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PubMed1999

Aesthetic restoration of endodontically treated teeth.

The utilization of all-ceramic anterior restorations has been widely advocated by dental clinicians for the creation of a natural appearance, even in teeth that have undergone endodontic treatment. A suitable aesthetic level is generally more difficult to achieve, however, when a post and core system is required in the absence of adequate dental structure. In particular, conventional cast-metallic posts negate light transmission, which has long been considered a vital component in the creation of optimal aesthetics. This article provides an overview of the materials, fabrication methods, and procedures involved in anterior reconstruction using aesthetic alternative systems and solutions.

Ceramics↗
PubMedDate not supplied

Managing the endodontic patient with disabling anxiety or phobia.

Disabling anxiety and phobia are commonly encountered in dental practice. Successful management of these patients is especially important in endodontic practice, where patients are often compelled to seek treatment because of acute or threatened pain. This article reviews the recognition and management of these common disorders. Mild anxiety can be managed with oral sedatives and/or nitrous oxide; however, moderate to severe anxiety and phobia is best treated with deep sedation or general anesthesia.

Anesthesia, Dental↗
PubMed1999

[Possibilities and efficacy of treating perio-endodontic syndrome type III].

The aim of the investigation was to assess two methods of the treatment of III type perio-endo syndrome by Simon, Glick and Frank. In group I only periodontic treatment was performed including scaling, root planing and curettage. In group II periodontic treatment was supplemented by endodontic therapy. The results were registered by: Plaque Index, Sulcus Bleeding Index, Sulcus Fluid Rate, Bone Lost Index EMR, pocket depth and tooth mobility; before treatment, 7 days after treatment, 6 weeks and 6 months after treatment. In group II in selected cases (teeth with vital pulp and pocket depth more than 6 mm), microbiological examination of the dental pulp and dental plaque from the pocket was carried out. The results showed that the periodontal therapy was not effective. In first group, after 6 months the teeths mobility was extend, the pocket depth was reduced by 1 mm only, in gingiva there was registered still with chronic inflammation and the bone growth was not significant. In the second group the teeth mobility was less significant, the pocket depth was reduced more than 3.5 mm, in 21% persons the gingiva was in good health condition and the bone growth was significant (7.5%). The anaerobic bacteria were incubated in 9 probes of dental pulp for 10 examinations.

Adult↗
PubMed2000

[IgE allergy due to formaldehyde paste during endodontic treatment. Apropos of 4 cases: 2 with anaphylactic shock and 2 with generalized urticaria].

We report 4 cases of allergic reaction to formaldehyde-containing root canal sealant after endodontic care: 2 anaphylactic shocks and 2 local reactions with generalized urticaria. Allergic IgE mediated mechanisms were suggested by the clinical presentation, skin tests and high levels of anti-formaldehyde IgE. These infrequent but potentially severe reactions after canal treatment led us to examine the involved mechanisms, the diagnostic procedure and the possibility of prevention in odontostomatology.

Adult↗
PubMedDate not supplied

Treatment of endodontic perforations by guided tissue regeneration.

Case reports of mandibular molars with iatrogenic perforations are presented. Such perforations have been treated with internal amalgam repair or by surgical intervention. However, the potential exists for tissue migration and pocket formation. The use of guided tissue regeneration as a barrier for apical migration is beneficial in surgical treatment of perforations. Follow-up examination of perforated teeth treated with resorbable barriers showed successful repair. Results obtained with this technique offer the possibility of a successful repair for an otherwise hopeless complication of endodontic therapy.

Absorbable Implants↗
PubMed2001

Evaluation of Er:YAG laser and EDTAC on dentin adhesion of six endodontic sealers.

The effect of Er:YAG laser application and EDTAC on the adhesion of epoxy resin-based endodontic sealers to human dentin was evaluated in vitro. A total of 99 extracted human maxillary molars with their crowns worn flat were used. The teeth were divided into 3 groups: group 1, the dentin surface received no treatment; group 2, EDTAC was applied to the dentin surface for 5 min; group 3, the dentin surface received Er:YAG laser application (2.25 W potency; 11 mm focal distance; 4 Hz frequency; 200 mJ energy; 62 J total energy; 313 mean impulse). Three teeth from each group were analyzed by scanning electron microscopy for changes in dentin surface. The epoxy resin root canal sealers used were: AH Plus, Topseal, Sealer 26, AH 26, and Sealer Plus. The zinc oxide eugenol-based sealer Fillcanal was used as control. Adhesion was measured with a Universal testing machine. The results showed a statistically significant difference at the level of 1% among the dentin treatments. The dentin treated with Er:YAG laser showed greater adhesion with the sealers than dentin treated with EDTAC which was greater than dentin that received no treatment. The Tukey test showed the formation of 5 groups in decreasing order of adhesion: AH Plus, Topseal and Sealer 26, AH 26, Sealer Plus, and Fillcanal (Grossman cement).

Adhesives↗
PubMedDate not supplied

Comparative evaluation of strength of various core restorative materials for endodontically treated anterior teeth.

In the present study, four restorative materials were used for the restoration of endodontically treated anterior teeth and their strength were compared with that of natural teeth. 100 freshly extracted Maxillary Central Incisors were used. The teeth were restored with Pin-retained amalgam-core buildups, Dowel-post with Glass ionomer-Amalgam alloy combination Cast Core build up. The natural tooth showed the maximum strength. Though some of the restorative materials showed promising results, none of them is able to show strength anywhere near to that of natural tooth.

Cementation↗
PubMed2001

[The preprosthetic preparation of the endodontically treated abutment tooth. Post and core technique: a questionnaire analysis].

The goal of the questionnaire was to determine the materials and methods that general dentists in Switzerland at present use for the treatment of non-vital abutment teeth. Questionnaires were sent to 1000 dentists from a computer generated random sample of the list of members of the SSO (Swiss Dental Society). The return ratio was 36%. The responses provided information on the current philosophies and prevailing techniques used to restore endodontically treated abutment teeth. Most of the answering dentists believed it was necessary to stabilize a root treated tooth with a post. The preferred restoration in anterior teeth was the cast post and core, while composite resin build-up with a prefabricated post was predominantly made for posterior teeth. Conical or combined cylindrical-conical posts, which had a sand-blasted surface, were predominantly used. Most of the answering dentists strove to stabilize the remaining tooth structure by circular enclosure of the tooth structure by the later crown (ferrule effect). Zinc phosphate cement was still preferred for cementation of metal posts and ceramic posts were most often fixed with the help of the acid etching technique. The most frequently described failures were retention loss or root fractures.

Acid Etching, Dental↗
PubMedDate not supplied

Development and treatment of retrograde peri-implantitis involving a site with a history of failed endodontic and apicoectomy procedures: a series of reports.

Osseointegrated implants provide predictable restorative support for crowns, restorations, prosthesis abutments, and removable dentures. Their widespread use in recent years has produced different types of complications. Retrograde peri-implantitis, a lesion occurring at the periapical area of an osseointegrated implant, has recently been described. This paper presents a series of reports describing the occurrence and management of retrograde peri-implantitis involving implants replacing teeth with histories of failed endodontic and apicoectomy procedures.

Aged↗
PubMed2001

Calcific metamorphosis: a challenge in endodontic diagnosis and treatment.

Calcific metamorphosis (CM) is seen commonly in the dental pulp after traumatic tooth injuries and is recognized clinically as early as 3 months after injury. Calcific metamorphosis is characterized by deposition of hard tissue within the root canal space and yellow discoloration of the clinical crown. Opinion differs among practitioners as to whether to treat these cases upon early detection of CM or to observe them until symptoms or radiographic signs of pulpal necrosis are detected. In this review, the clinical, radiographic, and histopathologic appearance of CM is described; a review of the literature is presented to address these issues in an attempt to establish a sound rationale for treatment. Approximately 3.8% to 24% of traumatized teeth develop varying degrees of CM. Studies indicate that of these, approximately 1% to 16% will develop pulpal necrosis. Most of the literature does not support endodontic intervention unless periradicular pathosis is detected or the involved tooth becomes symptomatic. It may be advisable to manage cases demonstrating CM through observation and periodic examination.

Dental Pulp Calcification↗
PubMed2000

[Test your decision-making. When to do endodontic retreatment? Some therapeutic alternatives].

The aim of the present article was to propose examples of treatment alternatives for the management of 14 clinical cases. All these cases involved endodontically treated teeth and have been managed by the same practitioner. In this paper, the authors tried to show the variety of treatment alternatives as well as the complexity of the decision-making process and, not to consider that proposed alternatives were the most adequate.

Adult↗
PubMed2001

A case report of reattachment of fractured root fragment and resin-composite reinforcement in a compromised endodontically treated root.

The composite reinforcement technique has been used clinically to salvage damaged root-filled teeth compromised by caries, trauma, developmental abnormalities, internal resorption and iatrogenic causes. This clinical case report describes the use of the technique to reattach a fractured fragment in a compromised endodontically treated root besides reinforcing it for continued function in the mouth. Factors of clinical importance related to this additional application; including reattachment of tooth fragments, post crown retention, coronal microleakage and fracture resistance and strength, are also briefly discussed.

Acid Etching, Dental↗
PubMed2001

[Clinical study on preventing endodontic interappointment pain with dexamethasone].

OBJECTIVE: To investigate the effect decreasing of the incidence of endodontic interappointment pain(EIP) by local injection of 5 mg dexamethasone. METHODS: 5 mg dexamethasone was injected submucosally at apical region of 80 teeth with asymtomatic pulp necrosis after root canal therapy, then observing the incidence of EIP and compared with control group. RESULTS: The clinical observation revealed that the incidence of EIP of dexamethasone group (10.00%) was lower than that of control group (33.75%), P < 0.01, and the level of pain was decreased. Ordinal logistic regression revealed that EIP was related to tooth location, fistula, and root canal therapy. CONCLUSION: The incidence of EIP can be reduced after 5 mg dexamethasone local injected.

Adult↗
PubMed2000

Endodontic anatomy of the root canals of lower incisors.

Ninety lower incisors of known age (18 to 20 yr, 30 to 40 yr and over 50 yr) were grouped into 2 sets of 45 pieces each. Cross sections of the root at 4 levels (coronal, middle and apical thirds and 2 mm from the apex) were employed to study: 1. The shape of the canals 2. The changes in diameter induced by age 3. The correlation at the apex of the maximum diameter of the root canal with the Dzero diameter of endodontic instrument. The results showed that the canal anatomy of lower incisors is not as simple as it appears to be and that it is characterized by the predominance of flat shapes even in the vicinity of the foramen. The statistical analysis showed that the dentin deposits, typically age-associated, are influenced by the morphological changes that take place. A true compensation occurs between the different buccolingual and mesiodistal diameters, particularly in the vicinity of the apex, to guarantee irrigation in old age and avoid calcification fo the canal. The correlation between the maximum diameter of the canal at 2 mm from the apex and the Dzero diameter of the instruments evidenced the difficulties involved in adequate apical preparation of these teeth, regardless of age.

Adolescent↗
PubMed2001

The application of digital radiography and radiodensitometry in evaluation of chronic fibrous periapical changes of endodontically untreated teeth.

Lesions in hard tissues of teeth can be detected on radiograms only when there exists considerable decrease in mineralisation. By means of digital radiography the diagnostics of dental pathologies becomes more precise and objective. The aim of the paper was the radiodensitometric evaluation of chronic fibrous periapical changes. The material comprised 308 digital intraoral radiograms of teeth with periapical changes among which there were chosen the cases of clinically confirmed chronic fibrous periapical inflammations of endodontically untreated teeth. All radiograms were analysed in the Digora Soredex digital radiography system in gray scale, in full colour and using the tomosynthesis function. The linear measurements of root densities were carried out at the distance of 1 mm from radiological apices while the measurements of alveolar bone at the distance of 2 mm from it. Twenty-five teeth without evident periapical changes formed the control group. There were found significantly lower densities of roots and alveolar bone in the group of chronic fibrous periapical lesions in comparison with the control group. A characteristic feature of chronic fibrous periapical changes is the density of the root of an affected tooth that is higher than in acute inflammation and at the same time lower than in the control group. The radiodensitometry proved to be useful in evaluation of chronic fibrous periapical changes.

Absorptiometry, Photon↗
PubMed2002

Endodontic patency. How to get it. How to keep it. Why it is so important.

Complete elimination of the root canal contents is imperative for predictable endodontic success. Establishing and maintaining apical patency of the root canal system is critical for proper cleaning, shaping and obturating objectives, despite timidity about this region in the past. Contemporary concepts are discussed.

Anti-Infective Agents, Local↗