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At least 307 records · Page 17Linked to original sources
PubMed2005

The use of guided tissue regeneration principles in endodontic surgery for induced chronic periodontic-endodontic lesions: a clinical, radiographic, and histologic evaluation.

BACKGROUND: Chronic periodontic-endodontic lesions are not uncommon in clinical practice and their regenerative capacity has long been questioned. However, there are no published studies investigating the application of guided tissue regeneration techniques in combination with endodontic surgery using an induced perio-endo defect model. This study evaluated the clinical, radiographic, and histologic outcomes of three surgical procedures used to treat induced perio-endo lesions. METHODS: Pulpal necrosis was induced in foxhounds along with surgical removal of radicular buccal bone. After 4 weeks, chronic lesions were clinically and radiographically assessed. Treatment surgery consisted of apicoectomy, root canal instrumentation, and retrofilling with mineral trioxide aggregate. Teeth were then assigned to one of the following treatment groups: open flap debridement only (OFD), OFD with bioabsorbable porcine-derived collagen membrane (BG), or OFD with BG and anorganic bovine bone matrix (BO/BG). Clinical parameters and standardized radiographs were assessed at defect creation; treatment surgery; and at 1, 2, 4, and 6 months. Animals were sacrificed at 6 months and specimens prepared for histometric analysis. RESULTS: Clinical and radiographic conditions improved during the study period. Mean epithelial attachment was similar between all groups. Mean connective tissue attachment for groups OFD, BG, and BO/BG was 3.79 mm, 2.63 mm, and 1.75 mm, respectively, and mean radicular bone height was 2.16 mm, 3.24 mm, and 3.45 mm, respectively. Statistically significant increases in the amount of new cementum were observed in groups BG and BO/BG when compared with OFD (P <0.05). CONCLUSIONS: Treatment of combined induced perio-endo lesions using bioabsorbable collagen membranes alone or in combination with anorganic bovine bone matrix resulted in increased amounts of bone, periodontal ligament, and significant increases in the amount of new cementum when compared to open flap debridement in a canine model.

Absorbable Implants↗
PubMed1996

Treatment of large radicular cysts by modified marsupialization.

We describe the enucleation of large radicular cysts to the maximum extent, and their treatment based on the concept of marsupialization and drainage after apicoectomy. Marsupialization requires a long period for healing, imposing a burden on the patient with regard to postoperative management. Considering this, together with the difficulty involved in the clinical diagnosis of radicular cysts, curettage of the cyst wall and drainage may be more effective for facilitating the healing process than use of marsupialization alone.

Adult↗
PubMed2005

In vitro comparison of three materials as apical sealants of equine premolar and molar teeth.

REASONS FOR PERFORMING STUDY: Surgical endodontic therapy is a conservative dental technique used in horses with some degree of clinical success. Failure of this procedure can partially be explained by inadequate sealing of the root apices with resultant microleakage in the periapical area. OBJECTIVES: To assess and compare in vitro sealing ability of 3 different dental restorative materials used as apical sealants during equine surgical endodontics. METHODS: Thirty extracted equine cheek teeth were divided randomly into 3 groups and subjected to apicoectomy and apical sealing using 3 materials: reinforced zinc oxide-eugenol cement; intermediate restorative material (IRM); a resin-modified glass ionomer; and amalgam. After apical sealing, the teeth were submerged in a solution of Procion Brilliant Cresyl Blue stain for a period of 7 days. The teeth were then washed, embedded in resin, sectioned and assessed microscopically for dye leakage around the apical restorations. RESULTS: Although the materials proved effective as apical sealants, some dye leakage was encountered in all 3 groups with no statistical difference (P = 0.114). CONCLUSIONS AND POTENTIAL RELEVANCE: IRM, a resin-modified glass ionomer and amalgam all showed comparative features as apical sealants when used in vitro in equine teeth. IRM is currently regarded as the superior material in clinical situations due to its ease of handling and lesser sensitivity to environmental moisture during placement compared to the other 2 materials.

Animals↗
PubMedDate not supplied

[Periapical surgery of the molars].

INTRODUCTION: If loss of a great number of teeth occurs, one molar in the lateral segment is of great importance. Contemporary techniques and materials provide extremely successful conservative treatment of pulpal diseases and apical periodontitis. In some cases, however, surgery is indicated. INDICATIONS: Indications for periapical surgery used to be a matter of double standards. If periapical surgery is indicated in incisors, it is performed without delay, but if it is indicated in molars, it is often exchanged for extraction. Surgical access in the region of upper and lower molars is specific in regard to much more frequently operated incisors due to anatomic structures at the surgical site. Canal filling techniques, implants, endodontic surgical procedures are of importance and can provide better healing. High quality canal filling is condition sine qua non in treatment of apical periodontitis. It is performed prior surgery, by conventional orthograde endodontic techniques, during surgery by orthograde technique and/or retrogradely. Implants provide better bone healing and are recommended in surgery of molar apex. Surgical packing has numerous advantages (better psychological and mechanical care). CONCLUSION: Good knowledge of anatomy and surgical techniques is a pre-requisite for molar apicoectomy. Careful establishment of indications and good relations with the patient provide good prognosis of this therapeutic method.

Apicoectomy↗
PubMedDate not supplied

Buonocore memorial lecture. Adhesive dentistry applied to the treatment of traumatic dental injuries.

Dental adhesive techniques have led to a significant simplification of the immediate and definitive treatment of traumatic dental injuries. Composite restoration of fractured teeth, bonding of tooth fragments, the use of laminate veneers or porcelain onlays and resin retained bridges are some of the ways adhesive techniques are used to treat fractured teeth. Furthermore, splinting of luxated teeth almost entirely relies on the combination of adhesion and a flexible resin which simulates the mobility of a normal periodontal ligament during the healing period. The internal strengthening of immature root-filled teeth with composite using an adhesive technique may possibly prevent late root fractures caused by weakening of the tooth structure resulting from endodontic procedures. Finally, the adhesive principle using a retro-seal with composite after apicoectomy significantly increases the healing rate and healing mode.

Apicoectomy↗
PubMedDate not supplied

Periapical surgery of 29 teeth. A comparison of conventional technique, microsaw and ultrasound.

OBJECTIVES: A clinical and radiological study is made of the results obtained with different periapical surgical techniques. MATERIAL AND METHODS: Twenty-nine single-root teeth from 29 patients with periapical pathology following correct endodontic treatment were divided into three groups: (A) 10 patients in which rotary instruments were used to perform osteotomy, apicoectomy and cavity preparation; (B) 10 patients in which rotary instruments were used to perform osteotomy and apical resection, with ultrasound root-end cavity preparation; and (C) 9 patients in which microsaws were used for osteotomy, and ultrasound for cavity preparation. All teeth were filled with IRM. Clinical and radiological controls were made after 10 days, one and 6 months, and one year. RESULTS: Clinical success with the absence of symptoms was achieved in 17 cases (58.6%), while in 16 patients (55.2%) the X-ray images showed complete bony regeneration (complete healing). The clinical success rate after one year was 40%, 70% and 66.7% in groups A, B and C, respectively, while complete radiographic healing was recorded in 30%, 60% and 77.8%. There were three failures in group A, two in group C, and none in group B. CONCLUSION: In conclusion, the best results were obtained when ultrasound was used for root-end cavity preparation.

Apicoectomy↗
PubMedDate not supplied

Use of mineral trioxide aggregate (MTA) in root repairs. Clinical cases.

Several clinical situations, such as lateral root or furcation perforation during endodontic treatment, apexification and/or apicoectomy, require the use of reliable materials and techniques to address the problem. The materials historically used for these conditions do not provide a reliable clinical outcome nor a long-term prognosis. New materials and technology may help this challenging issue. Ideally, the repair material should be nontoxic, bacteriostatic and nonresorbable; should promote healing; and should provide an optimal hermetic seal. Among different materials usually used for this purpose--amalgam, ZOE, ZOP, gutta-percha, IRM, Super-EBA, glass ionomers, calcium hydroxide, bonding agents, Cavit, hydroxyapatite and, finally, mineral trioxide aggregate--only the last has provided a substantial advantage.

Adult↗
PubMed2002

[Apical thickness of root fillings in upper premolars. A comparison of orthograde-filled, apicoectomized and retrograde-filled teeth].

The objective of this study was to compare the apical leakage in root canal filled, apicectomised and retrogradely filled maxillary single rooted premolars with two canals of type II configuration. For this purpose the root canals of 51 maxillary type II premolars were shaped to size ISO #55, followed by a step-back preparation to size ISO #80. Subsequently, all teeth were obturated by means of lateral condensation and randomly divided into three groups, 17 teeth each. Group I was used as a control, whereas in group II and III an apicoectomy was performed. Retrograde glass ionomer restorations (Ketac Fil) were placed additionally in group III. The specimens were exposed to methylene blue for 24 hours, then cross-sectioned, and the deepness of dye penetration was measured. Data were analyzed and tested for significant differences between the various groups (Mann-Whitney test; alpha = 0.05). The teeth in group II showed the lowest mean dye penetration. The differences were statistically significant, if compared to group I (p < 0.001) and group III (p < 0.001). The dye penetration in group I was significantly lower than in group III (p = 0.024). In teeth with lateral canals, the mean dye penetration was higher (3,557 microns +/- 1,337 microns) than in teeth without lateral canals (3,096 microns +/- 1,931 microns). The teeth in group III showed a circular dye penetration in nearly all cases. For clinical purposes, the application of retrograde glass ionomer fillings must be considered very critically.

Apicoectomy↗
PubMedDate not supplied

Evaluation of decalcified allogenic bone matrix grafts in and around root apices. A histological study.

Decalcified Allogenic Bone grafts were implanted in and around eighteen root apices after apicoectomy. The procedure was carried out on eighteen rabbits, dividing them into three groups of six rabbits each. The animals were sacrificed after 48-72 hours, 8-10 days & 8-10 weeks period of interval. Result of the present investigation reveal that DABM grafts stimulate osteogenesis and cementogenesis after the initial phase of inflammation. Tissues simulating bone and cementum appear at the apical end, speculating that the grafts would certainly result in physiological sealing of root apices. The possibility of saving the life of non vital teeth with or without wide apical foramen will enhance in future.

Animals↗
PubMed2003

[Periradicular surgery with and without endoscopy: a prospective clinical comparative study].

A total of 129 teeth with periradicular surgeries (apicoectomies) were analyzed in a prospective clinical study. In the test group including 62 teeth, an endoscope (Tele-Otoscope with a 70 degrees viewing angle) was used as an intraoperative visualization aid to monitor the following surgical steps: root-end resection, root-end cavity preparation and retrograde root-canal obturation. In the control group including 67 teeth, intraoperative diagnostics were carried out using micromirrors. Fifty-four and 61 teeth could be re-examined after one year. Based on the clinical and radiographic findings they were categorized as success, uncertain healing or failure. In the test group with endoscopy, the success rate was 88.9%, whereas in the control group it was only 75.4%. However, statistically no significant difference was found between the two groups. Additional experimental and clinical studies will show if endoscopy will improve the success rates in periradicular surgery any further.

Apicoectomy↗
PubMedDate not supplied

Peri-implant pathology caused by periapical lesion of an adjacent natural tooth: a case report.

An implant was removed 6 months after restoration because of peri-implant pathosis. The implant had been placed adjacent to the mandibular right second premolar and close to a periapical lesion of the endodontically treated adjacent first premolar. Along with removal of the failed implant and an apicoectomy of the problem tooth, guided bone regeneration was used to restore the alveolar ridge defect at the site of the failed implant. A replacement implant was placed 6 months later and successfully restored after healing.

Adult↗
PubMedDate not supplied

The assessment of anesthetic efficacy of ropivacaine in oral surgery.

This paper describes the application of ropivacaine, local, amid, long-acting anesthetic in oral surgery. For infiltrative anesthesia, 0.75% of Naropin (ropivacaine) was used in eight patients undergoing various operations (maxillary sinus with oro-antral communication, extraction of upper and lower impacted wisdom teeth, cystectomy, apicoectomy and tooth extraction). The achieved anesthesia in all patients enabled analgesia in the course of the operation, and the expected intraoperative and postoperative bleeding, whereas postoperative analgesia lasted long enough (up to 380 minutes) to prevent the intake of analgesics. Side effects or local reaction on ropivacaine were not detected.

Adult↗
PubMedDate not supplied

Management of apical bone loss around a mandibular implant: a case report.

Various terms, etiologies, and treatment strategies have been suggested in conjunction with bone loss limited only to the apical portion of an implant that remains otherwise well osseointegrated. Proposed etiologic factors include bone overheating, microbial involvement of adjacent teeth, pre-existing bone infection, and overload. However, the mandible and maxilla seem to have different predispositions in response to these causative agents. Treatment protocols for peri-implant infection have included minimally invasive approaches such as granulation tissue removal and detoxification of the implant surface, as well as more aggressive measures. This case report demonstrates the achievement of osseous healing and reosseointegration in a patient who presented with presented apical bone loss and signs of infection around a mandibular implant. Reosseointegration was achieved following an intraoral apicoectomy-like approach, ie, removal of the infected nonintegrated portion of the implant, and meticulous debridement of the granulation tissue. A literature review of 13 relevant published studies was conducted. The current understandings regarding the etiology and treatment strategies for management of apical bone loss around dental implants are summarized and presented.

Alveolar Bone Loss↗
PubMedDate not supplied

Therapeutic management for immediate implant placement in sites with periapical deficiencies where coronal bone is present: technique and case report.

A surgical approach is presented that enables the clinician to repair apical bony defects during immediate dental implant placement without compromising the integrity of the coronal bone and gingiva. This apical surgical technique retains the soft tissue form in the coronal aspect of the gingiva and allows the clinician to repair the apical bone loss or fenestration. A clinical case is presented to describe the technique. This technique is utilized in cases of immediate implant placement. After extraction of the tooth, the socket is evaluated. In cases where coronal bone is intact but apical bone is deficient, a flap technique is utilized to expose the defect. The implant osteotomy is prepared, and the implant is placed. A healing cap or gingival prosthetic component is connected. The bony defect is repaired with a bone graft and, where necessary, a membrane. The apicoectomy flap is sutured. The clinical results obtained using this technique will enable the clinician to accomplish the bone regenerative procedure without extending the flap to the coronal aspect of the socket during immediate implant placement. This technique assists in the maintenance and integrity of the soft tissue form, which is critical for optimal esthetic results.

Apicoectomy↗
PubMedDate not supplied

[Use of thermoplasticized gutta-percha in retrograde obturation].

In 29 teeth, apicoectomies with retrograde instrumentation and retrofilling with low temperature thermoplasticized gutta-percha were performed. Nineteen of them were clinically an radiographically evaluated, showing the following average rate: successes 84.2% (16 cases), failures 10.5% (2 cases) and incomplete healing 5.2% (1 case). The observation period varied from 12 to 41 months. The use of retrograde instrumentation an retrofilling with thermoplasticized gutta-percha is suggested as a useful method in surgical procedures.

Apicoectomy↗
PubMedDate not supplied

[Nonsurgical retreatment of lateral radiopacity after surgical treatment].

A case report is presented of an upper central incisor with incomplete endodontic procedure evidencing a radiolucent image that was treated by apicoectomy and retroamalgam. A year later the periapical lesion had healed completely but a new lateral radiolucency is observed. A reentry of the canal is performed eliminating the old obturating material, biomechanical preparation and obturation with sealer and thermo gutta-percha. The lesion was cured in nine months.

Adult↗
PubMed1995

[Hemostasis in patients at high hemorrhagic risk].

Surgical treatment in patients with heavy coagulation disorders needs measures that minimize immediate and post-surgical hemorrhagic risk. Besides the subjects afflicted with constitutional coagulation pathologies such as haemophilia A, B, C, AB, Von Willebrand disease, platelet disorders and others, too many are the patients that need pharmacological therapy to impede the creation of intra-vascular coagula. Today, surgical treatment of these patients is possible with the use of human fibrin glue (Tissucol) that permits excellent surgical and post-surgical hemostasis without therapy suspension, independently of coagulation disorder. The purpose of this study is a clinical evaluation of a surgical procedure based on the use of human fibrin glue in association or not with suture, hemostatic sponge and lyophilized dura mater in patients with coagulation disorders. In a group of 309 patients in oral anticoagulant therapy have been done a total of 822 operations such as root fragments extraction with mucoperiosteal flap elevation, teeth or roots simple extractions, third molar extractions, cyst removal, apicoectomies. Only patients with PA over 20% have been treated. All the operations have been leaded with minimal trauma; after the extractions, alveolar margins have been regularized to improve flaps adaptation. Hemostatic sponge or dura mater have been used like basis for the flaps and the fibrin glue, that was injected in the residual cavity after surgical suture. In a few cases, for example with little extraction wounds, only fibrin flue without suture or sponge has been used. In all cases and after all operations, the presence or absence of bleeding has been evaluated after 2 hours, 24 hours, 7 days after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Dental↗
PubMed1995

[The late results of the conservative and surgical treatments of chronic periodontitis of the permanent teeth in children and adolescents].

The authors view results of conservative and surgical treatment of constant tooth chronic periodontitis in 90 children and adolescents aged 7-18 20 hemisections, 45 apicoectomies, 10 radix amputations were performed. The patients were followed up 6 months to 5 years. X-ray films show osseous restoration on the maxilla tooth to complete in 5-6 months, on the mandible tooth in over 8 months. The authors describe indications and contraindications to such kind.

Adolescent↗