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Biomedical subjects

A Y Kaufman

Publications and source records attributed to A Y Kaufman.

At least 19 recordsLinked to original sources
PubMed2003

Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth--report of two cases.

AIM: Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. CASE REPORT: Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. KEY LEARNING POINTS: Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.

Adolescent↗
PubMed2002

Accuracy of a new apex locator: an in vitro study.

AIM: The purpose of this study was to test in an in vitro model the accuracy of a Bingo 1020 electronic apex locator, to compare the results to those of a well known apex locator, Root ZX, as well as to those of the radiographic method of tooth length determination. METHODOLOGY: A total of 120 extracted teeth, preserved in Thymol solution and kept refrigerated, was used for the study. The experiment was performed on single-rooted teeth and on one-root canal, chosen randomly, in multirooted teeth. The teeth were randomly divided into 12 groups of 10 teeth each. After access preparation, the actual length (AL) was measured. The teeth were embedded in an alginate model specially developed for testing apex locators. Electronic tooth length measurements (EL) were carried out prior to root canal preparation using the two electronic apex locators (EAL) - Root ZX and Bingo 1020; three measurements were taken and an average computed. After the third measurement, the file was left in the root canal and a periapical radiograph was taken. The radiographic length (RL) was recorded by measuring the file length from the coronal reference point to the tip of the file. Each root canal was then prepared to a no. 40 K-file diameter using a standardized technique; saline was used for irrigation. Upon completion of the root canal preparation, EL measurements were taken by each EAL in dry conditions and with different irrigation solutions. Each measurement was repeated three times. The RL was recorded according to the last EL measurement. Results were subjected to statistical analysis. RESULTS: In all parameters tested, a significant statistical difference was found between Bingo 1020 and the Root ZX. Measurements obtained using the Bingo 1020 were consistently closer to the AL (0.08 mm) than those obtained using the Root ZX. Both EALs measured the tooth length with great accuracy and a positive correlation of 0.76 (P = 0.00) existed between the two devices. No significant difference was found between the two apex locators when measurements were taken with the different irrigants (P = 0.34) and the content of the root canal did not affect the accuracy of the measurements. Lengths obtained by calculations from the radiographs were longer than the AL as well as the length obtained by both EALs (P = 0.00). CONCLUSIONS: The Bingo 1020 proved to be as reliable as Root ZX and was user friendly. Under the experimental conditions, electronic measurements were more reliable than radiographs in the process of root length determination.

Analysis of Variance↗
PubMed1997

Reliability of different electronic apex locators to detect root perforations in vitro.

The aim of this study was to evaluate the accuracy of the electronic apex locator Root ZX compared to the Sono Explorer Mark II Junior and Apit III in detecting root perforations. Extracted human teeth (n = 30) were perforated artificially in the middle third of the root and embedded in a box containing alginate. Detection of all perforations were carried out with K-files attached to the apex locators tested. The teeth were radiographed after each electronic measurement. The actual location of the tip of the file in relation to the external root surface and the radiographic determination of the perforations were carried out using a stereomicroscope. The mean distance of the tip of the file from the external outline of the root surface was short for all instruments and clinically acceptable (0.06-0.25 mm). There was no clinically significant difference between the morphometric measurements and the radiographic measurements. No statistical significance was found between large perforations (0.55-0.60 mm) and small perforations (0.25-0.40 mm). Under the conditions of this study, all electronic apex locators tested were acceptable clinical tools in the detection of root perforations.

Analysis of Variance↗
PubMed1996

Determination of location of root perforations by electronic apex locators.

OBJECTIVES: This study was conducted to evaluate the accuracy of two electronic apex locators, the Sono Explorer Mark 2 Junior (Hakusui, Osaka, Japan) and Apit 2 (Osada, Tokyo, Japan) in detecting root perforations. The adequacy of radiographs for identifying root perforations was also assessed. STUDY DESIGN: Thirty-two extracted human teeth were perforated in the middle third of the root and embedded in alginate. Determination of all perforations were carried out with K-files no. 25 attached to the apex locators tested. Two radiographs were taken at two angulations after each electronic measurement. The actual location of the file tip in relation to the perforation was determined with a stereomicroscope. A total of 512 radiographs were evaluated to attempt to identify root perforations. RESULTS: The mean distance of the file tip from the external outline of the root surface was short for both instruments. A statistical difference (p < 0.05) was found between the two apex locators in dry canals or if saline solution was present. There was no significant difference between the two instruments in the presence of sodium hypochlorite. Evaluators radiographically identified 45% of the root perforations when located in buccal-lingual directions. CONCLUSION: Under the in vitro conditions of this study, both devices determined the location of the perforations in an acceptable clinical range short of the root surface. Radiographs were found to be less reliable in identification of perforation locations.

Chi-Square Distribution↗
PubMed1996

Electronic length measurement using small and large files in enlarged canals.

Electronic apex locators are frequently used attached to a small size endodontic file; however, the effect on the measurement of the relative diameters of the file and the root canal has not been clarified. In this study, the length of enlarged canals was measured using small size files and files matching the canal diameter to observe a possible discrepancy. The accuracy of electronic length control during canal preparation with rotary files was also assessed. The root canals in 21 extracted, single rooted teeth were accessed, and their actual length (AL) established by passing a size 10 file just through the minor apical foramen. The teeth were then embedded in an alginate mold. The initial canal length (IL) was measured with the Root ZX apex locator by negotiating a size 10 file to the apical constriction. The canal was enlarged to size 60 with rotary files while the length was continuously controlled with the apex locator. Then, the final length measurements were obtained with a size 10 file and a size 60 file (FL-10 and FL-60, respectively). The average values of IL, FL-10 and FL-60 were calculated and compared using Repeated Measures Analysis of Variance followed by Tukey's Studentized Range test (P < 0.05). Using composite resin, the size 60 files were secured at the FL-60 length, the teeth were removed from the alginate mold, stained with Picroformal DI Buoin stain and the position of the file tip was observed histomorphometrically after the apical 4 mm of the canal was exposed by grinding the buccal aspect of the root. The IL was 0.45 mm shorter than AL (P < 0.05). The differences between FL-10, FL-60 and IL were not statistically significant. Histomorphometrically, the apical constriction was absent in all the teeth, but the file tips were confined within the root. This study concluded that the Root ZX indicated the location of an apical constriction even when the anatomic constriction was eliminated. In the enlarged canals, length measurements obtained with small and large size files were comparable.

Analysis of Variance↗
PubMed1993

Root invagination treatment: a conservative approach in endodontics.

The occurrence of dens invaginatus, a developmental anomaly, is reported to be 0.04 to 10%. Treatment modalities, such as extraction, endodontic surgery, and conventional instrumentation of the defect and/or the pulp canal, have been reported. Most suggested treatment modalities are based on the assumption that the tissue inside the invagination communicates with the pulp tissue. However, histological studies show that depending on the type of invagination, the entrapped tissue is mostly connective tissue which may or may not contain pulp tissue components. In situations where the invaginated tissue is contaminated and yet no communication with the pulp cavity exists, it is possible to instrument and disinfect the invagination without affecting the pulp and sacrificing tooth vitality. Such treatment will be referred to as "root invagination treatment." A case is described where tooth vitality was preserved when only the invagination was treated.

Adult↗
PubMed1991

Tooth length determination: a review.

Tooth length determination is a crucial step in endodontic treatment. Until the late 1970s, tooth length determination was based mainly on radiographic interpretation. The advent of apex locators, which identify the difference in the electrical resistance between the root canal and the periodontal membrane, ushered in a new era for measuring tooth length. However, the accuracy of these devices has been questioned. Pertinent literature is discussed with the aim of providing information on the development of the concept, techniques, and devices for tooth length determination.

Dental Pulp Cavity↗
PubMed1990

Developmental anomaly of permanent teeth related to traumatic injury.

A case is presented where a 4-year-old girl was injured in an automobile accident. The dental injury, intrusive luxation of the maxillary deciduous incisors, seemed unimportant at the time, since the child was in critical condition. The situation was first evaluated 5 years later, when the child was referred for treatment of an apical periodontitis originating from the right central incisor. The present case reflects several important aspects that were overlooked at the time of injury: the potential of intruded luxated deciduous teeth to cause developmental anomalies to the permanent dentition; the necessity of a longer follow-up period to detect such anomalies; and the need to develop effective treatment methods.

Child↗
PubMed1989

The efficiency and reliability of the Dentometer for detecting root canal length.

The accuracies of an analog-indicating electronic device, the Dentometer, and of an audio-indicating device, the Sono-Explorer, were compared to each other and to the radiographic method of tooth length determination. Readings obtained by the Dentometer were shorter, an average of 0.28 +/- 0.64 mm than those obtained by the Sono-Explorer (p less than 0.001) and 0.32 +/- 0.63 mm shorter than the results obtained by the calculated working length (p less than 0.001). No statistically significant difference was found between the readings of the Sono-Explorer and the calculated radiographic working length. The results indicate that the measurements calculated by the radiographic method were longer than those obtained by the electronic method of tooth length determination. The statistically significant difference found between the two devices indicates that to determine the accuracy of electronic devices, they should be tested and compared to other methods or devices.

Dental Pulp Cavity↗
PubMed1989

Life and AH26 as sealers in thermatically compacted gutta-percha root canal fillings: leakage to a dye.

Calcium hydroxide-containing root canal sealers may encourage apical obturation by cementum. Hard-setting bases with calcium hydroxide induce calcification, but set too quickly to permit lateral condensation of gutta-percha. Since thermatic compaction requires less time than lateral condensation, the possibility of using this method with Life as a sealer was investigated. Seventy roots were prepared and filled with gutta-percha using the Engine Plugger for thermatic compaction. In one group of 20 Life was used as a sealer. AH26 was used in another group of 20. The remainder served as controls. Leakage was tested by linear penetration of Procion B Blue dye measured after clearing the teeth. In the Life group the mean dye penetration was 0.575 mm versus 1.025 mm in AH26, but the difference was not statistically significant. The results indicated that Life could be used in thermatic compaction of gutta-percha and that it provided a seal comparable to that obtained with AH26.

Bismuth↗
PubMed1989

Conservative treatment of root perforations using apex locator and thermatic compactor--case study of a new method.

Endodontic perforation, a serious complication in dental practice, is among the most common problems associated with endodontic procedures. Recommended methods of treatment are surgical or conservative using calcium hydroxide paste. A method in which perforations can be obturated immediately after their detection is described. The method utilizes an apex locator for measurement and detection of the perforation and a two-step treatment of thermatic compaction for filling the root canal as well as the perforation. A number of cases with a long follow-up are presented.

Adult↗
PubMed1989

Hypersensitivity to sodium hypochlorite.

Sodium hypochlorite (NaOCl), the most commonly used irrigant in endodontics, is known to produce allergic reactions. This fact, however, is rarely mentioned in endodontic texts. Until now, only two cases of adverse reaction describing accidental injection of NaOCl have been reported. In the current study a case is presented in which hypersensitivity to household bleach was proven with skin patch tests. The clinician was warned of the possible health hazard from using NaOCl in this patient by the past medical history. Endodontic therapy was carried out with an irrigant not containing NaOCl after the allergy to NaOCl was verified. Treatment was uneventful. It is suggested that before any endodontic treatment in which sodium hypochlorite is to be used, the patient should be asked about hypersensitivity to household bleaching materials.

Adolescent↗
PubMed1989

Reduction of dental plaque formation by chlorhexidine dihydrochloride lozenges.

The effect of chlorhexidine dihydrochloride (chlorhex HCl) in lozenges on plaque growth was assessed on 21 subjects with fresh plaque of 7 days duration. The lozenges, which contained 5 mg chlorhex HCl, were sucked three times daily after meals, for 2 weeks. The study was a single-blind crossover. Placebo lozenges had all the ingredients except chlorhex HCl. These were used as a control. Results indicated that lozenges containing chlorhex HCl were a potent plaque inhibitor. The mean plaque score was reduced by 62.8% from an initial mean plaque score (DO) of 2.38 +/- 0.48 to (D7) 0.89 +/- 0.26 (p less than 0.0001), after 1 wk of usage. A further reduction to plaque score (D14) of 0.56 +/- 0.27 (p less than 0.0001) was recorded by the end of the 2nd wk. Usage of the placebo during the same time period did not show significant differences in the plaque score (DO = 2.38; D7 = 2.33; D14 = 2.42). Inhibition of plaque formation to the 1104 test surfaces revealed a total elimination of the higher levels of plaque (scores 4 and 5), a considerable reduction of the middle levels (scores 2 and 3) and a significant increase (44.7%) of low level plaque (score 1). Total elimination of plaque (score 0) was observed in 50.3% of the test group surfaces. Lozenges containing 5 mg chlorhexidine dihydrochloride, taken three times daily, were an efficient, comfortable and potent agent for reducing and inhibiting plaque formation. These lozenges are a more convenient alternative to chlorhexidine mouthrinses and may prove to be superior to these.

Adolescent↗
PubMed1989

An enigmatic sinus tract origin.

Diagnosis of the origin of a sinus tract is very complex. In this case report, a sinus tract stoma appeared above the left maxillary incisor, but the causative tooth was the right maxillary incisor. Incorrect diagnosis led to endodontic treatment of a healthy tooth followed by apicoectomy, which was also ineffective. An endodontic consultation revealed the true origin of the sinus tract. Five days after completing conservative endodontic treatment of the right maxillary incisor, the sinus tract disappeared. This case confirms the need to include a diagnostic tracing radiograph as part of routine diagnostic procedures.

Adult↗
PubMed1986

Comparative study of the configuration and the cleanliness level of root canals prepared with the aid of sodium hypochlorite and bis-dequalinium-acetate solutions.

Bis-dequalinium acetate (BDA), a quaternary ammonium compound, was introduced as a bactericidal and chemotherapeutic agent for endodontic use. This study was undertaken to compare the efficacy of this compound to 5.25% sodium hypochlorite in the cleansing and shaping of root canals. One hundred twenty freshly extracted teeth were divided into three groups. Each group was treated with the aid of the test material; saline solution was used as a control. After completion of the endodontic preparation, a silicone imprint of the canals was performed and the teeth were decalcified. The imprints were examined three-dimensionally to determine the amount of debris and canal configuration due to defective preparation and anatomic variation. No significant difference could be observed between the tested materials with respect to cleanliness and the shape of the canals. At the apical third, however, the BDA-treated canals showed more favorable results with respect to cleanliness. On the basis of the present and previous findings, it was concluded that BDA might be a favorable replacement for sodium hypochlorite as an irrigation solution.

Dental Pulp Cavity↗