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Television radiographic evaluation of periapical osseous radiolucencies.

Periapical lesions were experimentally induced in forty-five teeth of seven beagle dogs by both septic and aseptic techniques. Preoperative and postoperative serial radiographs were produced with a specifically designed animal head x-ray device, at 30-, 60-, and 90-day periods. Four anatomic study areas, which consisted of the cervical, interradicular, proximal root, and periapical areas of each tooth, were evaluated by viewbox observation of radiographs, television subtraction radiographic imagery, and histologic examination. The findings obtained with the subtracted image and histologic examinations were correlated with viewbox observations. Diagnostic evidence of periapical pathosis was identified in the subtracted image 7 to 42 days before this same evidence was noted on the viewbox radiograph. The periodontal membrane space, lamina dura, bone trabeculae, and medullary spaces were markedly enhanced, with defined outlines of the periapical lesions noted in the subtracted image.

Alveolar Process↗

Densitometric analysis of experimentally produced periapical radiolucencies.

Artificial periapical lesions were created in a mounted dried human mandible. These lesions were radiographed by means of a reproducible projection technique. A penetrometer was projected on the same radiographs as the dental and bony structures. The developing process was standardized. The radiographs were evaluated by means of densitometric analysis. The densitometer readings of the dental and bony structures on the radiographs were converted to a millimeters-of-aluminum-equivalents scale by means of the densitometer readings of the penetrometer images on the same radiographs. The measurements on the radiographs were presented in graphs and isodensitometric images. Areas where bone was removed could be reproducibly distinguished by densitometric analysis from areas where no bone was removed. For this purpose, the densitometric analysis of periapical radiographs proved to very useful, whereas the interpretations of the same radiographs by ten dentists differed greatly.

Densitometry↗

Retrograde root filling with amalgam and Cavit.

In a 3-year review of 218 teeth with retrograde root filling with amalgam orCavit, the results obtained with the former proved significantly better than those obtained with the latter. The difference seemed to be due to a better obliteration of the canal by amalgam. The obliterating effect of amalgam probably eliminates the need for revision of incomplete othograde root filling, for example, in cases with a post in the root canal. Irrespective of type of filling materials, the results were less good in cases with marginal bone loss.

Alveolar Process↗

Evaluation of a technique for standardized periapical radiographs.

A paralleling instrument with an orientation bite-block was designed to provide standardized projections on periapical radiographs with the extension cone paralleling technique. The reproducibility of root images on these radiographs and the relocation of the orientation bite-block in relation to root structures were tested in five patients. Three radiographs were subsequently made of each patient and compared. The projection error proved to be negligible.

Evaluation Studies as Topic↗

Immunologic aspects of pulpal-periapical diseases. A review.

The relationship of immunologic concepts to endodontic diseases is discussed. Immunologic mechanisms are considered, including antigens, haptens, antibodies, and cell-mediated responses. Studies of immunologic manifestations in endodontic diseases are given. These include (1) localization of plasma proteins in inflammed human dental pulp, (2) introduction of microbes into animal root canals, (3) introduction of non-microbial antigens into animal root canals, (4) introduction of root canal antigens into human beings, (5) introduction of root canal antigens into animals, (6) studies of "focal" infection, (7) examination of serum antibodies, (8) examination of periapical lesions, and (9) a cell-mediated study. Next, immunologic concepts related to periapical pathosis are considered. Finally, preventive and treatment concepts are reviewed.

Animals↗

Analysis of interpretations of full-mouth and panoramic surveys.

The purposes of this study were to determine differences in interpretation of radiographic findings of full-mouth and panoramic surveys by junior and senior dental students and differences in their interpretive skills. The parameters of interest were caries, incipiencies, lamina dura interruptions, periodontal membrane changes, and periapical bone changes. The questions to be answered regarding the differences between the full-mouth and panoramic surveys were: (1) In which type of radiograph were the most lesions found? (2) In which type of radiograph are the most "non-existing" lesions found? (3) In which type of radiograph are the most lesions undetected? (4) Does the junior or senior dental student demonstrate the most accuracy in his interpretation?

Alveolar Process↗

Oral assessment of the "risk" patient.

Certain patients may be considered as being at "risk" with respect to the possibility of development of significant diseases of either a local or a systemic nature as a direct result of the presence of oral infection. The problems relating to the development of bacteremia subsequent to surgery in the patient with cardiovascular disease are well appreciated. Thought should be given to the possibilities of such developments in relation to the presence of periapical pathosis. It is demonstrated that a definitive evaluation of the status of the nonvital tooth cannot be made by the presently accepted methods of clinical and radiographic examination.

Disease↗

Bony defects in dried Bantu mandibles.

Forty-three dried South African Bantu mandibles were examined visually and radiographically for the frequencies of occurrence of apical defects, bifurcation involvements, dehiscences, and fenestrations. Statistical evaluation of the data revealed no significant discrepancy between the visual and radiographic findings.

Adult↗

Submergence of roots for alveolar bone preservation. II. Reimplanted endodontically treated roots.

Root canal therapy was accomplished on the mandibular premolars of four dogs. These premolars were then extracted, contoured, reimplanted, and submerged. Resorption occurred up to 60 days; healing progressed satisfactorily, with some evidence of coronal osseous regeneration. Root canal sealer was expressed out the coronal orifice after the roots were submerged. This sealer appeared to affect normal healing over the coronal surface of the roots.

Alveolar Process↗

Relationship of oral complications to peripheral blood leukocyte and platelet counts in patients receiving cancer chemotherapy.

Patients undergoing cancer chemotherapy often suffer from oral complications as a result of their disease and its treatment. The effects of the chemotherapy on the bone marrow and oral mucosa, coupled with the patient's immunosuppressed state and altered oral microbial flora, predispose these patients to oral mucositis, infection, and hemorrhage. The oral mucosa appears to mirror the effects of the chemotherapy on the bone marrow, as there appears to be a direct relationship between the changing peripheral blood counts and the status of the oral mucosa.

Adult↗

Clinical and radiographic study of dens invaginatus.

After a determination of the frequency of dens invaginatus by means of radiographic observations, various problems of its identification are discussed. The 188 teeth showing a distinct loop-shaped invagination apically on the radiograph were studied for the presence or absence of caries and periapical lesions. It was demonstrated that periapical lesions caused by caries are mostly due to interproximal caries and that the frequency of periapical lesions caused by caries in the dens invaginatus area was less than previously reported. Comments are made on the dens invaginatus cases having periapical lesions without caries and the parameters for future studies.

Adult↗

Response of periapical pathosis to endodontic treatment in monkeys.

Response of induced periapical lesions in monkeys to a conventional endodontic technique was investigated at varying periods ranging from 15 to 365 days after treatment. The findings indicate that response to treatment is influenced by the extent of the root canal filling, the time lapse between treatment and death, and the presence or absence of bacteria in the apical portion of the canal.

Animals↗