Microbial microleakage and pulpal inflammation: a review.
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Bacterial Physiological Phenomena↗
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Results for “Pulpitis”
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Effect of pulpal inflammation on bacterial penetration of acid-etched and non-etched dentin.
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Acid Etching, Dental↗
A one-year follow-up of partial pulpotomy and calcium hydroxide capping in primary molars.
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Calcium Hydroxide↗
Pulpal response to an anhydrous glass ionomer luting cement.
This investigation was designed to study the pulpal responses to Aquacem, an anhydrous glass ionomer luting cement, and to compare the results with those previously obtained for a conventional glass ionomer luting cement, Chembond. The study was carried out according to the BSI (1980) recommendations for testing restorative materials in vivo. Aquacem caused more pulpal inflammation than the control material, Kalzinol, though by an indirect mechanism. The statistical model demonstrated a significant association between bacterial presence within the experimental cavity and pulpal inflammation. The type of restorative material has no direct association with the degree of inflammation, but the model suggests that it exerts an indirect influence via its antibacterial properties and hence its influence on microbial microleakage.
Animals↗
Similarities in the microfloras of root canals and deep periodontal pockets.
Although not universally accepted, retrospective histological, roentgenological and microbiological studies have indicated that cross-infection can occur between infected pulps and deep periodontal pockets. This review provides examples of similarities in the microfloras of these adjacent oral sites, supporting the idea that infection spreads from one site to the other. The organisms most often involved are probably bacteroides, fusobacteria, eubacteria, spirochetes, wolinellas, selenomonas, campylobacter, and peptostreptococci. Important qualities of cross-infecting organisms may be the ability to survive in highly reduced environments and motility. Precautions should be taken to prevent in vivo seeding of such micro-organisms, particularly in compromised teeth and hosts.
Bacterial Infections↗
Role of immune cytokines in the pathogenesis of periapical lesions.
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Bone Resorption↗
Mandibular first premolar with three root canals.
This report presents a case of endodontic treatment of a mandibular first premolar with 3 root canals and a review of the literature concerning root canal anatomy of lower premolars. It is stressed that, even in teeth with a low frequency of abnormal root canal anatomy, the possibility of additional root canals has to be considered in the clinical and radiographic examination of the patient.
Adult↗
Polyamine analysis of infected root canal contents related to clinical symptoms.
The contents of infected root canals were collected by mechanical and chemical debridement. Intracanal polyamines were identified and quantified by HPLC in all canals examined, however, no histamine was detected in any canal. The relationship between the amount of each polyamine and clinical signs of the teeth was analyzed statistically. The teeth without clinical signs tended to have limited varieties and smaller amounts of polyamines. Using chi 2, the amounts were significantly greater in teeth with spontaneous pain, swelling and putrescent odor (p less than 0.01), with exudate (p less than 0.025) and with percussion pain (p less than 0.1) than in teeth without. Amounts of putrescine (p less than 0.05) and total polyamines (p less than 0.01) were greater in teeth with spontaneous pain and percussion pain than in teeth without clinical sign, and those with root canal exudate also had greater amounts of total polyamines than those without (p less than 0.01). The amounts of cadaverine, however, from the teeth with gingival fistulae, was greater than from those without (p less than 0.05). No significant relationship was established between the amount of each polyamine and the presence of putrescent odor or gingival swelling. Intracanal polyamines, especially putrescine may leak out through apical foramen and may be implicated in pain production by eliciting acute inflammatory response in the periapical tissues.
Adolescent↗
Leukotrienes: their possible role in pulpal and periapical diseases.
Leukotrienes play an important role in inflammation and its sequelae such as pain, swelling, and bone resorption. This review covers, their history, structure, synthesis, metabolism, biological effects, inhibitors, antagonists, and their possible role in pathogenesis of pulpal and periapical disease.
Arachidonic Acid↗
Immunoglobulins in periapical exudates of infected root canals: correlations with the clinical findings of the involved teeth.
This study quantified the concentrations of IgG and IgA in the periapical exudates obtained from 69 single-rooted teeth using enzyme-linked immunosorbent assays, and examined their correlation with clinical findings of the involved teeth. Changes in the levels of these immunoglobulins during root canal treatment were also investigated. The average levels of IgG (85.61 mg/ml) was significantly higher than that of IgA (0.65 mg/ml) (P < 0.001). The exudates from the canals with large lesions (> or = 1 cm in diameter on radiographs) showed significantly higher IgG and IgA levels than small lesions (< 1 cm in diameter) (P < 0.01). The tendency for these to be a decrease in the levels of IgG and IgA was observed following the root canal treatment. These observations suggest that IgG and IgA are involved in the immunopathogenesis of periapical lesions.
Bacterial Infections↗
Pulpal reaction to a dental adhesive in deep human cavities.
In the last years several dental adhesives have been developed. They are supposed to chemically adhere to dentin and a liner to protect the pulp is not used. The aim of this study was to compare the short-term pulpal reaction, in an intra-toothpair study, between a dental adhesive, Scotchbond 2, and a lining system, Tubulitec, in combination with P-50 in surface-sealed cavities. Deep buccal cavities in 16 human pairs of premolars, 32 teeth, were restored in vivo with a light cured composite resin, P-50. To minimize bacterial contamination all cavities were treated with a cleanser, Tubulicid, and the cavities were surface-sealed with temporary cement, Coltosol. One tooth in each pair, the test, was treated with Scotchprep Dentin Primer and Scotchbond 2 Light Cure Dental Adhesive. In the other tooth in the pair, the control, Tubulitec Primer and Liner were used. The teeth were extracted after 6-14 days. The sections were evaluated for degree of inflammation and the presence of bacteria. Irrespective of treatment of dentin the majority of teeth, 23, including one pulpal exposure, revealed no inflammation or a few inflammatory cells. In four test teeth, including one pulpal exposure, and two controls, growth of bacteria was found on the cavity walls and slight or moderate inflammation was seen in the corresponding pulps. In one test and two control teeth slight inflammation was seen but no bacteria could be detected. In the absence of bacteria Scotchbond 2 did not seem to irritate the pulp.(ABSTRACT TRUNCATED AT 250 WORDS)
Bacteria↗
Three independent canals in the mesial root of a mandibular first molar.
Endodontic therapy was performed in a mandibular first molar with three canals in the mesial root. The mesiobuccal and the mesiolingual canals were found in their normal locations. The third was located in the middle of the distance between the other two. Radiographically, it ended in its own distinct foramen. Many reports deal with three orifices in the mesial root, but very few describe three independent canals, indicating a rare anatomical configuration. To locate the third possible intermediate canal it was suggested to reduce the mesial dentinal wall of the pulp chamber after instrumenting the main two canals.
Adult↗
Prognosis of conventional root canal treatment reconsidered.
In endodontic literature, the so-called success rate of conventional root canal treatment is reported to range between 70% and 95%. This has been calculated as the percentage of successfully treated teeth of all teeth followed up or included in the clinical trial. This approach, however, does not allow for valid assertions on the prognosis of root canal treatment as the individual observation times are not considered. This article discusses some methodological and statistical aspects of how to design a prognostic study which focuses on the outcome of endodontic therapy and of how to analyse the data appropriately. Methodologically, the response variable should preferably be the individual time required for the occurrence of an event, e.g., success or failure of endodontic therapy, which should clearly be defined on the basis of widely accepted criteria in endodontology. Event times can appropriately be analysed by the Kaplan-Meier method, which estimates the probability that the event will not occur within a fixed time. This probability, together with the approximate 95% confidence interval (CI), permits an evaluation of the prognosis of a particular treatment. Two data sets were re-analysed to clarify the rationale behind the analysis of event times. Accordingly, the probability that an endodontically induced lesion will completely heal, e.g., within the first 3 years after root canal therapy ranges between 0.87 (CI: 0.74-1.00) and 0.89 (CI: 0.80-0.98). In this situation, the simple calculation of success rates would overestimate the chance of complete periapical healing within the first years after therapy but underestimate it over longer observation periods. Another example was used to analyse the time to occurrence of periapical pathosis associated with root canal treated teeth not diseased periapically. In this case the chance of recording a successful endodontic treatment is initially underestimated by the percentage of successful cases of all teeth integrated in the study but is markedly overestimated for longer observation periods. Potential risk factors affecting the outcome of the endodontic therapy and thereby the event times can adequately be determined by applying the Cox's or Aalen's regression model.
Humans↗
Detection of interleukin-6 in human dental pulp and periapical lesions.
Pulpal and periapical diseases are characterized by inflammation. The cytokine IL-6 is a major mediator of the host response to tissue injury and infection. This study examined the level of interleukin-6 (IL-6) in six inflamed human pulps and six human periapical lesions of endodontic origin using ELISA. Pulp samples from eight clinically impacted teeth were used as controls. The periapical samples exhibited significant levels of IL-6 (mean = 78.1 +/- 9 pg/mg protein) as did inflamed pulpal tissues mean = 36 +/- 3.9 pg/mg protein) compared to healthy pulp mean = 0.01 +/- 0.02 pg/mg protein). These data indicated that IL-6 was produced and released locally in the inflamed pulpal and periapical lesions.
Adult↗
Failure of inferior alveolar nerve block in endodontics.
Analgesia is essential for successful completion of modern dental procedures. Standard inferior alveolar nerve block (IANB) is the primary method used to achieve mandibular analgesia. Difficulty experienced in obtaining satisfactory analgesia after IANB, especially of an acutely inflamed mandibular molar, remains a common clinical problem. Even when a proper technique is employed, clinical studies show that IANB fails in approximately 30% to 45% of cases. The reasons for failure are not fully understood. Anatomical considerations and abnormal physiological responses in the presence of inflammation as explanations for IANB failure are discussed in this paper.
Anesthesia, Dental↗
Inflammatory and replacement resorption in reimplanted permanent incisor teeth: a study of the characteristics of 84 teeth.
Avulsion is a serious injury which can cause damage to some or all of the dental and surrounding tissues. This study examined the profiles of teeth showing inflammatory resorption, in terms of time prior to reimplantation, contamination, pulp extirpation time and period of splinting and compared them to teeth without resorption. There were a total of 71 children in the present study (mean age 9.8 years, range 6-16 years) with a total of 84 reimplanted teeth. Inflammatory resorption was present in 22 teeth. There was a significant relationship between the presence of inflammatory resorption and the time the teeth were dry prior to reimplantation, with a lesser effect for total delay time. There were slightly later pulp extirpation times for teeth with inflammatory resorption, with median delays of 16 and 11 days respectively and increased inflammatory resorption in teeth extirpated at 20 days or later. Replacement resorption was present in 40 teeth. There was a significantly longer splinting time in teeth with replacement resorption and more resorption in teeth splinted for longer than 10 days. It was concluded that pulp extirpation time was not critical unless the delay exceeded 20 days and that splinting time should not exceed 10 days.
Adolescent↗
Exposed human pulp caused by trauma and/or caries in primary dentition: a histological evaluation.
The aim of this study was to compare the pulpal reactions after exposure due to trauma and/or caries and to suggest the appropriate treatment options for the management of pulp, in the light of the histological findings in the primary teeth. Fifteen primary maxillary incisors with pulpal exposure were examined with light microscope in a blind study. After the histological evaluation, teeth were divided into three groups for the etiological factors due to the exposure according to the patient's files: trauma group, caries group and caries and trauma group. The inflammatory infiltration was diminished from the pulp chamber towards the apical third of the root canal in all of the examined teeth. Teeth in the trauma group presented fewer inflammatory cells in the root canal in comparison with other groups. It was concluded that the teeth with traumatic pulp exposure were considered as more likely to respond positively to pulpotomy technique. Pulpectomy or extraction seemed to be indicated for the decayed or decayed and traumatically injured teeth.
Child, Preschool↗
Dentin bonding: overview of the substrate with respect to adhesive material.
The current challenge in adhesive dentistry is to develop dentin bonding systems that will reproducibly achieve high bond strengths similar to those obtained between resins and acid-etched enamel. Some of the limitations of dentin as a bonding substrate are that it changes its structure as it is prepared deeper, it is difficult to dry, and its smear layer is weak. Further, it is difficult to avoid contaminating proximal boxes with blood. Such contamination lowers dentin bond strengths to very low values. Decontamination of such dentin must be done prior to resin placement. The forces of polymerization contraction depend, in part, on the shape of cavities and how they are filled. Bulk filling of class I cavities can lead to conditions in which the forces of polymerization contraction exceed dentin bond strength with some materials and locations. The future development of resin systems that do not shrink on polymerization would eliminate many current problems in adhesive dentistry.
Composite Resins↗