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PubMed1995

Aesthetic treatment of discoloration of nonvital teeth.

Attempts to treat discoloration in nonvital teeth were first reported a century ago. This article discusses two potential causes of nonvital tooth discoloration-trauma and endodontic treatment-along with a step-by-step clinical procedure for treatment of the discoloration. In trauma, hemoglobin is released into the tissues; iron oxides, formed by oxygen and iron in hemoglobin, cause discoloration and swelling that infringes on pulp space, forcing the pulp to recede with a potential loss of tooth vitality. After endodontic treatment, either hemorrhaging, materials used, or incomplete removal and breakdown of necrotic tissue may cause staining. The learning objective of this article is to review the causes and the prevention/treatment of discoloration in nonvital teeth.

Adult↗
PubMed1996

Oral health in alcohol misusers.

One hundred and seven chronic alcohol misusers (mean age 42.9 years; range 21-65 years; 80 males) attending four centres in South East London were interviewed on their current and past alcohol consumption. Their nutritional status (body mass index (BMI) and mid arm muscle circumference) was also recorded. Each subject completed a dental and oral mucosal examination. Ninety four per cent of the sample consumed greater than 50 units of alcohol per week and 80 per cent greater than 100 units of alcohol per week. Smoking and alcohol misuse were found to be related, 81 per cent reporting both habits. Neither plaque index scores or mean subject pocket depths were correlated with alcohol consumption but both were positively correlated with the frequency and duration of smoking. Overall mean DMFT was 15.4; age specific mean DMFT and tooth loss of the sample were closely similar to the 1988 United Kingdom adult dental health survey data. The prevalence and severity of tooth wear and attrition were greater in the sample than levels described in the literature and these dental features may prove useful markers to the practitioner. Trauma to teeth and oral mucosae was noted in 25 per cent of the sample. Seven oral mucosal lesions (including one treated carcinoma) were detected; mucosal trauma could have acted as a co-factor. Furthermore, 21 per cent of the alcoholics were malnourished (BMI < 20). It is concluded that, unlike several reports from the United States, dental health in this sample of alcoholics is not compromised; however mucosal health is a cause for concern.

Adult↗
PubMed1997

A root perforation and treatment.

According to Lemon (1992) the internal matrix concept of repairing perforations has distinct advantages over the surgical method. The procedure is more time-efficient when compared with other methods. The technique requires direct access and visualization of the perforation site in order to place the repair material. It is therefore restricted to perforations in the furcation area, and the straight portions of the root canal.

Aged↗
PubMedDate not supplied

Histopathological studies on the effects of experimental trauma and N-methyl-N-nitrosourea on the developing molar in rats.

Physical trauma to the developing first molar after initial dentin formation (5-day-old rat) and apposition stage (10-day-old rat) caused disturbance in amelogenesis, dentinogenesis, root formation which lead to aberrant odontogenesis. On the other hand, a combination of trauma and injection of carcinogenic substance (NMU) produced a more pronounced disturbance in odontogenesis and higher incidence of unerupted tooth. The transformation of the retained reduced enamel epithelium to squamous type cells was an interesting finding and has not been reported elsewhere. The presence of large proliferating type of odontogenic cell rests was observed.

Animals↗
PubMed1998

Use of a resin-ionomer in the treatment of mechanical root perforation: report of a case.

A perforated root represents a difficult challenge to the clinician, and treatment of such defects often involves surgical and/or advanced restorative techniques. This typically requires a series of lengthy, often stressful appointments, may compromise esthetics, and invariably involves additional costs to the patient. This case report describes the nonsurgical treatment of separate mechanical perforations that resulted from the removal of a failed prefabricated post. The tooth was restored in a minimum number of visits through the use of a novel application of a resin-ionomer material originally designed for routine restorative procedures.

Adult↗
PubMed1998

Root resorption of dental and traumatic origin: classification based on etiology.

While root resorption is a relatively common complication of dental trauma, classifications of root resorption are inconsistent and confusing. All pathological root resorption of dental origin is inflammatory in nature. For root resorption to occur, the protective superficial layer must be (internally or externally) damaged or changed and an inflammatory stimulator must be present. This article attempts to classify root resorption on the basis of etiology, i.e., the cause of the protective layer loss and the cause of the inflammatory response, to facilitate more efficient treatment.

Bacterial Infections↗
PubMedDate not supplied

The use of resin-ionomer in restorative procedures.

As the average age of the population increases, we are seeing a significant rise in root caries and in the need for restorative procedures associated more often with an older population. This paper describes the subgingival placement of a resin-ionomer for several restorative procedures, including root caries, resorption, endodontic perforation and root fracture. After endodontic therapy, full thickness flaps may be used to gain access to the lesion or root defect. The defects may be prepared with ultrasonic instruments and the preparations treated with a dentin conditioner. The preparations are then washed and lightly air-dried and treated with a dentin bonding agent. A resin-ionomer may then be syringed into the preparations and either light-activated or allowed to undergo a chemical set. No untoward effect has been observed during the time frame of this project. The cases presented indicate that a resin-ionomer may be used as a subgingival restorative and may be placed in lesions originally thought to be unrestorable. Thus, teeth may be saved that were previously designated for extraction.

Dental Restoration, Permanent↗
PubMedDate not supplied

Minor oral injuries in children.

Traumatic injuries involving the oral cavity in children often result from falls or collisions with stationary objects. Repair of lacerations involving the soft tissue structures within the oral cavity is described. These injuries often can be managed by emergency department personnel, with referral to an oral and maxillofacial surgeon for follow-up care. Initial management of more extensive injuries such as dentoalveolar fractures, penetrating injuries and burns is also described. Immediate consultation with the appropriate specialist is suggested, because significant deformity and/or morbidity may result from minor oral injuries.

Burns, Electric↗
PubMed1999

Evaluation for tooth stabilization and treatment of traumatized teeth.

Thorough evaluation and correct treatment of traumatized teeth improve their chances for survival. This article provides an overview clinical evaluation and how best to treat the tooth that has been traumatized. The rationale and techniques for tooth stabilization of the traumatized tooth will also be presented.

Contusions↗
PubMed2002

[Acute and chronic facial pain due to injured neural plexus of the upper teeth].

The general causes of upper dental plexus injury are tooth disturbances and the periodontal tissues diseases, the pathology of maxillary sinus, various traumatically manipulations in the area of tooth and maxilla as well. The main symptom of upper tooth neural plexus injury is acute and chronic pain in the alveolar sprout of maxilla, gums or in the area of singly tooth, which rarely spreads into neighboring maxillofacial areas. The authors recommend that the acute pain syndrome would be called the inflammation of upper tooth plexus, and the chronic pain syndrome--plexopathia of upper tooth. Study presents the differential diagnosis according to character of facial pain syndrome and the data of sensority disorders research and investigation of pain thresholds as well. The recommendations for treatment tactic and methods of analyzed indispositions are suggested.

Acute Disease↗
PubMed2006

Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth.

A prospective study of 140 intruded permanent teeth was done to evaluate the following healing complications: pulp necrosis (PN), root resorption (surface, inflammatory and replacement resorption) (RR) and defects in marginal periodontal healing (MA). These complications were related to various preinjury and injury factors. Age appeared to be related to all three healing complications in that patients younger than 12 years had the lowest complication rate. Stage of root formation at the time of the injury was very strongly related to PN and MA, with immature root formation (i.e. incomplete root formation or completed root formation with wide open apex) having better prognosis than more mature root development. Lateral incisors showed significantly more defects in MA, a finding possibly explained by the observation that lateral incisors were more often involved in multiple intrusions compared to other teeth and noting that multiple intrusions had a significantly higher frequency of MA. An associated crown fracture with exposed dentin resulted in more frequent PN, a finding possibly related to bacterial invasion through dentinal tubules into an ischemic pulp. The presence of a gingival laceration added to both PN and MA. The extent of intrusion (in mm) showed some relation to both RR with intrusion 1-3 mm having the lowest frequency of RR, whereas PN and MA showed no significant relation to the extent of intrusion. Finally, multiple adjacent intruded teeth were more frequently involved in a significantly greater loss of interproximal marginal bone (MA) than single intrusions. In conclusion, the relationship between healing complications and preinjury and injury factors could generally be explained by better healing possibilities in teeth with immature root formation. A possible explanation for that could be the softer bone surrounding the tooth, whereby trauma to the periodontium might be diminished.

Adolescent↗
PubMed1984

An electron microscopic analysis of the trans-synaptic effects of peripheral nerve injury subsequent to tooth pulp extirpations on neurons in laminae I and II of the medullary dorsal horn.

To examine the effects of peripheral nerve injury on second-order neurons in laminae I and II of the medullary dorsal horn, tooth pulps of all mandibular teeth in adult cats on one side were extirpated. This procedure severed and removed the receptors and terminal branches of the primary trigeminal neurons which innervate the tooth pulps of these teeth. The empty pulp chambers were then filled with dental cement to prevent regeneration. At 30 and 60 days postoperatively, membrane-lined cavities had formed inside many of the small-caliber dendrites of second-order neurons in laminae I and II. Cavity formation occurred mainly in dendritic shafts less than 2 micron in diameter and involved dendrites with synaptic vesicles as well as those without synaptic vesicles. The cavities extensively hollowed out these dendrites, often occupying more than half the cross-sectional diameter of the shafts and extending for appreciable distances in the long axis of the shaft. The process of cavitation ultimately resulted in the destruction of the affected dendrites. Many cavities became patent to the intercellular space with the cavity membrane establishing continuity with the dendritic membrane. Many cavities often formed in a single dendrite, and such severely cavitated dendrites became reduced to a trabeculated shell which ultimately fragmented into several small pieces. The presence of synaptic connections from a number of different kinds of axonal endings, including scalloped and dome-shaped endings, was not sufficient to prevent cavitation. The actual severing of synaptic connections on the cavitated dendrite appeared to be a relatively late event in the process since small pieces of dendritic debris could still be found clinging to their axodendritic synapses. Evidence that dendrites were being lost from the neuropil was most readily apparent in many of the disrupted glomeruli in lamina II in which many of the scalloped depressions in the central axonal endings that normally contained small dendrites were empty. Many central axonal endings remained in synaptic contact with only a single dendrite which often showed signs of cavitation. Such central endings showed only subtle remaining traces of their normal scalloped contours. This study demonstrates that injury to the distal branches of primary trigeminal neurons which innervate tooth pulps resulted in trans-synaptic degenerative changes in the dendritic arbors of second-order neurons which destroyed fine-caliber higher order dendrites.

Animals↗