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At least 1,117 records · Page 62Linked to original sources
PubMed2002

Capping the inflamed pulp under different clinical conditions.

BACKGROUND: A great deal of controversy exists regarding the reliability of capping the inflamed pulp. In particular, the use of calcium hydroxide as a capping agent has come into question. In this study, hard tissue barrier formation after inflamed pulps were capped directly or after partial pulpotomy was compared with calcium hydroxide or bonded resin and with no additional seal or an IRM surface seal. Seventy teeth in five dogs were used. Ten untreated teeth were used as negative controls. In 60 teeth, pulpal inflammation was induced by preparing a cavity close to the pulp and sealing a cotton pellet soaked in plaque in it for 1 to 2 weeks. The cavities were then re-entered and extended to expose the pulps. MATERIALS AND METHODS: In half the teeth (n = 30) a partial pulpotomy was performed and in the other half (n = 30) pulpal treatment was performed on the superficial exposed pulp. Both pulpal treatment groups received the same restorative procedures: (1) calcium hydroxide + amalgam + IRM surface seal; (2) OptiBond Solo, Prodigy with IRM surface seal; or (3) OptiBond Solo, Prodigy without IRM surface seal. The presence, absence, and quality of a hard tissue barrier were evaluated histologically. RESULTS: The calcium hydroxide groups were statistically superior to all other groups. The IRM surface seal resulted in significantly better healing. Although there was no statistically significant difference between direct pulp capping and partial pulpotomy with the numbers in this study, power statistics indicated that in clinical practice a partial pulpotomy would be preferable. CLINICAL SIGNIFICANCE The results of this study suggest that a partial pulpotomy, calcium hydroxide medicament, and a bacteria-tight coronal restoration represent a viable technique for capping the inflamed pulp.

Animals↗
PubMed2000

Reversible and irreversible painful pulpitides: diagnosis and treatment.

The foregoing clinical evidence indicates that when pain is severe, or when mild to moderate pain is present with a previous history of pain in the aching tooth, with or without periapical radiolucency, the tooth is in the IRPP category. Treatment dictates endodontic therapy or extraction. On the other hand, when clinical evidence indicates that the pain is mild or moderate with no previous history of pain, normal pulp vitality, and there is no positive percussion sign, the pulp is in the RPP category. Treatment dictates indirect or direct pulp capping in teeth with or without periapical radiolucency. The success rate favours teeth with no periapical radiolucency, 98%; in teeth with periapical radiolucency the success rate is less favorable, 43%. Efforts should be made to maintain pulp vitality. Endodontic therapy can always be done, if in time the pulp develops necrosis.

Adolescent↗
PubMed2002

The mechanism of pulpal wound healing.

The favourable response of exposed pulp tissue against a variety of materials used for pulp capping in experimental conditions, as observed by hard tissue (reparative dentine) formation, demonstrates an intrinsic capacity of pulp tissue for healing. However, in the clinical situation, in which a pulpal exposure is usually accompanied by a long-term external irritation with the subsequent long-term inflammatory response to that irritation, the outcome of pulp capping procedures is not as predictable. While some of the factors related to the defensive reactions and healing after pulp exposure and capping procedures are well understood, the mechanisms and importance of others remain less well-known. Understanding the mechanisms regulating the spread of inflammation and necrosis in pulp tissue, and the factors regulating healing after closure of the wound, would facilitate the development of new and better treatment procedures with more predictable outcomes. In this review, some of the aspects considered to be important in pulpal wound healing are discussed.

Animals↗
PubMed2003

To do a "root canal".

Endodontic treatment is often referred to as "a root canal". This article discusses the need to be more refined and descriptive in the selection of treatment alternatives. The pathological involvement of teeth needing endodontic treatment varies significantly from superficial pulp inflammation to pulp necrosis and infection, often complicated with a periradicular osteolytic process. This diversity should lead to a variety of treatment modalities based on the severity of the disease. Failure to do so and use a one-size-fits-all approach--"a root canal"--is an oversimplification and a disservice to the patient and the profession.

Dental Pulp Necrosis↗
PubMed2004

Role of occlusion in endodontic management: report of two cases.

The two clinical cases reported demonstrate that traumatic occlusion can play a role in the initiation and progression of pulp and periradicular inflammation. The symptom of persistent pain did not subside after the commencement of endodontic treatment. Traumatic occlusion was identified in both cases to be the main cause and hence occlusal adjustment was performed. This resulted in the gradual resolution of the symptoms. The findings suggest that occlusal trauma is often overlooked in the diagnosis and management of endodontic diseases.

Adult↗
PubMed2005

Comparing the quality of anaesthesia in normal and inflamed teeth by pulp testing.

Failure to achieve complete anaesthesia of teeth with acutely inflamed pulps is a well-known clinical symptom. In this study, we compared the quality of anaesthesia in intact and inflamed mandibular teeth by using an electric pulp tester. Thirty patients with inflamed lower teeth, which had spontaneous or night pain, were selected; two healthy teeth in the same quadrant were used as control teeth. Electric pulp testing and thermal tests were made on each inflamed and control tooth. Teeth were then anaesthetised by inferior alveolar nerve block and electric pulp tests were repeated on inflamed and control teeth. Significant differences were found between electrical stimulation of inflamed and intact pulp (p approximately 0). There was no significant difference between the responses of inflamed teeth to electric pulp testing before and after anaesthesia (p = 0.327), which showed that the teeth could become resistant to anaesthesia due to the inflammation.

Anesthesia, Dental↗
PubMed1999

Dentist reliability in classifying disease risk and reason for treatment.

OBJECTIVES: The reliability of practicing dentists' classifications of patients' caries risk and periodontal disease risk and reason for treatment for individual teeth were determined. The risk classification protocols had been in use in a group practice for more than a year, and the reason-for-treatment protocol had been introduced six months previously. METHODS: Eight dentists' classifications for caries (n = 66) and periodontal disease risk (n = 66), and six dentists' classifications for reason for treatment (n = 73) were compared to those of a nominal standard examiner. Reliability was expressed as percent agreement and kappa values. RESULTS: Percent agreement was 76 percent, 83 percent, and 74 percent for caries, periodontal disease, and reason for treatment, respectively, with kappa values of 0.56, 0.70, and 0.69. CONCLUSIONS: Dentists can attain reasonable levels of reliability using simple classification protocols with little formal training, although misclassification may be problematic for specific administrative or research-related purposes.

Decision Making↗
PubMedDate not supplied

A prospective survey of hospital ambulatory dental emergencies. Part 2: Follow-up to emergency treatment.

Two hundred and fifty-three patients treated for dental emergencies at the University Hospital dental clinic over a three-month period were surveyed by telephone 24 to 48 hours and one year after treatment. The purpose was to investigate the success of treatment in resolving the chief complaint of pain and to determine the compliance with further dental care for the original dental problem. The results of the telephone survey showed that: patients available for questioning totaled 49.1% at 24 to 48 hours and 28.9% at one year; an 80.7% success rate was recorded in resolving pain within 24 to 48 hours; and the original emergency problem did not motivate a large number of these patients to seek further dental care.

British Columbia↗
PubMedDate not supplied

Trigeminal neuralgia with intraoral trigger points: report of two cases.

A variety of pathologic conditions can cause orofacial pain. Establishing the etiology of the pain is key to providing appropriate treatment. Trigeminal neuralgia (TN) is a relatively uncommon condition and can present a diagnostic challenge to even the experienced dental practitioner. The authors discuss two cases of TN that exhibited intraoral trigger points, which initially resulted in confusion regarding the establishment of a correct diagnosis and treatment.

Aged↗