Infection-related mental and inferior alveolar nerve paresthesia: literature review and presentation of two cases.

A review of the literature on infection-related mental and inferior alveolar nerve paresthesia is given. This is followed by 2 case reports. The first case is of a mandibular left second molar in which a chloropercha overfill puff occurred in the vicinity of the inferior alveolar canal. The tooth remained asymptomatic until 2 and 1/2 yr later, when the periapical lesion enlarged and swelling, pain, and paresthesia developed. The paresthesia resolved 2 weeks following periapical surgery. The second case is of a mandibular right first premolar in which paresthesia began 1 day after the initial endodontic treatment. The intracanal medication was formocresol on a cotton pellet that was squeezed dry. The paresthesia was treated by irrigation, antibiotics, and dexamethasone. The paresthesia lasted 7 weeks, and when it resolved the root canal was filled with gutta-percha/eucapercha. Almost 9 months later, the tooth remained asymptomatic.

Endodontic-related inferior alveolar nerve and mental foramen paresthesia.

Paresthesia is a condition that involves perverted sensations of pain, touch, or temperature. It has a variety of possible causes. This article presents a literature review and case reports of endodontically related inferior alveolar nerve and mental foramen paresthesia. Nondrug prevention methods and the dental uses of dexamethasone are also discussed.

An investigation into the use of hypertext as a user interface to taxonomic keys.

In an attempt to overcome some of the drawbacks of existing taxonomic keys, we have experimented with a computerized version of a key, changing the interface to the key, but leaving the information contained in the key essentially unchanged. This is in contrast to most previous work on the use of computers in taxonomy, where work has concentrated on alternative identification techniques and techniques for manipulating taxonomic data. Hopkin's (1991) Key to the Woodlice of Britain and Ireland was converted (including the diagrams and colour photographs), into a hypertext document using the Unix Guide hypertext system. An experiment was conducted where test subjects with a wide range of experience of taxonomic keys and computing skills were asked to identify woodlouse specimens using the paper and hypertext forms of the keys. The results showed that test subjects were more likely to obtain an identification with the hypertext version of the key, they found it easier to use and preferred using it to the paper version of the key. However, there were indications that test subjects were more likely to obtain a misidentification using the hypertext key than the paper version of the key. Further work is needed to discover the possible causes of the increased frequency of misidentifications, and ways in which the usability of hypertext keys can be further enhanced.

Stress: clarification of a confused concept.

First, dictionary definitions of stress and stress-related terms are given. Next, a review of Cannon's, Selye's, and other early pioneers' stress definitions are given. Following this, current definitions are reviewed. Finally, using new findings, an up-dated version of the stress concept is presented.

Anxiety and its control.

First, a discussion is given of the several types of anxiety. Next, a review is given of the non-pharmaceutical methods of managing anxiety. Finally, an in-depth examination is made of the various types of drugs used to treat the different types of anxiety.

The potential for computer-aided identification in biodiversity research.

Species identification lies at the heart of most ecological studies, but it is recognized as a difficult and often frustrating task. Taxonomists have sought to overcome the difficulties of species identification by developing a range of tools and techniques that have increasingly involved the use of computers. We describe recent developments in computer-aided species identification, which have been in four main areas; multi-access keys; hypertext keys; expert systems; and neural networks. We also suggest which technique might be appropriate for a particular taxonomic group.

Age estimation using dental periapical radiographic parameters. A review and comparative study of clinically based and regression models with the Operation Desert Storm victims.

A brief discussion of teeth and aging is followed by a review of the first four studies by our group at Temple University. In the present study, periapical, postmortem radiographs taken with the bisecting-angle technique from U.S. armed forces personnel killed during Operation Desert Storm were analyzed for age estimation. A total of 74 sets of dental radiographs (52 complete and 22 incomplete) with documented age of the individual at the time of death recorded were examined by investigators (D.R.M. and J.V.E.), who were blind to age range and specific ages of the victims. Comparisons were made between the same clinically based and multiple regression models used in a previous study of age estimation from private dental practice patients in which the long-cone radiographic technique had been used. Age estimation for both models was based on the same radiographic parameters used in that previous study (13 for the clinical model and eight for the regression model). Results showed that, in contrast to that previous study, the clinical model was superior to the regression model. Mean difference between estimated and actual age was +/- 4.4 years (clinical) and +/- 6.3 years (regression). Median difference between estimated and actual age was +/- 2.0 years (clinical) and +/- 6.0 years (regression). Mode difference between estimated and actual age was +/- 2.0 years (clinical) and +/- 6 and 7 years (regression). The results from the present study show that the clinical and regression models developed from full-mouth series of periapical radiographs taken of living patients by the long-cone radiographic technique can be used with decedents' radiographs taken with the bisecting-angle technique.

Brain wave synchronizers: Part 2--A pilot EEG study and a clinical observational study.

In the first brain wave synchronizer study by our group at Temple University (the readers are referred to part 1, which appeared in the January 1994 issue of The Compendium), patients undergoing endodontic therapy were divided into three groups: the Relaxodont unit, the Relaxodont unit with a relaxation tape, and a control group. The anxiety levels of the groups were compared using galvanic skin resistance, pulse rate, subjective response, and physical reactions. The results showed that the two Relaxodont groups did significantly better than the control group. In part 2, a pilot brain wave synchronizer electroencephalogram study is presented. The results of a clinical observational study on endodontic patients by our group at Temple University using simple chairside means to assess anxiety is also presented.

Brain wave synchronizers: Part 1--Review of the literature and the first dental anxiety study.

Using specific frequencies, photostimulation was developed into units known as brain wave synchronizers. Medical literature has shown the results of brain wave synchronizer use in obstetrics during labor and delivery, as an aid in anesthesiology, and for hypertension control. Dental studies have been conducted using brain wave synchronizers to relax patients during anxiety-inducing endodontic treatment. The first part of this article will review the medical and dental literature on brain wave synchronizers and the first brain wave synchronizer study on dental patients.

A radiographic study of aging changes of the dental pulp and dentin in normal teeth.

One aspect of a previous retrospective radiographic study was an examination of diameter and length changes of root canals at various ages. It was found that root canal shrinkage increased with advancing age. In the present follow-up study, a larger population (500 subjects) was used and only mandibular anterior teeth were evaluated. Root canal shrinkage was calculated vertically and horizontally. Measurements taken were tooth length, coronal length, apical length, root canal length, cervical width, midroot width, and apical width. Six age groups were examined: 17 through 29; 30 through 39; 40 through 49; 50 through 59; 60 through 69; and 70 through 79. Root canals showed statistically significantly more shrinkage with advancing age; there were significant changes among all groups. These findings could prove useful in anthropology and forensics and as an aging biomarker.

The effect of the Relaxodont brain wave synchronizer on endodontic anxiety: evaluation by galvanic skin resistance, pulse rate, physical reactions, and questionnaire responses.

The effects of a brain wave synchronizer (BWS) on endodontic (root canal) anxiety was evaluated in the clinical practices of the senior author. The experimental groups were: (1) a verbal method (routine calming words by dentist) plus BWS (N = 10) and (2) verbal method plus BWS and alpha relaxation tape (N = 10). The control group was verbal method alone (N = 10). All three groups were evaluated during a complete endodontic treatment by the use of galvanic skin resistance (GSR), pulse rate (PR), physical responses, and pre- and post-treatment questionnaires. Recordings were made during the following periods: (1) start; (2) local anesthetic injection; (3) rubber dam application; (4) drilling; (5) x-ray taking; (6) instrumentation; (7) obturation; and (8) conclusion. Results showed that the experimental groups were significantly better than the control group in the reduction of endodontic anxiety. The findings reinforced the belief that local anesthetic injection is the most anxiety producing aspect of endodontic treatment.

Age-related changes of the dental pulp complex and their relationship to systemic aging.

The dental pulp and its associated structures, the dentin and the cementum, are discussed. Because many of the age-related pulpal changes have components considered in several of the current theories of aging, these theories are briefly reviewed. Part 2 describes the age-related changes of the dental pulp, the dentin, and the cementum (the dental pulp complex). An attempt is made to differentiate inherent aging changes from physiologic defensive changes and pathologic irritant-induced changes. Part 3 describes the relationship of age-induced changes in the dental pulp complex to components of the current aging theories together with a unified concept of the dental pulp complex aging. Part 4 considers whether dental pulp complex aging can be used as a biomarker for generalized aging. Whether age-related changes of the dental pulp complex can be altered by interventions is discussed.

A review of aging of dental components and a retrospective radiographic study of aging of the dental pulp and dentin in normal teeth.

A review of aging of dental components is followed by a clinical radiographic study. Patients received radiographs at 5-year intervals with a 10-year minimum followup. Data obtained were age, gender, tooth, and systemic diseases. Measurements taken were tooth length, coronal length, apical length, cervical width, midroot width, and apical width. Root canal shrinkage was calculated vertically, horizontally, and as a combination (vertical and horizontal). Results showed statistically significantly more shrinkage in men, the elderly, and people with calcification-related diseases. Shrinkage increased with advancing age. With further studies, radiographically determined root canal measurements could prove useful in anthropology, forensics, and as a biomarker of aging.

The antimicrobial effect of various endodontic sealers.

The antimicrobial activity of an endodontic sealer can be helpful in destroying any remaining root canal microbes. Therefore it was decided to test the antimicrobial activity of several commonly used endodontic sealers. The sealers used were Grossman's sealer, Tubliseal, Calciobiotic, Sealapex, Hypocal, eucapercha, Nogenol, and AH26. Also tested were dry calcium hydroxide powder, calcium hydroxide mixed with saline, and a Teflon formulation. The microbes used were Streptococcus mutans (a gram-positive microaerophile). Staphylococcus aureus (a gram-positive facultative anaerobe), and Bacteroides endodontalis (a gram-negative obligate anaerobe). The freshly mixed sealers were placed into the prepared wells of agar plates inoculated with the test microorganisms. After varying periods of incubation, the zones of inhibition of bacterial growth were observed and measured. Grossman's sealer had the greatest overall antibacterial activity. However, AH26 had the greatest activity against B. endodontalis. The zinc oxide-eugenol-based sealers had more antimicrobial activity than either the calcium hydroxide-based sealers or eucapercha.

A dentist's dilemma: nonsurgical endodontic therapy or periapical surgery for teeth with apparent pulpal pathosis and an associated periapical radiolucent lesion.

First presented is a brief review of nonsurgical versus surgical treatment of radicular cysts. This is followed by a consideration of the use of radiographs for differential diagnosis of periapical radiolucent lesions. Some of the nonendodontic local and systemic lesions that can occur periapically are then presented. Next examined are the fallibilities of pulp vitality testing methods. The need for histopathologic examination of periapical lesions is the subject of the next discussion. The dentist's dilemma is then examined: should teeth with apparent pulpal pathosis and an associated periapical radiolucent lesion have routine surgical treatment including biopsy or should they be treated nonsurgically and have periodic follow-ups? A possible resolution of this dilemma is the final consideration.