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The biocompatibility of commonly used four endodontic sealers and three brands of gutta-percha was studied by cell attachment experiment in vitro and SEM technique.The results indicated that all the materials tested had significant cytotoxicity.Clinically,in order to avoid irritrating periapical tissue mechanically and reduce cytotoxicity,overfilling should be avoided when possible.
OBJECTIVE: To estimate the related factors and prophylactic measures of endodontic interappointment emergencies (EIE). METHODS: The clinical cases were divided into three groups. Cases in the routine group were treated according to the routine procedures of root canal therapy. Cases in the medicament group took dexamethasone tablets after the instrumentation. Root canals in the drainage group were prepared at the first visit and had been left open for two or three days. The related factors were recorded. The incidences and flare-up index (FUI) value of EIE were statistically analyzed. RESULTS: The EIE incidence of the routine group was 19.1%. The EIE incidence and FUI value of the overinstrumented teeth were significantly higher than those of other teeth (P < 0.05). EIE were not significantly related to the age, gender, tooth location and pathosis of the pulpal and periapical tissue (P > 0.05). The FUI value of the medicament group was significantly lower than that of the routine group (P < 0.05). Less severe EIE occurred in the cases of the drainage group than those of the control group (P > 0.05). CONCLUSION: The occurrence of EIE was significantly related to overinstrumentation. Taking dexamethasone may relieve EIE.
OBJECTIVES: Data are scarce on the prescribing habits of dental practitioners. Drug use in dentistry and stomatology is undertaken to determine the pattern of drug use for patients seeking treatment. METHODS: 1820 prescriptions of dental patients attending the dental outpatient departments at Manipal Teaching Hospital, Nepal were collected by a random once weekly survey between March '01 to February '02. The information was compiled, scored and analyzed in consultation with dentists using WHO guidelines. RESULTS: Males numbered 801 (44%) and females 1019 (56%). Most of the patients were aged between 13-25 years. The dental disorders most frequently reported in our study were diseases of pulp and periapical tissue (36.5%), gingivitis and periodontal disease (28.5%), and dental caries (16%). The average number of drugs prescribed was 2.03 (3698 / 1820) and 66% prescriptions contained antimicrobials (1 or 2). 21% drugs were prescribed in generic names and 38% drugs were fixed dose combinations of 2 or more drugs. 4/5 of the prescribed drugs were systemic agents and 1/5 were local/topical agents. The most commonly prescribed systemic agents were analgesics (43.7%) followed by antimicrobials (39%). The most conmonly prescribed local / topical agents were anti-infectives (74%). In the present study, NSAID's (89.6%) were the preferred analgesics over narcotic analgesics (10.4%). The most frequently prescribed systemic analgesic and antimicrobials were ibuprofen and amoxycillin, respectively. CONCLUSIONS: This study may help in identifying the problems involved in therapeutic decision making. Also, there is a clear need for the development of prescribing guidelines and educational initiatives to encourage the rational and appropriate use of drugs in dentistry.
A 51-year-old man was referred to an oral and maxillofacial surgeon because of persistent complaints after endodontic treatment of tooth 22. Apical endodontic surgery was performed and periapical tissue was examined histopathologically, showing an osteosarcoma. In retrospect, signs of malignancy were already present on the radiograph taken prior to the endodontic treatment.
AIM: The objective of this study was to radiographically assess and compare the quality of post-retained crowns fabricated at the Dental Health Centre of the Jordan University of Science & Technology (JUST). METHODS AND MATERIALS: Study data were collected in 2002 from existing dental records for all patients receiving treatment with post-retained crowns between October, 1997 and June, 1999. The posts were assessed radiographically to evaluate various aspects of the quality of post-retained crowns. All 129 posts were fabricated in the dental school. RESULTS: The most-frequently restored teeth were the maxillary incisors (38.8%). Sixty-two percent of the posts were tapered, while 38% were parallel-sided. The mean length of the posts was 0.95 mm (SD 0.41) with a range between 0.22-2.85 mm. Caries was diagnosed radiographically in 10.8% of cases with lesions located on root surfaces in 64.3% of them, while 35.7% of lesions were within the root canal. Three posts (2.3%) were deviated from the line of the root canal in the mesio-distal plane. No evidence of root filling was found in 2.3% of the cases. In the remainder of teeth 15.5% had gutta percha extended to the radiographic apex of the tooth, while 59.7% fell 0.5-1 mm short of the radiographic apex. Gutta-percha was extruded beyond the apex in 22.5% of the teeth. Space between the end of the post and the root filling was found in 22.2%. The percentage of canals with apparently completely healthy periapical tissue was 51.2%. In the rest of the cases 34.8% had areas of radiolucency at or near the root apices and 14% demonstrated widening of the periodontal space around the root apex. Root resection had been completed in 2.3% cases. Signs of external resorption were apparent in one case (0.78%). CONCLUSION: The standards of the treatment of the endodontically treated teeth made at the dental hospital were satisfactory but could be improved by a controlled academic supervisory environment and a strict scientific approach to fixed prosthodontics within the dental school.
The major goal of endodontic therapy has been achieved by condensing filling materials into the root canal. It is not uncommon to find excess material in the periapical tissue. It therefore becomes obligatory to use filling materials that have acceptable biocompatibility. The purpose of this investigation was to obtain a "toxicity profile" of some root canal materials and to compare our observations to study results found in literature. Gutta-percha and five endodontic filling cements were tested in vivo and in vitro. The in vivo biocompatibility involved the placement of the test material in 10 mm teflon tubes with an outer diameter of 1,3 mm which were then implanted subcutaneously into rats. The implants were left in situ for periods of 30 and 90 days. The hemolysis test was used for in vitro evaluations. The histological examination showed cellular responses of different intensity and extent. In some cases severe infiltration of inflammatory cells and areas with necrostis were observed. As a result, the root canal materials evaluated showed slight, moderate, and severe reactions, therefore, a different pattern in tissue response.
Person identification from the teeth depends on establishing a number of points of correspondence between ante- and postmortem dental data, but a single characteristic, if unique enough, may be sufficient. The use of amalgam tattoos in establishing identity has not been reported in the literature. Two cases in which amalgam tattoos were used in conjunction with other dental data to establish identity are reported. Ante- and postmortem radiographs showed the presence of amalgam within the adjacent alveolar bone and periapical tissues, respectively. Attempts were made to duplicate the angulation of the original antemortem radiographs so that a direct comparison could be made of the amalgam fragments. The antemortem radiographs date from 1984 and 1985 in the two respective cases. In both instances the pattern of amalgam remained fairly similar, differences being ascribed to angulation which could not be reproduced exactly. From these results it seems that amalgam tattoo may be a reliable method of identification, even though a number of years may have elapsed since the ante- and postmortem radiographs were taken. The pattern of amalgam dispersal may be sufficiently unique so that identity can be established using this single characteristic.
The authors present a study of the physical and biological properties of a new endodontic cement known as Sealapex. In its composition the presence of calcium hydroxide is introduced in order to induce calcification of the periapical tissue. Our results using glass round cover slips implanted on the subcutaneous tissue of mice indicated a persistent foreign body reaction (60 days). The physical properties studied compared to N-Rickert ciment indicated, a decreased leakage. Adhesivity tests didn't give us significant values. Laboratorial studies and clinical trials are necessary to a complete acceptance of this new ciment in endodontic treatment.
Sodium hypochlorite is still today the most popular irrigating solution used in endodontics. History, chemical and bactericidal properties, effect on periapical tissue, dissolution of pulp tissue, removal of debris and depth of penetration and attempts to improve its activity are discussed in this article.
The study included 48 cases of pulpitis grade II of one-root teeth in 42 patients of either sex aged 21-35 years treated by pulp extirpation under analgesia with immediate filling of canals. In 28 teeth Biopulp was used as an intercalated substance between the periapical tissues and the material filling the canal. The control group comprised 20 teeth filled only with Endomethasone paste. The observations made immediately after filling and clinical-radiological control examination after from 6 months to 3 years showed a high usefulness of calcium hydroxide. Good results were achieved in 100% of cases while in the control group in 70% of cases.
The purpose of the study was evaluation of the results of treatment of molar pulp diseases by the formocresol method from the standpoint of the development of inflammatory complications in periapical tissues, disturbances of physiological resorption of roots, disturbances of mineralization of crowns of homologous permanent teeth. For the treatment milk molars were qualified with the diagnosis of grade II pulpopathy in children aged from 3 to 9 years. The treatment was done using formocresol by a modified method of pulp amputation according to Buckley after previous devitalization with parapaste. The status of 143 teeth was examined again 1 to 4 years after completion of treatment. The proportion of positive results after one year was 94%, after two years it was 90%, after three years 87% and after four years 80%. The cause of premature loss of most teeth was root resorption acceleration by 18-24 months. No harmful action of formocresol on the buds of permanent teeth was noted.
In this study, in order to determine a method for obtaining a good reaction, the reactive products of 3.8% Ag (NH3)2F, using formalin as a reducing agent, were studied. Saforide RC was used as the 3.8% Ag (NH3)2F solution and 10% neutral formalinsolution was used as a reducing agent. The silver mirror test and reaction products on the root canal wall were investigated under the scanning electron microscope, along with observation of dye penetration using a stereoscopic microscope. Reaction of periapical tissue to the materials was studied histologically in dogs. In the natural reduction group, less amounts of reactive products were seen, and sealing of the dentinal tubules of the root canal wall was inadequate. In the formalin reduction group, large amounts of reactive products were found, and the dentinal tubules of the root canal wall were sealed. CaF2, Ag3PO4, Ag2O and Ag were identified as reactive products. In the natural production groups, obstruction was present but incomplete. In Formalin groups, dye osmosis obstruction was recognized. No harmful action of the solution on the surrounding tissue of the dog's tooth was recognized.
Typical errors in teeth roentgenography reproduced in experiment, indicate that considerable disproportional distortions of images of anatomical structures which are decisive for radiodiagnosis, may occur in these cases. These distortions influence the accuracy of assessment of the condition of periapical tissues, marginal parts of the alveolar process, cavity sizes, and the actual end of the root of the canal. Standardization of intraoral roentgenography is based on a strict position of the patient's head, angle of inclination and alignment of a tube. Specialized P3-1 film should be used. Its processing should strictly correspond to the instructions of a manufacturing factory otherwise the quality of an image is deteriorated and an effective equivalent dose on the vital organs is increased.
In 1984, during 201 voyages of cargo ships of Polish Ocean Lines having doctors on board, 30340 medical consultations were given to crew members, in 15506 cases of complaints and diseases. Doctors also consulted injured seafarers 2456 times in cases of injuries, wounds, contusions, broken bones, burns, scalds etc. During these 201 voyages, 33 cases of serious medical conditions were reported among crew members, which required disembarkation and hospital treatment abroad; in this number two cases of myocardial infarction ended fatally. There were also 13 casualties among seamen, which were treated in hospitals in foreign ports; all of them survived. One of the important health problems of seafarers were diseases of teeth, pulp, and periapical tissue. Such cases constituted the majority (66.9%) of all 1868 cases referred for consultation and treatment in foreign ports. Oral diseases prevention among seafarers needed improvement. The working time of doctors on board ship was under-utilized. To a greater extent they should be involved in training seafarers in first aid and primary health care, and in health education activities among seamen, during sea voyages. Materials presented in the paper may be of use in planning efficient and cost-effective health services for crews of ships.
The objective of this study was to determine if intraligamentary injection causes qualitative histopathologic changes in the dental pulp of a Cynomologus monkey. In as much as the pulp and periapical tissues of the monkey are similar to that of humans, nonresolving damage to the pulp would contraindicate periodontal ligament injection in procedures where the tooth would not be extracted or the pulp extirpated. Periodontal ligament injection in this study did not produce any histopathological pulpal changes when compared to the pulps of uninjected teeth.
Intracanal medicaments in endodontics have been used for a number of reasons both in the past and currently. These include the elimination or reduction of microorganisms, rendering canal contents inert, prevention of post-treatment pain, and to enhance anesthesia. The chemical nature of medicaments employed are varied; they come from a number of different groups. Often, different chemicals or drugs are combined in a "cocktail" in an attempt to elicit a variety of effects with a single application. After reviewing in vivo and in vitro research, there is a decided lack of evidence of the clinical effectiveness of intracanal medicaments, with the exception of steroids for prevention of pain. What is clear from the research, is the toxicity and potential allergenicity of the commonly used intracanal medicaments, particularly those of the phenolic and aldehyde derivatives. Ready accessibility to periapical tissues and systemic circulation raises serious doubts as to whether their use is safe. It is also unlikely that most medicaments enhance clinical success. Considering the research, the findings of which are reinforced by clinical experience, intracanal medicaments are primarily useless. The one exception is intracanal or systemic steroids. They are effective in reducing the incidence of post-treatment pain.
The disinfectants called Oxpara liquid, N2 medical liquid and merfen are being used in the treatment of pulp and periapical tissue infections in medical dentistry. In the clinics of H. U. Medical Dentistry Faculty these disinfectants are used in their undiluted, concentrated forms. As it was thought they might be harmful to the tissues in their concentrated forms, it was attempted to find out their least toxic but sufficiently effective dilutions on different bacteria, compared with pheunol. In the light of findings the in vivo values were investigated in another work. The Inhibition Coefficients (IC) for S. aureus were found to be 1/100 in phenol and Oxpara liquid, 1/1000 in Merfen, for S. typhi 1/200 in phenol and N2 medical liquid, 1/2000 in Oxpara liquid and Merfen. The Inferior Lethal Coefficients (ILC) for S. aureus were found to be 1/90 in phenol, 1/80 in phenbol, 1/80 in Oxpara liquid, 1/100 in N2 medical liquid, 1/1400 in Merfen, and for S.typhi 1/100 in phenol and N2 medical liquid and 1/700 in Merfen. The Superior Lethal Coefficients (SLC) for B.subtilis were found to be 1/80 in phenol, in Oxpara and N2 medical liquids, and 1/500 in merfen. When Phenol Coefficients were considered, Oxpara and N2 medical liquids were found to be in equal strength with phenol as antibacterial agents, however Merfen was approximately 15 times stronger than phenol.
UNLABELLED: Yunnan Baiyao (YNBY), amalgam, hydroxylapatite and calcium hydroxide were used separately in repairing the experimental pulp chamber floor perforation (PCFP) of dog teeth. The animals were killed at the time of 1, 4, 8 and 12 weeks after experiment. The experimental teeth with periapical tissue were removed and observed their histological changes by optical microscope. The effects that different materials in repairing the tissue of PCFP were observed. Twenty teeth were taken from every dog, each group contained four teeth, the others were used for control group. RESULTS: In initial period (1st, 4th week) inflammatory infiltration was present in PCFP of every group, but the group with YNBY was milder. Pyogenic foci were present in the hydroxylapatite and calcium hydroxide groups. In late stage of experiment (8th and 12th week) inflammatory reactions of each group were alleviated except control group. Epithelial metaplasia and cicatritation were found in the vicinity of perforated area. Dentin cementum and alveolar bone were absorbed in majority of experimental group. It was also observed in the group with YNBY. But in late stage similar cementum formation and alveolar bone neogenesis were found in the perforated area around the repairing materials. It revealed that hemostasis, Promoting Blood Circulation to Remove Stasis and antiphlogistic actions were advantageous to the inflammation, control and repair course of the PCFP. The article discussed that YNBY might promote the repairing of cementum and alveolar bone of perforated area.