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PubMedDate not supplied

Management of endodontic failures: case selection and treatment modalities.

General dentists should realize that endodontic failures can be retreated successfully, avoiding tooth loss. Retreatment of endodontic failure and initial root canal therapy share similar biologic principles and treatment objectives. The criteria for successful root canal therapy are important factors that must be understood before teeth are retreated. This article demonstrates three retreatment modalities for managing endodontic failures as an alternative to tooth extraction.

Dental Restoration Failure↗
PubMed1996

[Directly etched bridges. Experiences in 33 patients].

A study of immediately fabricated composite-etch bridges by using the crown of the extracted tooth as a pontic or by using a full-composite pontic is presented. The teeth to be replaced were to be extracted because of severe periodontal problems. The lifespan, the need for repair and possible advantages of this semi-permanent bridgework are discussed. The results indicate a favorable prognosis for this type of treatment in cases where there is a wish for postponing the insertion of removable partial dentures or extensive crown and bridgework.

Acid Etching, Dental↗
PubMedDate not supplied

A retrospective study of dental treatment under general anesthesia of children with or without a chronic illness and/or a disability.

BACKGROUND: The indications for dental treatment under general anesthesia have been described by various authors as extensive decay, behavioral management problems, a medically compromised patient, a handicapped patient, and a combination of these. Few studies have been undertaken to identify the range of treatment provided for chronically sick children. The aim of this study was to identify the characteristics of dental procedures performed under general anesthesia on children with a chronic illness and/or a disability, and compare these findings with other normal children. METHODS: A retrospective, comparative study was designed. Children who received comprehensive dental treatment under general anesthesia at Kaohsiung Chang-Gung Memorial Hospital, Taiwan, in 2002 were enrolled in this study. Patients with a chronic illness and/or a disability were included in group I, and other relatively normal patients were placed in group II. RESULTS: Group I children were significantly older than those of group II (p < 0.0001). Different patterns of dental treatment were noted when the 2 groups were compared. Significantly greater numbers of stainless steel crown build-ups (p = 0.028) and pulpal treatments (p = 0.003) were found among group II patients. There was no significant between-group difference in restorations (p = 0.934); however, group I had a significantly higher (p = 0.006) number of extractions. CONCLUSIONS: By comparing the different patient groups receiving comprehensive dental treatment under general anesthesia, it was found that patients with a chronic illness and/or a disability had a significantly higher average surgical age and fewer pulpal treatments, received fewer stainless steel crowns, and underwent more extractions. Providing early treatment for children with a chronic illness and/or a disability may improve their dental health and maintain full dentition so as to reduce the number of subsequent tooth extractions. Thus, it is highly recommended to refer these children at an earlier age to a hospital where tooth restoration under general anesthesia can be performed.

Anesthesia, General↗
PubMed2004

Mineralized bone loss in partially edentulous trabeculae of ovariectomized rabbit mandibles.

OBJECTIVE: The purpose of this study was to evaluate trabeculae changes in partially edentulous bone in ovariectomized rabbits. BACKGROUND: Numerous clinical studies have suggested that the greater risk for oral bone loss in females may be correlated with osteoporosis after menopause. Knowledge of trabecular changes in partially edentulous bone in animals with loss of ovarian function may be beneficial in the diagnosis and treatment of partially edentulous patients of postmenopausal women. METHODS: Twelve adult female Japanese white rabbits were examined. The mandibular incisors were initially extracted to simulate the partially edentulous bone. Six animals were bilaterally ovariectomized and the other six sham-ovariectomized 12 weeks after tooth extraction. The partially edentulous parts of distal mandibular bodies were processed undecalcified 12 weeks after ovariectomized or sham-ovariectomized surgeries and examined by quantitative trabecular bone histomorphometry. RESULTS: In ovariectomized rabbits, there were significant increases in trabecular separation, osteoid volume, osteoid thickness, osteoid width, eroded surface, and mineral apposition rate, and a significant decrease in trabecular number. CONCLUSION: The results of sparser trabecular structure, more trabecular osteoid, and increased trabecular bone turnover demonstrate mineralized bone loss in partially edentulous trabeculae of ovariectomized rabbit mandibles and suggest that the same loss may occur in postmenopausal women.

Analysis of Variance↗
PubMed2002

Healing of alveolar bone in resorbable and non-resorbable membrane-protected defects. A histologic pilot study in dogs.

Two main types of membrane barriers are used for bone regeneration, non-resorbable and resorbable. Polytetrafluorethilene non-resorbable membranes have been extensively studied but they require a second surgical step for removal. Although polylactic acid (PLA) resorbable membranes avoid this problem, they have not been sufficiently evaluated on bone defects. The purpose of this pilot study was to compare the healing events of bone regeneration after placement of non-resorbable or resorbable membranes and to evaluate the amount of newly formed bone 2 and 4 months after membrane placement. Mandibular second, third and fourth premolars of four adult mongrel dogs were extracted bilaterally. Two rectangular bone defects (8 mm corono-apical and 12 mm mesial-distal) were created bilaterally 3 months after tooth extractions. Each dog received two resorbable membranes and one non-resorbable membrane; one defect was left untreated. Two dogs were killed at 2 months and the remaining two at 4 months following surgery. Undecalcified sections were obtained and stained with toluidine blue and pyronin G. Histomorphometric analysis was performed using the NIH Image software. Newly formed bone was observed under both resorbable and non-resorbable membranes. The amount of regenerated bone was similar between both treatments at 2 and 4 months after surgery. At 2 months, the newly formed bone was still immature whereas at 4 months some areas of woven bone were observed. The bone formation observed in the untreated defects was significantly lower than that observed in both resorbable and non-resorbable membrane-protected defects. In summary, the present study suggests that PLA membranes can yield good results when used on bone defects while avoid a second surgical procedure.

Animals↗
PubMed1992

The effectiveness of the air-powder abrasive device for root planing during periodontal surgery.

The efficacy of the air-powder abrasive device (APAD) in root planing during flap surgery was assessed in vitro and in vivo. Two teeth on which full-thickness flaps were raised underwent root planing by hand-scaling alone and hand-scaling combined with APAD. One tooth extracted prior to surgery underwent unrestricted hand-scaling under a binocular microscope (control). The two teeth root planed in situ and the tooth root planed in vitro were observed by scanning electron microscopy (SEM). Then, 10 patients with periodontitis requiring flap surgery were selected for a clinical study. After raising full-thickness flaps, 29 sites from five patients underwent root planing using hand-scaling combined with APAD, whereas 22 sites from six patients underwent root planing by hand scalers only. SEM revealed that root surfaces planed in situ by hand-scaling combined with APAD were smoother than those root-planed using hand scalers alone. The control tooth surface was as smooth as those submitted to combined root planing. The clinical study showed that sites submitted to combined root planing displayed enhanced attachment level gain and pocket reduction. These results, associated with the shortened instrumentation time, suggest APAD as a useful instrument for root planing during flap surgery.

Air↗
PubMed2001

Endoscopic extraction of an intranasal tooth: a review of 13 Cases.

OBJECTIVE: To present the clinical experience of a series of 13 consecutive cases of an intranasal tooth treated by endoscopic extraction during a 15-year period. STUDY DESIGN: Retrospective review. METHODS: The records of 13 patients who underwent endoscopic extraction of an intranasal tooth at Taipei Medical University Hospital and Chang Gung Memorial Hospital between 1986 and 2000 were reviewed. RESULTS: All the patients had an uneventful recovery and the presenting symptoms were completely relieved after surgery. The follow-up period was 6 months to 14 years 5 months (average, 9 yr 2 mo). Examination of these extracted teeth showed that 11 were supernumerary teeth and two were ectopic permanent canine teeth. CONCLUSIONS: Endoscopic extraction of the intranasal tooth has the advantages of good illumination, clear visualization, and precise dissection, and in our experience the result of endoscopic extraction of an intranasal tooth is satisfactory. We recommend the routine use of a rigid endoscope in the treatment of an intranasal tooth.

Adolescent↗