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PubMed1998

Anaerobic bacteremia and fungemia in patients undergoing endodontic therapy: an overview.

Oral focal infection, a concept neglected for several decades, is a subject of controversy. Recent progress in classification and identification of oral microorganisms has renewed interest in focal infection. The aim of this study was to use phenotypic and genetic methods to trace microorganisms released into the bloodstream during and after endodontic treatment back to their presumed source--the root canal. Microbiological samples were taken from the root canals of 26 patients with asymptomatic apical periodontitis of single-rooted teeth. The blood of the patients was drawn during and 10 minutes after endodontic therapy. Microorganisms in blood were collected after anaerobic lysis filtration and cultured anaerobically on blood agar plates. The phenotypic methods used for characterization and tracing of microorganisms in blood and root canals were: biochemical and antimicrobial susceptibility test, SDS-PAGE of whole-cell soluble proteins, and gas chromatography of cellular fatty acids. Phenotypic data were verified by DNA restriction patterns and corresponding ribotypes of the root canal and blood isolates by using a computer-assisted system fro gel analysis. All root canals contained anaerobic bacteria. The frequency of bacteremia varied from 31% to 54%. The microorganisms from the root canal and blood presented identical phenotype and genetic characteristics within the patients examined. These characteristics differed between patients. The present study demonstrated that endodontic treatment can be the cause of anaerobic bacteremia and fungemia. The phenotypic and genetic methods used appeared valuable for tracing microorganisms in the blood back to their origin.

Bacteremia↗
PubMed1988

Treatment of endodontically and periodontally involved teeth. A case report.

Treatment of endodontically and periodontally involved teeth requires accurate diagnosis to determine the primary cause. The case presented involves a deep periodontal pocket associated with a necrotic tooth. The cause was diagnosed as being primarily endodontic and regeneration of the attachment apparatus occurred after endodontic therapy.

Adult↗
PubMed1998

The influence of endodontic infection on periodontal status in mandibular molars.

The purpose of the study was to investigate the influence of an endodontic infection on periodontal probing depth and presence of furcation involvement in periodontally-involved mandibular molars. All first and second mandibular molars in 100 patients were selected if at least one was root-filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodontal clinic which represented an adult population with a mean age between 50 and 60 years. For mandibular molars with periapical destruction at both roots, mean periodontal probing depth was significantly greater compared to teeth without periapical destruction. Horizontal furcation depths > or =3 mm were significantly more frequent at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis-involved molars may potentiate periodontitis progression by spreading of endodontic pathogens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis-prone patients.

Adult↗
PubMed1998

Impact of endodontic conditions on marginal bone loss.

This study was undertaken to examine the extent to which the marginal alveolar bone may be influenced by the condition of the dental pulp. A total of 115 pairs of contralateral teeth were observed in 87 patients (25 to 45 years old) in which the test tooth, but not the control tooth, was either endodontically treated or not treated but with a periapical radiolucency. The distance from the cemento-enamel junction to the marginal bone level was measured using intraoral radiographs. The condition of the endodontic filling, the periapical status, and the presence of root canal post were also assessed. With clinical parameters similar between teeth in the two groups in terms of visible plaque, bleeding on probing, probing depth, and attachment level, the results showed a somewhat (mean value 0.1 mm; SD 0.7) larger reduction of the alveolar bone support in test than control teeth. This difference was not statistically significant on a patient level. Hence, this study failed to demonstrate a correlation between a reduced marginal bone support and endodontic status.

Adult↗
PubMed2005

Squamous cell carcinoma presenting as an endodontic-periodontic lesion.

BACKGROUND: Regardless of advances in diagnosis and treatment during the past 40 years, the overall 5-year survival rates for oral and oropharyngeal squamous cancers have only slightly improved and remain around 50%. Thus, the early diagnosis and treatment of carcinoma by health care providers are essential in achieving a good prognosis. We report a case of invasive squamous cell carcinoma that presented as a benign endodontic-periodontic lesion with a 7-mm periodontal pocket on tooth #15 in a 40-year-old, non-smoking woman. The subsequent management of the case is also discussed. The study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2000. METHODS: Our patient was seen for a comprehensive periodontal examination including a periodontal charting, occlusal analysis, study casts, electronic pulp test for tooth #15, and complete mouth periapical radiographs. As there was a periapical radiolucency, an endodontic consultation was obtained. A periodontal flap surgical procedure was performed on teeth #13 to #15, and as there was bone erosion into the maxillary sinus, a biopsy of the soft tissue was submitted to the local hospital for histological analysis. RESULTS: The biopsied lesion was diagnosed as invasive, moderately differentiated squamous cell carcinoma with focal spindle and clear cell differentiation (grade II to III of IV). Bone invasion was also identified. The treatment of the carcinoma involved a hemimaxillectomy with the removal of the maxillary left posterior teeth. The patient remained free of tumor for 5 years after the initial presentation. CONCLUSIONS: Patient education and periodic oral cancer examinations by dental professionals are necessary to reduce diagnostic delay and improve prognosis. This case report emphasizes the important role of dental professionals, especially periodontists and endodontists, of being aware that squamous cell carcinoma may manifest itself clinically and/or radiographically as a common periodontal or endodontic lesion.

Adult↗
PubMedDate not supplied

Endodontic management of taurodontic teeth.

Taurodontism is a morpho-anatomical change in the shape of the tooth in which the body of the tooth is enlarged and the roots are reduced in size. Although taurodontism is a dental rarity, this unusual radicular form should merit circumspect considerations in planning and treatment. Endodontic management in taurodont teeth has been described as complex and difficult. The present paper describes the successful completion of endodontic treatment in three taurodontic teeth with appropriate use of instruments and techniques and also emphasizes the need for post endodontic rehabilitation.

Calcium Hydroxide↗
PubMedDate not supplied

Endodontic needs of geriatric patients in private practice.

Twenty-five (25) teeth of fifteen (15) elderly patients endodontically treated in a private clinic for the span of three (3) years were evaluated in terms of success and failure of treatment. The attitudes of the patients towards endodontics were determined. Also, medical, dental and radiographic records were reviewed. Of the fifteen (15) patients. 53.3% belonged to age group 60 to 69 years old and the other half belonged to the 70 years and above age bracket. Majority were female, married and college graduates. Premolars constituted 40% of the teeth treated. Post, core and PFM crowns were the most common restoration for both anterior and posterior teeth. Success rate of root canal treatment was a high 84%. Patients gave a more positive attitude to the endodontic treatment mentioning relief of pain, appreciation of better food and self-esteem. Calcification was the most common problem encountered during the treatment. Quality radiograph, proper instrumentation, appropriate techniques and chemical adjuncts are recommended. Likewise, proper patient management, needed rapport and patience have to be stressed.

Aged↗
PubMed1999

Guided tissue regeneration in the management of severe periodontal-endodontic lesions.

Diagnosis of combined periodontal-endodontic lesions can prove difficult and frustrating. They are often characterised by extensive loss of periodontal attachment and alveolar bone, and their successful management depends on careful clinical evaluation, accurate diagnosis, and a structured approach to treatment planning for both the periodontic and endodontic components. Recent advances in regenerative periodontics have led to improved management of periodontal-endodontic lesions. This paper reviews the management of such lesions in light of these recent advances and illustrates this through reports of two patients who had severe periodontal involvement.

Adult↗
PubMed1975

A new approach to the basic principles of endodontics.

The basic principles on which successful endodontic therapy depends have been commonly accepted as (1) debridement, (2) sterilization and (3) obturation. Each of these principles is subjected to critical evaluation. Because of the morphological complexity of most root canals complete debridement is not possible. No sampling technique is yet available to ensure total sterility of the prepared root canal nor is it possible to ensure that the root canal system is hermetically sealed by the filling material. Although it has been shown that 43 per cent of biopsies from the periapical area of endodontically involved teeth show evidence of cyst formation, the fact that up to 90 per cent of cases show evidence of healing following endodontic treatment without surgery indicates that radicular cysts can resolve without surgical intervention. In the light of these findings it is suggested that the basic principles should be accepted as (1) adequate debridement, (2) adequate obturation and (3) trephination where indicated.

Apicoectomy↗
PubMed1976

The frequency, technical standard and results of endodontic therapy.

The present summary and the following papers (I--VI) have been accepted in partial fulfilment of the requirements of the degree of Doctor Odontologiae at the Dental Faculty, University of Bergen. Paper I: Tooth mortality and endodontic status of a selected population group - before and after treatment in a teaching clinic. Paper II: The apical level of root fillings made by general practitioners, undergraduate students and an endodontist. Paper III: Radiographic evaluation of endodontic treatment-a methodological study. Paper IV: The quality of the seal of root fillings made by general practitioners, undergraduate students and an endodontist. Paper VI: A radiographic follow-up of endodontically retreated roots. In this summary these papers will be referred to by the above Roman numerals. Other investigations will be referred to in the conventional manner.

Adolescent↗
PubMed1999

Residual antimicrobial activity associated with a chlorhexidine endodontic irrigant used with sodium hypochlorite.

PURPOSE: To evaluate the in vitro efficacy of 2.0% chlorhexidine gluconate (CH) as an endodontic irrigant combined with the traditional irrigant, sodium hypochlorite (SH). MATERIALS AND METHODS: Extracted single-rooted human teeth were instrumented using one of three regimens: CH alone; SH alone until instrumentation with the last file, at which time CH was used as the filing irrigant; or SH alone followed by a single rinse with CH. After instrumentation, each root canal was dried with endodontic paper points, filled with sterile water, and maintained in a water-saturated environment. At 6, 12, 24, 48 and 72 hours after instrumentation, the root canal fluid was absorbed with an endodontic paper point, and the canal was irrigated and refilled with sterile water. The paper points containing root canal fluids were assayed for antimicrobial activity by placing them on agar plates inoculated with Streptococcus mutans, and measuring zones of inhibition after incubation. RESULTS: Comparisons of the results obtained from the three treatment regimens indicated there were no significant differences (P > 0.5) in the relative in vitro antimicrobial activity remaining in the three groups of teeth.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Cuspal reinforcement in endodontically treated molars.

UNLABELLED: This in vitro study compared the ability of horizontal pins and a dental adhesive to reinforce the facial cusps of endodontically treated mandibular molars. Seventy-two mandibular molars were divided into six groups and mounted in acrylic blocks (n = 12). In Groups 1-5 standardized endodontic access and instrumentation in the coronal one-third of each root canal were completed. In Groups 1-4 the lingual cusps were reduced, leaving the buccal cusps intact. The facial cusps of the teeth in each group received one of the following modes of reinforcement: Group 1--no reinforcement; Group 2--dentin adhesive (Amalgambond Plus); Group 3--two horizontal TMS Minim pins; Group 4--two horizontal TMS Minim pins and Amalgambond Plus. Teeth in Group 5 were prepared for and restored with a complete cuspal coverage amalgam restoration using four vertical TMS Minim pins. Group 6 consisted of intact natural teeth. Using an Instron Universal Testing Machine, the lingual slope of the facial cusp of each specimen was loaded to failure using a compressive force applied at an angle 60 degrees to the long axis of the tooth. The mean fracture strengths for all groups were analyzed using a one-way ANOVA and Student-Newman-Keuls multiple range test (alpha = 0.05). Fracture patterns and modes of failure were also evaluated. RESULTS: The intact teeth (Group 6) were significantly more fracture resistant than all other groups, with the exception of Group 4 (combination of pins and adhesive). Group 1 (non-reinforced teeth) was significantly weaker than all other groups. Groups 2-4 (specimens with reinforced cusps) were not significantly different from each other. The use of horizontal pins or a combination of horizontal pins plus dentin adhesive for cuspal reinforcement resulted in significantly more teeth demonstrating favorable fracture patterns than did the use of adhesives alone. CONCLUSION: The buccal cusps of endodontically treated mandibular molars reinforced with a combination of horizontal pins and dentin adhesive were not significantly weaker than intact teeth. Of the restored teeth, those which had buccal cusps reinforced with horizontal pins and those treated with complete cuspal coverage amalgam restorations exhibited the most favorable restorative prognosis following cusp fracture.

Chi-Square Distribution↗
PubMed1999

[Effect of the quality of endodontic treatment on the longevity of fixed prostheses. Apropos of 64 pulpectomies].

64 teeth with well-fitting post-retained crown were examined radio graphically and clinically and a number of failures were assessed including the peri-apical condition and the quality of root filling. All the teeth were vital and prosthetic was the only reason of endodontic treatment. Results have shown that 25% of the teeth had areas of radiolucency around the root apices. Various criteria parameters were reviewed for possible correlation to the failures. 15 out of the 16 cases of failures could be related to the endodontic therapy procedures: lack of using a rubber dam during the treatment and an unsatisfactory condensed and sealed root filling. Only one case was related to the deviation of post from the line of canal suggest a lateral perforation. To perform a post-retained crown the quality of endodontics must be considered: the operative procedures should be more controlled and enough time should be observed after root canal therapy to ensure its successful.

Adolescent↗
PubMedDate not supplied

Aesthetic posts and cores for metal-free restoration of endodontically treated teeth.

Utilization of contemporary post and core systems has facilitated the aesthetic restoration of endodontically treated teeth. Light transmission and biocompatibility have been enhanced by the introduction of metal-free post systems. The periodontal and endodontic status, root length, and histological structure of the devitalized teeth must be considered in order to achieve successful restoration following endodontic treatment. This article presents various restorative criteria for the aesthetic placement and buildup of post and core materials, as well as the preservation of maximum coronal and root structure.

Biocompatible Materials↗
PubMed2001

The outcome of teeth with periapical periodontitis treated with nonsurgical endodontic treatment: a computerized morphometric study.

OBJECTIVES: This study investigated the prognosis for successful endodontic treatment and the correlation between the size of the periapical lesion, the quality of the root canal treatment, and the type of coronal restoration. METHOD AND MATERIALS: Periapical radiographs of 319 teeth with periapical periodontitis were studied. The area of each lesion was measured before treatment and 1 to 12 years after completion of the endodontic treatment. The measurements were performed using computerized morphometry. RESULTS: In 65.2% of the teeth, the size of the lesion decreased, while in 34.8% of teeth, there was an increase. Lesions larger than 10 mm2 had a greater tendency for healing. CONCLUSION: No significant correlation was found between the quality of root canal treatment, the type of the coronal restoration, and the success rate of the endodontic treatment.

Adolescent↗
PubMed2000

An evaluation of resin-ionomers to prevent coronal microleakage in endodontically treated teeth.

While a gutta-percha system is most commonly used by practitioners for canal obturation, there is no agreement on how best to close the chamber of an endodontically treated tooth. Some materials used in restorative dentistry may have endodontic applications. Restorative materials of particular interest to endodontists are those used as subgingival restorations. Their properties include insolubility in oral fluids, adhesiveness, dual-cure capabilities, radiopacity, hardness and fluoride release, low cure shrinkage and a low coefficient of thermal expansion. The purpose of this in vitro study was to test three products that could be used to seal pulp chambers of endodontically treated teeth to prevent bacterial infiltration. A bacteriological assay system was used to determine the efficacy of three commercially available restorative materials to prevent penetration of Streptococcus salivarius from the pulp chambers into the prepared canals. The materials evaluated were: Geristore two-paste system with Tenure Quik with fluoride, Dispersalloy with Tenure Quik with fluoride, and Marathon posterior composite with Tenure Quik with fluoride. During the sixty days of the study, the analysis indicated that the Geristore two-paste system with Tenure Quik with fluoride provided a statistically significant improved seal when compared to the Marathon posterior composite and Dispersalloy amalgam with Tenure Quik with fluoride.

Composite Resins↗
PubMed2001

[Endodontic treatment of gangrenous teeth--literature review].

This overview was put together to update the endodontic knowledge of the general practitioners. Several treatment methods sometimes with contradicting principles are applied in Hungary using a wide range of endodontic medicines. The aim of the paper was not only to clarify the basic therapeutic principles but also to provide practical information about the relevant endodontic products for the everyday use.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Restoring endodontically treated teeth: a survey of current opinions among board-certified prosthodontists and general dental practitioners in Sweden.

PURPOSE: The main aim was to investigate the current opinions among general dental practitioners and board-certified prosthodontists in Sweden on how to restore root-filled teeth. MATERIALS AND METHODS: A questionnaire containing 31 multiple-choice questions was mailed to 892 general practitioners and 150 board-certified prosthodontists in Sweden. The questions asked for information on when the clinicians used posts in endodontically treated teeth and what kind of clinical procedure they used. They were also asked if they believed that a post strengthened a root-filled tooth. RESULTS: Sixty percent of the general practitioners and 67% of the prosthodontists returned the questionnaire. Twenty-nine percent of the responding general practitioners and 17% of the prosthodontists were of the opinion that a post reinforces a root-filled tooth. Only a few clinicians used posts "always" or "most of the time" when restoring endodontically treated teeth with fillings, while the vast majority used posts when restoring such teeth with crowns or fixed partial dentures. In both groups of dentists, cast posts were most commonly used. Despite the present knowledge that parallel-sided posts have a significantly higher success rate than tapered cast posts, only a minority of Swedish dentists use parallel-sided posts. CONCLUSION: In contrast to the results of several current studies, a high proportion of both general practitioners and prosthodontists believe that a post reinforces an endodontically treated tooth. This is one probable explanation for the almost ubiquitous application of posts when teeth are restored with crowns or fixed partial dentures.

Attitude of Health Personnel↗