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Biomedical subjects

P V Abbott

Publications and source records attributed to P V Abbott.

At least 19 recordsLinked to original sources
PubMed2005

Prevalence of apical periodontitis and the quality of endodontic treatment in an adult Belarusian population.

AIM: To estimate the prevalence of teeth with apical periodontitis (AP) and technically failed root fillings in an adult Belarusian population. METHODOLOGY: Panoramic radiographs of all 1423 patients over 15 years of age not seeking emergency dental care, and attending the Dental School of the Belarusian Medical University for the first time during the period from 1 January to 31 December 2001 were examined. The quality of root fillings was scored according to criteria of length proposed by De Moor et al. [International Endodontic Journal 33 (2000) 113] and the periapical status of all teeth (except third molars) was categorized on the basis of presence or absence of radiographic signs of AP. The data were analysed using the chi-square test and odds ratio. RESULTS: Radiographs indicated that 8632 teeth (22% in the maxilla; 21% in the mandible) were missing leaving a total of 31,212 teeth to be assessed. Twenty per cent of the teeth had some filling material in the root canal(s). AP was found in 1141 subjects (80%) and 12% of the teeth. AP was more frequently associated with molar teeth (23%) than premolar (14%), canine (4%) and incisor teeth (6%). AP was diagnosed in 45% of root filled teeth, the remaining cases with AP had not been root filled. Statistical analysis showed that the probability of radiological detection of AP in root filled teeth was 25-fold higher than when the root canals had not been filled (chi2 = 8636.04, P < or = 0.001, odds ratio with 95% confidence intervals: 23.01 < 25.17 < 27.45). Periapical radiolucencies with adequately filled root canals occurred significantly less often than with teeth in which the root canal was filled more than 2 mm from radiographic apex or when filling material was extruded through the apex. CONCLUSION: The prevalence of AP in all age groups in Belarus was higher than in other populations. The probability of AP increased significantly after root canal treatment and was closely correlated with the quality of the root filling.

Adolescent↗
PubMed2005

Drugs for pain management in dentistry.

Pain is one of the most common reasons patients seek dental treatment. It may be due to many different diseases/conditions or it may occur after treatment. Dentists must be able to diagnose the source of pain and have strategies for its management. The '3-D's' principle--diagnosis, dental treatment and drugs--should be used to manage pain. The first, and most important, step is to diagnose the condition causing the pain and identify what caused that condition. Appropriate dental treatment should then be undertaken to remove the cause of the condition as this usually provides rapid resolution of the symptoms. Drugs should only be used as an adjunct to the dental treatment. Most painful problems that require analgesics will be due to inflammation. Pain management drugs include non-narcotic analgesics (e.g., non-steroidal anti-inflammatory drugs, paracetamol, etc) or opioids (i.e., narcotics). Non-steroidal anti-inflammatory drugs (NSAIDs) provide excellent pain relief due to their anti-inflammatory and analgesic action. The most common NSAIDs are aspirin and ibuprofen. Paracetamol gives very effective analgesia but has little anti-inflammatory action. The opioids are powerful analgesics but have significant side effects and therefore they should be reserved for severe pain only. The most commonly-used opioid is codeine, usually in combination with paracetamol. Corticosteroids can also be used for managing inflammation but their use in dentistry is limited to a few very specific situations.

Acetaminophen↗
PubMed2004

Assessing restored teeth with pulp and periapical diseases for the presence of cracks, caries and marginal breakdown.

BACKGROUND: To determine whether clinical examinations and periapical radiographs provide sufficient information to assess the cause of pulp and periapical diseases, the status of teeth when restored and their further treatment needs. Other aims were to determine whether restorations should be removed prior to commencing endodontic treatment, and whether the type and longevity of restorations were related to the presence of disease. METHODS: Information was collected regarding 245 restored teeth from 220 consecutive patients referred for endodontic treatment. Teeth were examined before and after the restorations were removed and the findings were compared. RESULTS: Pre-operative examination revealed 47 (19.2 per cent) teeth had caries, 57 (23.3 per cent) had cracks and 96 (39.2 per cent) had marginal breakdown. After restoration removal, the figures were 211 (86.1 per cent), 147 (60 per cent), and 244 (99.6 per cent) respectively. Almost all teeth (93 per cent) had more than one of these factors and periapical radiographs were unreliable indicators of their presence. There was only a 56.1 per cent chance (with 95 per cent Confidence Interval) of finding caries, cracks or marginal breakdown prior to restoration removal. Composite resins were more often associated with early onset and rapid progression of pulp diseases. CONCLUSIONS: All restorations should be removed prior to endodontic treatment in order to remove the common factors that may have caused the pulp and periapical disease, and to assess the tooth's prognosis and future treatment needs.

Composite Resins↗
PubMed2002

Effect of immediate intracanal placement of Ledermix Paste(R) on healing of replanted dog teeth after extended dry times.

Ledermix Paste is a paste containing triamcinolone and demeclocycline with demonstrated anti-inflammatory activity that may slow down resorptive processes after severe traumatic injuries to the dentition. A total of 29 premolar roots of six mongrel dogs were extracted and instrumented with rotary nickel titanium files. Fifteen of these roots were then filled with a calcium hydroxide (Ca(OH)2) slurry and 14 roots were filled with Ledermix Paste paste. All accesses were sealed with glass ionomer and the roots replanted after an extraoral dry time of 60 min. After 4 months, the dogs were killed and the roots prepared for histological evaluation. Five-micrometer thick cross-sections of the root and surrounding tissue taken every 90 micro m were evaluated for healing. In addition, residual root mass was also measured to determine the extent of root structure loss for each treatment method. The Ledermix Paste-treated roots had statistically significantly more healing and less resorption than the roots treated with Ca(OH)2. Root filling with Ledermix Paste also resulted in significantly less loss in root mass due to resorption compared to those roots filled with Ca(OH)2. Immediate intracanal placement of Ledermix Paste at the emergency visit after an avulsion injury appears to decrease resorption and increase favorable healing.

Animals↗
PubMed2002

Incidence of root fractures and methods used for post removal.

AIM: This study was undertaken to determine the incidence of root fractures during post removal, as well as the methods used and the success rates achieved with various post removal devices and techniques. METHODOLOGY: Patient records from a specialist endodontic practice were examined. A total of 1600 teeth from which posts were removed were identified. These teeth had no preoperative signs or symptoms to suggest root fractures. The incidence of root fractures was determined and a subset of 234 patient records were examined in detail to determine the methods used to remove different types of posts. RESULTS: Only one tooth fractured during post removal (0.06%) and all posts were successfully removed, typically in about 3 min. Most cast posts were removed with an Eggler post remover but some dislodged when the crown was removed; ultrasonics was used occasionally. Most parallel-sided posts were removed with ultrasonics and threaded posts were unscrewed. The Masserann kit and ultrasonics were combined to remove fractured cast posts and some parallel-sided posts. CONCLUSIONS: This study indicates that, with good case selection, post removal is a predictable procedure. If appropriate techniques and devices are used for the particular type of post being removed, then root fracture is a rare occurrence.

Cohort Studies↗
PubMed2002

Measurement of strain on tooth roots during post removal with the Eggler post remover.

AIM: The aim was to measure root surface strains in teeth when removing cast post/cores with the Eggler post remover. METHODOLOGY: Two groups of 10 teeth each were tested: group 1 had 1 mm thickness of dentine coronally, and group 2 had 2 mm thickness of dentine. After root filling, 10 mm long cast post/cores were constructed and cemented with zinc phosphate cement, and strain gauges were applied to the roots. The post/cores were removed with the Eggler post remover whilst strain measurements were being recorded. Posts were removed twice: initially along the long axis of the tooth and then at a 10 degrees angle to the long axis. Comparisons between groups 1 and 2 were analysed statistically with the Mann-Whitney U-test whilst strains within each group were analysed with the Wilcoxon Signed Rank test at the 95% level of confidence. RESULTS: There was no significant difference in the strains measured between groups 1 and 2, and no significant difference within each group when removing posts along the long axis of the tooth and at a 10 degrees angle. Three teeth in group 1 and one tooth in group 2 fractured when removing posts at the 10 degrees angle. Three fractures were small slivers of dentine at the point where the Eggler's repeller arms contacted the tooth mesially and distally, whilst one tooth (from group 1) fractured obliquely. CONCLUSIONS: Post removal with the Eggler device is a relatively safe procedure but care must be taken when there is a possibility of pulling the post out in a nonaxial direction or when less than 1 mm of dentine surrounds the apical end of the post.

Cementation↗
PubMed2001

Correlation between clinical success and apical dye penetration.

AIM: This study was undertaken to examine whether a correlation exists between apical dye penetration and the clinical performance of root fillings. METHODOLOGY: Apical dye penetration into 116 roots of human teeth that had been root-filled at least 6 months prior to extraction was tested in vitro using a vacuum technique and by measuring the length of dye penetration. Endodontic treatment was classified as clinically successful or unsuccessful and results for these groups were compared using analysis of variance and the Student's t-test. Positive and negative controls were used to test the experimental system. RESULTS: All controls performed as expected. Dye penetrated significantly further in unsuccessful cases although the raw data suggested little difference. Overall, dye penetrated 99.5% of the specimens, indicating that the presence of dye in the canal is a poor indicator of whether the technique or material will succeed. However, the extent of dye penetration may be related to the clinical outcome. CONCLUSIONS: Clinically placed root canal fillings do not provide an apical seal that prevents fluid penetration. The outcome of treatment cannot be predicted from the results of apical dye leakage studies.

Coloring Agents↗
PubMed2001

Blood flow changes in human dental pulps when capsaicin is applied to the adjacent gingival mucosa.

OBJECTIVE: The purpose of this study was to determine whether changes occur in pulpal blood flow when capsaicin is applied to the adjacent gingival or alveolar mucosa in human beings. STUDY DESIGN: Laser Doppler flowmetry was used to measure changes in pulpal blood flow (PBF) after applying capsaicin to adjacent gingival mucosa in 20 human volunteers. The procedure was repeated on 10 subjects after administration of an ipsilateral inferior alveolar nerve block and on the other 10 subjects after application of topical anesthetic to their adjacent gingival and alveolar mucosa. RESULTS: PBF increased in 16 subjects and did not change in 4 subjects after capsaicin application. Ipsilateral inferior alveolar nerve block did not alter this effect. Pretreatment with topical lidocaine resulted in no change or decreased PBF in 8 subjects and increased PBF in 2 subjects. CONCLUSION: Changes occur in the PBF of the mandibular canine teeth of some humans when capsaicin is applied to the adjacent gingival or alveolar mucosa.

Adult↗
PubMed2000

The effects of Ledermix paste on discolouration of immature teeth.

AIM: The aims of this study were to: (i) investigate the effects of Ledermix paste as an intracanal medicament on discolouration of immature teeth, (ii) examine whether the discolouring effects were related to the method of application, (iii) examine the effects of sunlight upon discolouration of immature teeth and (iv) compare the degree of discolouration between mature and immature teeth. METHODOLOGY: The root canals of 45 immature extracted human teeth were prepared and filled with either Ledermix paste, calcium hydroxide [Ca(OH)2], or saline. In group 1, Ledermix paste was only placed apical to the cemento-enamel junction (CEJ) whilst in groups 2 and 3, the paste filled the entire pulp chamber and the root canals. In group 4, Ca(OH)2 paste and in group 5, saline (control) were allowed to fill the pulp chamber and the root canals. Group 3 teeth were kept in the dark and the other groups were exposed to daylight for 12 weeks. RESULTS: After 12 weeks, sunlight exposure had caused dark grey-brown staining in the Ledermix groups but this did not occur when the teeth were kept in the dark. More severe staining was noted when Ledermix paste filled the pulp chamber than when the paste was restricted to below the CEJ and when teeth were exposed to sunlight. When compared to the results of a similar study using mature teeth, the results were similar but the immature teeth were more severely stained than the mature teeth. The Ca(OH)2 paste caused an increase in lightness and yellowness in immature teeth. CONCLUSION: It was concluded that Ledermix paste may cause discolouration of immature teeth. Such effects can be minimized if placement of the paste is restricted to below the gingival margin. Clinicians should ensure that Ledermix paste is not left on the walls of access cavities, especially in immature teeth.

Analysis of Variance↗
PubMed2000

The effects of Ledermix paste on discolouration of mature teeth.

AIM: The aims of this study were to: (i) investigate the effects of Ledermix paste as an intracanal medicament on discolouration of mature teeth, (ii) examine whether the discolouring effects were related to the method of application, and (iii) examine the effects of sunlight upon discolouration of mature teeth. METHODOLOGY: The root canals of 45 mature extracted human teeth were prepared and filled with either Ledermix paste, calcium hydroxide [Ca(OH)2], or saline. In group 1, Ledermix paste was placed apical to the cemento-enamel junction (CEJ), whilst in groups 2 and 3 the paste filled the entire pulp chamber and root canals. In group 4, a Ca(OH)2 and methyl cellulose paste and, in group 5, saline (control) were allowed to fill the pulp chamber and the root canals. Group 3 teeth were kept in the dark and the other groups were exposed to indirect sunlight for 12 weeks. RESULTS: After 12 weeks, sunlight exposure had caused dark grey-brown staining of the teeth in the Ledermix groups, but this did not occur when the teeth were kept in the dark. More severe staining was noted when Ledermix paste filled the pulp chamber than when the paste was restricted to below the CEJ. CONCLUSIONS: It was concluded that Ledermix paste may cause discolouration of teeth. Such effects can be minimized if placement of the paste is restricted to below the gingival margin. Clinicians should ensure that Ledermix paste is not left on the walls of access cavities.

Analysis of Variance↗
PubMed2000

Apical inflammatory root resorption: a correlative radiographic and histological assessment.

AIM: To assess the reliability of routine single radiographs in the diagnosis of inflammatory apical root resorption by correlating the radiographic and histological findings. METHODOLOGY: The material comprised serial and step serial sections of plastic-embedded root-apices with attached apical periodontitis lesions that were prepared for a previous study and the diagnostic radiographs. The histological sections of 114 specimens were analysed by light microscopy and categorized into three groups: (i) those without any resorption (0); (ii) those with moderate resorption (+); and (iii) those with severe resorption (+ +). The radiographs were examined by a separate examiner and graded with a similar categorization of no resorption (0); moderate (+); and severe (+ +) apical resorption. RESULTS: Radiographically, 19% of the teeth were diagnosed as having apical inflammatory root resorption, whereas histologically, 81% of the teeth revealed apical inflammatory root resorption. A correlative radiographic and histological assessment (n = 104) revealed a coincidence of diagnosis in 7% of the specimens and noncoincidence of diagnosis in 76% of the specimens. CONCLUSIONS: The results indicate that routine single radiographs are not sufficiently accurate or sensitive to consistently diagnose apical root resorptive defects developing as a consequence of apical periodontitis.

Dental Cementum↗
PubMed2000

Selective and intelligent use of antibiotics in endodontics.

Antibiotics have been used extensively for the management of odontogenic infections since their discovery early this century. Although they have been invaluable in the management of acute and severe infections, many members of the dental and medical professions have unfortunately used these drugs inappropriately for the management of dental pain when "local" dental treatment would have sufficed. This, and the general over-use of antibiotics in other situations such as for growth enhancement in animals for human consumption, is leading to the widespread development of strains of bacteria that are resistant to antibiotics--hence, their effectiveness is being reduced at a rapid rate. The dental profession has a responsibility to patients and to the community as a whole to restrict the use of antibiotics to those situations that actually require them. This philosophy should also be extended to other professions who may be called upon to manage dental pain at times.

Agrochemicals↗
PubMed2000

The periapical space--a dynamic interface.

The ultimate aim of endodontic treatment is to encourage the healing of apical periodontitis, or to prevent it from occurring if it was not present prior to treatment. Apical periodontitis is a general term used to describe an inflammatory response to irritation caused by the contents of a root canal system and it has several distinct forms. The most common is a granuloma but this can develop into other disease entities such as an abscess, a periapical pocket cyst or a true cyst, all of which present as radiolucencies. However, periapical radiolucencies may also be caused by extra-radicular infections, foreign body reactions and periapical scars, or they may be due to other tumours and cysts that have not originated from pulp disease. Practitioners must recognize and understand the different pathological entities and the dynamic interactions that occur in the periapical tissues in order to correctly diagnose and treat these conditions.

Acute Disease↗
PubMed1998

Labial and palatal "talon cusps" on the same tooth: A case report.

Talon cusps are uncommon. Although they normally occur on the palatal surface of maxillary incisors, the literature contains two case reports of labial talon cusps. This is the first report describing a tooth with both a labial and a palatal talon cusp and its successful management.

Child↗
PubMed1998

Complicated crown fracture of an unerupted permanent tooth--a case report.

Trauma to primary teeth may result in direct damage to underlying developing permanent teeth because of the close relationship that exists between the apices of the primary teeth and their permanent successors. Injuries to developing teeth have been classified into ten different categories, using a classification that is largely based on developmental alterations to the permanent teeth. However, this classification does not include other types of trauma that may occur to developing teeth, such as crown fractures. Although apparently rare, such injuries can occur by direct contact of the impacting object with a developing tooth, as illustrated by the following case report.

Child, Preschool↗