Cold Allodynia after C2 Root Resection in Sprague-Dawley Rats

OBJECTIVE: The purpose of this study was to evaluate pain-related behaviors after bilateral C2 root resection and change in pain patterns in the suboccipital region in rats. METHODS: Male Sprague-Dawley rats were randomly assigned to three groups (n=25/group); näive, sham, and C2 resection. Three, 7, 10, and 14 days after surgery, cold allodynia was assessed using 20 μL of 99.7% acetone. c-Fos and c-Jun were immunohistochemically stained to evaluate activation of dorsal horn gray matter in C2 segments of the spinal cord 2 hours, 1 day, 7 days, and 14 days after surgery.

Cold Allodynia after C2 Root Resection in Sprague-Dawley Rats

OBJECTIVE: The purpose of this study was to evaluate pain-related behaviors after bilateral C2 root resection and change in pain patterns in the suboccipital region in rats.METHODS: Male Sprague-Dawley rats were randomly assigned to three groups (n=25/group); näive, sham, and C2 resection. Three, 7, 10, and 14 days after surgery, cold allodynia was assessed using 20 μL of 99.7% acetone. c-Fos and c-Jun were immunohistochemically stained to evaluate activation of dorsal horn gray matter in C2 segments of the spinal cord 2 hours, 1 day, 7 days, and 14 days after surgery.RESULTS: Three days after surgery, the response to acetone in the sham group was significantly greater than in the näive group, and this significant difference between the näive and sham groups was maintained throughout the experimental period (p < 0.05 at 3, 7, 10, and 14 days). Seven, 10, and 14 days after surgery, the C2 root resection group exhibited a significantly greater response to acetone than the näive group (p < 0.05), and both the sham and C2 resection groups exhibited significantly greater responses to acetone compared with 3 days after surgery. No significant difference in cold allodynia was observed between the sham and C2 root resection groups throughout the experimental period. Two hours after surgery, both the sham and C2 root resection groups exhibited significant increases in c-Fos- and c-Jun-positive neurons compared with the naive group (p=0.0021 and p=0.0358 for the sham group, and p=0.0135 and p=0.014 for the C2 root resection group, respectively). One day after surgery, both the sham and C2 root resection groups exhibited significant decreases in c-Fos -positive neurons compared with two hours after surgery (p=0.0169 and p=0.0123, respectively), and these significant decreases in c-Fos immunoreactivity were maintained in both the sham and C2 root resection groups 7 and 14 days after surgery. The sham and C2 root resection groups presented a tendency toward a decrease in c-Jun-positive neurons 1, 7, and 14 days after surgery, but the decrease did not reach statistical significance.CONCLUSION: We found no significant difference in cold allodynia and the early expression of c-Fos and c-Jun between the sham and C2 resection groups. Our results may support the routine resection of the C2 nerve root for posterior C1–2 fusion, but, further studies are needed.

Evaluación de la frecuencia, ubicación y tipos de itsmos en raíces mesiobucales de primeros molares maxilares: un estudio ex vivo / Evaluation of Isthmus frequency, location, and types in mesiobuccal roots of first maxillary molars: an ex vivo study

El objetivo fue describir la configuración interna del sistema canalicular de la raíz mesiobucal (MB) del primer molar maxilar, identificando el número de canales junto a la frecuencia, ubicación y tipos de itsmo a 1, 3 y 5 mm del ápice. Esta investigación fue aprobado por el comité de ética. Se realizó un estudio descriptivo ex vivo de corte transversal. Molares extraídos fueron limpiados, desinfectados y fijados en formalina al 10 %. Se identificó la raíz MB y se obtuvieron cortes transversales (3) a 1, 3 y 5 mm desde apical a coronal, identificadas como secciones A, B y C. Ciento cincuenta secciones fueron teñidas con azul de metileno y observadas bajo microscopio óptico, tanto en la superficie apical como coronal, y analizadas mediante el programa ImageJ. Se obtuvieron estadísticas descriptivas (media ± DE), y mediante las prueba ANOVA y chi-cuadrado de Pearson se compararon las secciones a diferentes niveles. Se observaron un total de 445 canales radiculares, 289 correspondieron a canales accesorios. El 41,6 % fueron canales mesiobucales secundarios (MB2) y 5,1 % un tercer canal accesorio. Se observaron con mayor frecuencia istmos Tipo I (48), seguidos de Tipo IV (26); los Tipos II, III y V no superaron el 15 %. De acuerdo con la prueba de chi-cuadrado de Pearson, existen diferencias significativas entre los tipos istmos y distancia del ápice (p> 0,001). La incidencia del Tipo I fue mayor cerca del ápice, con un descenso hacia los 3,0 mm. Se observó una compleja morfología del sistema canalicular apical en la raíz MB, que explica su baja tasa de éxito cuando son tratados con endodoncia. Las variaciones anatómicas, tales como MB2 o más canales accesorios e istmos deben ser considerados en la planificación y realización del tratamiento de endodoncia convencional o cirugía apical, con el fin de lograr procedimientos más exitosos. Se recomienda que las apicectomías se extiendan por lo menos a 3,3 mm del ápice.

The aim was to describe the internal configuration of the canalicular system of the mesiobuccal root (MB) of the maxillary first permanent molar, identifying the number of canals and isthmus frequency, location, and types at 1, 3 and 5 mm from the apex. This research was approved by the ethics committee. A descriptive ex vivo cross-sectional study was conducted. Extracted molars were cleaned, disinfected and fixed in 10% buffered formalin. The non-instrumented MB root was identified and 3 cross sections at 1, 3 and 5 mm from apical to coronal identified as A, B and C were obtained. 150 sections were stained with methylene blue and observed under microscope, in both apical and coronal surface using the ImageJ program. Descriptive statistics (Mean±SD) was obtained, and ANOVA and Pearson chi-square tests were used to compare the sections at different levels. A total of 445 root canals were observed, 289 corresponded to accessory canals. 41.6% were secondary mesiobuccal canal (MB2) and 5.1% a third accessory canal. The isthmus observed were Type I (48), followed by Type IV (26); Types II, III and V did not exceed 15%. According to the Pearson chi-square test, there are significant differences between the isthmus types and distance of the apex (p> 0.001). The incidence of Type I was greater near the apex, with a decline towards 3.0 mm. A complex morphology of the apical maxillary MB root system was found, and explains their low success rate when treated endodontically. Anatomical variations such as MB2, accessory canals and isthmus should be considered when planning and conducting endodontic treatment or apical surgery, in order to achieve more successful procedures. It is recommended that apicectomies extend at least 3.3 mm from the apex.

Hemisection: Resection For Conservation.

Abstract: Furcation defects represent a formidable problem in the treatment of periodontal disease, principally related to the complex and irregular anatomy of furcations. The presence and severity of a furcation lesion reduces the success rate of conventional periodontal therapy in these specific areas and therefore worsens the long-term prognosis of that particular tooth.While regeneration of the periodontium is an accepted treatment goal, not all furcation defects can be effectively treated using regenerative procedures. Hence, resective therapies like root resection, bicuspidization or hemisection for the treatment of furcation defects is an essential part of the periodontal treatment, which must be performed in order to attain a result which can eventually be considered more conservative. Here is a case report of a 38-year-old male with hemisection procedure performed in the right mandibular 1st molar with grade III furcation involvementfollowed by fixed partial denture.

Treatment of Endo - Perio Lesion With Syringeable Bio Active Alloplastic Bone Graft Material : A Case Report.

Endodontic–periodontal lesions present challenges to the clinician as far as diagnosis andprognosis of the involved teeth are concerned. Etiologic factors such as bacteria, fungi,and viruses as well as various contributing factors such as trauma, root resorptions,perforations, and dental malformations play an important role in the development andprogression of such lesions. The relationship between the pulp and periodontium has been extensively studied. The pathways for the spread of bacteria between pulpal and periodontal tissues have been discussed with controversy. This case report presents a successful treatment of a 43 year old systemically healthy male suffering with endoperio lesions of upper right first and second molar teeth.

Ressecção radicular na terapia das lesões de furca: revisão de literatura e relato de casos clínicos / Root resection therapy in furcation defects: literature review and case reports

As lesões de furca são caracterizadas pela reabsorção óssea e perda de inserção na área inter-radicular constituindo-se um dos maiores problemas na terapia periodontal e resultando em um maior número de perdas dentárias. O objetivo deste estudo foi abordar a terapia das lesões de furca por meio da ressecção radicular, discutindo seus resultados e relatando dois casos clínicos, com mais de 10 anos de manutenção. A ressecção radicular consiste na hemissecção e restauração com coroa unitária de molar tunelizado, pré-molarização, ou uso como pilar de prótese fixa em molares inferiores e, associada ou não a trabalhos protéticos, em molares superiores. O prognóstico depende da quantidade de suporte ósseo de pelo menos 50% das raízes remanescentes, ausência de mobilidade e condições adequadas para a restauração dos dentes. Os resultados desta terapia apresentam resultados muito variados, com faixa de sucesso entre 60 e 100%, provavelmente em função de diferentes critérios de inclusão, diversas técnicas cirúrgicas empregadas e formas de restauração. A maioria dos estudos mostra que as falhas são devido a razões endodônticas, fraturas e lesões por cárie, e em menor escala a progressão da doença periodontal.

The furcation lesions are characterized by bone resorption and attachment loss in the inter-radicular area constituting a major problem in periodontal therapy and resulting in a greater number of tooth loss. The aim of this study was to aproach the therapy of furcation defects by root resection, discussing its results and reporting two clinical cases, over 10 years of supportive therapy. Resection consists of the root hemisection and restoration with single crown of molar tunneled, bicuspidization, or use with pillar fixed prosthesis in lower molars, and with or without prosthetic works in molars. The prognosis depends on the amount of bone support of at least 50% of the remaining roots, lack of mobility and appropriate conditions for the restoration of teeth. The results of this therapy have very varied results, with successful track between 60 and 100%, probably due to different inclusion criteria, different surgical techniques and forms of restoration. Most studies show that failures are due to endodontic reasons, tooth fractures and injuries, and to a lesser extent the progression of periodontal disease.

Comparison of root resection and tunnel preparation in the clinical outcome of furcation-involved mandibular molars / 대한치주과학회지

PURPOSE: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. MATERIALS AND METHODS: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. RESULTS: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. CONCLUSION: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.

Root resection of compromised molars / 대한치주과학회지

PURPOSE: Studies reported controversial results about prognosis of root resection with 0%-38% failure rate. The purpose of this study is to consider clinical efficacy of root resection. MATERIALS AND METHODS: This study reported three cases of root resection which were performed on different sites. In first case, lower right first molar showed pus discharge and 7 mm of probing pocket depth. It was diagnosed as fracture of mesial root. Hemisection of mesial root was performed In second case, upper right first molar showed severe bone loss on disto-buccal root and 7 mm of probing pocket. Resection of disto-buccal root was performed In third case, lower left second molar showed severe bone loss on distal root including apex and 15mm of probing pocket depth. Hemisection of distal root was performed. RESULT: In these three cases of root resection, compromised molars were treated successfully and conserved. CONCLUSION: Root resection is a successful procedure treating compromised multi-rooted teeth and conserving teeth when proper case selection is performed.

A Retrospective Anaylsis of Root-Resected Teeth / 대한치주과학회지

The purpose of this study was to evaluate the clinical validity of multi-rooted teeth subjected to root-resection treatment. Over a period of 1-7 years, 60 root-resected molars in 59 patients were examined clinically and radiographically. All patients were periodically recalled once or twice a year. Root-resections were due to periodontal, more specifically furcal bone loss or marginal bone loss, in 34 cases and extensive dental carious destruction in 10 cases. In other cases, root-resections resulted from 6 cases of root fracture, 6 cases of periodontal-endodontic combined lesion, and 1 case of endodontic problem. Root-resection was carried out on 26 maxillary molars and 34 mandibular molars. The results are as follows; 1. 14 cases(23.3%) were considered failures. 8 cases(13.3%) of them occurred within the first year(8 cases, 13.3%), 4 cases(6.7%) between 1-3 years, and 2 cases(3.3%) between 4-7 years. 2. 8 cases(13.3%) were considered failures due to periodontal reasons, 3 cases(5%) due to root fracture, 2 cases(3.3%) due to endodontic problem, and 1 case(1.7%) due to prosthetic problem. 3. 37 cases(61.7%) showed up for the recall appointments, and the percentage of failures(13.5%) was lower compared with that of all patients(23.3%). The results of the present study indicate that the prognosis of root-resected teeth is favourable if attention is paid to the selection of proper case and to achieving optimal oral hygiene and periodic check up.