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At least 325 records · Page 18Linked to original sources
PubMed2002

Papilla base incision: a new approach to recession-free healing of the interdental papilla after endodontic surgery.

AIM: The purpose of the present study was to describe and evaluate a new incision technique: the papilla base incision. METHODOLOGY: Twenty healthy patients referred for surgical treatment of persisting apical periodontitis, who were free of periodontal disease and had intact interdental papillae were included in the study. The preoperative papilla height was recorded by measuring the distance between the contact point and the most coronal point of the papilla. The papilla base flap, consisting of the papilla base incision and two releasing incisions, was used to expose the bone. The papilla base incision consisted of a shallow first incision at the base of the papilla and a second incision directed to the crestal bone, creating a split thickness flap in the area of the papilla base. Further apically a full thickness flap was raised. Following standard root-end resection and filling, flap closure was achieved with microsurgical sutures. The papilla base incision was sutured with 2-3 interrupted sutures, which were removed 3-5 days after the surgery. The experimental sites were evaluated at the conclusion of the surgery, at suture removal and after 1 month, and compared to the preoperative findings. The healing pattern, complications and postoperative recession were recorded. The experimental sites were observed with a x 3 magnification and graded as to whether a visible scar resulting from the incision could be detected. Twenty experimental sites were analysed. RESULTS: Complete closure of the wound was achieved in all cases after surgery. Except for four patients with delayed healing at suture removal, all other patients displayed rapid healing. No noticeable space was created beneath the contact point area. The change in distance between the reference point and the most coronal point of the papilla comparing the preoperative and the one-month postoperative situation was 0.05 +/- 0.39 mm. The probing depth remained within normal limits. One month postoperatively, observation of the incision demonstrated: four sites with a visible incision line (grade 1), in seven sites the incision defect could be partially detected (grade 2) and nine incisions could not be detected (grade 3). CONCLUSIONS: In patients with healthy marginal periodontal conditions the papilla base incision allows rapid and predictable recession-free healing following marginal surgical exposure of the soft tissues. One month postoperatively the majority of the incisions were completely or partially invisible. Long-term healing will be studied.

Adult↗
PubMed2003

Periapical endodontic surgery: a 3-year follow-up study.

AIM: To monitor the outcome of periradicular surgery in a group of teeth treated with microsurgical technology and ultrasonic root-end preparation. METHODOLOGY: One hundred and twenty-eight teeth with failed conventional root canal treatment were included. The surgical procedure was completed using ultrasonic retrotips and a zinc oxide-EBA (Super Seal, Ogna Pharmaceuticals. Milan, Italy)-reinforced material was used to seal the root end cavities. Lesions were examined radiologically at 1. 3. 6. 12, 24 and 36-month intervals. Radiographs were independently analysed according to a previously published classification. RESULTS: Eight teeth were extracted due to fracture or perforations undetected radiologically: these cases were excluded from the study. Of the 120 teeth examined. the overall success rate was 92.5%; 94 healed with complete bone filling of the surgical cavity, 17 were considered to have healed by apical scar formation, four demonstrated uncertain healing and five were considered failures. Eighty of 120 teeth examined had successfully healed from a radiological point of view within 12 months. No differences in outcome occurred between anterior, premolar and molar teeth. Although all failures occurred in teeth with posts, no statistically significant difference was noted (Mann-Whitney U-test, P = 0.37). CONCLUSION: Modern surgical endodontic procedures associated and ERA (Super Seal, Ogna Pharmaceuticals, Milan, Italy) root end fillings were successful over 3 years in 92.5% of cases.

Adolescent↗
PubMed2003

Reactions of connective tissue to compomers, composite and amalgam root-end filling materials.

AIM: To evaluate the subcutaneous connective tissue reaction to compomers, composite and amalgam root-end filling materials. METHODOLOGY: This study was conducted in 30 Wistar albino rats. The materials were mixed or light-cured according to the manufacturer's directions and placed in polyethylene tubes. Group 1 - Dyract compomer (Dentsply); group 2 - F2000 compomer (3M); group 3 - Valux Plus composite (3M); group 4 - Oralloy high-copper amalgam (Coltene). The tubes containing the materials were implanted into the dorsal connective tissue of rats, which were killed 7, 15, 30, 60 and 90 days after the implantation procedure. Thirty extra empty tubes were also placed as controls. The implant sites were excised and prepared for histological evaluation. Sections of 6-microm thickness were stained with haematoxylin and eosin and assessed under light microscopy. The presence of inflammation, predominant cell type and thickness of fibrous connective tissue adjacent to each implant were recorded. Reactions were scored as: 0: none or few cells and no reaction; 1: less than 25 cells and mild reaction; 2: between 25 and 125 cells and moderate reaction; 3: 125 and more cells and severe reaction. Fibrous capsules were considered to be thin if their thickness was less than 150 microm and thick if it was more than 150 microm. Necrosis and formation of calcification were categorized as 'yes' or 'no'. RESULTS: All four materials caused moderate or severe inflammatory reactions in the first 7-day period, but these reactions decreased by the 60th and 90th days. No significant difference in inflammatory cell numbers between the materials could be detected at the 90th day. CONCLUSIONS: Valux Plus composite, Dyract and F2000 compomers and Oralloy amalgam were biocompatible.

Analysis of Variance↗
PubMed2003

Investigation of the marginal adaptation of root-end filling materials in root-end cavities prepared with ultrasonic tips.

AIM: To compare the surface topography of root apices following ultrasonic root-end preparation, and again after root-end fillings submitted to three different finishing techniques. METHODOLOGY: Eighty-one root-end cavities prepared ultrasonically in human canines, were divided at random into three test groups of 27 each. The cavities were filled with Super-EBA, IRM, or ProRoot-MTA and finished by ball burnishing. Eighteen roots from each group received a final finish with either a 30-fluted tungsten carbide finishing bur, or a Zekrya carbide 28 mm bur after storage in water at 37 degrees C for 24 h. The root-end surface topographies were reproduced by means of polyvinylsiloxane impressions and epoxy resin replicas. Scanning electron micrography (SEM) images of each replica were taken prior to and after root-end filling. An image analysis system was used to compare the alteration of the marginal chipping areas and to calculate the gaps located in the dentine/root-end filling interface. RESULTS: When a bur was used to finish the set materials, a significant (P < 0.05) area of marginal chipping was eliminated. The finishing technique did not significantly (P > 0.05) affect the incidence of gaps in groups root-end filled with MTA or IRM. Super-EBA and IRM retrofillings finished with a ball burnisher or a Zekrya bur displayed a significantly (P < 0.05) larger calculated gap area than roots filled with MTA. CONCLUSION: Under this in vitro study, the marginal adaptation of MTA was good with or without finishing procedures. Applying a finishing bur over the condensed and set IRM and Super-EBA created better marginal adaptation.

Aluminum Compounds↗
PubMed2003

A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery.

AIM: To assess the success rate of the root-end filling material, Mineral Trioxide Aggregate (MTA). METHODOLOGY: Referred adult patients were recruited using strict entry criteria and randomly allocated to receive MTA or IRM. A standardized surgical technique was employed: the root end was resected perpendicularly and a root-end cavity was prepared ultrasonically and filled. A radiograph taken immediately after surgery was compared with those taken at 12 and 24 months. Customised film holders and the paralleling technique were used; radiographs were assessed by two trained observers using agreed criteria. The results from 122 patients (58 in IRM group, 64 in MTA group) after 12 months and 108 patients (47 in IRM group, 61 in MTA group) for the 24-month review period were analysed using the chi2 test. RESULTS: The highest number of teeth with complete healing at both times was observed when MTA was used. When the numbers of teeth with complete and incomplete (scar) healing, and those with uncertain and unsatisfactory healing were combined, the success rate for MTA was higher (84% after 12 months, 92% after 24 months) compared with IRM (76% after 12 months, 87% after 24 months). However, statistical analysis showed no significant difference in success between materials (P > 0.05) at both 12 and 24 months. CONCLUSIONS: In this study, the use of MTA as a root-end filling material resulted in a high success rate that was not significantly better than that obtained using IRM.

Adult↗
PubMed2003

Comparison of papilla healing following sulcular full-thickness flap and papilla base flap in endodontic surgery.

AIM: To compare the loss of papilla height when using the papilla base incision (PBI) or the standard papilla mobilization incision in marginal full-thickness flap in cases with no evidence of marginal periodontitis. METHODOLOGY: Twelve healthy patients referred for surgical treatment of persisting apical periodontitis, who were free from periodontal disease and had intact interdental papillae, were included in the study. The preoperative papilla height was recorded by measuring the distance between a reproducible coronal point on the tooth and the most coronal point of the papilla. The flap design consisted of two releasing incisions connected by a horizontal incision. The marginal incision involved the complete mobilization of the entire papilla in one interproximal space, and the PBI in the other interproximal space. The PBI consisted of a shallow first incision at the base of the papilla and a second incision directed to the crestal bone creating a split thickness flap in the area of the papilla base. Further, apically, a full-thickness flap was raised. In the other interproximal space, the buccal papilla was carefully incised and elevated completely. Following flap retraction, standard root-end resection and root-end filling were performed. Flap closure was achieved with microsurgical sutures. The PBI was sutured with two to three interrupted sutures (size 7/0) and the elevated papilla was reapproximated with vertical mattress sutures, which were removed 3-5 days after the surgery. The height of the interdental papilla was evaluated preoperatively and postoperatively after 1 month and at the 3-month recall, using plaster replicas. The loss of papilla height was measured using a laser scanner. Twelve papilla-paired sites were evaluated. The results were statistically analysed using the t-test. RESULTS: Complete closure of the wound was achieved in all treated sites followed by uneventful healing in all patients. The total mobilization of the papilla resulted in loss of papilla height of 1.10 +/- 0.71 mm at 1 month and 1.25 +/- 0.81 mm at the 3-month recall. At the 3-month recall, the retraction had increased in nine sites, whereas in three sites, the loss of height had slightly diminished compared to 1 month. In contrast, after the PBI, only minor changes could be detected: 0.07 +/- 0.09 mm at 1 month and 0.10 +/- 0.15 mm at 3 months. There was a significant difference between the two incision techniques studied (P < 0.007). CONCLUSIONS: In patients with healthy marginal periodontal conditions, the PBI allows rapid and predictable recession-free healing, whereas complete mobilization of the papilla led to a marked loss of the papilla height. In aesthetically relevant areas, the use of the PBI is recommended, to avoid opening of the interproximal space, when periradicular surgical treatment is necessary.

Adult↗
PubMed2003

Effect of apical root-end filling materials on gingival fibroblasts.

AIM: To determine the influence of root-end filling materials on specific cellular responses of gingival fibroblasts (GF). METHODOLOGY: The reactions of cells in contact with mineral trioxide aggregate (MTA), amalgam and a chemically inert titanium alloy were determined based on the assessment of prostaglandin (PGE2) release with and without arachidonic acid stimulation, protein and lactate synthesis, and cell proliferation. Cells cultured without test materials served as controls (100%). RESULTS: The fibroblasts showed a highly significant decrease in protein synthesis when in contact with amalgam (61.8 +/- 13.6%); MTA (91.2 +/- 5.9%) and titanium (92.4 +/- 4.7%) had little effect on this parameter. The rate of cell proliferation in contact with MTA (98.0 +/- 1.6%) and titanium (97.9 +/- 7.4%) was only slightly influenced and showed similar values to that of the controls after 96 h of incubation. On the contrary, a significant and continuous reduction in the rate of cell proliferation was observed for cells in contact with amalgam (61.0 +/- 2.5%) after 96 h. No significant increases in lactate synthesis values were registered for any of the materials (MTA 101.8 +/- 1.7%, titanium 94.8 +/- 8.6% and amalgam 105.8 +/- 10.3%). There was a significant decrease in PGE2 synthesis potential when cells were in contact with amalgam (85.2 +/- 3.5%). In comparison to the controls, titanium and MTA resulted in an elevated level of cellular PGE2 synthesis (titanium: 131.6 +/- 19.1%; MTA: 147.3 +/- 18.9%). The cell cultures stimulated with arachidonic acid (10-5 m) showed no significant differences with any material (MTA: 88.8 +/- 17.6%, titanium: 97.6 +/- 14.4%, amalgam: 85.5 +/- 16.8%). CONCLUSIONS: MTA demonstrated cellular responses similar to those of titanium. Amalgam showed an irritation rate higher than that of MTA and titanium.

Aluminum Compounds↗
PubMed2004

Intentional replantation - a 'last resort' treatment or a conventional treatment procedure? nine case reports.

Intentional replantation is an accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure. This article reviews nine cases of intentional replantation (IR) that show the feasibility of the procedure in a variety of indications. Only one case of replantation showed evidence of pathosis that reflected root resorption or ankylosis. This report suggests that IR is a reliable and predictable procedure and should be more often considered as a treatment modality in our efforts to maintain the natural dentition.

Adult↗
PubMed2004

Efficacy of low level laser therapy in reducing postoperative pain after endodontic surgery-- a randomized double blind clinical study.

The aim of the study was to evaluate the effect of low level laser application on postoperative pain after endodontic surgery in a double blind, randomized clinical study. Fifty-two healthy adults undergoing endodontic surgery were included into the study. Subsequently to suturing, 26 patients had the operation site treated with an 809 nm-GaAlAs-laser (oralaser voxx, Oralia GmbH, Konstanz, Germany) at a power output of 50 mW and an irradiation time of 150 s. Laser treatment was simulated in further 26 patients. Patients were instructed to evaluate their postoperative pain on 7 days after surgery by means of a visual analogue scale (VAS). The results revealed that the pain level in the laser group was lower than in the placebo group throughout the 7 day follow-up period. The differences, however, were significant only on the first postoperative day (Mann-Whitney U-test, p<0.05). Low level laser therapy can be beneficial for the reduction of postoperative pain. Its clinical efficiency and applicability with regard to endodontic surgery, however require further investigation. This is in particular true for the optimal energy dosage and the number of laser treatments needed after surgery.

Adult↗
PubMed2000

Tumor necrosis factor-alpha and transforming growth factor-beta1 in chronic periapical lesions.

OBJECTIVE: Proinflammatory cytokines are involved in the pathogenesis of periapical lesions. The purpose of this study was to evaluate the presence of the cytokines tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta(1) (TGF-beta(1)) in periapical pathosis and to determine their relationship to the size of the lesions. STUDY DESIGN: One tooth from each of 25 patients was root-end resected, and the periapical lesion was collected. The amounts of TNF-alpha and TGF-beta(1) were assessed by enzyme-linked immunosorbent assay. RESULTS: TGF-beta(1) was detected in 21 of 25 lesions. In samples with scar tissue, no TGF-beta(1) activity was detected. A statistically significant correlation was found between TGF-beta(1) per milligram of tissue and the diameter of the lesions. TNF-alpha was detected in only 2 samples. CONCLUSIONS: TGF-beta(1) was present in periapical granulomas and cysts but not in lesions with scar tissue. The correlation between the amount of TGF-beta(1) per milligram of tissue and the size of the lesion was significant.

Adult↗
PubMed2002

Leakage associated with intermediate restorative material and glass-ionomer cement retrograde fillings: a human and sheep teeth comparison with 2 different aging procedures.

OBJECTIVES: Leakage around retrograde fillings is an important cause of endodontic surgery. This in vitro study sought to compare the following: (1) methylene blue dye leakage linked to retrofillings in human and sheep teeth with the degree of dye penetration when intermediate restorative materials and Chemfil were used as retrofillings, (2) the apical microleakage in filled with that in unfilled root canals, and (3) 2 storage techniques, incubator-based and subcutaneous implantation in rats. STUDY DESIGN: Tested were 198 human and 196 sheep teeth that were retrofilled with intermediate restorative material or Chemfil, then stored in an incubator or subcutaneously in rats for 10, 20, and 30 days before immersion in methylene blue dye for 24 hours. Linear dye penetration was evaluated, and the results were statistically analyzed by means of analysis of variance. RESULTS: Leakage between sheep and human teeth was significantly different (P <.05). Chemfil had significantly less leakage than intermediate restorative material after storage in rat (P <.05) for up to 20 days, but not after 30 days. No differences were found between leakage of unfilled and filled human root canal teeth. CONCLUSIONS: The sheep incisor is a poor experimental model of the human tooth, and both aging procedures demonstrate extensive leakage of retrofilling materials after long-term storage.

Aluminum Silicates↗
PubMed2003

pH and calcium ion release of 2 root-end filling materials.

OBJECTIVE: The purpose of this study was to evaluate the pH and calcium ion release of 2 materials used for root-end fillings and perforation repair. STUDY DESIGN: ProRoot and MTA-Angelus were placed in plastic tubes and immersed in glass flasks containing deionized water. After 3, 24, 72, and 168 hours, the water in which each had been immersed was tested to determine the pH changes and released calcium. RESULTS: The values for pH and calcium ion release were slightly higher for MTA-Angelus than ProRoot. The calcium release and pH of both materials were initially higher. CONCLUSION: The results suggest that both materials release calcium and promote alkaline pH.

Aluminum Compounds↗
PubMed2003

Extraoral endodontic treatment by retrograde insertion of posts: a long-term study on replanted and transplanted teeth.

OBJECTIVE: The aim of the study was to investigate the healing results of teeth replanted or transplanted in different indications and treated by extraoral root canal therapy. STUDY DESIGN: Extraoral root canal treatment was performed from a retrograde direction with posts made of ceramics or titanium. Preoperatively, the pulp status was classified as definitely infected (n = 47) or not infected/symptomless (n = 78), and the condition of the periodontal ligament (PDL) was classified as damaged (n = 50) or not damaged (n = 75) according to trauma type and extraoral storage. The healing after replantation or transplantation was diagnosed as functional, ankylosis, or infection depending on clinical and radiographic findings. RESULTS: In total, 125 teeth in 99 patients were replanted or transplanted. Mean observation period was 44.4 months. Teeth with a less damaged PDL in no case exhibited ankylosis/replacement resorption after a mean observation period of 53 months. Teeth without preoperative infection of the pulp in no case showed infection-related complications after a mean observation period of 30 months. Teeth classified as definitely infected before treatment had a high frequency of continuous periradicular bone and root resorption. CONCLUSIONS: The extraoral insertion of posts appeared to inflict no additional damage to the PDL that was clinically relevant. Infection-related complications were prevented. Teeth that were classified as definitely infected at the time of treatment had a low rate of healing and should undergo conventional root canal disinfection before this surgical procedure is applied.

Adolescent↗
PubMed2005

In vivo study of the Nd:YAP laser in persistent periapical lesion.

OBJECTIVE: The aim of this study was to evaluate the therapeutic effect of ND:YAP laser in persistent lesions through signs and symptoms such as the presence of fistulas and pain, respectively. BACKGROUND DATA: Periapical lesions with bacterial invasion, giving origin to bacterial infections, appear many times during the endodontic treatment, which aims at preparing and disinfecting the root canal system, in canals with mortified pulp. The endodontic treatment aim at eliminating infections and reinfection prevention; however, sometimes re-treatment is necessary, and it can be complemented with paraendodontic surgery due to reinfection, which can also persist. METHODS: Our study group consisted of six clinical cases (endodontic treatment), with the introduction of a 300-microm optic fiber through the fistula channel, where three applications were carried out with an interval of 15 sec, each with a discharge of 300 mJ of energy and frequency of 30 Hz. RESULTS: After a 7-day interval, the signs and symptoms were absent, even after a follow-up of 18 months. It was also observed, through a microbiological study, the decrease of the local microbiota. CONCLUSIONS: Our results supported the use of Nd:YAP laser, in part since it created an unfavorable environment for the continuing development of microorganisms.

Apicoectomy↗
PubMed2000

Retreatment decisions--a comparison between general practitioners and endodontic postgraduates.

One of the most subjective areas with regard to interexaminer variations is the dental radiograph. The variations in radiographic interpretation lead to differences in treatment planning decisions. This study compared the endodontic retreatment planning decisions for endodontically treated teeth between 12 general practitioners and 12 endodontic postgraduate students. Utilizing dental radiographs of completed cases, both groups were asked to make treatment choices based on two hypothetical ages of a case: 1 or 3 yr postoperatively. General practitioners chose to initiate treatment at an earlier date and also chose more extensive treatment modalities. The age of the root filling was looked on as more important in treatment planning by the endodontics postgraduates.

Apicoectomy↗
PubMed2000

Cytotoxicity of mineral trioxide aggregate using human periodontal ligament fibroblasts.

The purpose of the present study was to compare the cytotoxicity of mineral trioxide aggregate (MTA) to other commonly used retrofilling materials, Super-EBA and amalgam. This was accomplished using a cell viability assay for mitochondrial dehydrogenase activity in human periodontal ligament fibroblasts after 24-hr exposure to extracts of varying concentrations of the test materials, in both freshly mixed and 24-hr set states. Methyl methacrylate 2% (vol/vol) served as the positive control, and complete culture medium served as the negative control. Differences in mean cell viability values were assessed by ANOVA (p < 0.05). In the freshly mixed state, the sequence of toxicity was amalgam > Super-EBA > MTA. In the 24-hr set state the sequence of toxicity at a low extract concentration was Super-EBA > MTA, amalgam, and Super-EBA > amalgam > MTA at a higher extract concentration. This study supports the use of MTA in the root-end environment.

Aluminum Compounds↗
PubMed2000

Adhesion of human osteoblasts on root-end filling materials.

Adhesion of human osteoblasts to root-end filling materials (mineral trioxide aggregate (MTA), IRM, composite, and amalgam) was observed by scanning electron microscopy. Root-end filling materials were inserted into 96-well flat-bottomed plates and condensed to disks of approximately 1 mm thick and the same diameter as the wells. After the disks were set, they were placed in the bottom of Nunc four-well culture plates at one disk per well. Then human osteoblasts were seeded into the wells at 1.5 x 10(5) cells per well. After 1 day in culture the disks of root-end filling materials along with cells grown on their surface were examined with a scanning electron microscopy. Results showed that osteoblasts attached and spread on MTA and composite by forming a monolayer. Osteoblasts also attached on amalgam, but with few cells spreading. In the presence of IRM, osteoblasts appeared rounded with no spreading. These results indicate that osteoblasts have a favorable response to MTA and composite resin compared with IRM and amalgam.

Aluminum Compounds↗
PubMed2000

Charcot-Leyden crystals within a periapical lesion.

Transmission electron microscopy revealed the presence of Charcot-Leyden crystals within a periapical lesion, which was assessed histopathologically as consistent with a periapical granuloma that failed to resolve after conventional endodontic treatment. This paper presents the clinical, radiographic, histological, and ultrastructural findings of this case and discusses their potential clinical significance.

Apicoectomy↗