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At least 541 records · Page 30Linked to original sources
PubMed1989

Root canal treatment in the General Dental Service 1948-1987.

Endodontic treatment has been available under NHS Regulations since its inception in 1948, and details of the incidence of treatment carried out is available from the Dental Estimates Board, Eastbourne. These records are analysed to show that, among other trends, the amount of root canal treatment provided has increased to a peak in 1984, with highest incidence in the 21-30 age group, and in single rooted anterior teeth.

Adolescent↗
PubMedDate not supplied

The effect of two different local anaesthetic solutions on pain experience following apicectomy.

Post-operative pain experience following apicectomy of a single maxillary anterior tooth was compared in two groups of patients having this treatment under local anaesthesia. Twenty patients received 3.6 ml of 2% lignocaine with 1:80,000 adrenaline and 23 patients the same volume of 1.5% etidocaine with 1:200,000 adrenaline, as the local anaesthetic agent. Although soft tissue anaesthesia lasted significantly longer when etidocaine with adrenaline was used, pain experience and analgesic intake did not differ between regimens. Lignocaine with adrenaline produced better operating conditions as haemorrhage control was more effective and the quality of operative anaesthesia was more satisfactory than with etidocaine and adrenaline. The use of etidocaine with adrenaline offered no advantages over lignocaine with adrenaline when administered as infiltration anaesthesia for apical surgery.

Adult↗
PubMed1994

The provision of oral surgery services in England and Wales 1984-1991.

Data from the Department of Health and the Dental Practice Board demonstrate substantial increases in the volume of oral surgery performed in England and Wales both in the General Dental and Hospital Services during the period 1984-1991. In the General Dental Service, although the number of routine extractions decreased by 10%, the number of surgical procedures increased by 20%, with a substantial increase (33%) in the number of third molar extractions in the period 1988-1991. There have been no decreases in the annual rate of extractions of permanent and deciduous teeth in the GDS since 1987. In at least one Regional Health Authority, there was a five-fold increase in the number of oral surgery patients aged 0-9 years treated in the hospital service (1982-1991). Overall, although this study takes no account of extractions carried out in the Community Service, these findings suggest that numbers of deciduous extractions may have actually risen in some areas, particularly after 1987. In the Hospital Service there was a 55% increase in numbers of day-cases, from 30,090 (1984) to 46,499 (1990); a 10% increase in throughput of in-patients and a 13% decrease in numbers of people waiting for in-patient surgery. These changes were in the same direction as those in plastic and ENT surgery; though plastic surgery achieved a greater utilisation of day-care services. The implications of these changes and their possible effect on the future provision of oral and maxillofacial surgery services are discussed.

Apicoectomy↗
PubMed1995

Minor oral surgery 'specialisation' in general dental practice.

A practitioner with 4 years' hospital oral surgery experience undertook minor oral surgery procedures within a general dental practice over a 4-year period. The variety of work completed is shown. The National Health Service fees for the procedures indicate that a practice limited to minor oral surgery is both practically and financially viable when referral fees and x-rays are included. Differences in the types of procedure undertaken by visiting 'specialist' practitioners and 'specialist' practices is highlighted. A population of 310,000 is suggested for a 'specialist' practice in minor oral surgery to be feasible.

Apicoectomy↗
PubMed1995

The patient's view of minor oral surgery in dental practice.

A recent audit of patients who underwent minor oral surgery within their own general dental practice confirms that treatment performed in this environment can have a high level of patient satisfaction. This article reports the results of the audit and explores the reasons why the patients chose to receive treatment in this way.

Apicoectomy↗
PubMed1997

Evidence-based dentistry: endodontic failure--how should it be managed?

OBJECTIVE: To review the evidence on the most appropriate management of failed endodontic treatment. DATA SOURCES: Appropriate articles were selected from the international literature. RESULTS: There was good evidence that conventional endodontic treatment is associated with a successful outcome in a significant proportion of cases. The results of surgical treatment are more difficult to interpret since account should be made of the status of the existing root filling. However, there is evidence of an increased success rate with a satisfactory orthograde root filling. CONCLUSIONS: It is difficult to make direct comparisons from cited studies to advance a clear argument in support of one treatment modality. However, it is judged that a conventional endodontic retreatment approach is the most appropriate in the first instance, providing access to the root canal is possible. This does not preclude a subsequent surgical approach. Teeth that are permanently restored soon after retreatment are more successful than those which are not. There are significant challenges in setting up prospective research studies to directly address the problem of the failed root filing.

Apicoectomy↗
PubMed2003

Molar apicectomy with amalgam root-end filling: results of a prospective study in two district general hospitals.

AIM: To determine the five-year success rates, site or sites of failure, prognostic indicators and lower lip morbidity associated with molar apicectomy using amalgam root-end filling. DESIGN: Multicentre, prospective study. SETTING: The departments of oral and maxillo-facial surgery in two district general hospitals. METHOD: One thousand and seven molar apicectomy procedures, combined with amalgam root-end filling were expedited during the period 1974-1995. A five-year review of each operated tooth was carried out or attempted between 1979-2000. RESULTS: Of the 790 (78%) operated molars successfully reviewed at 5 years or later 451 (57%) exhibited 'complete healing' and 39 (5%) 'uncertain healing'. Three hundred (38%) were classified as 'unsatisfactory healing' (failures), and these included 12 which were assumed to be of periodontal origin. Whilst longitudinal root fracture, perforation and/or infection in the furcation, periodontal disease or a non-restorable crown accounted for treatment failure and often the need to remove teeth subsequently, the study probably pointed to the apical ends of the roots rather than the furcation as being the major sites at which 'unsatisfactory healing' occurred. Mandibular first molars attracted the highest 'complete healing' rate (60%) and mandibular second molars the lowest (46%). 'Good' root canal treatment (RCT) at the outset improved the prognosis of a root-end filling (REF) whilst the absence of RCT compromised it. Cystic change pointed to a better prognosis than apical granulomatous change as did a deep compared with a shallow 'bone cuff'. Disease at the furcation suggested a worse prognosis. Teeth which showed 'complete healing' at 1 year had a 75% probability of maintaining this outcome at 5 years. Sensory disturbance of variable duration occurred in the lower lip following 20-21% of mandibular molar procedures. In the majority of cases (79-80%) this had remitted within 3 months. A permanent deficit occurred in 8 patients (1%) where the apicectomy could definitely be incriminated as causative. Four were associated with first molar apicectomy and four with second molar apicectomy. CONCLUSIONS: Molar apicectomy with amalgam root-end filling attracts an overall 'complete healing' rate at 5 years of 57%, the results being best with mandibular first molars and worst with mandibular second molars. The prognosis is also better where there is 'good' initial orthograde root filling, an associated radicular cyst as compared with granulomatous change and where the buccal sulcus is deep rather than shallow. It is worse when orthograde root filling is absent and when there is disease in the furcation. 'Complete healing' at 1 year can be expected to be maintained at 5 years in 75% of cases. The commonest site of subsequent periradicular rarefaction seems to be 'apical' whilst failure at the furcation is probably comparatively rare. There is a threefold increase in the occurrence of permanent lower lip sensory impairment following second molar surgery in comparison with first molar surgery, the overall incidence being 1%.

Adult↗
PubMed2005

Surgical endodontics.

Root canal treatment usually fails because infection remains within the root canal. An orthograde attempt at re-treatment should always be considered first. However, when surgery is indicated, modern microtechniques coupled with surgical magnification will lead to a better prognosis. Careful management of the hard and soft tissues is essential, specially designed ultrasonic tips should be used for root end preparation which should ideally be sealed with MTA. All cases should be followed up until healing is seen, or failure accepted, and should form a part of clinical audit.

Anesthesia, Dental↗
PubMed2003

Short-term periradicular tissue response to mineral trioxide aggregate (MTA) as root-end filling material.

AIM: The aim of the present study was to evaluate the short-term response of periradicular tissues to MTA when used as a root-end filling material in ideal tissue conditions. METHODOLOGY: The experimental procedures were performed on the healthy teeth of dogs. Pulps were removed and root canals prepared and filled with gutta-percha and sealer. At the same session, buccal mucoperiosteal flaps were reflected and the root ends resected. MTA or IRM were used as root-end filling materials. The periradicular tissue reactions were evaluated histologically from 1 to 5 weeks. Hard tissue formed on the MTA surface was further examined by scanning electron microscopy. RESULTS: The most characteristic tissue reaction to MTA was the presence of connective tissue after the first postoperative week. Inflammation was seen occasionally. Early tissue healing events after MTA root-end filling were characterized by hard tissue formation, activated progressively from the peripheral root walls along the MTA-soft tissue interface. In contrast, hard tissue was not seen over the IRM root-end filling. CONCLUSIONS: MTA is a biocompatible material that stimulates periradicular tissue repair at the root-end situation; however, the nature of the newly formed tissues requires further elucidation.

Aluminum Compounds↗
PubMed1997

Periapical radiolucencies as evaluated by bisecting-angle and paralleling radiographic techniques.

Two groups of patients were included in the study. The first group consisted of patients who received root canal treatment of single-rooted teeth (n = 63). The completed roof fillings were exposed to two different radiographic techniques, the paralleling and the bisecting-angle technique. The second group consisted of 1-year review radiographs of patients who had received apicectomies of single-rooted teeth (n = 105). Three observers examined the radiographic images. First, they were asked to identify teeth with a normal apical condition and those with an apical radiolucency. Thereafter pairs of radiographs were compared; cases judged as normal by all observers were excluded. The observers were now asked to ascertain whether the apical radiolucency was largest in the first image, the apical radiolucency was largest in the second picture or both radiolucencies were the same size. Both intraobserver and interobserver agreement, calculated as Cohen's kappa, was high with respect to the presence of lesions within both samples and it was at the same level for both radiographic techniques. The evaluation of the size of the lesions proved to be more inconsistent. Kappa values were in the range 0.38-0.71 for intraobserver comparisons and in the range 0.25-0.48 for interobserver comparisons. No significant difference was found between the size of lesions as recorded by the two techniques (P > 0.05). It is concluded that, when correctly adjusted the bisecting-angle technique and the paralleling technique provide similar diagnostic results.

Alveolar Bone Loss↗