Research progress on conservative endodontic access cavities and its stress analysis of teeth / 口腔疾病防治

@#Conservative endodontic access cavity (CEC) is the first step of minimally invasive endodontics. After that operation, teeth retain the dental hard tissue, such as crest and peri-cervical dentin, to a large extent. It is of great significance to reduce the tissue excision and achieve a favorable prognosis. There are a variety of approaches and corresponding cavities in CEC. The methods to determine the medullary approach include X-ray localization, micro CT/cone beam CT localization and digital guide plate localization. Among them, X-ray film and micro CT/cone beam CT are simple and commonly used in the clinic. For more complex root canal systems, the use of a digital guide plate can establish a more accurate pulp opening pathway and reduce the unnecessary loss of tooth hard tissue. However, the positioning price of a digital guide plate is high, and it has not been widely used in the clinic. The hole types of CEC include minimally invasive medullary hole type, super conservative minimally invasive medullary hole type, "Truss" hole type and cutting end hole type. The stress analysis of CEC and traditional endodontic access (TEC) cavity are mainly based on the loading of teeth by a universal mechanical testing machine in vitro, finite element analysis and clinical observation. Most scholars’ studies have shown that minimally invasive endodontics can improve the fracture resistance of teeth, but the differential capacities of CEC and TEC remain controversial. How does on balance the purpose of pulp treatment and the maximum retention of tooth tissue? Further exploration is still needed.

The infection control method for early radiation therapy in the head and neck cancer patients with advanced odontogenic infectious lesions : report of cases

The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head and neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision and drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

The infection control method for early radiation therapy in the head and neck cancer patients with advanced odontogenic infectious lesions : report of cases

The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head and neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision and drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

Estudo comparativo da ação do formocresol e glutaraldeído pós-pulpotomia: revisão de literatura / Comparative study between formocresol and glutaraldehyde in pulpotomy: literature review

As exposições pulpares ocasionadas por lesões de cárie ou traumas, na dentição decídua, frequentemente resultam na necessidade de pulpotomia, compreendida pela remoção do tecido que preenche a câmara pulpar - ou seja, polpa coronária - e proteção do remanescente radicular com um medicamento. Tal procedimento conservador pulpar está indicado em dentes decíduos que se encontrem em fase inicial do processo de rizólise ou, idealmente, naqueles em que tal processo ainda não tenha se iniciado, além dos que apresentarem características inflamatórias reversíveis, requisito básico para a manutenção da vitalidade pulpar. A presente investigação teve por objetivo contribuir para a decisão terapêutica acerca do uso do formocresol ou glutaraldeído como agentes químicos nas pulpotomias de dentes decíduos. A conclusão é que tanto o formocresol como o glutaraldeído não são fármacos totalmente biocompatíveis, no entanto a pulpotomia seguida do uso do glutaraldeído sugere ser superior àquela com formocresol, pois apresenta menor índice de reações pulpares indesejáveis, quando usado a 2% por tempo igual a 5 minutos

The pulps exposures caused by caries lesions or trauma, in deciduous teeth, frequently result in pulpotomy. Pulpotomy is the removal of the tissue that fills the camera pulp ­ that is to say, coronary pulp ­ and also the protection of the remaining root pulp with medication. This conservative procedure is recommended to deciduous teeth in the initial phase of the root reabsorption process or ­ even better ­ when the process hasn't occurred yet. Besides, they present reversible inflammatory characteristics, basic requirement to maintain the pulp vitality. The present study aims at determining if one should make therapeutic use of the formocresol or glutaraldehyde as chemical agents in the pulpotomy of deciduous teeth. The conclusion is that the formocresol as well as the glutaraldehyde are not totally innocuous materials. However, the pulpotomy with glutaraldehyde seems to present better results than that one, because it presents a lower rate of undesirable pulp reactions, when used at 2% for a 5-minute period.