[Various clinical problems of subgingival caries in endodontic and periodontic treatments].
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Dental Caries↗
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A panoramatomographic study of the teeth and jaws of Finnish university students.
A random sample of panoramic radiographs was taken of 1027 (386 male and 641 female) university students. All the students were born between 1965 and 1971. The following were examined: caries, apical radiolucencies, endodontically treated teeth, marginal and vertical bone loss, third molars, supernumerary, missing, and persisting teeth, bone structure, condyles, maxillary sinuses and soft tissue calcifications. In the inter- (of two examiners) and intra-examiner variation Kappa indices varied between 0.15 and 1.00, and agreement percentages from 52, to 100. Kappa index was poor (0.15) in evaluation of the bone structure. The mean DMFT index for the students was 8.4. A sound dentition was found in 6.6%, and 48.4% of the students were free of caries. The mean number of carious lesions was 1.1. There were 50 retained roots (49 from primary teeth). 76.6% of the students had one or more unerupted wisdom teeth and 22.7% had radiologic changes typical of pericoronitis in the region of the mandibular third molars. 16.2% of the students had at least one missing wisdom tooth. Bone structure was normal in 92.4% of the students, idiopathic osteosclerosis being the most common divergence (3.5%). Arthrotic changes in the condyles were found in 9% of the students. In eight cases there was erosion of the condyles, which was diagnosed as arthritis. Styloid ligament calcifications were found in 21.5% of the students. In the maxillary sinuses, male students exhibited changes 1.7 times more often than female students (26.3% in males and 15.1% in females).
Adult↗
[Results and consequences of clinical-radiological follow-ups of root canal treated teeth. 1. Correlations between the results and the type of tooth and diagnosis. Correlation between clinical and radiological findings].
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Dental Caries↗
The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study.
BACKGROUND: The decision between pulp capping and root canal therapy after pulp exposure is a clinical issue. The aim of the authors' study was to evaluate the outcome of direct pulp-capping procedures performed by dental students. METHODS: The authors followed the treatment outcomes of 193 patients with 204 pulp exposures with direct pulp capping. They determined the outcome of pulp capping radiographically using periapical radiographs taken at least three years after pulp exposure. The outcome was considered as successful if the tooth was present and not associated with periapical radiolucency or root canal treatment; otherwise, the outcome was considered as being a failure. RESULTS: Overall, the success rate of pulp capping was 59.3 percent. The success was associated more with mechanical exposure than with carious exposure (92.2 versus 33.3 percent) (P < .001), more with permanent restoration than with temporary restoration (80.8 versus 47.3 percent) (P < .001) and more with class I occlusal restoration (83.8 percent) than with proximal multiple surface restorations (Class II, 56.1 percent; Class III, 58.8 percent; mesial-occlusal-distal, 28.6 percent) (P = .009). Patients' age, sex, and tooth location and position had no significant effect on the outcome (P > .05). CONCLUSION: The success rate of direct pulp capping was 92.2 percent with mechanical exposure and 33.3 percent with carious exposure. CLINICAL IMPLICATIONS: Direct pulp capping is recommended after mechanical exposure with immediate placement of permanent restoration, while root canal therapy would be the choice of treatment if the exposure was due to caries.
Adolescent↗
Validation of self-reported oral health measures.
OBJECTIVES: To assess the validity of self-reported oral disease and health care measures in two populations. METHODS: Telephone interviews were conducted among a subsample of participants in the VA Dental Longitudinal Study (VADLS) asking them about periodontal disease status and treatment. Radiographic alveolar bone loss evaluated at all the interproximal sites was used as the standard. A separate study was carried out among first-time patients at the Harvard School of Dental Medicine (HSDM) student clinic. Self-reported measures were obtained by a self-administered questionnaire and compared with clinical and radiograph examinations. The measures used were based on published work that demonstrated good validity of self-reported periodontal measures among health professionals. RESULTS: Among 145 VADLS participants, self-reports of periodontal disease showed a good specificity (59.8%-90.7%), but low sensitivity (17.7%-64.7%). Among 58 HSDM patients, the self-reported numbers of remaining teeth, fillings, root canal therapy, and prosthesis were strongly correlated with clinical records (r = 0.74-1.0); self-report was less accurate for measures of periodontal disease (r = 0.56) and decayed teeth (r = 0.47). CONCLUSIONS: Self-reports provide reasonably valid estimates for numbers of remaining teeth, fillings, root canal therapy, and fixed and removable prostheses. However, they appear to be less useful for the assessment of dental caries and periodontal disease in the two populations we have studied. There remains a need and potential to further develop self-report oral health measures that are valid for use in large population studies. Such self-report measures would yield great cost and time savings.
Adult↗
Clinical, radiographic, and histological manifestations of dentin dysplasia, type I: Report of case.
Dentin dysplasia, type I, is a rare dental anomaly characterized by abnormal dentin formation affecting the roots of both primary and permanent teeth. Short, conical roots with occlusion of the pulp chamber and canal are produced. Periapical radiolucent areas are common, although no evidence of caries or trauma to the tooth may be seen. Coronal mantle dentin is unaffected, resulting in an apparently normal clinical crown. An abnormality may not be suspected until radiographs reveal pulp and root changes. Orthodontic treatment can be a successful variation of the usual treatment offered to patients, and is discussed in this case report.
Adult↗
Root reinforcement with a resin-bonded preformed post.
PURPOSE: This study evaluated the ability of resin-bonded posts to reinforce teeth that are structurally weak in the cervical area against fracture. MATERIAL AND METHODS: Forty canine roots were endodontically treated and randomly distributed into four groups of 10. Parallel-sided preformed posts were cemented into the roots of these teeth after their crowns were removed. The cervical third of the canals were flared to simulate teeth weakened in this area as a result of caries or endodontic therapy. Three resin cements and a zine-phosphate cement, which was used as the control, were used to secure the posts into the roots. Cemented posts were loaded in an Instron testing machine with a gradually increasing force at a 60-degree angle to the long axis of the root until the root fractured. RESULTS: Roots in which the posts were cemented with Panavia were significantly more resistant to fracture than those where zinc phosphate was used (p < 0.05). Because of the inability to determine exactly the point of failure of the zinc-phosphate cement, no statistically significant difference was found when compared with the other two resin cements (ANOVA and Student-Newman-Keuls test).
Analysis of Variance↗
Strontium content of deciduous teeth in northern and southern Finland.
A possible connection has been suggested between strontium and a low prevalence of dental caries. An investigation of this subject was initiated by measuring the strontium content of deciduous teeth by atomic absorption spectrophotometry in different regions in Finland. The material analysed consisted of a total of 2,482 tooth crowns and 392 tooth roots. The results showed that the Sr content of the tooth crowns in northern Finland was about two-fold that in the south, about 400 and 200 mug/gCa, respectively. The difference was apparently caused by corresponding differences in dietary strontium. The tooth roots contained much more Sr than the crowns, about 600 and 200 mug/gCa, respectively, in southern Finland, presumably owing to changes occurring in the dietary habits of the child during the development of the crowns and roots of the deciduous teeth.
Dental Caries↗
[Observations on 2d deciduous molars with application of selective root preservation method for the induction of eruption of first molars].
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Child, Preschool↗
Peripheral inflammatory root resorption. A review of the literature with case reports.
External resorptions associated with inflammation in marginal tissues are many times misdiagnosed and confused with caries and internal resorptions. A lack of uniformity in nomenclature has added to the confusion. This paper reviews the literature and presents cases to illustrate a rational approach to diagnosis and treatment. A new name is suggested to better reflect the features of this type of root resorption: peripheral inflammatory root resorption.
Adult↗
Phosphoprotein analysis of sequential extracts of human dentin and the determination of the subsequent remineralization potential of these dentin matrices.
Phosphoprotein appears to play an important role in the mineralization of dentin during tooth development and remineralization after demineralization by dental caries. To better understand this role, we describe the extraction and characterization of phosphoprotein from immature, human root apex dentin during and after EDTA demineralization. The extraction procedure included dissociation of the demineralized dentin matrix by guanidine hydrochloride (Gdn.HCl) followed by subsequent digestion with cyanogen bromide (CNBr) and collagenase. Characterization of these extracts included 'Stains-All' staining of SDS polyacrylamide gels (SDS-PAGE) and amino acid, protein and phosphorus analyses. The ability of these matrices to remineralize was determined by TEM and measuring calcium levels in the remineralized tissue by atomic absorption spectroscopy. The staining of SDS-PAGE gels and amino acid analysis showed that an intact phosphophoryn was extracted from the dentin of the immature apices during EDTA demineralization and that it had an apparent Mr approximately 140,000. In the subsequent extracts and digests, the phosphoprotein has a range of molecular weights, some of which may have been degraded products of the intact phosphoprotein. A greater quantity of phosphoprotein was found in the EDTA-demineralized dentin matrices than in dentin after Gdn.HCl, CNBr and collagenase digests. These EDTA-demineralized matrices also remineralized to a greater extent than those dissociated with Gdn.HCl. The differences in both the quantity and the quality, as defined by the amino acid residue profile, of the phosphoprotein in the sequential extracts of the root apex dentin may be important in affecting the ability of this tissue to remineralize.
Adolescent↗
Endodontic treatment of bilaterally occurring 4-rooted maxillary second molars: case report.
The presence of 4-rooted maxillary second molars has been described in only a limited number of case reports. Studies of anatomical features have demonstrated substantial variation in the number of roots and root canals in different teeth. The maxillary second molar usually has 1, 2, or 3 roots and generally 3 or 4 root canals. This case describes the presence of 4 roots occurring bilaterally in maxillary second molars in one patient.
Adult↗
Secondary caries adjacent to amalgam restorations lined with a fluoridated dentin desensitizer.
PURPOSE: To determine the in vitro effect of a fluoridated dentin desensitizer solution (DentinBloc) on (1) secondary caries formation, and (2) the interfacial adaptation when used as a cavity liner before amalgam (Dis-persalloy) placement. MATERIALS AND METHODS: 24 macroscopically caries-free molars were selected. Class V cavity preparations on mesial and distal surfaces were placed along the cemento-enamel junction, providing an enamel margin and a root surface margin. DentinBloc was applied prior to alloy restoration in the experimental group for 60 s (the excess was removed with cotton pellets), while a copal cavity varnish (Copalite) was used before alloy restoration in the control group. Polarized light evaluation was performed on longitudinal sections (24 caries risk sites for enamel and dentin margins in each group). Alloy-tooth interfaces were evaluated by SEM. RESULTS: Wall lesions were present in 100% of caries-risk sites for the control group, while 58% of enamel risk sites and 50% of root risk sites had wall lesions in the DentinBloc group. Surface lesion depth was reduced 13% at enamel margins and by 18% at root margins in the experimental group when compared to the control group. Relatively small interface gaps between the alloy and tooth surfaces were seen in both groups, but these were less for the root surface margins (2-5 microns) than for the enamel margins (5-15 microns).
Analysis of Variance↗
Dentine tubule infection and endodontic therapy implications.
A critical review of the literature suggests that the microenvironment of dentinal tubules appears to favour the selection of relatively few bacterial types irrespective of the aetiology of the infection process; coronal dental caries or pulpar necrosis. These bacteria may constitute an important reservoir from which root canal infection and reinfection may occur following pulp necrosis or during and after endodontic treatment. Previous studies of this microflora have utilized microbiological culture techniques which need to be supplemented by those that allow in situ demonstration as well as identification of the bacteria. Newer treatment strategies that are designed to eliminate this microflora must include agents that can penetrate the dentinal tubules and destroy these microorganisms, since they are located in an area beyond the host defence mechanisms where they cannot be reached by systemically administered antimicrobial agents.
Bacterial Infections↗
Introduction to Bayesian modelling in dental research.
OBJECTIVE: To explain the concepts and application of Bayesian modelling and how it can be applied to the analysis of dental research data. BASIC DESIGN: Methodological in nature, this article introduces Bayesian modelling through hypothetical dental examples. SETTING: The synthesis of RCT results with previous evidence, including expert opinion, is used to illustrate full Bayesian modelling. Meta-analysis, in the form of empirical Bayesian modelling, is introduced. An example of full Bayesian modelling is described for the synthesis of evidence from several studies that investigate the success of root canal treatment. Hierarchical (Bayesian) modelling is demonstrated for a survey of childhood caries, where surface data is nested within subjects. RESULTS: Bayesian methods enhance interpretation of research evidence through the synthesis of information from multiple sources. CONCLUSIONS: Bayesian modelling is now readily accessible to clinical researchers and is able to augment the application of clinical decision making in the development of guidelines and clinical practice.
Bayes Theorem↗
Familial bilateral blepharoptosis and subvalvular aortic stenosis.
A boy and his mother with bilateral congenital blepharoptosis, downslanting palpebral fissures, hypertelorism, microcephaly, short nose with flattened nasal root, microstomia, prominent lateral palatine ridges, bifid (boy) hypoplastic (mother) uvula, generalized dental caries, short neck, peculiar voice and mild conductive deafness are reported. The boy had subvalvular aortic stenosis. The mother had pectus excavatum but not any signs or symptoms of cardiovascular defect.
Abnormalities, Multiple↗
Carious lesions on the roots of teeth: a review for the general practitioner.
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Bacteria↗
Intraradicular space: what happens within roots of infected teeth?
The pulpo-dentine complex is normally protected from exogenous substances in the oral cavity by the overlying enamel or cementum. Dental caries, dental trauma, enamel/dentine cracks, and restorative procedures commonly breach the integrity of enamel or cementum and may allow infection of the pulpo-dentine complex to occur, possibly leading to pulp and periapical inflammatory disease. Infection of the intraradicular space is a complex and dynamic process involving interactions between host and microbial factors. An understanding of these factors has led to the development of endodontic techniques that offer predictable success.
Dental Caries↗