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PubMed1980

Zygomatic arch interference with correct radiographic diagnosis in maxillary molar endodontics.

Five hundred twenty-four periapical radiographs taken with the bisecting-angle technique were evaluated for interference of the zygomatic arch with the apical third of the roots of the first and second upper molars. The number of interferences around the second molar apices was much larger (42 percent average) than those around the first molar apices (20 percent average). For endodontic radiographic diagnosis of the upper two molars, the bisecting-angle technique has proved to be unreliable.

Humans↗
PubMed1981

Endodontic treatment of teeth with periapical radiolucent areas in a general dental practice.

Clinical details of 192 teeth with preoperative periapical radiolucent areas, treated endodontically, are described. The presenting signs and symptoms as well as some postoperative observations are listed. Periapical radiolucent areas were most frequently found related to maxillary teeth: 55 percent were adjacent to teeth with a single root canal and 30 percent related to teeth with three root canals. Radiographic follow-up 1 or more years after therapy was possible in 125 of the root-filled teeth: of those teeth, 59 percent shows disappearance of the radiolucent area and 29 percent exhibited a decrease in size of the area. The degree of success did not appear to be related to the number of root canals filled per tooth but, rather, to whether or not the root filling was short of the radiographic apex. In addition, the prognosis made at the time of root filling was accurate in most cases when compared to the estimated success rates.

Adolescent↗
PubMed1981

Acute pulpal-alveolar cellulitis syndrome. III. Endodontic therapeutic factors and the resolution of a Candida albicans infection.

An acute pulpal-alveolar cellulitis, involving a drug-resistant Candida albicans, was resolved successfully with endodontic treatment in 6 days. Effective debridement, irrigation, and intracanal medication were significant factors in obtaining a negative culture at completion of treatment. The case illustrates that clinical procedures and judgment can be major factors in the resolution of serious infection, where antibiotic therapy is not feasible. External heat compresses should be avoided in pulpal-alveolar cellulitis cases. Hot intraoral saline rinses are recommended to promote tooth drainage and the formation of fluctuant mucosal swellings. External cold compresses may help reduce facial swelling and provide relief from discomfort.

Adult↗
PubMed1981

The use of dequalinium acetate as a disinfectant and chemotherapeutic agent in endodontics.

Dequalinium compounds are known as chemotherapeutic and bactericidal agents. They are used in various areas of medicine and oral medicine for combating cases of mixed infections. Until now, results of basic research studies have been published whose objective was to examine the suitability of dequalinium preparations as cleansing agents and intracanal dressings for endodontic use. This article presents for the first time a number of selected cases from a clinical research study in which widespread periapical lesions revealed before the start of treatment were treated with a preparation whose active ingredient was dequalinium acetate. The results of treatment and follow-up are given. These case reports show that healing of the periapical lesions occurs relatively quickly and is generally completed within a period of 9 months.

Adult↗
PubMed1981

Probabilities of success and failure in endodontic treatment: a Bayesian approach.

Bayes' theorem provides a mathematical rule for changing a (prior) probability into a new (posterior) probability incorporating additional information. Application of the theorem is a way to overcome some limitations that the human mind has in processing information. A Bayesian approach is useful for the processing of data and as a tool for decision making. Bayes' theorem is expounded, and examples are given of the use of the theorem for computing the odds on success or failure of endodontic treatment of a tooth, given a particular preoperative status and given also the results of the preparation and filling of the root canal of the tooth in question. Application of Bayes' theorem using data collected provides an insight based upon probabilities and odds in the way preoperative conditions and operative results affect the ultimate treatment result.

Bayes Theorem↗
PubMed1981

Endodontic access to maxillary lateral incisors.

One hundred thirty-one maxillary lateral incisors were radiographed from a mesiodistal vantage point. Projections of the buccal and lingual walls onto the incisal showed that 16 percent opened to the buccal of the incisal edge; 32.9 percent were buccal and inclusive of the incisal edge, 43.5 percent were buccal and lingual to the incisal edge, 6.9 percent were inclusive of the lingual to the incisal edge, and 0.8 percent were entirely to the lingual of the incisal edge. Theoretically, the highest success rate that could be achieved for that portion of endodontic therapy that depends upon canal débridement would be gained by having the occlusal access opening in the most direct path to the long axis of the root canal. In this study it has been shown that, for maxillary lateral incisors, that path would necessitate that out occlusal opening be made inclusive of and slightly buccal to the incisal edge.

Debridement↗
PubMed1982

Management of endodontic perforations.

1. Perforations in the floor of the pulp chambers of molars offer an improved prognosis when treated aseptically and quickly. 2. Perforations in the apical third of the root canal, when made with a reamer or file that leaves 2 mm. or less of unfilled root canal space, have a good prognosis. 3. If a perforation, either mechanical or resorptive in etiology, occurs on the lingual surface and requires surgical management, prognosis is poor. 4. Recent advances in the use of calcium hydroxide to treat endodontic perforations show promise.

Adolescent↗
PubMed1982

Forces and efficacy in endodontic irrigation systems.

Measurements of the pressure necessary to activate three commercially available types of endodontic irrigation systems were obtained from an in vitro testing procedure. In addition, the irrigation process was observed in simulated 1 mm. diameter root canals prepared in clear acrylic. Except for one patented system, the force necessary to depress the plunger of an irrigation syringe was found to increase as the size of the needle decreased. the most effective irrigation was observed when the larger needles of a blunted, open-end design were inserted to the full length of the preparation.

Dental Pulp Cavity↗
PubMed1982

Evidence for antibacterial activity of endodontic gutta-percha cones.

In the presence of endodontic gutta-percha cones, several species of bacteria were killed in vitro. Silver points, when compared with gutta-percha cones, were not or were considerably less effective against the target organism. Staphylococcus aureus, in our assay system. Growth of bacteria in serum could be abolished by the mere presence of gutta-percha, especially when time was allowed for previous contact between the serum and the cones. It is concluded that gutta-percha cones possess a slowly acting, relatively weak, but, in our opinion, significant inherent antimicrobial property.

Bacteria↗
PubMed1983

A radiographic evaluation of the periapical status of teeth treated by the gutta-percha--eucapercha endodontic method: a one-year follow-up study of 458 root canals. Part II.

In Part I, which appeared in the last issue, the authors discussed the variations that exist in nonsurgical endodontic therapy with respect to methods of treatment and analyses of success and failure. They then reported on the materials and methods that were used in their clinical study of 458 root canals treated by the gutta-percha--eucapercha method and gave the criteria that were used for the radiographic analysis of success and failure in those cases. In Part II, the results of the one-year follow-up of those 458 root canals is presented. Tables and illustrations are used to substantiate the results.

Dental Pulp Cavity↗
PubMed1983

Bupivacaine anesthesia--a clinical trial for endodontic therapy.

In this double-blind clinical trial, thirty-two patients were randomly assigned to two groups of sixteen and administered 0.5 percent bupivacaine 1/200,000 epinephrine or 2 percent lidocaine 1/100,000 epinephrine for endodontic therapy. The onset and profundity of anesthesia were similar for the two groups. However, the bupivacaine group had prolonged anesthesia following treatment and a significant decrease in postoperative pain.

Adult↗
PubMed1983

Influence of bony resorption on endodontic treatment.

A review of prognosis studies has examined success rates between samples of teeth, both with and without radiolucent lesions, treated conventionally. The presence of a lesion predisposes the endodontic case to a lower success rate. On the basis of experimental data on the use of calcium hydroxide, investigation of increasing success with placement of calcium hydroxide in the canals of teeth with periapical lesions for 3 to 10 months prior to conventional filling is proposed.

Alveolar Process↗
PubMed1983

A radiographic evaluation of the periapical status of teeth treated by the gutta-percha-eucapercha endodontic method: a one-year follow-up study of 458 root canals. Part III.

In Part I which appeared two issues previously, the authors discussed the variations in treatment methods of nonsurgical endodontic therapy and in the determination of success and failure. They then reported on the materials and methods used and the radiographic criteria for success and failure in their clinical study of 458 root canals treated by the gutta-percha-eucapercha method. In Part II which appeared in the last issue, the one-year follow-up results were presented. Some of these results differ from previous investigations. For example, better success was found in (1) necrotic cases with areas of pathosis than in necrotic cases without "areas and in (2) overfilled cases than in underfilled cases. In Part III the authors discuss the possible reasons for these and other findings and give some implications for clinical practice.

Biocompatible Materials↗
PubMed1983

Incidence of postoperative pain after single- and multiple-visit endodontic procedures.

A series of 359 endodontic cases were followed and evaluated by the frequency of reported postoperative pain. A statistical analysis of the data obtained attempted to identify a relationship between pain experienced and the anatomic location, the pulpal vitality as determined by hemorrhage, or the number of treatment visits used in completing the case. Data obtained indicated no relationship between pain experience and pulpal vitality, no statistically significant relationship to the anatomic location, and a significant relationship to the number of visits used. The data indicate a 2 to 1 higher frequency of pain reported following treatment completed in multiple visits as compared to that reported for those completed in one visit.

Appointments and Schedules↗
PubMed1984

The comparative efficiency of final endodontic cleansing procedures in removing a radioactive albumin from root canal systems.

Fifty-six teeth were initially instrumented, with the use of seven irrigants or irrigant combinations, and filled with radioactive albumin. The study then showed the relative ability of three final endodontic procedures (copious reirrigation with saline solution, drying with paper points, and reassuring patency of the canal with the final instrument) to remove the albumin. Even after copious irrigation, each additional procedure removed statistically significant amounts of albumin. Alternating an organic solvent and an inorganic solvent did appear to leave the canal system in the optimal condition for final cleansing procedures. The study then correlated the relative efficiency of irrigation alone versus instrumentation plus irrigation in removing the remaining albumin from the canal systems. Reinstrumentation plus copious irrigation removed significantly more albumin than copious irrigation alone.

Chelating Agents↗
PubMed1984

The predictive value of endodontic diagnostic tests.

The diagnostic usefulness of common endodontic tests was evaluated through the retrospective analysis of studies in which histologic examinations were performed. In general, tests were able to adequately identify persons who were likely to be free of disease but were substantially less effective in identifying disease-positive persons. Thus, persons who are test-positive for irreversible pulpal disease are frequently disease-negative on the basis of histologic examination. These findings suggest that practitioners continue to use all available evidence in making a diagnosis of irreversible pulpal disease.

Cold Temperature↗
PubMed1984

Intracanal use of a corticosteroid solution as an endodontic anodyne.

In fifty consecutive clinical patients with endodontically involved teeth that responded with vital pulp test readings, a corticosteroid solution and a saline placebo were alternately used as an intracanal anodyne. The patients subjectively rated their pain on a scale of 0 to 100 as "none," "mild," "moderate," and "severe" (0 = none, 1 to 33 = mild, 34 to 66 = moderate, 67 and above = severe). The ratings were done before the first treatment and then at 24, 48, and 72 hours after treatment. Corticosteroid-treated and placebo-treated cases were not significantly different in terms of type of teeth treated, clinical pulpal diagnosis, and preoperative patient evaluation of pain. The results showed a decreased subjective report of pain for the corticosteroid cases as compared to the controls through the three posttreatment time periods (p less than 0.10). A statistically significant decreased incidence of pain was reported for the corticosteroid cases as compared to the control at the 24-hour time period (p less than 0.05). No clinical indication of infection was noted in either the corticosteroid or saline control cases.

Dexamethasone↗