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Tooth exfoliation and necrosis of the crestal bone caused by the use of formocresol.

A 68-year-old woman received a formocresol pulpectomy of the right lower lateral incisor. The temporary restoration was lost within hours. The next day, the patient suffered continuous pain, the gingiva sloughed, and the alveolar bone was exposed. Four days after treatment, the patient complained of moderate pain. Six days after the pulpectomy, the tooth spontaneously exfoliated. At this time she was referred to our hospital. The clinical diagnosis was chronic alveolitis. Treatment consisted of irrigation of the area. Three weeks after the pulpectomy, the dull pain had subsided, but the alveolar bone of the area showed increased mobility. Five weeks after the pulpectomy, the mobility of the alveolar bone was more significant and a sequestrectomy was performed with the patient under local anesthesia. The sequestrum of necrotic bone was approximately 10 x 5 x 5 mm in size. The patient has been symptom-free for 2 years since the sequestrectomy.

Aged↗

[Comparison of the effects of three analgesic therapies on odontalgia caused by pulpitis in molars].

PURPOSE: To compare the effects of analgesic therapies on odontalgia caused by pulpitis in molars by three different methods. METHODS: 173 molars were diagnosed as irreversible pulpitis, and randomized block designed in three groups. Under block or local anesthesia: 46 cases of the first group, leaving teeth on open drainage, after 1 day, sealing devitalized material (arsenic), arranged next appointment 2 weeks later. 52 molars of the second group, enlarging exposure site, drainage several minutes only, sealed devitalized material, re-examined 2 weeks later. 75 cases of the third group, removing roof of pulp chamber, undergoing pulpectomy directly, re-examined 1 week later. Adopting VAS(vital analogue scale) to analyze the pulp receptivity of three different methods and to evaluate the analgesic effects by complete analgesia, effective analgesia, and no response. The data was analysed using chi-square test. RESULTS: The rate of complete analgesia was 50.0%, 63.46% and 76.0%, respectively. There was a significant difference in complete analgesia among the three methods. The analgesic effect of the third group (pulpectomy) was significantly higher than that of the first group (P<0.01).Pulpectomy group had impossibility of adverse effects caused by using devitalizing material (arsenic). CONCLUSIONS: It is worthy to adopt pulpectomy extensively to relieve the pain of molars caused by pulpitis clinically. The course of treatment of the third group was significantly shorter than other groups, and the simultaneous symptoms occurred rarely.

Adult↗

[Effect on the development of permanent successors due to the extraction and non-extraction of infected deciduous teeth].

The purpose of this study was to clarify the effects on the eruption and root formation of the permanent successors of deciduous teeth affected by periapical periodontitis. Materials used were forty-one healthy infant dogs about two months old. Standardized X-ray films were taken every two weeks. The period of study ran from the age of ten weeks to twenty eight weeks until the roots of the permanent successors were completed. A total of 328 mandibular teeth were used and classified as P2 and P3 with their preceding deciduous teeth being Dp2 and Dp3. The following four groups were used in this experiment. 1) Extraction group with infected deciduous teeth: The infected deciduous teeth were extracted after being left for four weeks following pulpectomy. 2) Extraction group with healthy deciduous teeth: Healthy deciduous teeth were extracted from fourteen-week olds. 3) Left-alone group with infected deciduous teeth: After pulpectomy the infected deciduous teeth were left until they were shed naturally. 4) Healthy group (control): Untreated teeth were observed which represented the opposites of all the teeth examined in the previous three groups. A study was made of the changes in location, eruption and root formation of the permanent successors of deciduous teeth in affected with periapical periodontitis and the condition of eruption and root formation of the permanent successors. The result were as follows. 1. Appearance rate of periapical periodontitis: 1) DP2: Two weeks after pulpectomy, periapical periodontitis was observed in eleven out of twenty-one teeth (52.4%), and after four weeks in seventeen out of twenty-one teeth (81.0%). 2) Dp3: Two weeks after pulpectomy, periapical periodontitis was observed in eighteen out of twenty-one teeth (85.7%), and after four weeks in all of the experimental teeth. The appearance rate of periapical periodontitis in Dp3 was higher than in Dp2. 2. Eruption of permanent successors: 1) Extraction group with infected deciduous teeth: (1) The eruption of permanent successors was accelerated more than the other experimental groups. This tendency was stronger in P3 than in P2. (2) There were changes in location in the upper and lower directions of P2 before extraction of Dp2, in the lower direction for P3 before extraction of Dp3, and in the upper direction for P2 and P3 after extraction of Dp2 and Dp3. 2) Extraction group with healthy deciduous teeth: (1) Eruption of P2 appeared to be almost the same as the control group, but the eruption of P3 was delayed slightly at the eruption from the alveolar bone.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Current and potential pulp therapies for primary and young permanent teeth.

OBJECTIVES: This paper aims to alert the dental practitioner to the rapidly evolving therapies for treating the pulps of primary and young permanent teeth. DATA SOURCES: Experimental research on animals, clinical studies and case reports. STUDY SELECTION: Indirect pulp capping, direct pulp capping, pulpotomies, and pulpectomies are standard procedures for treating primary teeth. However, direct pulp capping, heretofore not very successful, is being revisited. Based on studies in animals and clinical findings in humans, there has been a movement in pediatric dentistry to find alternatives to formocresol and calcium hydroxide for pulpotomy therapy. Venues range from eradication by cautery to the possibility of healing with growth factors. New studies with iodoform paste for pulpectomies are confirming the success rates of previous publications. The new dental adhesives are being tested as agents for direct pulp capping, as well as partial and complete pulpotomy protocols. CONCLUSIONS: More thought is being given by clinicians to preserving pulp, either through more ambitious indirect pulp therapy or partial pulpotomy. Formocresol and calcium hydroxide pulpotomies, while still popular, may soon be challenged by other chemical treatments, electrocautery or stimulation of reparative dentine by growth factors. Iodoform pastes are promising easier and more successful pulpectomy therapy. Total etch direct bonding materials could soon transform direct pulp capping, as well as partial and complete pulpotomy protocols.

Adolescent↗

Effectiveness of prophylactic use of rofecoxib in comparison with ibuprofen on postendodontic pain.

The purpose of this study was to determine if prophylactic rofecoxib would significantly reduce postendodontic pain, when compared with ibuprofen or placebo. An additional objective was to establish if any relationship exists between periapical diagnosis and the need for additional medication after completion of pulpectomy. A total of 45 patients consented to a double-blind, single-dose oral administration of 50 mg of rofecoxib, 600 mg of ibuprofen, or a placebo before conventional root canal therapy. The root canal treatment was performed in two appointments. Patient-reported visual analog scale ratings of pain intensity were conducted upon initial clinical presentation and at 4, 8, 12, 24, 48, and 72 h after completion of pulpectomy. Results showed that at the 4- and 8-h periods, both rofecoxib and ibuprofen provided significantly better pain relief than placebo. At the 12- and 24-h periods, rofecoxib demonstrated significantly better pain relief than both ibuprofen and placebo. Patients with a periapical diagnosis of acute apical periodontitis showed a significantly increased need for additional medication after completion of pulpectomy compared with all other periapical diagnoses.

Acute Disease↗

[Importance of analogs of LHRH in the treatment of bone metastasis of cancer of the prostate in 1988].

LHRH analogous drugs cause a marked decrease of the testicular secretion, similar to that noted after pulpectomy or estrogen therapy. The experience acquired enables to consider LHRH analogous drugs as alternative in the first intention treatment of the bone metastases prostatic cancer if pulpectomy is refused or if estrogen therapy indicated because of its cardiovascular risks. It is not yet whether the systematic and long-term adjunction of an anti-androgen to LHRH analogous drugs, really increases its efficacy. In the late stage of bone metastases, when the effects of pulpectomy estrogen therapy have ended, LHRH analogous drugs only result in when the tumor process is still hormone-dependent.

Androgen Antagonists↗

Pulp treatment for extensive decay in primary teeth.

BACKGROUND: Dental decay in primary teeth remains a considerable health problem. Where decay extends to involve the dental pulp, pulp treatment techniques are often used to manage both symptomatic and symptom free teeth. OBJECTIVES: To assess the relative effectiveness of: various pulp treatment techniques in retaining primary molar teeth with decay involving the pulp for at least 12 months; pulp treatment techniques and extractions in avoiding long term sequelae. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register (August 2002); the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to August 2002); EMBASE (1980 to August 2002); Science Citation Index Expanded (1981 to August 2002); Social Science Citation Index (1981 to August 2002); Index to Scientific and Technical Proceedings (1982 to August 2002); System for Information on Grey Literature in Europe (August 2002). Key journals were handsearched. There was no restriction on language of publication. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs) comparing different pulp treatment techniques (with each other, with extraction or with no treatment) for extensive decay in primary molar teeth. Primary outcomes were extractions following pulp treatment and long term effects. DATA COLLECTION AND ANALYSIS: Data extraction and quality assessment were carried out independently and in duplicate. Authors were contacted for additional information where necessary. MAIN RESULTS: Eighty-two studies were identified but only three were suitable for inclusion. Nine studies meeting the inclusion criteria but with inappropriate study design or analysis are also described. Included trials investigated formocresol pulpotomy, ferric sulphate pulpotomy, electrosurgical pulpotomy or zinc oxide eugenol pulpectomy in symptom free, cariously exposed teeth. Data were unavailable on long term effects. Data on extraction following pulp treatment was available in all three studies and in two studies there was no statistically significant difference between the treatments. The difference seen in the other study, where more teeth treated by ferric sulphate pulpotomy were extracted compared to zinc oxide eugenol pulpectomy, must be viewed with caution. REVIEWER'S CONCLUSIONS: Based on the available RCTs, there is no reliable evidence supporting the superiority of one type of treatment for pulpally involved primary molars. No conclusions can be made as to the optimum treatment or techniques for pulpally involved primary molar teeth due to the scarcity of reliable scientific research. High quality RCTs, with appropriate unit of randomisation and analysis are needed.

Controlled Clinical Trials as Topic↗

Endodontic therapy in the veterinary patient.

Standard root canal therapy is more clearly described as conventional endodontics. Most modern endodontic treatment involves removal of the irreversibly damaged pulp followed by cleaning and shaping of the root canal space and subsequent filling, or obturation, with a semisolid material and a sealer. A general increase in awareness of the benefits of veterinary endodontics has created a rise in the demand for endodontic procedures that help to retain the teeth longer. This article on endodontic therapy includes endodontic anatomy, diagnosis of endodontic disease, pulpectomy techniques of access preparation, canal preparation and filling the canal, partial coronal pulpectomy, and treatment of the open apex. Familiarity of the techniques covered in this article and with advances in veterinary endodontics have become necessary for the veterinary dental practitioner.

Animals↗

A survey of endodontic practice amongst Flemish dentists.

AIM: The purpose of this study was to gather information on routine endodontic treatment performed by Flemish (Dutch-speaking Belgian) dentists. METHODOLOGY: A postal questionnaire was sent to all the 4545 Dutch-speaking dentists registered in Belgium. The questionnaire was made up of 38 questions with multiple-choice answers. Results from 32 questions are presented, covering subjects, such as demographic and professional activity, root-canal preparation and instrumentation, emergency procedures and postoperative complications, choice of irrigants and disinfectants, and choice of obturation techniques. RESULTS: A total of 1143 questionnaires (25.1%) were returned. Approximately 94% of the respondents were general practitioners. The results indicate that there are discrepancies between daily practice and academic teaching, especially regarding the use of rubber dam (only 3.4% report using it as a standard procedure) and the detection and preparation of a second mesiobuccal canal in maxillary first molars (70% never or seldom). Most GDPs reported that they completed treatment in two visits. The majority of practitioners used manual instruments manipulated with a filing technique; 38.9% of the respondents prepared root canals 1 mm short of the radiographic apex. The most popular emergency procedure for acute pain was pulpectomy (40.2%); 48% performed pulpectomy, prescribed analgesics and antibiotics for acute apical periodontitis. Approximately 35% reported complications after cases with chronic apical periodontitis were treated. The first-choice root-canal irrigant was sodium hypochlorite and approximately 65% used intracanal medication. The most popular obturation technique was cold lateral condensation (60%) with 29% using AH26 as a sealer. A high proportion of GDPs (80%) performed re-treatments. CONCLUSIONS: The results of this study confirm that many Flemish general practitioners are not following quality guidelines for endodontic treatment.

Acute Disease↗

Factors affecting treatment outcomes following complicated crown fractures managed in primary and secondary care.

The aims of this retrospective observational study were to determine the factors which affect treatment provision and the Median Survival Time (MST) for maintenance of tooth vitality following complicated crown fracture. The survey was carried out for patients treated at Newcastle Dental Hospital (NDH) according to departmental guidelines over a 2-year period following the introduction of a new protocol for management of these types of injuries. Seventy-three cases of complicated crown fracture were identified in 69 children with a mean age of 10.3 years (SD = 2.5 years). Seventy-one percent of the fractures occurred in males (M:F ratio was 2.5:1). Fifty-one percent of the complicated crown fractures were in immature teeth. Of the 73 traumatised teeth, 45% presented initially in general dental practice (GDP), 37% at the dental hospital and 8% at local accident and emergency departments with the remaining 10% seen at other or unrecorded locations. Of the 41 fractures, which presented initially at a location other than the dental hospital, 38% were referred to the dental hospital without the provision of an emergency pulp bandage. The overall definitive treatments provided for the 37 open apex teeth included pulp cap (19%), partial pulpotomy (32%), cervical pulpotomy (8%) and pulpectomy (35%), while for the 36 closed apex teeth it was pulp cap (28%), pulpotomy (11%), and pulpectomy (61%). Of the 30 teeth, which underwent vital pulp therapy (18 open and 12 closed apex), the MST for the 15 teeth treated with pulp caps was 1460 days (95% CI: 1067, 1853) while for the 15 teeth treated with pulpotomies it was 1375 days (95% CI: 964, 1786). There was no statistically significant difference in the MST between teeth treated with pulp caps and pulpotomies. In conclusion, the proportion of patients referred to secondary care with complicated crown fractures without provision of a pulp bandage is of some concern. More conservative treatment of closed apex teeth sustaining complicated crown fractures, utilizing vital pulp therapy techniques would appear to be appropriate.

Adolescent↗

[Follicular cyst. Apropos of a case].

When there's a diagnosis of follicular cyst. In front of lesions of advanced decay in deciduoud teeth about which is possible to presume chronical apical infection, we have to evaluate carefully the choice of treatment: pulpectomy or exodontia and the placement of a space maintainer. In this article there's a case in which a non-indicated pulpectomy was practised and caused a follicular cyst which is a menace to the formation and position of the unerupted permanent teeth. After the surgery we proceeded to exodontia and subsequently to place a space maintainer.

Child↗

[Clinical use of the Sonic Air MM 1500 and the Meca Sonic 1400 in canal preparation in endodontics].

INTRODUCTION: The preparation for canalisation has remained manual for a long time, technically constrictive and lasting for a long time. The application of ultrasound in Endontony allows us to tackle more calmly the canal course of the teath. The aim of this work is to make a qualitative comparison of the endosonic technique and the manual technique with reference to cases treated in the Dentisterie Opératoire clinic in Dakar. MATERIAL AND METHOD: 40 teeth of a complex canal anatomy and or in the posterior position in the buccal cavity were submitted to either a manual canalisation preparation or endosconic followed by monconic canal filling with a paste: 3 inc oxyde eugenol and iodoform. OPERATING FORMULA: Preparatory X rays: Allow us to evaluate the length of the work or the operating length after catheterisation: LO--length PRO, APEX RADIO-IMM LO--operating length PRO - occlusive point of reference The parietal support technique: The "synergetic" effect of ultrasonic oscillations of cavitation and of micro-acoustic currents associated with the action of the irrigation solution allow us to obtain canal incision. INSTRUMENTS: the pneumatic Sonic Air MM 1500; the Meca Sonic MMR 1400 coupled to a standard ISO motor; SHAPERS and Meca Shapers. Activated by shaper or Méca Shaper. Classic monoconic canal filling: Wadding paste + zinc oxyde paste-iodoform eugenol. X rays for orthocentric monitoring. RESULTS--DISCUSSION: In 60% of the cases treated, the patients presented with a complete dentition. The third inferior molar was in almost all the cases, the cause of the patient seeking a dental consultation. By endosonic treatment-conservation of teeth which would otherwise have been destined for extraction; biopulectomy or instituted pulpectomy for cases of desdodontite, endosconic amplication and canal sealing after the cooling of the inflammation. Duration of treatment: 2 sessions for gangrenous cases or desmodondite and one session for biopulpectomy or pulpectomy, with 4 sessions in 10% of the cases. Operation times: Saving of time of 40-50%. If a second session was necessary, 15-20 minutes was sufficient. Incidents or accidents during or after the operation: breakage of instruments, post-operative inflammatory reaction. CONCLUSION: better distribution of the irrigation solution, lessening of the risk of infection, better quality of the state of the canal surface, reduction in operating time, precision and reliability, conservation of teeth which would otherwise have been extracted, as many of the elements which encourages the appreciation of ultrasound in endodonty.

Dental Cavity Preparation↗

[Root resorption of vital and endodontically treated teeth in orthodontic movement].

Orthodontic tooth movement frequently induces the resorption of the tooth root, although valuable information concerning the relationship between the root resorption and force magnitude, duration and types of tooth movement and the condition of periodontium obtained. However, it is incompletely known that the situation of candidated tooth itself of orthodontic movement in which pulpectomized non-vital condition influence the process of root resorption and subsequent repairing. Thus, the study was conducted to clarify the effect by the pulpectomy accompanied with tooth movement on the process of root resorption and regeneration of periodontium. A hundred and fifty Wistar rats, weight 180-200 g, 6 weeks old, were used as experimental animals. Prior to experimental tooth movement, first molars of 50 rats were received pulpectomy on both sides followed by filling of root canal (first group) and those of another 50 rats on single side (second group). Maxillary first molars of the other 50 rats were saved as a vital dental pulp control (third group). The first and the third groups of animals were then subjected to experimental tooth movement with the interproximal insertion of elastic rubber as described by Waldo (1953) for 3 days, 1, 2, 3 and 4 weeks. After tooth movement was terminated, animals were sacrificed by ether inhalation or by perfusion of glutaraldehyde fixation solution. The upper jaw from each rat was dissected and prepared specimens for non-decalcified section and light microscopic section. Root resorption and regeneration of cementum were evaluated quantitatively using the modular system for semiautomatic quantitative evaluation of images on the light microscopic section. Occurrence of external root resorption with multinucleated odontoclast associated with experimental tooth movement in pulpectomized tooth were lesser and later than those of vital teeth. These findings suggest that the dental pulp plays an important role in the processes of root resorption and remodeling of cementum associated with orthodontic tooth movement.

Animals↗

Occlusion of dentinal tubules and selective block of pulp innervation prevent the nociceptive behaviour induced in rats by intradental application of irritants.

OBJECTIVES: Application of irritants on the exposed dentine of the incisors has been shown to produce aversive behaviour in awake rats. This study aims to demonstrate that the observed aversion is due to the infiltration of irritants through the dentinal tubules and the activation of capsaicin sensitive fibres in the tooth pulp. METHODS: Different groups of rats were subjected, under anaesthesia, to cutting of the distal 2 mm of their lower incisors and the fixation of an artificial crown that allows the application of 10-15 microl of solution. Several procedures were followed to prevent the action of the irritants including occlusion of the dentinal tubules, local application of lidocaine, selective ablation of the capsaicin sensitive primary afferents (CSPA) or incisor pulpectomy; the reactions to intradental application of either capsaicin (1%) or formalin (2.5%) were tested using a newly designed behavioural score. RESULTS: Occlusion of dentinal tubules produced significant attenuation of the nociceptive behaviour induced by dentinal application of either capsaicin or formalin. Similar results were observed following either local block with lidocaine (2%), selective ablation of capsaicin sensitive afferents or total denervation by pulpectomy. CONCLUSIONS: The present results confirm the hypothesis of infiltration of irritants to the incisor pulp through the dentinal tubules and suggest that the reported inflammatory reaction and hyperalgesia are mediated, to a large extent, by capsaicin sensitive primary afferents.

Anesthetics, Local↗

A comparative and ultrastructural study of synaptic contacts established by primary sensory fibers in the spinal trigeminal nucleus of the rat.

A quantitative evaluation of the types of afferent synaptic contacts in the pars oralis, using transganglionic degeneration and a comparison of previous data obtained from the pars interpolaris (Lapa & Bauer, 1992), of the rat was performed. Following left inferior alveolar nerve transection or partial pulpectomy of the first and second left lower molar teeth well-defined degenerating terminals appeared bilaterally. In both experiments, the majority of these afferent synapses formed single asymmetric contacts with intermediate and distal dendritic segments in the pars oralis. Fewer contacts were observed with dendritic spines, proximal dendritic segments, perikarya, and other terminals. Double and multiple synaptic contacts, preferentially with small dendritic profiles, were also found. Pars oralis showed higher density of degenerating terminals and higher proportion of the contralateral contacts than pars interpolaris suggesting that it is a prime input area and that it may play a role in the bilateral management of sensory information. Pars oralis showed a higher density of contacts with intermediate and distal dendritic segment and a lower density of double contacts in comparison to the pars interpolaris. Partial pulpectomy revealed a distribution in synaptic types similar to that following IAN transection suggesting that sensory fibers conveying pain-related stimuli are not distinguished from fibers of other sensory modalities as to preference of synaptic contacts. The overall pattern demonstrates a structural organization of the sensory inputs to the spinal trigeminal nucleus regarding the bilateral handling of sensory information.

Afferent Pathways↗

Evaluation of the combination of flurbiprofen and tramadol for management of endodontic pain.

Effective management of endodontic pain represents a continuing challenge. In this study, we evaluated the efficacy of flurbiprofen and a novel centrally acting analgesic, tramadol, alone and in combination, for reducing pain in endodontic emergency patients. Patients (n = 49) were administered a local anesthetic and underwent pulpectomy. They were then administered, on a double-blind basis, either: (i) placebo (one capsule to start and then every 6 h); (ii) flurbiprofen (100 mg loading dose and then 50 mg every 6 h); (iii) tramadol (100 mg loading dose and then 100 mg every 6 h); or (iv) the combination of flurbiprofen and tramadol (as above). Pulpectomy combined with placebo medication resulted in a 50% reduction in pain by 24 h (p < 0.01). Patients treated with flurbiprofen and tramadol reported less pain, compared with placebo treatment at 6 and 24 h (p < 0.01 for both). These results suggest that a nonsteroidal anti-inflammatory drug/opiate combination, together with endodontic therapy, may be useful in the management of endodontic pain.

Analgesics, Opioid↗

Dental injuries of permanent teeth treated in private practice in Athens.

Although there are several epidemiological studies on dental trauma internationally, there are not many studies that record, analyse and follow different kinds of dental trauma treated in a private office, and that evaluate how parameters such as type of dental trauma, as well as time lapse until treatment might influence the final outcome and the prognosis of the teeth. The sample consisted of 242 patients, 6-17 years of age, with 369 injured teeth treated within a period of 5 years. All the case were treated by the first author and were followed for at least 3 years. The treatment modalities used were based upon the clinical examination and the history of the case and included direct and indirect pulp capping, partial pulpotomy, pulpotomy, pulpectomy and splinting. The type of trauma was classified based on WHO classification partially modified. Seventy six percent of the teeth suffered only hard tissue injuries and 22% had only periodontal ligament PDL) trauma. Of the total number of teeth class I represented 3%, class II 59%, class III 20% and class IV 2%. Of the PDL injuries 14% of the teeth suffered concussion, 69% luxation and 17% exarticulation. The highest incidence of dental trauma was observed at the age of 10. Sixty eight percent of the patients sought treatment 3 days or more after the trauma had occurred delayed treatment), while only 32% within the first 3 days (immediate treatment). The main reasons for delayed treatment were neglect (50%) and unawareness 37%). Of the teeth with delayed treatment 43% became necrotic, while only 28% of the teeth that were treated on time needed pulpectomy. Luxations caused more pulp necrosis (46%) than Class I (0%) Class II (7%) or Class III (34%) type of trauma. The data from this study suggested that a most of the dental injuries on permanent teeth were class II or III type, b) a high percentage (68%) of the patients sought treatment more than 3 days after the injury (delayed treatment), c) delayed treatment caused more necrotic teeth, d) the public should be informed of the importance of immediate treatment in an effort to improve the prognosis of the pulp, e) dentists should be informed of the appropriate treatment of dental injuries since 10.3% of the cases were mistreated.

Adolescent↗

Histological study of the effect of some irrigating solutions on bacterial endotoxin in dogs.

The aim of this study was to evaluate, histopathologically, the effectiveness of mechanical preparation of root canals using different irrigating solutions in dog teeth filled with LPS after pulpectomy. A total of 120 root canals of 6 mongrel dogs were filled with a solution of LPS after pulpectomy. The irrigating solutions used were saline, 1, 2.5, and 5% sodium hypochlorite, and 2% chlorhexidine. No irrigation was used in the control group. The animals were sacrificed after 60 days and the teeth were fixed and demineralized. Subsequently, serial 6-microm sections were stained with hematoxylin and eosin and Mallory's trichrome for histopathological analysis and Brown-Brenn for verification of bacterial contamination. Analysis showed that the inflammatory infiltrate was statistically less intense in the groups in which the root canals were irrigated with 5% sodium hypochlorite and 2% chlorhexidine. However, none of the irrigating solutions completely inactivated the harmful effects of LPS. Mechanical preparation associated with different irrigating solutions did not completely inactivate LPS.

Animals↗