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PubMed2005

Endodontic and esthetic/restorative treatment of the same tooth: a synergistic approach for successful outcomes.

Endodontic and restorative treatment of compromised teeth should not be considered separate, unrelated procedures. It is beneficial for both the endodontist and the restorative dentist to consider the other's treatment of a patient with compromised teeth. Both practitioners should thoroughly understand their respective modalities and the ways in which their work affects the remaining structure and integrity of the teeth being treated. The restorative dentist also should be aware that there are 2 primary goals of endodontic treatment: cleaning and disinfecting the affected canals, and sealing those canals to prevent reinfection. The endodontist should be aware that the objectives of the restorative dentist are to ensure postoperative root strength, prevent vertical root fracture, and retain the core of the restoration. This article describes a synergistic approach to treating teeth requiring both endodontic and restorative treatment.

Dental Bonding↗

PubMed1991

[Evaluation of radiation risk associated with endodontic radiography].

Endodontic patients are sometimes concerned about the risks of tumors or cataracts from radiation exposure during root canal therapy. By using established dose and risk information, we calculated the extent of these risks. The chance of getting leukemia from an endodontic x-ray survey using 90 kVp was found to be 1 in 7.69 million, the same as the risk of dying from cancer from smoking 0.94 cigarettes or from an auto accident when driving 3.7 km. Risk of thyroid gland neoplasia was 1 in 667,000 (smoking 11.6 cigarettes, driving 45 km) and risk of salivary gland neoplasia 1 in 1.35 million (smoking 5.4 cigarettes, driving 21.1 km). Use of 70 kVp radiography reduced these risks only slightly. To receive the threshold dose to eyes to produce cataract changes, a patient would have to undergo 10,900 endodontic surveys.

Cataract↗

PubMed1991

Innovative adjuncts to the endodontic armamentarium.

The primary objective of nonsurgical endodontic therapy is total debridement of the root canal system concomitant with three dimensional obturation of the entire intraradicular space recent supplements to the endodontic armamentarium have enhanced the predictability of clinical success by maximizing the potential for canal identification and by ensuring the maintenance of a closed, aseptic system during treatment. In addition, two systems have been introduced that facilitate retreatment of cases wherein biologic failure is occurring. One is used to remove solid core obturating materials that previously would have been considered inaccessible and the second enables disassembly of a previously restored endodontically treated tooth in order to access the deficiencies within the root canal system.

Cellulose↗

PubMed1991

Recognition and prevention of failures in clinical dentistry. Endodontics.

There are many factors that can contribute to endodontic failure, but the major factor that will be associated with almost every failure is the presence of bacteria. Treatment procedures must include techniques that will remove the bacteria that are already present and then prevent further bacterial ingress. Failures can usually be recognized by thorough clinical and radiographic examinations. They can be prevented by careful case selection and by following the accepted standard endodontic procedures and not deviating from these for the sake of expediency. This paper provides an overview of the factors affecting endodontic success and discusses methods used to recognize and prevent failures.

Humans↗

PubMed1991

Anatomical barriers in endodontics.

Endodontic therapy can be challenging at the diagnostic and technical levels. The more one can advance one's accomplishments, the more that would-be barriers cease to be so. Difficult aspects of tooth isolation and assessment of root integrity can be rendered less problematic by some relatively simple methods. Gaining a clear awareness of the internal layout of a coronal chamber and any possible inclusions can be assisted by use of a modified endodontic explorer. It can be usefully employed to resolve with certainty the common dilemma of whether openings at the base of a molar or maxillary premolar coronal access cavity are exposures in the pulp chamber roof or orifices in the chamber floor. Locating and then gaining full working length entry into partly calcified canals, even when they are not radiographically discernible, remains one of the difficult tasks in endodontic therapy, but methods can be implemented that maximize their successful negotiation and management. The use of fine engine-driven reamers, but absolutely restricted to a reciprocating action handpiece, is described.

Dental Cavity Preparation↗

PubMed1991

[Determination of working length in endodontics. 1. Radiographic method].

Incomplete instrumentation and faulty obturation are the main reasons for endodontic failures. Exact determination of working length is one of the basic principles of a successful endodontic therapy. In this paper technique, benefits and problems of radiographic determination of endodontic working length are described.

Adolescent↗

PubMed1990

Success rate in endodontics.

Over the thirty years since Strindberg's comprehensive study, much effort has been invested in an attempt to formulate a clear-cut answer to the basic question: What is the success rate in endodontics? The discrepancy and disagreement as reported in the endodontic literature with regard to success rate and the influence of the various factors on treatment results, prompted us to engage in a thorough analysis of the major causes for the variability of the reported data. These causes are related to the design of the studies, the endodontic techniques employed in them, the qualifications of the operators performing the treatment and the complexity of the included cases. They are also related to the observation period in each study, as well as to the criteria that were used for evaluating the treatment results.

Dental Pulp Diseases↗

PubMed1990

Assessment of endodontically treated teeth for restorative procedures.

This article describes a case report in which cementation of cast posts and cores in endodontically treated upper central incisors resulted in extrusion of zinc phosphate cement into the periapical tissues. This case demonstrates the necessity for careful evaluation of existing endodontic therapy before proceeding with the restorative phase of treatment. Some primary indications for endodontic re-treatment are suggested.

Adult↗

PubMed1990

[Endodontics in horses. An experimental study].

A total of 44 experimental endodontic treatments were performed in incisors of eight horses of different ages. Four different endodontic pastes were used: Cloropercha, AH26 De Trey, Eugenol-Endometasone, and Universal N2. Gutta-percha points were also included in the last two treatments. Access to the pulp cavity of incisors was gained through their vestibular and occlusal faces. Holes drilled in vestibular faces were sealed with composite and those drilled in occlusal faces were sealed with Amalgama. Animals were observed during eighteen months at least after endodontics. Radiographic controls were done just after surgery and before slaughtering. Treated incisors and alveoli were studied histopathologically. During the experiment all animals were in good condition. They ate apparently without trouble, and neither clinical nor radiological signs were present.

Animals↗

PubMedDate not supplied

[Endodontic therapy in irradiated patient].

Endodontic treatment should be the treatment of choice in irradiated patients in order to avoid extraction or to postpone it to a less threatening post irradiation period. Regressive changes in the irradiated area supplied by these damaged vessels appear so far to be of a nutritional nature. Endodontic procedures should be accomplished with judicious precision and gentle. The tooth should never leave "open for drainage" in an irradiated patient. Shorter lengths during instrumentation of the root canals would appear to be more desirable than over extended lengths. Canal obturation with gutta percha by means of lateral condensation is effective. This report demonstrated multiple endodontic treatments in two patients after cancericidal radiation to the head and neck area. The successful treatment had been followed up after 2 years.

Follow-Up Studies↗

PubMedDate not supplied

The effects of dyadic combinations of endodontic medicaments on microbial growth inhibition.

In recent years dyadic combinations of endodontic medicaments have been used increasingly in clinical pediatric dentistry with little regard to the possibility of pharmacological antagonism of the components. In this investigation, a microbial growth inhibition assay was used to determine changes in antimicrobial activity in dyadic mixtures of endodontic medicaments. The combinations assayed were Ledermix (corticosteroid-antibiotic) and Calyxl (calcium hydroxide), Ledermix and Kri (iodoform), Kri and Calyxl, and formocresol and eugenol. All these compounds have antibacterial activity when used individually. In the dyadic combinations assayed, results showed that adding calcium hydroxide to another antibiotic preparation has deleterious effects on growth inhibition, and combining any two antimicrobial medicaments produces no additive or synergistic effects. It is concluded that it may be clinically advantageous to use endodontic medicaments in the dyadic combinations shown in this investigation.

Analysis of Variance↗

PubMedDate not supplied

[Fundamental principles for the restoration of the endodontically treated teeth].

The teeth in which an Endodontic Therapy is about to take place usually present destruction of the crown, which after the end of the endodontic therapy needs restoration. For this purpose various technics and materials are used. The advantages and disadvantages of each technic in clinical practice of the restoration of the endodontically treated tooth are described with details is this paper.

Crowns↗

PubMed1990

[Endodontic treatment in patients at risk].

The course of the endodontic treatment of periapical process in a patient with renal engraftment is described. Such a patient is under a constant cytostatic therapy suppressing the immune system, thus the risk of the endodontic treatment failure being higher, with the possibility of patient's health impairment. Preparation, premedication and performance of endodontic therapy applicable in patients at risk are described and explained. Consultations with respective medical professionals were necessary, pointing to the need of an interdisciplinary approach in such patients.

Adult↗

PubMed1990

Endodontic considerations in restoration of partial overdenture abutments.

Overdenture abutment teeth often require endodontic treatment. Various factors, such as status of the pulp, periodontal state of the tooth, and the sequence of overdenture treatment, influence endodontic management of the patient. After completion of endodontic treatment, the coronal part of the root filling is removed, leaving an adequate amount of the root filling in the apical part of the root canal undisturbed. The abutment tooth is then permanently restored with a filling material, or is prepared for a cast restoration.

Crowns↗

PubMed1990

The smear layer in endodontics.

With the cascade of new restorative products being unveiled almost monthly, dentists incorporating endodontics into their practices must be able to evaluate the potential of these products for successful integration into their procedures. This evaluation should be based on a knowledge of how the new products relate to the smear layer formed along the root canal walls. Rather than relying on information supplied by the dental manufacturers, the aware dentist should regularly resort to the most current research reports available in journal or abstract form. With the use of certain products in some clinical situations, other branches of restorative dentistry may suggest retention of the smear layer. Although pulpally infected teeth have been successfully treated for generations in the presence of the smear layer, it has become accepted practice now in endodontics to remove the smear layer. Different quantities and qualities of smear layer can be produced by various techniques of instrumentation. However, they all present a barrier to intimate contact between obturating materials and the canal wall. Various types of solvents will produce different results in smear layer removal. One ideal endodontic irrigant follows the use of the antimicrobial 5.25 per cent sodium hypochlorite solution with the equally antimicrobial 6 per cent citric acid solution or 17 per cent EDTA. Chelating agents are effective in that they remove the smear layer, open the dentinal tubules, and produce a clean surface for closer obturation. Removal of the smear layer encourages the creation of a good apical plug to prevent over filling, post-filling sensitivity, and possible microleakage. The use of glass ionomer cements and unfilled resin as a cementing medium following smear layer removal shows promising results in both strength of cementation and the possibility of reducing post lengths. Controversies will always arise in dentistry with the advent of new information and the discovery of new clinical techniques. But a total awareness of both sides of a controversy will enable the practitioner to find a way through the confusion.

Chelating Agents↗

PubMed1989

Intraalveolar transplantation of teeth. IV. Endodontic considerations.

Twenty-six teeth with crown-root fractures have been subjected to intraalveolar transplantation. In 13 teeth the endodontic treatment was instituted before transplantation and in another 13 teeth 3-4 weeks after transplantation. Bacteriological tests showed that endodontic treatment after transplantation was preferable with statistically fewer treatments and more reliable results. The results thus points in favour of a late endodontic treatment with controlled aseptic conditions.

Adult↗

PubMedDate not supplied

[Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion.

Adult↗

PubMed1989

[Need and quality of endodontic treatment].

In the literature, the need of endodontic treatment appears to be studied radiographically by looking for the frequency of apical radiolucencies. Dependent on the age of the subjects, one percent to almost ten percent of all teeth and one third to two thirds of all subjects are found to show apical osteolysis. The outcome of endodontic treatment is also assessed to be rather poor, in view of the findings that one third to one half of the endodontically treated teeth show apical rarefactions. Of even more teeth the root canal fillings are assessed to be 'unacceptable'. Confirmation of this kind of findings for the Netherlands needs further study.

Health Services Needs and Demand↗