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At least 613 records · Page 34Linked to original sources
PubMed1996

Evaluation of periapical injection of Ketorolac for management of endodontic pain.

Effective pain management of the endodontic emergency patient is often a problem. Ketorolac tromethamine is the first nonsteroidal anti-inflammatory drug available for intramuscular injection in the United States. Although its analgesic efficacy is comparable with opiates after intramuscular injection, to date no study has evaluated its efficacy after intraoral periapical injection. Fifty-two endodontic emergency patients were injected (injection routes = intraoral infiltration/intramuscular deltoid) on a double-blind basis with either: (i) placebo/placebo, (ii) 30 mg ketorolac/placebo, (iii) placebo/30 mg ketorolac, or (iv) 2% mepivicaine with 1:20 K levonordefrin/placebo. Infiltration injection of ketorolac at on oral site produced significant analgesic effects, particularly in treating pain of mandibular origin. These results suggest that intraoral injection of ketorolac may prove to be a useful adjunct in the management of endodontic pain patients. Further studies are required to replicate these findings and to develop optimal treatment combinations.

Adolescent↗
PubMed1997

The change of periapical exudate prostaglandin E2 levels during root canal treatment.

We have previously demonstrated that detectable levels of prostaglandin E2 exist in periapical exudates (PE-PGE2) from root canals of periapical periodontitis. Our data from a cross-sectional study also suggested the association of PE-PGE2 concentrations with the active phase of periapical lesions. The objective of this study was to investigate the longitudinal changes of PE-PGE2 levels during root canal treatment. Periapical exudate specimens were quantitatively sampled from root canals of 20 nonvital teeth at consecutive treatment visits to measure PGE2 concentrations. The mean PE-PGE2 levels significantly decreased following the endodontic therapy (158.0 +/- 54.1 pg/microliter in the first samples versus 48.4 +/- 37.9 pg/microliter in the second samples). A significant correlation was also found between the changes in PE-PGE2 levels and the clinical disease expression of periapical periodontitis (p < 0.01). Decreased PGE2 production is considered to reflect the remission of disease activity. These results suggest the central roles of PGE2 in regulatory mechanisms for the expression of periapical disease.

Dental Pulp Cavity↗
PubMed1997

Periapical replacement resorption of permanent, vital, endodontically treated incisors after orthodontic movement: report of two cases.

Radiographic observations show that periapical replacement resorption (PARR) is a frequent and unpredictable sequella of orthodontic movement of permanent maxillary incisors. Only the apical root portion undergoes resorption, and it is subsequently replaced with normal bone. PARR also occurs without orthodontic tooth movement, but these resorptions differ as to type and location. PARR clearly occurs in teeth with vital pulps after orthodontic movement; however, our two cases and a review of 43 other cases indicate that endodontically treated incisors show a statistically significant lesser frequency and severity of apical resorption than untreated teeth. The role the vital pulp plays in this apical resorption is yet to be determined. A hypothetical explanation is offered suggesting that pulpal neuropeptides may be involved in PARR in both vital and endodontically treated incisors. The role calcium hydroxide plays in endodontically treated teeth is also considered.

Adolescent↗
PubMed1998

Relative distribution of plasma cells expressing immunoglobulin G subclass mRNA in human dental periapical lesions using in situ hybridization.

Immunoglobulin G (IgG)-producing plasma cells are the predominant immunoglobulin secreting plasma cells in human dental periapical lesions, compared with immunoglobulin A- and immunoglobulin M-producing plasma cells. In this study, the cells expressing mRNA, that encoded the distinct IgG subclasses, were detected using an in situ hybridization technique in 25 periapical lesions. These lesions consisted of 14 periapical granulomas and 11 radicular cysts. Four oligonucleotide probes were chemically synthesized from IgG subclass-specific hinge region genes to ensure specificity of the probes. Plasma cells expressing mRNA, which coded for the IgG subclasses, were detected in formalin-fixed/paraffin wax-embedded sections. Background staining was negligible in all of the sections tested. The in situ hybridization method used in this study was both specific and sensitive for the detection of mRNA encoding each of the four distinct IgG subclasses, whereas the cells retained good morphology. The relative proportions of plasma cells expressing each of the IgG subclass-specific mRNAs in both granulomas and cysts were as follows: IgG1 (57.4 and 55.5%); IgG2 (34.1 and 34.6%); IgG3 (4.0 and 4.3%); and IgG4 (4.0 and 5.5%). There were no significant differences between the percentages of plasma cells expressing each of the IgG subclass mRNAs between the two types of lesions. IgG1 producing plasma cells comprised the highest proportion of IgG-producing plasma cells in both types of periapical lesion. IgG2-producing plasma cells were next in abundance, followed by plasma cells for either IgG3 or IgG4, which were in roughly equivalent numbers.

Adult↗
PubMed1997

Assessment of the periapical and clinical status of crowned teeth over 25 years.

OBJECTIVES: The purpose of this study was to examine radiographically changes in the periapical status and compare the clinical status of teeth with a vital pulp and root-filled teeth restored with crowns and bridge retainers during 25 years. METHODS: During 1967/68, 114 patients received prosthodontic treatment by senior dental students at the Oslo Dental Faculty. In all, 291 teeth with a vital pulp and 106 root-filled teeth were restored with 158 prostheses. All root-filled teeth were restored with a cast dowel and core. The casts were made in a type-3 gold alloy, and cemented with zinc phosphate cement. Forty-six teeth were restored with crowns and 351 teeth with bridge retainers. Radiographs were taken preoperatively, immediately after cementation, and every fifth year. Two independent observers assessed the periapical status on the radiographs according to the PAI-index. At the 25 years examination, 32 patients (28%) with 101 restored teeth (24%) remained in the study. Survival rates of the prostheses and of the restored teeth were estimated using Kaplan-Meyer non-parametric statistics. RESULTS: The PAI-score of the periapical status deteriorated in 13 vital and four root-filled teeth. The survival rates of the fixed prostheses were not influenced by the pulp vitality of the restored tooth at the baseline. The survival rates of the restored teeth with a vital pulp and of the root-filled teeth were similar. Clinical failures were recorded on approximately one-third of the restored teeth. The main reason for tooth failure was caries (12%), and for the teeth with a vital pulp also pulpal deterioration (10%). Estimates of the proportions of crowned teeth with a vital pulp that will remain free from signs and symptoms of pulpal deterioration were 98% after five years, 92% after 10 years, 87% after 20 years and 83% after 25 years. CONCLUSIONS: The incidence of periapical lesions on radiographs of crowned teeth was low during 25 years observation. Crowned, root-filled teeth with a high quality endodontic treatment and an optimal morphology of the dowel and core have a similar survival rate as crowned teeth with a vital pulp. A high proportion of crowned teeth with a vital pulp will remain free from signs and symptoms of pulpal deterioration over 25 years.

Adult↗