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PubMed2004

Transalveolar screws and the incidence of dental damage: a prospective study.

The incidence of screw/tooth contact in the placement of transalveolar screws was prospectively studied. The clinical significance of such contact when it occurred was assessed. Patients with fractures of the mandible requiring intra- or post-operative control of their occlusion with transalveolar screws were entered into the study. Following screw removal, contact was assessed radiographically and all teeth adjacent to screws were tested for vitality. Any contacts were judged to be minor if less than 50% of the diameter of the screw hole impinged on a tooth root or major if this was more than 50%. Fifty-four male and one female patients completed the study. There were 232 screws placed in these patients adjacent to 440 teeth. Twenty-six screws (11.2%) had major contacts and 37 (15.9%) had minor contacts. Seventeen teeth tested as non-vital with electronic pulp testing but of these only 6 showed any impingement by screws. Two screws were associated with complications in two patients. Screw/tooth contact does occur using transalveolar screws, however, the incidence of clinically significant damage appears to be very low.

Adolescent↗
PubMed2006

Furcation perforation repair comparing gray and white MTA: a dye extraction study.

The purpose of this study was to evaluate the ability of gray and white ProRoot MTA to seal furcation perforations in mandibular molars using a dye extraction leakage model. Sixty-four mandibular molars were randomly divided into four experimental groups. Six teeth with perforations were used as positive controls and six teeth without perforations were used as negative controls. Perforations in groups 1 and 2 were repaired with white MTA. Groups 3 and 4 were repaired with gray MTA. Dye leakage was tested from an orthograde direction (groups 1 and 3) and a retrograde direction (groups 2 and 4). After dye extraction, absorbance was measured on a spectrophotometer at 550 nm. No statistically significant difference in leakage was found between gray and white MTA when used as a furcation perforation repair material. However, there was significantly more leakage when the perforations were challenged from the orthograde than the retrograde direction (p < 0.001).

Aluminum Compounds↗
PubMed2006

Motorcycle-related maxillofacial injuries among Nigerian intracity road users.

PURPOSE: We sought to determine the etiology and pattern of motorcycle-related maxillofacial injuries among intracity road users in Nigeria. PATIENTS AND METHODS: We conducted a prospective review of all patients presenting at the maxillofacial surgery units of the Obafemi Awolowo University Teaching Hospital Ile-Ife and Usmanu Dan Fodiyo University Teaching Hospital Sokoto with motorcycle-related injuries. RESULTS: One hundred seven patients were included in the study. A significant male preponderance was observed (P = .002). Overall, the peak age incidence was 20 to 29 years, whereas female patients had a peak age incidence of 10 to 19 years. Victims were mostly riders (50.5%) but none of them was a female. While 8.4% of accidents occurred on motorcycles with more than one pillion passenger, none of the victims reported using a crash helmet. Mechanism of accident was mostly head-on collision (39.2%). The injuries sustained were predominantly soft tissue injuries or in combination with bone injury. Bone and dental injuries were attributed mostly to falls. Facial bone injuries occurred mostly in the mandible (64 of 104). A symmetric distribution of injuries was observed in the upper, middle, and lower thirds of the face, but the middle third had the highest injury sites while the upper third had the least. CONCLUSIONS: Motorcycle-related maxillofacial injuries among Nigerians affect males predominantly. The injuries sustained have a symmetric distribution and were mostly soft tissue injuries in isolation or in combination with bony injuries. The middle third of the face is most vulnerable. Mandatory use of safety helmets and education of cyclists on the appropriate number of pillion passengers are imperative to minimize the morbidity and mortality associated with motorcycle accidents.

Accidents, Traffic↗
PubMed2005

The risk of furcal perforation in mandibular molars using Gates-Glidden drills with anticurvature pressure.

OBJECTIVE: The aim of this study was to determine whether using Gates-Glidden (GG) drills and anticurvature pressure in curved mesial root canals of mandibular molars could remove more dentin from the mesial canal wall and remove less dentin from the distal canal wall at a level 2 mm below the furcation. STUDY DESIGN: In 5 groups of mesial roots with an average curvature of 32-34 degrees, 103 canals were prepared using a size #2 or #3 GG drill in the coronal third (straight portion of the canal only) or coronal half (straight portion and part of the curved portion), with or without applying anticurvature pressure. Using a modification of the Bramante muffle mold the cross-section of the mesial root at 2 mm below bifurcation was photographed twice, before and after the use of GG; the photos were then scanned as tagged image files. The thickness of the mesial and distal canal walls wer measured using an image analysis program. The reduction of the wall thickness after the use of GG was calculated. RESULTS: Before enlargement, the average and minimal thickness of the distal wall was 0.92 and 0.43 mm respectively, thinner than that of the mesial wall (1.50 and 0.87 mm, correspondingly). After the use of GG, the reduction of the mesial wall was similar to the reduction of the distal wall (P > .05 for all groups). In 4 groups the maximal reduction of the distal wall was > or =0.72 mm. CONCLUSIONS: After using GG drills and anticurvature pressure, dentin was uniformly removed regardless of the size of the GG and the depth of placement of GG. Flaring with GG drills in mandibular molars may result in perforations; application of anticurvature pressure did not reduce the risk.

Dental Instruments↗
PubMed2005

Histologic study of furcation perforations treated with MTA or Super EBA in dogs' teeth.

OBJECTIVE: The aim of this study was to investigate the histologic response to MTA or Super EBA when used for the repair of furcation perforations in dogs' teeth. STUDY DESIGN: Ninety mandibular premolar and molar teeth of 9 mongrel dogs were used in this study. The teeth were divided into 3 groups. Seventy-two teeth were repaired with either MTA or Super EBA (36 each), and 18 teeth were not repaired and used as negative controls. All groups were histologically examined at 1 month, 3 months, and 6 months after treatment. Histologic evaluation was done with regard to inflammation and type of healing. RESULTS: The Super EBA group showed moderate inflammation in 1 month; the inflammation decreased over time, but most of specimens showed inflammatory reaction from mild to severe at the end of 6 months. The perforation area was filled by connective tissue in specimens in which no inflammation was seen. In the MTA group, mild inflammation was seen in 1 month, it decreased in 3 months, and no inflammation was detected in 6 months. New cementum formation was taken in place in 4 specimens in 1 month, in 8 specimens in 3 months, and in all specimens in 6 months. CONCLUSIONS: MTA showed less inflammation than Super EBA. MTA specimens showed healing with new cementum formation in the perforation area, whereas Super EBA specimens in which no inflammation was seen showed connective tissue healing.

Aluminum Compounds↗
PubMed2006

Treatment of lateral root perforation with mineral trioxide aggregate: a case report.

Root perforations are undesired complications of endodontic treatment which result in loss of integrity of the root and further destruction of the adjacent periodontal tissues. In recent literature mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair. In this case iatrogenic perforation was observed in a maxillary central incisor. It was not possible to reach the perforation from the access cavity due to the angulation and excessive bleeding even though the root canal was filled with calcium hydroxide paste between appointments. Therefore, surgical intervention was preferred. After the root canal was filled with gutta percha and AH plus, the perforation site was subsequently sealed with MTA. The restoration was made with strip crown and composite resin. The symptoms were ceased and the results were satisfactory after 15 months follow-up.

Adolescent↗
PubMed2006

Biocompatibility of furcal perforation repair material using cell culture technique: Ketac Molar versus ProRoot MTA.

OBJECTIVE: The objective of this study was to evaluate the cytotoxicity of furcal perforation repair materials, GI and MTA, using cell culture technique. STUDY DESIGN: The extract of ProRoot MTA and Ketac Molar were treated on PDL cells in a 96-well tissue-culture plate. Cell proliferation after an incubation period of 3 days was determined by using MTT assay. RESULTS: The growth of cultured human periodontal fibroblast cells were suppressed by both perforation repair materials. The percent of cell viability in the Ketac Molar group was lower than in the ProRoot MTA group (P = .000). CONCLUSIONS: Although Ketac Molar has the advantage of adhering to dentine, it is more cytotoxic to the PDL cells than MTA. In selecting the perforation repair material, it is recommended not only to consider the sealing ability of the material with dentine but also the biocompatibility of material to the underlying tissue.

Aluminum Compounds↗
PubMed1996

The dental pathology of feral cats on Marion Island, part I: congenital, developmental and traumatic abnormalities.

Skulls (n = 301) of adult feral cats from Marion Island, a sub-Antarctic island, were examined macroscopically. Congenital anomalies, which were rare, included a few supernumerary premolars, located mesially to those normally present. Supernumerary roots, mainly of the maxillary third premolar, were found in just over 10% of cases. The maxillary second premolar was absent in 16.8% of skulls; dichotomous and double-formed roots of this tooth were present in 20.1% and 1.9% of cases, respectively. Enamel hypoplasia, which is most unusual in this species, was noted in 24.6% of cases, and persistent deciduous teeth in 2.0%. Dental abrasion, which was noted in 19.3% of cats, affected only 2.3% of teeth, most commonly the lower fourth and upper third premolars. Dental fractures, mainly complicated crown fractures and root fractures, were noted in 54.8% of cats and 7.0% of teeth. Fractures were found most commonly in the canine and carnassial teeth, as also were periapical lesions, which were often severe. Mandibular fractures in various stages of healing were found in 11 cats (3.7%); such fractures most frequently affected the body of the mandible and resulted in malunion. It was concluded that the high prevalence of dental fractures and associated periapical lesions probably exerted a significant adverse effect on health and survival in this population of feral cats.

Animals↗
PubMed1978

The uses of endodontic implant stabilizers in posttraumatic and periodontal disease.

Use of the endodontic implant stabilizer presents a sound physiologic procedure for stabilizing mobile teeth. It can increase root length, alter rootcrown ratios, immobilize fractured roots and periodontally compromised teeth, or supply combinations of these benefits. Case selection, operative technique, and case reports with follow-up are presented in order to demonstrate uses and versatility.

Cellulitis↗
PubMed1995

Effect of dentin preparation and acid etching on the sealing ability of glass ionomer and composite resin when used to repair furcation perforations over plaster of Paris barriers.

Access openings and furcation perforations were prepared in 60 human extracted teeth and randomly divided into four equal groups. Plaster of Paris barriers were created in all perforations. The defects were obturated using either glass ionomer or composite resin with or without acid etching of the dentin. The pulp chambers and access openings were filled with composite resin. After immersion in 2% methylene blue solution for 2 weeks, the teeth were sectioned longitudinally and dye penetration was measured under a stereomicroscope using the NIH Image 1.47 Macintosh program. The results indicated that light-cured glass ionomer provided a significantly better seal than did the light-cured composite resin with or without dentin preparation and acid etching. The glass ionomer allowed significantly less dye penetration when used on etched dentin than it did on nonetched dentin.

Acid Etching, Dental↗
PubMed1995

Redemption of a perforated furcation with a multidisciplinary treatment approach.

A long-standing lesion associated with an undetected perforation of the furca in a mandibular molar was successfully managed using a multidisciplinary treatment approach. The sequence of therapeutic procedures involved conventional endodontic retreatment, an initial orthograde sealing of the perforation, guided tissue regeneration, and a subsequent orthograde resealing of the perforation with Ketac-Endo and Intermediate Restorative Material.

Adult↗
PubMed1997

Effect of agents used in perforation repair on osteoblastic cells.

The effects of dental materials on osteoblastic responses in bone were measured using biosynthesis of matrix proteins, osteopontin (OPN), and osteocalcin (OCN) as indices. Materials used in perforation repair were standardly mixed and extracted in sterile water for 10 days. Extracts were added to the medium of osteoblastic ROS 17/2.8 cells and cultured for 48 h. Water incubated in parallel served as the vehicle/dilution control. 1,25-Dihydroxyvitamin D3, which increases biosynthesis of OPN and OCN, served as the positive control. After culture, total cellular RNA was isolated from individual monolayers, and Northern blotting was performed to quantitate mRNA levels encoding OCN and OPN. mRNA levels in treated samples were compared with controls, and significant differences were detected for several materials. Changes in matrix biosynthesis were modest (< 2-fold), compared with 1,25-dihydroxyvitamin D3 (6-fold). Materials used in perforation repair may produce small, but measurable effects on osteoblastic responses.

Analysis of Variance↗
PubMed1998

Retrograde sealing of accidental root perforations with dentin-bonded composite resin.

Surgical treatment was performed on 100 iatrogen perforations, of which 94 showed radiolucency of bone adjacent to the perforation and 83 presence of an exposed post. The perforations were in all cases sealed with a resin composite (Retroplast) bonded to adjacent root dentin with a dentin bonding agent (Gluma). Cases were examined after approximately 1 yr (first recall) and, if necessary after 1 1/2 to 11 yr (mean: 4.1 yr) (latest recall). It was observed that the presence or absence of bone on the root between the perforation and cervix at the time of operation had no significant effect on the healing result, and that the radiographic classification "partial" healing with a border of cortical bone or a lamina dura often remained unchanged for many years. At latest recall, the healing result of 65 teeth originally having root perforation elsewhere than at the furcation was: 71% complete, 11% partial, 3% uncertain, and 15% failure. This is significantly different from the healing result of 27 molar teeth originally having perforation at the furcation: 30% complete, 41% partial, 11% uncertain, and 18% failure.

Adult↗
PubMed1998

Evaluation of setting properties and retention characteristics of mineral trioxide aggregate when used as a furcation perforation repair material.

Furcation perforations were created in 32 extracted maxillary and mandibular molars. The perforations were prepared in the center of the pulp chamber floor parallel to the long axis of each tooth and a saline-moistened Gelfoam matrix was placed below the perforation to simulate a clinical condition. The teeth were randomly divided into four groups, and the perforations were all repaired with mineral trioxide aggregate (MTA) and then covered with either a wet or dry cotton pellet for 24 or 72 h. Instron testing was used to measure the force required to displace the material from the perforation. The force measurements showed that MTA resisted displacement at 72 h to a significantly greater level than at 24 h (p < 0.05). When slight displacement occurred at 24 h the material demonstrated the ability to re-establish resistance to dislodgement from the dentin wall. The presence of some moisture in the perforation during placement was advantageous in aiding adaptation of MTA to the walls of the perforation, but there was no significant difference in MTA retention when a wet or dry cotton pellet was placed in the pulp chamber during the setting time (p > 0.05).

Aluminum Compounds↗
PubMed1999

Histological evaluation of repair using a bioresorbable membrane beneath a resin-modified glass ionomer after mechanical furcation perforation in dogs' teeth.

Resorbable barriers have been shown both clinically and histologically to produce favorable periodontal regenerative outcomes. The purpose of the present study was to evaluate the histological response to one such resorbable barrier (Atrisorb) when used as a matrix under a resin-modified glass ionomer (RMGI) sealant in the repair of furcation perforations in experimental animals. After anesthesia, pulp extirpation and filling of radicular canals with zinc oxide-eugenol cement, furcal perforations were made in 30 lower premolar (P2, P3, and P4) teeth of labrador dogs with a 1 mm diameter round bur in a conventional handpiece. The perforated teeth were randomly divided into two groups of 15 teeth. Group 1 teeth were treated with RMGI alone and group 2 with the resorbable barrier under RMGI. Six teeth without perforations served as negative controls. Pulp chambers of all teeth were filled with RMGI cement. Animals were sacrificed after 3 months. The teeth and the surrounding structures were processed for light microscopy. There were no differences found between results for glass ionomer alone and barrier with glass ionomer. The conclusion of this study is that placement of a resorbable barrier at the pulp chamber aspect of a furcation perforation did not result in superior healing, compared with the use of resin-modified glass ionomer alone.

Absorbable Implants↗
PubMed1999

Effect of matrix placement on furcation perforation repair.

Furcation perforations are a serious complication during endodontic treatment, and a matrix to aid placement of repair material has been recommended. This study tested the sealing ability of amalgam and Ketac silver placed with and without plaster of Paris as a matrix. A bacterial penetration technique was used to test the seal. Perforations created in the pulpal floor of extracted human mandibular molars were repaired as follows: group 1, amalgam; group 2, amalgam plus plaster as a matrix; group 3, Ketac silver; and group 4, Ketac silver plus plaster (17 teeth/group). Leakage was measured by placing bacteria (Streptococcus sobrinus) in the pulp chamber, and recording the time taken for bacterial growth in a medium bathing the root surface. A plaster of Paris matrix improved the seal with amalgam, but not with Ketac silver. Ketac silver provided the best seal, but all materials showed complete leakage within 22 days.

Calcium Sulfate↗
PubMed1999

Clinical applications of mineral trioxide aggregate.

An experimental material, mineral trioxide aggregate (MTA), has recently been investigated as a potential alternative restorative material to the presently used materials in endodontics. Several in vitro and in vivo studies have shown that MTA prevents microleakage, is biocompatible, and promotes regeneration of the original tissues when it is placed in contact with the dental pulp or periradicular tissues. This article describes the clinical procedures for application of MTA in capping of pulps with reversible pulpitis, apexification, repair of root perforations nonsurgically and surgically, as well as its use as a root-end filling material.

Aluminum Compounds↗
PubMed1998

Endodontic diagnosis in dogs.

Complete endodontic evaluation should diagnose endodontic involvement, provide a treatment plan, and evaluate the true success or failure probabilities. Evaluation of the age, physical and oral health of the patient, the endodontic anatomy, clinical and radiographic findings can provide a treatment plan and a predictable prognosis.

Animals↗