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PubMed1998

The buccal bifurcation cyst: in non-surgical treatment an option?

The mandibular buccal bifurcation cyst (BBC) was first described by Stoneman and Worth in 1983. It is a lesion with a specific location, classically the buccal surface of the mandibular first molar and less frequently the mandibular second molar. There have been numerous reports in the literature describing the BBC and its treatment. Treatment advocated thus far includes extraction of the involved first molar, marsupialization and enucleation of the cyst. In their most recent article, Pompura, Sándor and Stoneman reported on the successful treatment of 44 cysts with enucleation without tooth extraction. This article will describe the diagnostic features of the BBC and present three cases with a total of five cysts, which were treated non-surgically and ultimately resolved. The authors, therefore, propose that a more conservative non-surgical approach to these lesions may be considered.

Cheek↗
PubMed1996

Apical root strain as a function of post extension into a composite resin core.

This study tested the hypothesis that there is no difference in the amount of strain measured in the root of an extracted tooth at the apical end of a prefabricated post, whether a composite resin core completely covers the head of the post or the post is exposed at the occlusal surface of the core. Twenty extracted teeth were measured (1) after endodontic treatment (baseline), (2) after a composite resin core was fabricated over a prefabricated post, and (3) after a cast crown was cemented. The teeth were randomly divided into two groups after baseline testing. In group 1, the post was buried within the core, and in group 2, the head of the post was exposed on the occlusal surface of the core. Analysis of results indicated a statistically significant decrease in strain from the baseline to the crown when 1 mm of composite resin covered the head of the post. However, based on the small strain values measured, the difference may not be clinically significant.

Composite Resins↗
PubMed2005

Fibrin adhesive implant in wound healing repair of dental sockets with topical application of epsilon aminocaproic acid: histological analysis.

The aim of the study was to evaluate wound healing repair of dental sockets after topical application of 5% epsilon-aminocaproic acid (EACA) and the use of fibrin adhesive implant in rats under anticoagulant therapy with warfarin. Sixty Albinus wistar rats were used, divided into three groups of 20. In Group I, the animals were given 0.1 mL/100 mg of 0.9% saline solution per day, beginning 6 days before dental extraction and continuing throughout the experimental period. In Group II, the animals received 0.03 mL of sodium warfarin daily, beginning 6 days before the surgery and continuing until the day of sacrifice; after tooth extractions, the sockets were filled with fibrin adhesive material. In Group III the animals were treated as in Group II, and after extractions, the sockets were irrigated with 5 mL of 5% EACA and filled with the same fibrin adhesive material. All groups presented biological phases of wound healing repair, the differences being evident only in the chronology. The results obtained in Group III were very similar to those of Group I in the last period of wound repair, whereas Group II presented a late chronology compared to the other groups.

Administration, Topical↗
PubMed1994

Effect of a combined chlorhexidine and NaF mouthrinse: an in vivo human caries model study.

Chlorhexidine (CHX) is probably the most widely used and the most potent chemical plaque inhibitory agent, whereas fluoride (F-) is the only truly accepted anticaries agent available at present. As they have discrete mechanisms of action, a combination effect of these agents on human dental caries may exist. The inhibitory effect of CHX on the formation of, and acid production in, plaque may reduce a relatively extreme cariogenic challenge sufficiently for it to be overcome by the local F- concentrations achieved by brushing or rinses. The aim of this study was to evaluate the possible caries inhibitory effect of combining 2.2 mM CHX mouthrinses used twice daily with daily 11.9 mM NaF rinses in an in vivo human caries model using plaque-retaining bands on premolars scheduled for extraction. Nine subjects (a total of 28 teeth) were fitted with the bands for 4 wk. Saliva and plaque samples were collected before and after the study period for bacterial cultures, and the tooth surfaces were analyzed by microradiography after careful tooth extractions. The combination of CHX and F- rinses resulted in enamel mineral loss only slightly higher than that observed in "sound" enamel and clearly less than with F- rinses alone. Both total plaque bacteria and Streptococcus mutans were reduced by CHX rinses, confirming the discrete mechanisms of action.

Adolescent↗
PubMed1992

[Preliminary research on the prognosis of late reimplants with prior conditioning with a fluoridated solution].

The principal factors that affect the prognosis of a posttraumatic reimplantation are the length of the extra-alveolar persistence and the manner in which the extracted tooth is preserved. Both are fundamental for the maintenance of the fiber vitality of the periodontal ligament. The necrosis of these fibers cause ankylosis. It is observed that the conditioning of the radicular surface with fluoride solutions before the reimplantation is likely to slow down the evolution of radicular resorption. To evaluate the effectiveness of such methodology six cases of traumatic extractions, characterized by a length of extra-alveolar persistency (not longer than 24 hours), and unfavorable conditions of the preserved tooth have been treated by conditioning the radicular surface with the Na-fluoride solution before the reimplantation. Another group of reimplantation cases with the same characteristics have been examined without proceeding first to the radicular conditioning. The results of the study, although preliminary, verified the positive influence of the Na fluoride upon the radicular resorption.

Follow-Up Studies↗
PubMed1990

[Segmental surgery of the maxilla: the long-term assessment of the dental-periodontal integrity of the osteotomized sites].

Segmentary surgery of the jaws has increased the possibilities of therapeutic orthognathodontic surgery, allowing osteo-dental segments to be moved three-dimensionally to achieve a satisfactory occlusion. One of the potential limits of this method is the possibility of damaging the dental-periodontal structures bordering with the site of osteotomy. The aim of this study was to report the results of a long-term clinical and radiological survey in a group of patients undergoing segmentary surgery, performed without tooth extraction.

Adult↗
PubMed1996

Possible paroxetine-induced bruxism.

OBJECTIVE: To report the case of a patient with possible paroxetine-induced bruxism that was effectively treated with buspirone. CASE SUMMARY: A 20-year-old woman with no active medical conditions besides acne and no history of dental problems was seen in an outpatient psychiatry clinic for the evaluation of ongoing depression. The patient was prescribed paroxetine 10 mg every morning. After 5 days of therapy the patient reported no adverse effects, and the paroxetine dosage was increased to 20 mg every morning. Due to increased somnolence, the dosing schedule was subsequently changed to 20 mg hs. Two months later during a dental visit for a tooth extraction, the dentist noted that the patient's teeth appeared damaged in what he believed to be a pattern consistent with the grinding and clenching of teeth. Prior to this time, dental examinations had not revealed any tooth damage. The patient was thought to have paroxetine-induced bruxism and, based on earlier case reports, was treated with buspirone 5 mg hs. On day 4 of buspirone therapy the patient reported a significant reduction in the extent of gritting, tooth pain, and jaw tenderness. DISCUSSION: The selective serotonin reuptake inhibitors (SSRIs) fluoxetine and sertraline have been associated with bruxism in previous reports. This case suggests paroxetine-induced bruxism. The exact mechanism of SSRI-induced bruxism remains unclear. Many theories have been proposed, including sleep disturbance, serotonergic-mediated inhibition of dopamine manifesting as akathisia, and SSRI-induced anxiety. According to published reports, SSRI-induced bruxism may respond to therapy with buspirone. Consistent with these reports, this patient responded favorably to buspirone therapy. CONCLUSIONS: Clinicians should be aware that the potential for paroxetine-induced bruxism exists and that buspirone may be an appropriate therapeutic intervention.

Adult↗
PubMedDate not supplied

Immediate implant placement and provisionalization using implants with an internal connection.

Single-tooth implant restoration has evolved from traditional two-stage surgical procedures to techniques that allow implant placement and provisionalization immediately following tooth extraction. Restorative success using an immediately provisionalized implant system is based upon adherence to several clinical and biological parameters. This article will discuss the clinical and restorative considerations that must be addressed when immediately loading single-tooth implants. Four cases are presented demonstrating the clinical versatility of an immediate implant system for predictable and aesthetic restoration of the posterior region.

Adult↗
PubMed2002

Evaluation of lymphocyte populations and subpopulations extracted from inflamed periodontal tissues.

The aim of the present study was evaluation the distribution of B- and T-cells and T-cell subsets in periodontal tissues from patients with different periodontitis forms. Periodontal tissue samples were collected from group P patients during routine surgical procedures, while from group C during tooth extraction for orthodontic or prosthetic purposes. Directly after collection, tissue samples were placed in a criostat or fixed in 10% buffered formalin for 24 h at room temperature. Following fixation the material was embedded in paraffin and subjected to routine histological techniques. Examinations of B- and T-lymphocytes populations and T-lymphocytes subsets were made with the use of immunohistochemical method. In C group single T and B lymphocytes were found in histological examination in pocket epithelium zones. In early onset periodontitis (EOP) patients in inflammatory infiltration lymphocytes T were dominating while in adult periodontitis (AP) patients dominating were B lymphocytes. Mean CD4/CD8 ratio in control group was 1.7 and in EOP and AP patients 1.1 and 2.6 respectively.

Adult↗
PubMed2004

Extraction sockets and implantation of hydroxyapatites with membrane barriers: a histologic study.

The purpose of this pilot study was to investigate the effect on extraction socket healing when an absorbable hydroxyapatite (AH) and a nonabsorbable anorganic bovine bone mineral (ABB) covered with either an acellular dermal matrix allograft (ADMA) or expanded polytetrafluoroethylene (ePTFE) membrane barrier were left exposed to the oral cavity. Following tooth extraction, a total of 16 sockets in 15 patients with deficient buccal plates of > or =5 mm were randomly divided into 4 treatment groups: 1) AH covered with ADMA, 2) AH covered with an ePTFE membrane, 3) ABB covered with ADMA, and 4) ABB covered with an ePTFE membrane. Primary coverage was not attempted or obtained in any of the 16 treated sockets. Six to 8 months postextraction at the time of implant placement, histologic cores of the treatment sites were obtained. These cores were processed, stained with Stevenel's blue/van Gieson's picro fuchsin, and histomorphometrically analyzed. Vital bone, connective tissue and marrow, and residual graft particles were reported as a percentage of the total core. The mean vital bone was 34.5% (AH with ADMA), 41.7% (ABB with ADMA), 27.6% (ePTFE and AH), and 17.8% (ePTFE and ABB). The average percentage of vital bone in the 8 sockets covered with ADAMA was 38% compared with an average percentage vital bone of 22% in the 8 sockets covered with ePTFE membrane barriers. Because of the small number of specimens in the 4 groups, statistical analysis was not possible. However, in this pilot study, ADMA-covered sites resulted in more vital bone present 6 to 8 months postsocket treatment than obtained in the ePTFE-covered sites regardless of bone replacement materials used. Further research is warranted to see if these results show a similar difference in bone-to-implant contact after implant placement.

Adult↗
PubMed1995

Clinical diagnosis of internal resorption: an exception to the rule.

This paper describes a case in which the radiographic appearance of a resorptive lesion in a mandibular incisor tooth posed difficulty in the diagnosis of its origin. The lesion did not conform to the normally accepted criteria for diagnosis of internal resorption. Clinical examination did not support the diagnosis of external cervical resorption. Serial histological section of the extracted tooth subsequently confirmed the diagnosis of internal resorption. The criteria for differential diagnosis of resorptive lesions with smooth outlines in the cervical regions of teeth are discussed together with the rationale for their management.

Adult↗
PubMed1991

An in vivo study of dentin sensitivity: the relation of dentin sensitivity and the patency of dentin tubules.

Dentin hypersensitivity can be a major problem for periodontal patients. The relationship between dentin hypersensitivity and the patency of dentin tubules in vivo has been established. Thirteen adult patients with teeth scheduled for extraction were selected and a stent fabricated to confirm location of the root surface being examined. Response to a constant air blast was recorded on a numeric pain rating scale (from 0 to 4) during the course of treatment. The tooth surface was initially treated with 0.5 molar EDTA (pH = 7.4), to remove the smear layer and expose tubules. The region was then treated with either a 3% monopotassium-monohydrogen oxalate solution or a 3% sodium chloride solution, both at pH = 2.4. Solutions were prepared to be indistinguishable to the examiner. Response to air was evaluated before and after EDTA treatment and after treatment with a desensitizing agent. The patient was anesthetized and the treated tooth extracted. Specimens were sectioned, critical point dried, sputter coated with gold, and examined under the scanning electron microscope. Photomicrographs were analyzed by computer assisted digital analysis to evaluate the degree of tubule occlusion. Statistical analysis by repeated measures ANOVA for univariate tests of hypothesis for within subject effects showed the sodium chloride solution was more effective in reducing dentin sensitivity than the potassium oxalate solution. Scanning electron micrographic analysis revealed a mean dentin tubule aperture size of 1.720 square microns following EDTA treatment alone, 0.564 square micron following potassium oxalate treatment, and 0.386 square micron following sodium chloride treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Intentional replantation of a removable partial denture abutment tooth: a case report.

Intentional tooth replantation is a last-resort procedure, recommended only when all other techniques, short of tooth extraction, have been exhausted or are impractical. Although most endodontic textbooks describe the procedure, and many reports of intentional replantation have appeared in the dental literature, none have reported use of the technique to retain a removable partial denture abutment tooth. This article presents such a case and the rationale for the decision to intentionally replant. Eighteen-month follow-up clinical and radiographic results are presented.

Bicuspid↗