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Acute pulpal-alveolar cellulitis syndrome V. Apical closure of immature teeth by infection control: case report and a possible microbial-immunologic etiology. Part 1.

Das with Matusow and Goodall previously noted the rapid clinical apexogenesis of nonvital immature permanent teeth that are involved with an acute endodontic cellulitis. This apexogenesis was achieved by control of infection and by nonspecific intracanal medication without the use of calcium hydroxide. The case report confirms the clinical observations. The experimental canine endodontic cellulitis in a Cebus primate was induced as an immunologic pulp infection with a facultative Streptococcus species. The noted epithelial proliferation and organization into lacelike strands and bilaminar loops, similar to Hertwig's epithelial root sheath in root development, appear to be immunologic and genetic in origin, with an acceleration of the root maturation process.

Animals

Evaluation of Gram's method of staining for the prognosis of root canal treatment in nonvital dental pulps.

An evaluation of Gram's method of staining of 601 nonvital dental pulps was performed. It gave positive results in 60.1% of the cases, the most frequent finding was gram-positive cocci. Preoperative x-ray status correlated significantly with the staining results but the size of the radiolucency did not. Previously treated teeth gave less positive staining results than other teeth. There was an obvious correlation between presence of bacteria and various complications (p < 0.001), but no differences were noted between the combinations of bacteria. The teeth that were the most resistant to complications seemed to be the lower canines. The staining results did not correlate with sex, systemic diseases, or preoperative symptoms. We believe that Gram's method of staining is a useful, rapid aid in root canal therapy, especially in complicated cases.

Adolescent

Long-term effects of segmental alveolar osteotomy.

The long-term effects of segmental alveolar osteotomy are reviewed. Thirteen patients attended a follow-up appointment between 5 and 9 years after operation and investigations related to the teeth, their supporting structures and the osteotomy bone cuts. The teeth involved in the osteotomies which gave a vital response after 1 year with ethyl chloride all maintained this response in the long term and about half the number of the teeth not responding at 3 years had recovered this response after 5 years or more. The incidence of periodontal pocketing, non-vital teeth and tooth mobility was low. There was radiographic evidence of the osteotomy bone cuts in more than half of the cases in the long term, although clinically, union had occurred in all cases. The occlusion was stable in all except one class II div. 2 case, which had been treated by lower segmental osteotomy only, where relapse had occurred.

Adolescent