A Case of Periradicular Surgery: Apicoectomy and Obturation of the Apex

Introduction: The purpose of the current case is to give a detail description on an incidence of a traumatized upper left central incisor with symptomatic periapical periodontitis which was root treated. Descriptions: The apical portion of the tooth had a large apical lesion with external root resorption that end up with an open apex due to the loss of tooth cementum, dentine and adjacent hard tissue. The tooth was endodontically retreated, and the apical region was treated surgically with apical curettage and retrograde Mineral Trioxide Aggregate filling (MTA). Result(s): The affected tooth was considered successful both functionally and aesthetically during a 12-month follow-up. Conclusion(s): Apicoectomy and retrograde filling with MTA is a viable option in case of treating traumatized tooth with large peri-apical lesion and open apex.Copyright © 2023 Japan University of Health Sciences & Japan International Cultural Exchange Foundation.

Getting to the root of it: contact anaphylaxis from polyethylene glycol in a dental lubricant

A 46-year-old man with no known allergies or history of atopy was referred for the investigation of a severe anaphylactic reaction following root canal dental treatment. The procedure had been done under local anaesthetic and involved drilling the tooth, removal of dental pulp, cleaning and insertion of a temporary filling. Preliminary skin prick tests (SPTs) and intradermal tests were negative to natural rubber latex, articaine (the local anaesthetic used for his procedure), lidocaine and chlorhexidine. He had negative specific IgE to chlorhexidine and latex, and a negative lidocaine challenge, confirming that he was not allergic to lidocaine. He returned for further dental treatment, which was done without local anaesthetic. As the procedure was completed, he developed severe anaphylaxis again. He made a full recovery and his dentist was asked for detailed information and samples of all the materials used during the procedure. Subsequent SPT showed a positive weal of 12 x 6 mm to the dental lubricant, Glyde, which was used on both occasions. Its ingredients included polyethylene glycol (PEG) 4253. SPT to other high-weight macrogol-containing products showed positive reactions to a 5% lidocaine ointment, Movicol, EMLA cream and Depomedrone. On further questioning he recalled minor immediate irritation after using a brand of children's shampoo, but a SPT to the shampoo was negative. An open test, closed test and SPT to a lower-molecular-weight patch-test allergen (PEG400 in petrolatum) were negative. PEGs or 'Macrogols' are hydrophilic polymers used in food, cosmetics and pharmaceutical reagents. They have recently attracted attention as they are excipients in several COVID-19 vaccines and have been suggested as a possible cause of anaphylaxis. Anaphylaxis to higher-molecular-weight PEGs has been reported from the use of bowel preparations and parenteral steroids. There are a handful of reports of contact urticaria to PEG-containing medicaments. We report this case to raise awareness of severe immediate hypersensitivity to these apparently innocuous ingredients and a novel source of exposure. A low index of suspicion, lack of standardized nomenclature and commercial reagents for testing are current barriers to diagnosis.

Assessment of Endodontic Emergency Care in a COVID-19 Pandemic

Objective: This study compared the aerosol-generating and non-aerosol-generating endodontic emergency procedures' success and assessed the outcome of endodontic treatments initiated before a pandemic but could not be completed in the targeted time. Material(s) and Method(s): Emergency treatments were performed according to symptoms of teeth. Treatment success or failure was determined according to patients whether not re-referral with untimely pain. Short-term outcome and complications arising from teeth, which endodontic treatments were prolonged were also recorded. A chi-square test was used in the statistical analysis, and p<0.05 was considered significant. Result(s): The aerosol-generating procedure group's success rate was 86.2%, while it was 70.0% in the non-aerosol generating procedure group (p=0.050). The short-term survival rate of teeth was 83.7% in patients whose endodontic treatment had been prolonged. Conclusion(s): Considering the pros and cons, each emergency patient should be evaluated case-by-case. Copyright ©Meandros Medical and Dental Journal, Published by Galenos Publishing House.

Examination The Incidence of Dental, Neurological, Cardiovascular and Radiological Problems in Patients Affected by Covid-19 And Methosd of Drug Therapy in Patients

This study has done a systematic review of drug therapy and assessment of the occurrence of dental and neurological problems in patients affected by covid-19. There are various reasons that can cause an infection in the tooth. One of the most common causes of tooth infection is root canal treatments you have had in the past. Unfortunately, bacteria grow in this area and can lead to infection. Having an infection in the tooth can be very dangerous. Because it may spread to other parts of the body and cause serious problems. For this reason, it is very important to recognize the symptoms of infection. When a crack or cavity is formed on the tooth, if not treated in time, an infection may occur in the tooth. Because these are the gates that can pave the way for bacteria to enter your teeth. The most common type of disease is accompanied by episodes of severe pain that may be felt in the eyes, ears, lips, nose, forehead, cheeks, teeth or jaws, or anywhere on the face. The similarity of the symptoms of this complication with the symptoms of common dental diseases is a factor in misdiagnosis. This can lead to a series of unnecessary dental treatments that not only won't solve the problem, but may actually make it worse. Some patients undergo dental treatment at least once before the diagnosis of the disease. 1.

The effect of the COVID-19 outbreak on the periodontal status of patients with periodontitis in supportive therapy: a retrospective study.

OBJECTIVE: The aim of this study was to assess the impact of lockdown due to the coronavirus COVID-19 pandemic on the periodontal status of patients with periodontitis in supportive periodontal therapy. METHOD AND MATERIALS: A retrospective analysis of patients affected by periodontitis stage III-IV-grade A, B, and C, who had their supportive periodontal therapy to September 2020, after a period of 6 months from the planned maintenance recall (March 2020) was performed. Clinical parameters full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and probing depth (PD) were evaluated. Patients were assigned to three groups: A (nonsmokers); B (< 10 cigarettes/day); and C (> 10 cigarettes/day). Statistical analysis was used to compare intra-group and inter-group differences. RESULTS: In total, 55 subjects with the mean age of 47.7 ± 7.0 years were enrolled. The number of participants in group A and group B decreased, respectively, from 25 (45.5%) to 20 (36.4%) and from 17 (30.9%) to 13 (23.6%). The C group increased from 13 (23.6%) to 22 (40.0%). A statistically significant increase in mean FMPS was recorded in group A (from 22.5 ± 3.5 to 30.0 ± 28.3; P < .0001); group B (from 22.5 ± 12.7 to 42.5 ± 3.5; P < .0001); and group C (from 22.5 ± 25.5 to 42.5 ± 10.6; P < .0001). A statistically significant increase in mean FMBS was recorded in group A (from 15.0 ± 7.1 to 25.0 ± 21.2; P < .0001); group B (from 15.0 ± 0.0 to 37.5 ± 3.5; P < .001); and group C (from 12.5 ± 3.5 to 30.0 ± 7.1; P < .0001). A statistically significant increase in mean PD was recorded in group A (from 4.48 ± 0.5 to 5.25 ± 1.2; P < .001); in group B (from 4.71 ± 0.7 to 5.38 ± 1.31; P < .0001); and group C (from 6.00 ± 0.0 to 7.09 ± 1.1; P < .0001). CONCLUSIONS: Within the limitations of this study the results showed that the pandemic period resulted in an increase in probing depth for the patients in regular SPT, possibly due to increased tobacco consumption.