

Adolescent↗

Clinical significance of tooth morphology correlated with periodontal disease-I.

Anatomical abnormalities of tooth and root morphology may not only adversely influence the course and management of periodontal disease due to inaccessibility of periodontal instrumentation and oral hygiene efforts, but are also more likely to adversely become high risk areas for retention of dental plaque and calculus. This article reviewed the results of data on the root morphology and comparative literature associated with prevalence, anatomical considerations and clinical significance in the predisposing factors to the periodontal disease. The purpose was to emphasize the importance of understanding the knowledge concerning the variations of tooth and/or root anatomy as a high risk factor for periodontal disease and as a necessary tool for the prognosis, diagnosis and treatment of existing or potential periodontal disease.

Dental Enamel↗