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At least 865 records · Page 48Linked to original sources
PubMed2004

Pulpal necrosis with sickle cell anaemia.

AIM: To investigate radiographic manifestations of sickle cell anaemia (SCA) and whether or not a pulpal necrosis may develop without a pathological history. METHODOLOGY: Thirty-six patients with homozygous SCA were evaluated, and a further 36 individuals without SCA were included in the study as a control group. All 72 patients participating in the study ranged between the ages of 16 and 40 years. General and dental histories of the individuals were recorded. Electrical pulp test, percussion and thermal tests were applied to all the teeth having no restorations. Orthopantomograms of all the subjects were taken. Data obtained from questionnaires, sensitivity tests and radiographic examinations were evaluated by chi-square and Fischer's exact test. RESULTS: Fifty-one (6%) of the teeth having no restorations or history of trauma were determined as being nonvital in the SCA group. In 30 (83%) of these patients orofacial and dental pain with no obvious cause was detected and in 24 (67%) of the patients the quality of the bone tissue as examined radiologically had deteriorated. In eight (22%) of the patients cortical thinning and irregularity in the mandible was noted. A statistically significant difference between the SCA and control groups (P < 0.05) was found in terms of pulpal sensitivity and radiological findings. CONCLUSION: SCA is a genetic and systemic disease which may cause pulp necrosis without necessarily having an identifiable aetiology. SCA causes radiographically observable differences in jaw structure especially in the mandible.

Adolescent↗
PubMed2005

Prevalence of persistent pain after endodontic treatment and factors affecting its occurrence in cases with complete radiographic healing.

AIMS: To (i) determine the prevalence of persistent dento-alveolar pain following nonsurgical and/or surgical endodontic treatment conducted in a teaching dental hospital and (ii) identify the risk factors associated with persistent pain after apparently successful root canal treatment. STUDY DESIGN: A total of 175 patients/teeth were reviewed 12-59 months following treatment. The patients were examined clinically and radiographically and a detailed pain history obtained. Multiple logistic regression analysis was used to investigate the association between potential risk factors and persistent pain after successful endodontic treatment. RESULTS: The prevalence of persistent pain after successful root canal treatment was 12% (21/175). Treatment success was determined by the absence of clinical and radiographic signs of dental disease. The factors that were significantly (P < 0.05) associated with persistent pain following endodontic treatment were: 'duration of preoperative pain' [odds ratio (OR) = 8.6], 'preoperative pain from the tooth' (OR = 7.8), 'preoperative tenderness to percussion' (OR = 7.8), 'previous chronic pain problems' (OR = 4.5), 'gender' (OR = 4.5) and 'history of painful treatment in the orofacial region' (OR = 3.8). 'Type of treatment received (surgical or nonsurgical treatment)' showed borderline significance at the 10% level. CONCLUSIONS: The presence and duration of preoperative pain from the tooth site, lasting at least 3 months, a positive history of previous chronic pain experience or painful treatment in the orofacial region, and female gender were important risk factors associated with persistent pain after successful endodontic treatment.

Adolescent↗
PubMed2006

Referred pain: a confusing case of differential diagnosis between two teeth presenting with endo-perio problems.

AIM: A case of a patient with a confusing referred pain is reported that emphasizes the importance of providing a differential diagnosis in order to avoid inappropriate treatment. SUMMARY: This article describes the management of a patient presenting with a combined endo-perio problem that was apparently treated adequately. After a short period of time, the reappearance of mild pain was misdiagnosed. The situation was more complicated when multiple diagnostic procedures were attempted and inadequate therapies were tried consecutively. When the true differential diagnosis was established and appropriate treatment provided, the symptoms disappeared and normal function returned. Diagnosis of teeth with necrotic pulps may be difficult to establish with possible reasons including inconclusive and poorly localized symptoms and signs. The situation can be further complicated if other teeth developing endodontic or combined endo-perio problems occur simultaneously as this may lead to misdiagnosis and treatment of the wrong tooth.

Adult↗
PubMed2004

Changes in aspects of children's oral-health-related quality of life following dental treatment under general anaesthesia.

OBJECTIVES: This study was intended to examine the treatment-associated change in aspects of oral-health-related quality of life (QoL) among children (and their families) undergoing dental rehabilitation under general anaesthesia (GA). METHODS: The parents or caregivers of a consecutive clinical sample of children receiving comprehensive dental treatment under GA at the University of Otago School of Dentistry, Dunedin, and the Christchurch Oral Health Centre, Christchurch, New Zealand, were interviewed by telephone before and after the treatment. Questions were asked relating to the impact of the condition on the child and the family. The post-treatment questionnaire also sought information related to parental satisfaction with the care provided under GA. RESULTS: The parents or caregivers of 95 children participated in the study: 49 had treatment completed at the University of Otago School of Dentistry; and 46 were treated at the Christchurch Oral Health Centre. The child sample comprised 55.8% males and 44.2% females with a mean age of 5.1 years. Their mean dmft was 8.2. A consistent pattern of improvement was found with each indicator used. Complaints of pain, problems with eating and sleeping, and behaviour concerns showed significant improvements, with 100% improvement for children for whom frequent pre-GA problems associated with eating, sleeping and behaviour were reported. Sixty-six parents had to arrange time away from employment on the day of the GA and almost half of those incurred a loss of income. The majority of parents reported a high degree of satisfaction with the care received. CONCLUSIONS: Treating young children with high disease experience in a single session under GA results in immediate improvement in oral health and aspects of their QoL for both the children and their families.

Anesthesia, Dental↗
PubMed2005

Prevalence and impact of oral pain in 8-year-old children in Sri Lanka.

OBJECTIVE: The present study aimed to determine the prevalence and impact of oral pain in 8-year-old Sri Lankan children and their parents. DESIGN: A cross-sectional study using a multistage cluster sampling technique was carried out in a sample of 614 children attending schools in the Education Division of Badulla, Uva province, Sri Lanka. Data were collected by means of a pre-tested questionnaire that was sent to each of the children and their parents. The children were also given an oral examination. Of the 614 questionnaires which were sent to parents, 30 were not returned and eight had to be excluded from the analysis because the respondents had answered only two questions. Therefore, the present analysis is limited to data from 576 children and their parents. RESULTS: The lifetime prevalences of oral pain, as reported by the children and parents, were 49% and 53%, respectively. According to the children's report, 25% had experienced oral pain in the past 2 months while 31% of the parents reported that their child had experienced oral pain within the same period. Of those children who reported that they had experienced oral pain in the past 2 months, nearly 45% stated that the pain was severe. In 48%, the pain was triggered when biting. 'Presence of cavity/decayed tooth' was cited as the most common cause of oral pain (67%). Overall, 74% of children had experienced a negative impact as a result of the pain whilst 66% of the parents said that the child's pain had had an impact on them. Ethnic group, parental income and level of education, and the caries experience of the child were significantly associated with the reporting of oral pain in the past 2 months. CONCLUSIONS: The prevalence of oral pain was high among these children, and had a considerable impact on both the children and their parents.

Child↗
PubMed2005

Dental emergencies presenting to a university-based paediatric dentistry clinic in the West Indies.

OBJECTIVES: The aims of the present study were to investigate the type and prevalence of dental emergencies presenting at a teaching hospital paediatric emergency clinic in Trinidad, and to describe the socio-demographic factors related to the use of the service. DESIGN AND METHODS: The authors used a prospective study of consecutive dental patients presenting to a paediatric emergency clinic. Data recorded included type of presenting emergency and socio-demographic variables. RESULTS: Data were available for 309 participants; 47% were male and 53% female. The average age of the participants was 8.66 years (SD = 3.75 years; range = 1-16 years). Seventy-three per cent of the participants' parents were involved in manual work or unemployed, and 21% were in nonmanual/professional employment; the occupation was not known in 6% of cases. Caries-related problems accounted for 74% of emergencies. Dental trauma mostly affected the upper permanent incisor teeth, with concussion, subluxation and intrusion being the most common injuries. CONCLUSION: Dental emergencies presenting to this university-based clinic were predominantly related to caries and trauma. The service was more frequently utilized by children in the mixed dentition stage, children from lower socioeconomic groups and those living in the local area. The frequency of caries-related problems indicates the need for more community-based preventive strategies, including encouraging greater attendance for routine dental care and dental health education. Strategies for oral health promotion should also be developed to prevent dental trauma.

Adolescent↗
PubMed2006

Immunocytochemical investigation of immune cells within human primary and permanent tooth pulp.

AIM: The aim of this study was to determine whether there are any differences in the number and distribution of immune cells within human primary and permanent tooth pulp, both in health and disease. DESIGN: The research took the form of a quantitative immunocytochemical study. One hundred and twenty-four mandibular first permanent molars and second primary molars were obtained from children requiring dental extractions under general anaesthesia. Following exodontia, 10-microm-thick frozen pulp sections were processed for indirect immunofluorescence. Triple-labelling regimes were employed using combinations of the following: (1) protein gene product 9.5, a general neuronal marker; (2) leucocyte common antigen (LCA); and (3) Ulex europaeus I lectin, a marker of vascular endothelium. Image analysis was then used to determine the percentage area of immunostaining for LCA. RESULTS: Leucocytes were significantly more abundant in the pulp horn and mid-coronal region of intact and carious primary teeth, as compared to permanent teeth (P < 0.05, anova). Both dentitions demonstrated the presence of well-localized inflammatory cell infiltrates and marked aborization of pulpal nerves in areas of dense leucocyte accumulation. CONCLUSIONS: Primary and permanent tooth pulps appear to have a similar potential to mount inflammatory responses to gross caries The management of the compromised primary tooth pulp needs to be reappraised in the light of these findings.

Adolescent↗
PubMed1995

Comparison of partial and full crowns as retainers in the same bridge.

The purpose of this study was to assess longitudinally the success of partial and full crown abutment pairs in the same bridges. Fifty patients with a mean age of 45 years (range 22-70 years) were examined during spring 1981 (1-5 year follow-up), 33 of whom were examined a second time during spring 1990 (10-15 year follow-up). The status of the partial crowns, full crowns, and their abutment teeth was assessed using standardized questions, and clinical and radiographic examinations. At the first follow-up examination, all partial and full crowns, and consequently all bridges, were still in use. Before the second follow-up examination one of the full crown abutments had become badly decayed, and the bridge, including the partial crown, had been removed. The failure rate was 0.2% per year for the full crown as a unit, and consequently 0.2% per year for the bridge as a unit.

Acrylic Resins↗
PubMed2004

Investigation of bacterial communities associated with asymptomatic and symptomatic endodontic infections by denaturing gradient gel electrophoresis fingerprinting approach.

The purpose of the present study was to investigate the bacterial communities associated with asymptomatic and symptomatic endodontic infections and to compare denaturing gradient gel electrophoresis (DGGE) fingerprinting patterns of these two clinical conditions. The root canal microbiota of teeth associated with asymptomatic or symptomatic periradicular lesions was profiled by the PCR-DGGE method and then compared, taking into consideration the banding patterns. Bacteria were present in all examined cases. Comparative analysis of the two clinical conditions revealed bands that were common to both symptomatic and asymptomatic cases, but most DGGE bands appeared to be unique for each clinical condition. No single band occurred in all profiles. The mean number of bands detected in the 16S rDNA community profiles were 12.1 +/- 9.4 (range 2-29) for symptomatic samples and 6.7 +/- 2.7 (range 2-11) for asymptomatic ones. Clustering methods and principal component analysis of DGGE banding pattern placed the samples according to the presence or absence of symptoms. Four intense bands that were excised from the gel and sequenced showed similarities to species of the Campylobacter genus (found in 5/12 asymptomatic and in 3/11 symptomatic cases), Fusobacterium genus (4/11 symptomatic cases), Acinetobacter genus (5/12 asymptomatic cases), and Enterobacteriaceae family (11/12 asymptomatic and 2/11 symptomatic cases). The profiles of the predominant bacterial community appeared to be unique for each individual. These findings confirm that endodontic infections are polymicrobial and showed that there are significant differences in the predominant bacterial composition between asymptomatic and symptomatic cases.

Acinetobacter↗
PubMed1988

Tooth hypersensitivity after periodontal treatment. A case report including SEM studies.

Sensitive teeth after periodontal treatment are a rather common finding. Therefore, it has been questioned whether all the cementum on the root surfaces ought to be removed during periodontal therapy, since the sensitivity is caused by exposure of the dentin. Usually, the hypersensitivity represents a minor problem and will decrease or disappear with time. However, the following case demonstrates that repeated instrumentation of periodontally involved teeth can lead to an extreme degree of hypersensitivity.

Adult↗
PubMed1994

An evaluation of a pre-scaling gel (SofScale) on the ease of supragingival calculus removal.

SofScale is a pre-scaling gel, containing disodium EDTA and sodium lauryl sulphate, which is claimed to soften calculus and therefore facilitate its removal. 31 subjects were treated in a double blind randomised placebo controlled split mouth study to evaluate this product. Test or placebo gels were applied to the lingual surfaces of the mandibular teeth for 4 min and the time taken to complete the removal of supragingival calculus recorded. The operator recorded on which side the calculus was considered easier to remove and the patient indicated how comfortable the scaling had been. The mean calculus index was 1.99 for the SofScale group and 1.97 for the placebo. The mean time taken to complete scaling was 5.31 min for both groups. Using the Student t-test, there were no statistically significant differences (p > 0.7) between either the calculus index or time taken to complete the scaling between the groups. The operator did not consider SofScale to facilitate calculus removal and patients did not find calculus removal more comfortable when SofScale had been used. There was no increased sensitivity in the SofScale group following scaling. The results of this study do not support the use of SofScale as an adjunct to scaling.

Adult↗
PubMed2005

Effectiveness of a transmucosal lidocaine delivery system for local anaesthesia during scaling and root planing.

OBJECTIVE: This study compared the efficacy of transmucosal anaesthetic patches containing lidocaine (46.1 mg/2 cm(2)) to placebo for local anaesthesia during quadrant scaling and root planing using periodontal clinical indices and patient perception of pain. MATERIAL AND METHODS: Forty healthy adults with moderate periodontal disease and moderate subgingival calculus were scaled at weekly intervals, two quadrants randomized to treatment patches and two quadrants randomized to placebo patches. Bleeding, probing depths and attachment levels were evaluated prior to treatment and 1 month after quadrant scaling was completed. Subjects completed 100 mm visual analogue pain scales 15 min. after patch placement and at the end of treatment, and were asked for verbal assessment of perceived pain. RESULTS: Subjects' verbal ratings demonstrated consistently greater pain relief with active patches than placebo (p<0.0001). Visual analogue scales demonstrated significantly greater pain relief with the treatment patches after 15 min. (p=0.0003) and at the end of treatment (p=0.0149). Efficacy of periodontal therapy was equivalent for treatment and control groups. No adverse events were observed; localized minimal gingival irritation was noted in three subjects. CONCLUSION: Transmucosal lidocaine patches provided sufficient anaesthesia for therapeutic quadrant scaling and root planing procedures.

Administration, Cutaneous↗
PubMed2005

Self-reported oral health, oral hygiene habits, and dental attendance of pregnant women in Kuwait.

OBJECTIVES: The aim of this study was to describe self-reported oral health, oral hygiene habits, and frequency of visits to a dentist among pregnant women in Kuwait. MATERIAL AND METHODS: A cross-sectional study with an anonymous structured questionnaire was distributed among 650 pregnant women during May-June 2003, when they were admitted to the maternity ward at the largest government maternity hospital in Kuwait City. The response rate was 93% (n=603). RESULTS: Every fourth respondent was in her first pregnancy, while 36% already had three or more children. Every fifth woman felt that her oral health was poor, and one-third of the women believed that they had periodontal problems currently. About two-thirds of the women were brushing more than once a day and almost all (94%) at least once a day. Over the previous 6 months, 40% had experienced dental pain. Half of the women had visited a dentist during pregnancy, mostly for dental pain. Most of the women had received no instructions concerning oral health care during their pregnancy. CONCLUSIONS: A large proportion of the pregnant women in this study had oral health problems; however, half of the women had not seen a dentist during their pregnancy.

Adolescent↗
PubMed2006

Ibuprofen arginine for pain control during scaling and root planing: a randomized, triple-blind trial.

OBJECTIVES: The aim of this controlled clinical trial was to investigate the analgesic efficacy and tolerability of ibuprofen arginine in patients with mild-to-moderate periodontitis during and after non-surgical periodontal treatment. METHODS: This randomized, triple-blind, placebo-controlled, parallel-group trial assessed the analgesic efficacy of ibuprofen arginine (Spedifen) in patients undergoing routine periodontal scaling and root planing. 64 patients with chronic periodontitis received either 800 mg ibuprofen arginine or placebo 30 min. before treatment. Numeric pain and electronic visual analogue scales ranging from 0 to 100 were used. RESULTS: The average pain levels during treatment were lower following ibuprofen arginine (quartiles: 0.5, 4.5, 11) compared with placebo (4, 16, 26), corresponding to a percentage reduction in median pain of 72% (p=0.023). The median maximum pain was 28 (inter-quartile range 10-50) following placebo and 10 (4-31) following ibuprofen arginine (p=0.065). CONCLUSIONS: In patients with mild-to-moderate chronic periodontitis, ibuprofen arginine was safe and superior to placebo for alleviating pain during non-surgical periodontal treatment. Its painless administration and rapid onset of action make it well suitable for pain management in a general dental office.

Adult↗
PubMed1985

Incidence of pain conditions in dental practice in a Danish county.

From September 1981 to February 1982, an epidemiologic study was carried out on the incidence of pain conditions among patients between 18 and 70 yr of age in 30 dental practices in Ribe County, Denmark. A total of 35 464 patients consulted the 50 participating dentists during the study period. 823 patients consulted the dentist due to pain. The most frequent cause of pain was caries sequelae (pulpitis (35%) and acute apical periodontitis (31%)). There was a significant difference in the distribution of the diagnoses between patients with regular and non-regular dental care. Although the data in the present study may not be representative for the entire Danish population, it seems reasonable to assume that in Denmark there are at least 70 000 annual consultations to a dentist due to pain. Furthermore, a minimum of 4000 patients can be expected to be absent from work annually, due to illness caused by dental pain.

Adolescent↗