Case series: tooth retention 5 years after irretrievable separation of LightSpeedLSX instruments.

INTRODUCTION: Of 3,216 root canals treated endodontically at the Creighton University School of Dentistry from September 1, 2005, to August 31, 2007, with LightSpeedLSX instruments (LightSpeed Technology, Inc, San Antonio, TX), there were 12 cases of irretrievable instrument separation. More than 5 years after the separations, an attempt was made to contact the patients and assess for healing and tooth retention. METHODS: Third- and fourth-year dental students performed root canal procedures according to protocol from September 1, 2005, to August 31, 2007. A database was collected during the 24-month period recording cases with irretrievable LightspeedLSX separation. Efforts were made from July 2011 to December 2011 to contact the 12 patients for endodontic follow-up. Clinical and radiographic evaluations of healing were performed. RESULTS: Of the 12 patients with irretrievable separations, 8 patients were contacted and 5 returned to Creighton University School of Dentistry for follow-up. All 8 contacted patients confirmed the presence of the root canal-treated tooth in question, and the teeth of the 5 evaluated patients were determined to be asymptomatic and functional. Radiographic analysis resulted in 2 teeth being classified as complete healing, 2 as uncertain healing, and 1 as no healing. CONCLUSIONS: The 100% tooth retention rate and the lack of symptoms in 8 contacted (5 evaluated) patients 5 years after treatment suggests that long-term retention and functionality can occur after irretrievable instrument separation. Although tooth retention and functionality are desirable outcomes, radiographic findings may be indicative of inadequate periapical healing, thus requiring the clinician to evaluate whether additional treatment is necessary.

Repair of a large furcation perforation: a four-year follow-up.

This case report describes the management of a large furcation perforation in a maxillary first molar. Although the majority of the pulpal floor was destroyed and the mesiobuccal root was damaged, an attempt was made to repair the defect and restore the tooth. An absorbable gelatin sponge matrix was placed, and the defect was repaired with gray ProRoot mineral trioxide aggregate. Subsequently the endodontic treatment was completed; the tooth was restored and was later used as a fixed partial denture abutment. A 55-month recall showed no evidence of periodontal breakdown, no symptoms, and complete healing of all periradicular lesions.

An in vitro assessment of the sealing ability of resilon/epiphany using fluid filtration.

The aim of this in vitro study was to compare the sealing ability of Resilon/Epiphany to gutta-percha and Roth or AH Plus sealers. Leakage of the obturated roots was measured using the fluid filtration technique. There were eight groups of 12 teeth each. Group 1: obturated with Resilon/Epiphany; group 2: obturated with gutta-percha/Roth, allowed to set for 3 wk; group 3: obturated with gutta-percha/Roth; group 4: obturated with Resilon/Epiphany using a single cone; group 5: obturated with Resilon cones without using primer/sealer (positive control); group 6: obturated with gutta-percha/AH Plus; group 7: same as group 6, but allowed to set for 8 h; and group 8: sealed on the outside with three layers of nail varnish (negative control). The results showed that only the positive control (group 5) leaked significantly more (p < 0.05) than the other groups. There was no effect of time on leakage. Resilon/Epiphany was no better than gutta-percha/Roth or gutta-percha/AH Plus at sealing root canals.

Incidence of instrument separation using LightSpeed rotary instruments.

The use of nickel-titanium rotary instrument systems has gained popularity over the past 10 years. One of these instrument systems is the LightSpeed (LightSpeed Technology, Inc, San Antonio, TX). One drawback for all nickel-titanium rotary instruments is the incidence of instrument separation. The purpose of this study was to evaluate the incidence of nonretrievable instrument separation using the LightSpeed system in a clinical setting. A total of 3543 canals were treated over a 24 month period and during that time, 46 LightSpeed instruments were separated and found to be nonretrievable, resulting in a separation rate of 1.30%. This rate was lower than previous reported studies.

Esplenectomia en el tratamiento del linfoma primario de bazo / Splenefctomy in the treatment of primary lymphoma of the spleen

hasta el momento sólo veintiún casos reúnen los requisitos para ser considerados como linfomas primarios de bazo. En ellos el tratamiento ha sido heterogéneo, ya que además de la esplenectomía, la mayoría de ellos recibieron radioterapia o quimioterapia o en algunos casos ambas formas de tratamiento, lo que hace difícil evaluar las respuestas a los mismos. La esplenectomía como único tratamiento ha sido informada en casos muy raros, pero entodos ellos se ha observado sobrevida larga y sin evidencia de recaída del linfoma. Se presentan dos casos de linfoma primarios de bazo, en los que la esplenectomía, fue el único tratamiento, con una excelente respuesta, ya que ambos pacientes se encuentran vivos y sin evidencia de diseminación del linfoma