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Results for “Tooth, Nonvital”

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At least 163 records · Page 9Linked to original sources

PubMed1996

Repair of incomplete vertical root fractures in endodontically treated teeth--in vivo trials.

An in vivo clinical study was performed to evaluate the healing of a new approach to the repair of incomplete vertical root fractures. The two-stage surgical procedure incorporated ultrasonic fracture cleaning, bonding of the fracture repair with silver glass-ionomer cement, placement of a bone graft material, and application of guided-tissue regeneration. Of the six roots in the study, five failed within 2 to 11 months. One root continued to be symptom-free, without periodontal pocket formation for 1 yr, but then failed because of extension of the incomplete root fracture to the lingual of the root.

Bone Transplantation↗

PubMed1997

Frequency of endodontic treatment in Kuwait: radiographic evaluation of 846 endodontically treated teeth.

A retrospective study was conducted to evaluate the radiographic films of 846 endodontically treated teeth at Benied Al Ghar Dental Center in Kuwait. The most frequently treated tooth was the mandibular first molar (17.4%). The number, percentage, and distribution of the roots, root canals, and apical foramina were reported by individual tooth. The clinical findings were compared to the results of previously related in vitro and in vivo studies.

Adolescent↗

PubMed1997

Evaluation of a combined surgical repair and guided tissue regeneration technique to treat recent root canal perforations.

This study evaluated a technique that included retrofill to repair molar root canal perforations and guided tissue regeneration to restore the periodontium that was removed from the furcation area for access to the sites. Six dogs had root canal therapy on mandibular fourth premolars and first molars. The distal root of each tooth was perforated on the furcation aspect halfway between the furcation and the apex. Replaced flap surgery was performed for access to prepare and fill the perforation site with intermediate Restorative Material. A bone xenograft was placed in the access ostectomy site and covered with GoreTex Augmentation Material (GTAM). Controls included unfilled perforations and not using bone grafts and/or GTAM. Dogs were killed at 6, 12, and 24 wk postsurgery. Complications were more common when root perforations were left unfilled. Histomorphometry revealed a statistically significant decrease in inflammation and more bone fill when root perforations were filled and GTAM was used, respectively.

Analysis of Variance↗

PubMed1997

Periapical replacement resorption of permanent, vital, endodontically treated incisors after orthodontic movement: report of two cases.

Radiographic observations show that periapical replacement resorption (PARR) is a frequent and unpredictable sequella of orthodontic movement of permanent maxillary incisors. Only the apical root portion undergoes resorption, and it is subsequently replaced with normal bone. PARR also occurs without orthodontic tooth movement, but these resorptions differ as to type and location. PARR clearly occurs in teeth with vital pulps after orthodontic movement; however, our two cases and a review of 43 other cases indicate that endodontically treated incisors show a statistically significant lesser frequency and severity of apical resorption than untreated teeth. The role the vital pulp plays in this apical resorption is yet to be determined. A hypothetical explanation is offered suggesting that pulpal neuropeptides may be involved in PARR in both vital and endodontically treated incisors. The role calcium hydroxide plays in endodontically treated teeth is also considered.

Adolescent↗

PubMed1998

Strengthening immature teeth during and after apexification.

The purpose of this study was to evaluate the strengthening effect of an internal resin bonding technique. One hundred central incisors were endodontically treated and divided equally into five groups. Group 1, without any cervical preparation and with access repaired with bonded resin, served as the positive control. Teeth in groups 2 to 5 were cervically prepared to simulate the thin dentinal wall of immature teeth, and obturation material was removed to 3 mm below the cementoenamel junction (CEJ). In group 2, the negative control, the access was restored with bonded composite to the level of the CEJ. In group 3, access was restored with composite resin 3 mm apical to the CEJ using a clear post system. Group 4 was treated similarly to group 3, but an opaque post replaced the clear post. Group 5 was treated like group 3, after which a metal post was cemented into the channel left after removal of the clear post. All teeth were subjected to compression testing and the force required to fracture the teeth cervically was recorded for each group and the Kruskal-Wallis analysis performed to detect intergroup differences. All of the bonded resin techniques significantly strengthened the teeth against fracture, compared with the negative control group (p < 0.05). None of the experimental groups (3-5) were significantly different from the positive control group.

Composite Resins↗

PubMed1998

A clinical study using the collagen gel Zyplast in endodontic treatment.

The use of a collagen gel as a hard tissue induction material in fractured and undeveloped teeth is reviewed. Three of four cases demonstrate a modest amount of hard tissue formation within the pulp space previously occupied by the collagen gel. Limitations in positive results, compared with a previous animal study and one clinical case report, are probably due to the pre-existence of infection in the present study.

Adolescent↗

PubMed1998

Flare-up rate in pulpally necrotic molars in one-visit versus two-visit endodontic treatment.

This retrospective study compared one-visit versus two-visit endodontic treatment. The same technique and materials were used before and after making the sole change to one-visit endodontic treatment in 1991. Treatment records of 402 consecutive patients with pulpally necrotic first and second molars were compared. In 201 patients, treatment was provided by debridement and instrumentation, followed by obturation at a second visit; whereas the second group received single visit therapy. Flare-ups were defined as either patient reports of pain not controlled with over-the-counter medication or as increasing swelling. Sixteen flare-ups (8%) occurred in the two-visit group versus six flare-ups (3%) for the one-visit group. This showed an advantage for one-visit treatment at a 95% confidence level. In a second comparison, one-visit patients who had previously received two-visit treatment for a different pulpally necrotic molar served as their own control. No significant differences were present in this subgroup of 17 patients.

Acute Disease↗

PubMed1998

Microleakage of TERM used with sodium perborate/water and sodium perborate/superoxol in the "walking bleach" technique.

This study compared the sealing ability of TERM as an interim restoration for the "walking bleach" technique when using either sodium perborate/water or sodium perborate/superoxol. Thirty-three extracted maxillary premolars were restored with TERM after placing either a cotton pellet (control), a paste of sodium perborate and water, or a paste of sodium perborate and superoxol in the chamber. Microleakage was assessed at 24 h, 8 days, and 15 days using a fluid filtration method. Statistical analysis revealed both "walking bleach" groups had significantly higher numbers of teeth demonstrating microleakage than the control group. There was no statistically significant difference in microleakage between the two "walking bleach" groups. The results of this study indicated that the temporary restorative material, TERM, provided an unsatisfactory seal when used with either walking bleach technique. When used over a cotton pellet, TERM provided an excellent seal.

Borates↗

PubMed1998

Microleakage of endodontically treated teeth restored with posts.

A fluid filtration system using 15 psi of pressure on the penetrating fluid was used to quantify the amount of microleakage of a stainless-steel post and a carbon-fiber post system, each placed with various cements. Statistical analysis showed that there was a significant difference in microleakage between the cements (p < 0.001). Zinc phosphate cement showed the most microleakage, whereas C & B Metabond cement showed the least. There was no significant difference in microleakage between the stainless-steel and carbon-fiber posts. The results of this study showed that both posts, when cemented with dentin-bonding resin cements (C & B Metabond and Panavia-21), exhibited less microleakage than when cemented with non-dentin-bonding cements (glass ionomer and zinc phosphate).

Analysis of Variance↗

PubMed1998

An in vivo evaluation of an electronic apex locator that uses the ratio method in vital and necrotic canals.

The purpose of this study was to compare the canal length determined by an apex locator to the apical constriction in both vital and necrotic canals. Informed consent was obtained from patients waiting to have teeth extracted. The teeth were anesthetized, isolated, and accessed. The pulp was considered vital if bleeding was present in the pulp chamber. The Root ZX was used to measure the root canal length. The file was cemented into place, and the tooth was extracted. Twenty-nine teeth containing 34 cemented files were studied, and the distance from the apical constriction was measured. The Root ZX was 82.3% accurate to within 0.5 mm of the apical constriction. The mean distance from the apical constriction was 0.21 mm in vital cases versus 0.49 mm for necrotic cases. There was no statistical difference between the ability of the Root ZX to determine the apical constriction in vital canals versus necrotic canals.

Adult↗

PubMed1999

Radiographic appearance of titanium posts in endodontically treated teeth.

Titanium and titanium alloy posts are currently being used in complex dental restorations. Titanium posts have been shown to be less radiopaque than stainless steel and to have a radiographic density similar to gutta-percha. This radiographic similarity can make detection of a titanium post difficult. Failure to identify the presence of a titanium post before the initiation of retreatment could cause significant complications for the treating endodontist. Five cases are presented to describe the radiographic subtleties that can be used to detect the presence of a titanium post.

Dental Alloys↗

PubMed1999

A lesion of endodontic origin misdiagnosed as a globulomaxillary cyst.

This report presents a case of a lesion originating from a pulpless central incisor misdiagnosed as a globulomaxillary cyst. The initial diagnosis of globulomaxillary cyst was made solely from radiographs by observing an almond-shaped radiolucency between the lateral incisor and cuspid. No pulp testing was performed before surgical removal of the lesion. The final diagnosis of an endodontic lesion caused solely by a pulpless central incisor was complicated by the initial lack of a pulpal response from the lateral incisor next to the surgical site. By delaying the start of endodontic treatment, pulp sensibility returned to the lateral incisor and the diagnosis of an endodontic lesion caused only by a pulpless central incisor was confirmed.

Adolescent↗

PubMed1999

An evaluation of endodontically treated vertically fractured teeth.

For this survey, 92 vertically fractured endodontically treated teeth were evaluated clinically and radiographically before and after extraction. The maxillary second premolars (27.2%) and mesial roots of the mandibular molars (24%) were the most fractured teeth. In 67.4% of the teeth, a solitary buccal pocket was present; in 34.8%, a fistula frequently appeared closer to the gingival margin than to the apical area. A lateral radiolucency or a combination of lateral and periapical radiolucency was found in more than half of the cases. The general practitioners correctly diagnosed vertical root fracture in only one-third of the 92 fractured teeth in this survey.

Adolescent↗

PubMed1999

Long-term radiographic and histological observations of endodontically treated teeth.

Endodontic therapy was performed on 14 teeth in juveniles with inflamed or necrotic pulps. The patients were recalled at 6-month intervals for radiological and clinical examinations. After 1 yr, periapical surgery was performed on six teeth. After 18 months, 5 more patients were subjected to periapical surgery and, after 2 1/2 years, 3 more patients had periapical surgery. A small block section containing the root tip and surrounding tissues was removed from all of the patients. Radiographs showed reductions in size, but not elimination, of periapical lesions. Histological examinations revealed that most root canals were overfilled. Inflammation persisted around zinc oxide-eugenol particles beyond the tooth apexes. In addition, gutta-percha overfilling enhanced the proliferation of cell rests of Malassez. In some cases, dentin filings were found at and beyond the tooth apexes. The formation of new hard tissue was stimulated by the presence of dentin chips.

Extravasation of Diagnostic and Therapeutic Materi↗

PubMed1999

Evaluation of pigmented intraorifice barriers in endodontically treated teeth.

The purpose of this study was to evaluate the effectiveness of three pigmented glass ionomer cements used as intraorifice barriers to prevent coronal microleakage. One hundred ten extracted mandibular human premolars were divided into four experimental groups of 25 teeth each and two control groups of 5 teeth each. The experimental teeth were instrumented and obturated using thermoplasticized gutta-percha and AH26 sealer. Group 1 teeth received no further treatment. Teeth in groups 2 through 4 had 1 of 3 pigmented glass ionomers (Vitrebond, GC America, and Ketac-Bond) placed as an intraorifice barrier. Positive control teeth were instrumented but not obturated. The negative control teeth were instrumented, obturated, and externally sealed with epoxy resin. The coronal 3 mm of each root was sealed into the lumen of an 18-mm segment of latex surgical tubing. After the apparatus was sterilized, 2.0 ml of a 24 h growth of Proteus vulgaris in trypticase soy broth (TSB) was placed in the coronal reservoir of the tooth. The inoculated apparatus was placed into a presterilized test tube containing 1.5 ml of TSB and incubated for 90 days at 37 degrees C. The TSB in the lower reservoir was observed daily for turbidity, which would indicate leakage along the full length of the obturated root canal. To determine if differences in microbial leakage occurred among the four experimental groups, Pearson's chi 2 and Fisher's exact tests were performed. The confidence level was set at 95%. The positive and negative controls validated the microbial testing method. The teeth without an intraorifice barrier leaked significantly more than teeth with Vitrebond intraorifice barriers (p < 0.05). The difference in leakage among the experimental glass ionomer barriers was not significant (p > 0.05).

Chi-Square Distribution↗

PubMed1999

In vitro fracture strength of endodontically treated premolars.

The recent introduction of new bonding agents has led some authors to suggest that certain endodontically treated posterior teeth could be restored with a bonded restoration instead of a full-coverage crown or onlay. To test the fracture resistance of endodontically treated premolars restored with and without bonding agents, we randomly divided 56 intact and caries-free maxillary premolars into seven groups as follows: unaltered teeth; access only; MOD prep and RCT; MOD prep, RCT, and amalgam restoration; MOD prep, RCT, and amalgam with 4-META bonding agent; MOD prep, RCT, and composite resin restoration; and MOD prep, RCT, and composite resin with 4-META bonding agent. The teeth were subjected to compressive fracture tests in a Zwick 1435 Universal Testing Machine. Unaltered teeth and those with access only demonstrated similar fracture strengths. Under the conditions of this study, there was no significant difference in fracture strength between the experimental groups.

Acrylic Resins↗

PubMed1998

Bond strength between cements and metals used for endodontic posts.

OBJECTIVES: Adhesive cements used with metal endodontic posts may decrease fracture in non-vital teeth. Results from studies that evaluate cements for post retention by pulling posts out of extracted teeth are difficult to interpret owing to the number of interfaces where fracture might occur. The objective of this study was to isolate the metal/cement interface for tensile bond strength testing and microscopic observation. METHODS: Three metals and seven cement treatments were examined for bond strength by using a truncated cone tensile test. The bond strength data were analyzed by a two-way ANOVA and Scheffé's multiple comparison test at p = 0.05. Specimens were examined at 50x magnification to determine the failure mode and with scanning electron microscopy (500x) to observe the surfaces after debonding. RESULTS: Significant differences in tensile bond strengths were found among cements compared within two of the metal groups. One of the metal groups had no significant differences among cement bonds. When comparing within cement treatment groups, two groups had significant differences in bond strength among the metals. Microscopic observations revealed adhesive, cohesive and mixed failure modes that varied with cement treatment and metal combination. The interaction between metal and cement was a critical determinant of the strength and characteristic fracture mode of the bond achieved. SIGNIFICANCE: Some of the cement treatments performed better (i.e., higher bond strength) with some metals than with others. Other cements had similar bond strengths with all three metals. Because of this interaction, careful consideration of the materials combination should help to maximize the bond at the metal/cement interface.

Adhesiveness↗

PubMed1999

Long-term effect of mandibular midline distraction osteogenesis on the status of the temporomandibular joint, teeth, periodontal structures, and neurosensory function.

PURPOSE: This study retrospectively evaluated the long-term effects of transverse symphyseal distraction osteogenesis (DO) on the temporomandibular joint (TMJ) symptoms, periodontal health, tooth vitality, and nerve injury after surgery. PATIENTS AND METHODS: Twenty-three patients were treated with symphyseal DO during a 4-year period. Fifteen patients were available for follow-up from 7 to 45 months postoperatively (ave, 24.5 months). The patients were clinically evaluated for TMJ symptoms, periodontal pocket formation, tooth vitality and mobility, crestal bone loss, and attached gingival tissue changes. Radiographs of the mandibular anterior teeth were used to evaluate for periodontal bone loss, periapical lesions, or widening of the periodontal ligament (PDL). RESULTS: Preoperatively, 47% of the patients had TMJ symptoms. No patient had symptom worsening or developed new symptoms postoperatively. Five patients' TMJ symptoms improved, and 3 experienced complete resolution of symptoms. No periodontal bone loss or soft tissue recession were evident. Tooth vitality was maintained in 13 patients. Two patients developed Class II mobility of 1 mandibular central incisor, 1 patient had tooth pain and a widened PDL adjacent to the osteotomy/corticotomy site, and 1 patient experienced mental nerve paresthesia. CONCLUSIONS: DO can be used to treat transverse discrepancies of the mandible with limited morbidity.

Adolescent↗