Oral Radiographic Evidence of Secondary Hyperparathyroidism in an End-Stage Renal Failure Patient: A Case Report.

BACKGROUND: The authors report a case of a 42-year-old woman with End Stage Renal Disease (ESRD) undergoing dialysis therapy with the relative loss of tooth root lamina dura and several mandibular radiolucencies. Secondary hyperparathyroidism related to End Stage Renal Disease may result in the loss of bone density and radiolucent lesions, which has been previously described as Brown tumor. Findings significant for hyperparathyroidism may befound on routine dental imaging. RESULTS: The patient was evaluated, and treatment was initiated for her dental conditions. She is at present still on the kidney transplant waiting list. CONCLUSION: Patients with End Stage Renal Disease and hyperparathyroidism require communication and cooperation between dentists and physicians. PRACTICAL IMPLICATIONS: It is important for dentists to consider Brown tumor as a possible diagnosis of radiolucent jaw lesions.

The Effect of Root Canal Irrigation with Combination of Sodium Hypo-chlorite and Chlorhexidine Gluconate on the Sealing Ability of Obturation Materials.

OBJECTIVES: The aim of this study was to evaluate the effect of the precipitate that was formed by combining Sodium Hypochlorite (NaOCl) and Chlorhexidine Gluconate (CHX) on the sealing ability of root canal obturation materials. MATERIALS AND METHODS: The fluid filtration method was conducted on a total of 100 roots. Samples were randomly divided into two control (n=5) and three experimental groups (n=30). The samples in group 1 were irrigated with 1.5 mL of 2.5% NaOCl, and then the smear layers of the teeth were removed by 17% EDTA, while the specimens of group 2 were irrigated by 1.5 mL of 2.5% NaOCl and 1.5 mL of 2% CHX; after the smear layer removal, a final flush with 1.5 mL of 2.5% NaOCl was performed. The samples of group 3 were irrigated the same as group 1 but after the smear layer removal canals were irrigated again with 1.5 mL of 2.5% NaOCl and then a final flush with 1.5 mL of 2% CHX was performed. Teeth were obturated with gutta-percha and AH26 sealer and after seven days, microleakage was evaluated by the fluid filtration technique. The results were analyzed by the ANOVA and Tukey's test. RESULTS: The samples in group 3 had significantly greater microleakage compared to teeth in group 1, 2 (p<0.05), and the specimens in group 1 showed significantly less amount of microleakage than samples in group 2, 3 (p<0.05). CONCLUSION: The presence of the precipitate that is formed due to interaction between NaOCl and CHX has negative effect on the sealing ability of gutta-percha and AH26 sealer.

Effect of prior calcium hydroxide intracanal placement on sealing ability of MTA plugs.

This study sought to investigate how pretreatment intracanal placement of calcium hydroxide (Ca(OH)2) affected the sealing ability of mineral trioxide aggregate (MTA) plugs in simulated open apices. Maxillary central incisor teeth were cleaned and shaped in an identical manner. After root-end resection, samples were divided randomly into 2 control (n = 5) and 2 experimental groups (n = 35). The specimens in Group 1 were pretreated using a Ca(OH)2 medicament, while the samples of Group 2 received no medicament. One week later, a 5 mm apical plug of MTA was applied into the canals. The remaining portions of the canals were obturated with gutta percha. Group 1 had a significantly higher frequency of apical leakage than Group 2 (P < 0.05).