[New center for rare diseases. Interview by Marit Fonn].
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Biomedical subjects
Publications and source records attributed to K Langeland.
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The purpose of this study was to develop methods and criteria for the testing of the biocompatibility of endodontic materials. One hundred twenty-one teeth from 12 baboons (Papio anubis) were used to test three sealers: AH26, Kerr pulp canal sealer, and Kloroperka N.O. Gutta-percha cones were used as solid core in all cases. Under disinfected conditions, access preparation was performed, and with working length approximately 1.0 mm short of the foramen, the instrumentation of the root canal was started, using sodium hypochlorite (1%) for irrigation. After the root canals were cleaned and shaped, they were obturated with gutta-percha cones and the sealer, and by lateral condensation technique. Histologic periapical reactions were evaluated at 1, 7, 30, 365, 730, and 1095 days. The methods and criteria used were adequate for ranking of the biocompatibility of the tested materials in the short and long periods. At short observation periods (1 to 7 days) AH26 caused severe reactions, and Kerr pulp canal sealer and Kloroperka N.O., moderate and mild reactions, respectively. At 2- and 3-year observation periods the ranking was AH26, mild; Kerr pulp canal sealer, moderate; and Kloropercha N.O., severe.
One hundred fifty cases of endodontic treatment failures were studied clinically, radiographically, and histologically. Fifty-seven percent of the teeth were asymptomatic. Pain alone and/or associated with swelling was present in 21% of the teeth. There was no correlation between the size of periradicular rarefaction and the occurrence or severity of clinical signs and/or symptoms. Stainable bacteria were demonstrated in 69% of the teeth and were present mostly in the canal. The severity of periradicular inflammation was related to presence of stainable bacteria in the canal. Swelling and pain or a draining sinus tract was often associated with stainable bacteria inside the canal. The development of a radicular cyst associated with an endodontically treated tooth that has failed is not necessarily the cause of endodontic treatment failure.
This study consisted of biopsies of teeth and root tips removed after Ca(OH)2 therapy. The teeth were clinically intact or exposed to caries, trauma, and/or iatrogenesis. Following the therapy most of the canal walls were clean, but the canals contained varying amounts of pulp tissues, debris and Ca(OH)2 particles. In one case microrganisms were present in the apical part of the canal, but not beyond the foramen. The Ca(OH)2 therapy was efficient for its purpose.
Dentinal tubules of the root canal walls of human teeth were infected in vitro with a known bacterial isolate. The roots were exposed to either calcium hydroxide or iodine potassium-iodide for various periods of time and the viability of microorganisms was determined by incubation of entire root samples in a culture medium. The effects of the two agents on microbial viability were evaluated and compared. Iodine potassium-iodide disinfected dentin effectively. In contrast, bacteria remained viable in the dentin after relatively extended periods of calcium hydroxide treatment.
A random sample of 967 subjects selected from the total population in a Swedish county were examined radiographically regarding prevalence and quality of endodontic treatment and occurrence of periapical lesions. The relationship between the technical standard of endodontic treatment and the occurrence of periapical lesions was also analyzed. Of the selected individuals, 95% attended examination (751 dentate and 169 edentulous individuals). Of the 17,430 teeth examined, 1,492 (8.6%) were endodontically treated. Approximately 70% of the treated root canals were inadequately obturated; 10% showed excess of root filling beyond the apex. The prevalence of periapical lesions was 2.9%, and 24.5% of the endodontically treated roots demonstrated periapical lesions. Root fillings ending more than 2 mm from apex had a significantly lower frequency of periapical lesions than root fillings ending within 2 mm of the apex. No difference in the frequency of periapical lesions was found between properly and improperly obturated root canals. Excess of root filling material beyond the apex was related to a significantly higher frequency of periapical lesions.
A case of bilateral dens evaginatus is presented. The difficulty of clinical diagnosis and the limited value of pulp testing in cases of dens evaginatus are discussed.
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This study correlated clinical, radiographic, and histopathologic aspects of 50 endodontic failures involving the paste technique. All clinical and radiographic findings were recorded. The teeth were re-treated with gutta-percha/Kloroperka and lateral condensation. Subsequently, periapical surgery, including retrograde amalgam filling, was performed for the removal of material in the periapical tissue. The resulting biopsy specimens were processed for histologic evaluation. Although neutrophilic leukocytes predominated in some cases, all types of inflammatory cells were present. Macrophages and foreign body cells contained paste particles. The blood pigment distinguished hemorrhage due to surgery from pathologic circulatory changes. There was resorption/apposition of bone and root fragments. Epithelial strands and parts of cyst walls were observed. There was a correlation between a periapical radiolucency and inflammation but no correlation between amounts and types of inflammatory cells and pain. Paste placed beyond the foramen caused tissue damage and reduced prognosis.
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