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At least 289 records · Page 16Linked to original sources
PubMed1989

Dens invaginatus of a maxillary lateral incisor: endodontic treatment.

A right maxillary central incisor and an adjacent lateral incisor with a dens invaginatus were identified as requiring endodontic treatment. Both teeth were treated by nonsurgical means. Thirteen months postoperatively the central incisor showed evidence of periapical resolution, whereas the lateral incisor did not. The lateral incisor was then treated with apical curettage, an apicoectomy, and retrograde amalgam filling. One year after the surgical procedure the periapical tissues of both the lateral and central incisors exhibited satisfactory resolution. This case demonstrates that certain cases of dens invaginatus can be successfully treated only with a surgical approach.

Adult↗
PubMed1991

An in vivo study of the use of a nonresorbable ceramic hydroxyapatite as an alloplastic graft material in periapical surgery.

This study evaluated reactions to a hydroxyapatite after endodontic treatment and periapical surgery. Thirty-eight root canals in two Macaca speciosa monkeys were endodontically treated. Apicoectomy was then performed, leaving bony defects at the apex of each root. The defects were either packed with Durapatite ceramic crystals or allowed to fill with blood. Each animal received at least one dose of Procion red, a hard-tissue marking agent. After healing periods of 2 to 6 months, the apices were examined clinically, radiographically, and histologically. The ceramic material was well tolerated clinically with no gross evidence of inflammation or rejection. Histologically, the material was biocompatible. Healing of the experimental sites consisted of an initial investment of the apatite crystals in fibrous connective tissue followed by eventual replacement of the connective tissue with bone. Despite its excellent biocompatibility, the material appeared to retard osteogenesis by its physical presence. Although the ceramic eventually became entrapped in bone, without an intervening layer of connective tissue, there was a significantly greater amount of new bone in control sites.

Animals↗
PubMed1993

Use of dental operating microscope in endodontic surgery.

Endodontic surgery is an alternative therapeutic approach to endodontic treatment. The outcome of the technique is affected by several factors, some of which can be eliminated by the use of a dental operating microscope. The microscope was used during the performance of 50 apicoectomies, with or without retrograde fillings. For clinical evaluation cases treated with the dental operating microscope were compared to cases treated without it. The postoperative evaluation showed a reduced incidence of symptoms in the cases treated with the dental operating microscope. More important, the dental operating microscope enhanced and facilitated each phase of endodontic surgery. Its use is highly recommended.

Apicoectomy↗
PubMed1994

Chronic pain associated with a foreign body left under the soft tissue flap during periapical surgery.

A case is reported of a patient who requested treatment for chronic pain of 7 yr duration. After several unsuccessful endodontic procedures, a cotton pellet was discovered under the soft tissue near the apex of the left maxillary cuspid. It was theorized that the cotton was left under the tissue flap during a previous apicoectomy procedure. After the cotton was removed the patient subsequentially reported that the pain was relieved.

Adult↗
PubMed1995

Preventing root tip loss in the maxillary sinus during endodontic surgery.

Exclusion of infected root tips, dentinal debris, and inflammatory tissue from the maxillary sinus during endodontic surgery is imperative. A simple technique for preventing accidental root tip intrusion into the maxillary sinus using a 6-0 suture and needle and a hole prepared in the root tip with a #2 round bur prior to apicoectomy is presented.

Apicoectomy↗
PubMed1991

Dye leakage in retrofilled dog teeth and its correlation with radiographic healing.

In a previous study in beagle dogs, statistically significant differences in healing were observed radiographically 6 months after apicoectomy and retrofilling with amalgam and varnish, glass ionomer cement, or a composite resin. The purpose of this study was to compare the leakage of these retrofilling materials and to correlate leakage data with healing. After the dogs were sacrificed, 48 roots were extracted. Half of the roots had been irradiated with a CO2 laser on the bevelled root surface after retrofilling. The roots were coated with nail polish, except for their bevelled surface, and were suspended together with positive and negative controls in 2% methylene blue for 8 h. After the specimens were longitudinally split, they were ranked according to the severity of dye penetration, as observed with a dissecting microscope. The differences in dye leakage among the three retrofilling materials were not statistically significant. Consequently, dye leakage did not correlate with the previously assessed healing. Dye penetrated into the root through the bevelled root surface, regardless of CO2 laser exposure of that surface.

Animals↗
PubMed1998

Quantitative radiographic follow-up of apical surgery: a radiometric and histologic correlation.

The objective of this study was to establish an objective method for evaluating the treatment outcome of apical periodontitis (AP). AP was induced in the mandibular premolars of beagle dogs and apicoectomies were performed with retrofilling. Standardized periapical radiographs were taken immediately after completion of treatment and at 6 months. Ten pairs of standardized radiographs of 33 treated roots were analyzed. Radiographs were digitized and subtracted after warping and gamma correction. Areas of AP and adjacent normal areas (N) in digitized original and subtraction images were analyzed using eight radiometric computations. These computations were compared with subjective histologic evaluation and objective quantitative histomorphometry of the periapical condition at 6 months. The average gray value for AP on the subtraction images was found to have significant correlation with both objective (multiple regression p < 0.01) and subjective histology (logistic regression p < 0.01). Digital subtraction may be a useful tool in endodontic apical surgery assessment.

Absorptiometry, Photon↗
PubMed1976

Follow-up study of apicoectomized molars.

The present material consists of 46 respected molars, 20 of which were located in the maxilla and 26 in the mandible. Altogether, 93 different roots were resected and 109 root fillings made. The follow-up study was made 1-6 years after the apicoectomy. The patients were examined clinically, special attention being paid to the subjective and objective symptoms shown by each apicoetomized tooth. Then a stereoscopic picture of the resected tooth and an orthopantomogram were taken. Of these 46 apicoectomized teeth, 33 (71%) showed complete healing, five (11%) were uncertain, four (9%) showed unsatisfactory healing, and four (9%) were extracted. When examining molars it seems reasonable to study each root as a separate case. Among the 93 apicoectomized roots, there were 75 (81%) cases of complete healing, six (6%) of uncertain healing, four (4%) of unsatisfactory healing, and eight (9%) extractions. There was no difference between the groups of radicular cysts and periapical granulomas in healing. The percentage of cases of complete healing was higher when approximately one-half of the roots were resected than when approximately one-third were resected. The orthograde root filling made in connection with resection was found better than the retrograde or the earlier orthograde filling. It was also found that when several periapical lesions were present in the other teeth, the number of complete healings in the group of resected teeth was less.

Adolescent↗
PubMed2003

Cytomegalovirus and Epstein-Barr virus are associated with symptomatic periapical pathosis.

BACKGROUND: Recent studies have identified human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) in symptomatic periapical lesions. Little information exists on HCMV and EBV in asymptomatic periapical lesions. AIM: To compare the presence of late transcripts of HCMV, EBV and herpes simplex virus (HSV) in symptomatic and asymptomatic periapical lesions. METHODS: Periapical samples were collected from seven symptomatic and seven asymptomatic periapical lesions at the time of apicoectomy. HCMV, EBV and HSV late mRNAs were identified by reverse transcription polymerase chain reaction. RESULTS: HCMV mRNA was detected in all seven symptomatic periapical lesions and in one asymptomatic lesion (Chi-squared test, Yates'P-value = 0.007). EBV mRNA was detected in six symptomatic lesions and in one asymptomatic lesion (P = 0.04). One asymptomatic lesion yielded HSV mRNA. CONCLUSIONS: HCMV and EBV active infections are associated with acute exacerbation of apical periodontitis. HSV seems to be unimportant in periapical pathosis.

Apicoectomy↗
PubMed2002

Evaluation of the effect of heterologous type I collagen on healing of bone defects.

PURPOSE: The purpose of this investigation was to evaluate the effect of type I collagen on the healing of bone defects both experimentally and clinically. MATERIALS AND METHODS: In the experimental study, 16 adult male rabbits were divided into 2 groups: a collagen group and a control group. After the induction of general anesthesia with intraperitoneal ketamine, the anterior surfaces of tibias of the rabbits were surgically exposed, and a hole 4 mm in diameter was made in each tibia. In the collagen group, the defects were filled with type I collagen. The unfilled defects of the other animals were used as controls. During the study, the serum alkaline phosphatase activity of the rabbits, and radiopacity changes in the radiographs of the tibias of the rabbits were evaluated. The rabbits were killed on the 35th day, and histologic sections of the tibias were prepared. The clinical study was carried out on periapical defects in a total of 15 patients who underwent apicoectomy. After the surgical procedure, the osseous defects in periapical regions of 7 patients were filled with type I collagen. The unfilled cavities of the other patients were used for control purposes. The patients were evaluated clinically and radiographically in the postoperative period. The data were analyzed by Student's t-test and Mann-Whitney U test. RESULTS: In the experimental study, there was an increase in radiopacity corresponding with the serum alkaline phosphatase activity, and there were statistically significant differences between the control and collagen groups both radiologically and biochemically on the 14th and 28th days of the study. In the clinical study, the control cavities filled with a tissue of normal bone density in about 5 months, but the collagen cavities filled in 3 months. CONCLUSIONS: It was determined that heterologous type I collagen provides a more rapid regeneration of bone defects.

Adult↗
PubMed2002

Apicomarginal defects in periradicular surgery: classification and diagnostic aspects.

The prognosis of periradicular surgery is affected by the amount and location of bone loss. Apicomarginal defects are localized bony defects encompassing the total root length, and periradicular surgery on these teeth is associated with a lower success rate. This paper reviews the etiology, pathogenesis, and morphology of apicomarginal defects as encountered in periradicular surgery on the basis of a series of 24 consecutively treated patients. Periodontal data were recorded before surgery in all patients, and apicomarginal defects were diagnosed after flap reflection or, if applicable, apicoectomy. On the basis of the findings in these cases and on theoretic considerations, a classification system for apicomarginal defects with potential therapeutic and prognostic implications is presented and several criteria for differential diagnosis are discussed.

Adolescent↗
PubMed2000

Central (intraosseous) adenoid cystic carcinoma of the mandible: report of a case with periapical involvement.

Primary intraosseous salivary gland tumors are rare, with mucopidermoid carcinoma being the most frequent histotype. The authors present a case of adenoid cystic carcinoma, located in the mandibular incisor region, associated with pain. Endodontic treatment resulted in increased pain and progressive mandibular expansion. An apicoectomy was conducted, and an intraosseous adenoid cystic carcinoma was diagnosed at histological examination. The patient was treated by wide surgical resection, and is alive and well without recurrences or distant metastases 14 yr after the original diagnosis. The case presented herein calls attention to the preoperative clinical diagnosis of periapical lesions. Radiologically, focal sclerosing osteitis, cementoblastoma, cementifying and ossifying fibroma, periapical cemental dysplasia, complex odontoma, and calcifying epithelial odontogenic tumor should be considered in the differential diagnosis. In addition the unusual occurrence of salivary gland tumors in intraosseous location stresses the importance of systematic histological examination of any tissue sample obtained after endodontic procedures.

Apicoectomy↗
PubMed2001

Effect of an acid environment on leakage of root-end filling materials.

One hundred fifty-six single-rooted human extracted teeth received root canal treatment, apicoectomy, and ultrasonic root-end preparations. The roots were divided into six groups of 24 teeth. The groups were filled with Amalgam, Geristore, Super-EBA, Mineral Trioxide Aggregate (MTA), Calcium Phosphate Cement (CPC), or MTA with CPC matrix, respectively. Immediately after root-end filling, 12 teeth from each group were exposed to a pH of 5.0 for 24 h, and 12 teeth were exposed to a pH of 7.4 for 24 h. Twelve teeth served as controls. All teeth were exposed to Pelikan Ink for 5 days and cleared. Linear dye leakage was recorded. Data were statistically analyzed. An acid pH significantly reduced dye leakage of Geristore (0.67 vs. 3.93 mm) and MTA with CPC matrix (0.54 vs. 2.41 mm), whereas leakage of all other materials was not affected by pH. In conclusion an acid environment did not hinder the sealing ability of any of the materials tested, and enhanced the sealing ability of Geristore and MTA with CPC matrix.

Acids↗
PubMed2002

Case selection for apical surgery: a retrospective evaluation of associated factors and rational.

Endodontic failures associated with poor quality of endodontics respond favorably to retreatment. Nevertheless, under certain clinical conditions, apicoectomy should be the preferred procedure. A retrospective survey of 200 roots that were referred for apical surgery revealed that 83% of the roots were inadequately obturated, including 8.5% with no root canal filling at all. In 49 of the roots in this group (24.5% of the referred cases) nonsurgical retreatment was judged by an endodontist as either impossible or improbable because it might jeopardize the root integrity. Retreatment should have been the preferred treatment modality for the rest of the group, provided that coronal restorations could be safely bypassed or removed. Posts were found in 63 of these teeth, however 35 of them were either short or loosely fitting and could safely be removed. The rest of the posts were longer than 5 mm, which might have presented a problem if their removal was attempted. In 45% of the 200 cases in the present study, surgical intervention was justified. The rest of the cases (55%) should have either been subjected to a follow-up (10.5%) or retreated nonsurgically by a skilled endodontist (44.5%). These results indicate that referring dentists may not appreciate the retreatment possibilities offered by modern endodontics, and they emphasize the need for a shift of concept: endodontists should be involved in the decision making before referring a patient to surgery.

Apicoectomy↗
PubMed2004

Comparative study of sealing ability of two root-end-filling materials with and without the use of dentin-bonding agents.

The purpose of this study was to examine microleakage of two root-end-filling materials with and without the use of bonding agents. For microleakage measurement a fluid transport model was used. Sixty single-rooted teeth were used in this study. They were prepared with step-back technique and then an apicoectomy was performed. Then the teeth were divided into four groups. Group A were filled with Fuji II LC glass-ionomer cement, group B were filled with Fuji II LC and a new bonding agent, Fuji Bond, group C were filled with Admira composite resin, and group D were filled with Admira and Admira Bond, a new bonding agent. At 24 h, 1 month, and 2 months after filling the leakage along these filling materials was determined under a low pressure of 0.1 atm. At all experimental times, glass-ionomer groups showed significantly less microleakage than resins groups. Between Admira and Admira Bond groups, significantly less leakage was observed in the root sections with Admira Bond at 24 h.

Apicoectomy↗
PubMed2000

Implant-related damage to an adjacent tooth: a case report.

Implant-related damage to an adjacent tooth is shown to be an iatrogenic complication. The affected tooth may require apical curettage, root canal therapy, apicoectomy, or even extraction. A case is presented of a patient who complained of damage to an adjacent root after implant placement.

Apicoectomy↗
PubMed2003

Bilateral buccal radicular groove in maxillary incisors: case report.

AIM: To present the rare localization of a radicular groove on the buccal aspect of a tooth and to discuss the pathology and management of the concomitant endo-periodontal defect. SUMMARY: Bilateral buccal radicular grooves were found on the maxillary central incisors of a 60-year-old female Caucasian. One groove was associated with deep local pocketing resulting in pulp necrosis and the formation of a periodontal-endodontic lesion. After endodontic treatment of the affected tooth, periodontal surgery was performed during which an apicoectomy was carried out on the root-filled tooth. Both the buccal grooves were removed by grinding, the roots were planed with curettes and a guided-tissue regeneration technique applied using amelogenin (Emdogain, Biora, Sweden). Following a period of 2 years, re-examination showed excellent healing with the complete elimination of the periodontal pocket on both incisors and significant radiographic evidence of bone regeneration. KEY LEARNING POINTS: Deep radicular grooves can predispose to pulp necrosis and the establishment of combined periodontal-endodontic lesions. Evaluation of clinical signs and appropriate diagnostic tests are of paramount importance in order to prevent incorrect diagnosis and treatment. Endodontists must be capable of performing advanced periodontal regeneration techniques during endodontic surgery.

Alveolar Bone Loss↗
PubMed1996

Treatment of labial fenestration of maxillary central incisor.

A case of external inflammatory root resorption and labial fenestration in a maxillary central incisor is presented. The root canal was dressed with pure calcium hydroxide mixed with normal saline for 1 month before it was obturated with gutta percha and apicoectomy surgery undertaken to attempt primary closure of the fenestration. The PDL and the fenestration healed uneventfully.

Alveolar Bone Loss↗