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PubMed2004

[Apical endodontic surgery].

If (a revision of) a conventional endodontic treatment is not possible or not successful, apical endodontic surgery can be indicated. The contemporary indications, the better retrograde preparation techniques with ultrasonic retro-tips, and the better visualisation of the operation area with an operation microscope can lead to higher success percentages. Moreover, the current developments in the field of compatible filling materials are promising. Also the application of lasers is promising, but has still to prove its clinical usefulness.

Apicoectomy↗
PubMed2004

Assessment of morphological changes and permeability of apical dentin surfaces induced by Nd:Yag laser irradiation through retrograde cavity surfaces.

The purpose of this in vitro study was to observe the morphological changes and apical dye penetration at apical dentin surfaces induced by Nd:YAG laser irradiation at different power settings with and without a laser initiator. Seventy five single rooted human maxillary anterior teeth were used. Following the establishment of the working lengths, the root canals were enlarged with step-back technique. The apex of each root was resected 3 mm perpendicular to its long axis. Standard Class I cavities of 2 mm depth and 2 mm width were prepared. The teeth were randomly divided into five groups with fifteen teeth in each. In Group 1, the retrograde cavity preparations were lased with Nd:YAG laser at 2 W and those in Group 2 preparations were lased with Nd:YAG laser at 3.2 W. In Group 3, the retrograde cavity surfaces were lased with Nd:YAG laser at 2 W following the application of India ink. Group 4 was lased with the same settings of Group 2 after an absorbent cotton point soaked with India ink was inserted into the cut dentinal surfaces and the inner walls of the apical preparations. Group 5 served as control. Five teeth from each group were examined using scanning electron microscopy (SEM). The amounts of smear layer, debris, and recrystalized dentin present were assessed and scored. Retrograde cavities of ten teeth from each group were filled with amalgam to examine apical dye penetration. The teeth were immersed in 2% basic fuscin and kept for 48 hours. Dye penetration was evaluated by stereomicroscope at a magnification of X10. The results showed the usage of India ink with Nd:YAG laser enhanced the amount of melting and recrystalization of dentin and the radiation and initiator increased the leakage.

Analysis of Variance↗
PubMed2004

A comparison of retreatment decisions among general dental practitioners and endodontists.

This study compared the difference in decision making regarding retreatment of endodontically treated teeth by general dental practitioners and endodontists. Thirty radiographs of endodontically treated teeth taken from undergraduate records with their respective case descriptions were submitted to fifteen endodontists and fifteen general dental practitioners. Seven treatment alternatives were given as choices; reasons for retreatment, if chosen, were also requested and presented as choices. The results showed statistically different decisions among these two groups regarding retreatment cases. More endodontists opted for retreatment of cases, while higher percentages of general dentists decided to observe, not treat or extract. To prevent misdiagnosis and eventually mistreatment, endodontic decision making should be taught. Currently, there are no specific guidelines for management of failed root canal retreatment. It is suggested that guidelines generated by evidence-based dentistry may produce less variation in clinical decision making.

Adolescent↗
PubMed2005

Periapical surgery using the ultrasound technique and silver amalgam retrograde filling. A study of 71 teeth with 100 canals.

INTRODUCTION: Periapical surgery using ultrasound allows the treatment of root canals of difficult access, with the sacrifice of little root tissue. As a result, periapical disorders which were condemned to treatment failure in the past can now be dealt with successfully. MATERIAL AND METHODS: In 71 teeth presenting 100 root canals treated with ultrasound and subjected to retrograde filling with silver amalgam, the course and short-term success of management was evaluated in relation to lesion size, the magnitude of apical resection, and the size of the retrograde filling cavity. The duration of follow-up was one year, with post-treatment controls after 6 and 12 months. RESULTS: After 6 months, the percentage clinical and radiological success was 92% and 58%, respectively. One year after periapical surgery the corresponding percentages were 95% and 80%. Global success after 6 months was 63%, versus 84.2% after 12 months. No statistically significant relation was observed between treatment success and the size of the periapical lesion, the amount of apex resected, or the size of retrograde filling. CONCLUSION: Periapical surgery using ultrasound and retrograde filling with silver amalgam affords a high success rate after 12 months.

Adolescent↗
PubMed2005

[Periotest-analysis in penradicular surgery: preliminary results of a clinical-prospective study].

The two objectives of the present study were: to assess the healing after periradicular surgery using the Periotest device, and to compare the recorded Periotest values with the healing category determined after a one-year follow-up using radiographic and clinical criteria. In 43 patients with periradicular surgery, Periotest values could be recorded pre- and postoperatively, as well as after six and twelve months. Cases with a successful healing, as determined at the one-year follow-up, demonstrated a continuous decrease of the Periotest values over time, whereas one-year failures showed increasing Periotest values over the study period. In control teeth, the Periotest values remained unchanged for the whole study period. It appears that the Periotest measurements correlate with the postoperative healing mode following periradicular surgery, and therefore, allow an additional assessment of the healing outcome.

Adult↗
PubMed2005

Efficient correction of endodontic obturation and single-appointment CAD/CAM restoration.

Endodontic treatment, when performed with proper instrumentation, canal disinfection, and obturation can be a tremendous service to a dental patient and a key component of any restorative practice. It can be complicated by factors such as poor diagnosis, incomplete canal debridement, ineffective obturation, bacterial invasion, and insufficient restorative treatment. Retreatment or even tooth loss can occur when the canal space is not handled properly. This article demonstrates a procedure for the correction of pre-existing obturation and subsequent treatment with an all-ceramic restoration in a single visit.

Adult↗
PubMed2005

[The Retroplast Technique. Retrograde obturation with composite and adhesive technique in endodontic surgery].

Endodontic surgery, and in particular periapical surgery, has seen a significant development in the last few years, mainly following the introduction of microsurgical principles and the use of magnification devices. The successful outcome of periapical surgery, however, is based on the quality of the root-end obturation that should prevent any reinfection originating from the root canal. Since amalgam as a root-end sealing material was abandoned many years ago, a great diversity of obturation techniques and materials have been described. Besides the standard root-end cavity preparation with microtips, the author today has a preference for the Retroplast-technique. The paper describes this technique in detail and reports the possibilities and limits of this obturation method.

Apicoectomy↗
PubMed2006

[Periradicular surgery with endoscopy--a clinical prospective study].

Using an endoscope in periradicular surgery provides an impressive optical enlargement and may lead to better clinical diagnostics and a high rate of success. Aims of this investigation were examining this hypothesis as well as detecting influencing factors. In 2002 and 2003, 114 teeth of 91 patients were root-end resected using endoscope. Before surgery, the tooth, number of resected root-ends, content of root channels, clinical diagnosis and moment of surgery were recorded. Patients were controlled one year after surgery and success was evaluated as a summary of clinical and radiological findings. Four patients did not reappear for the control examination. Out of 110 teeth, treatment was successful in 91.8% and failed in 7.3%. 0.9% could not be classified. Statistically, more failures were noted after periradicular surgery in molars. The rate of success increased during the study by means of a learning curve. The results confirm the hypothesis that where using an endoscope periradicular surgery is highly successful.

Adolescent↗
PubMed2005

Combined endodontic therapy and surgery in the treatment of dens invaginatus Type 3: case report.

An accurate understanding of the morphology of the root canal system is a prerequisite for successful root canal treatment. Invaginated teeth have a complex root canal configuration that cannot be instrumented effectively and should be treated by both endodontic therapy and surgery. A case of dens invaginatus Type 3 in a maxillary lateral incisor with a periapical lesion and its successful treatment by these combined methods is reported.

Aluminum Compounds↗
PubMed2006

Use of a surgical microscope and endoscope to maximize the success of periradicular surgery.

The introduction of microsurgical principles in endodontic surgery involving techniques used for the preparation of root-end cavities brought about an investigation for ways of improving the visualization of the surgical field. The surgical microscope can be used in combination with the endoscope to enhance visibility during periradicular surgery. In this presentation, the authors highlight the application and analysis of these two magnification devices during endodontic microsurgery.

Apicoectomy↗
PubMed2006

Barodontalgia due to odontogenic inflammation in the jawbone.

A case is presented of severe anterior mandibular pain, which first appeared during descent of a long commercial flight, and lasted 3 d for a 28-yr-old military helicopter pilot. Apical periodontitis due to pulpal necrosis of the #31 tooth was diagnosed as the causative pathology of the pain. This pain was not ever felt in his daily routine helicopter flights, up to 6000 ft, only in the pressurized chamber of a commercial flight to 7000-ft conditions. Although barodontalgia, dental pain evoked by barometric pressure change in an otherwise asymptomatic tooth, has relatively low prevalence nowadays, it seems that periodic dental vitality tests and panoramic imaging of the jaws are worthwhile for aircrew members.

Adult↗