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1.
Int Endod J ; : 1096-1107, 2019 Mar 19.
Article in English | MEDLINE | ID: mdl-30891775

ABSTRACT

An abstract is a brief overview of a scientific, clinical or review manuscript as well as a stand-alone summary of a conference abstract. Scientists, clinician-scientists and clinicians rely on the summary information provided in the abstracts of systematic reviews to assist in subsequent clinical decision-making. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for Abstracts checklist was developed to improve the quality, accuracy and completeness of abstracts associated with systematic reviews and meta-analyses. The PRISMA for Abstracts checklist provides a framework for authors to follow, which helps them provide in the abstract the key information from the systematic review that is required by stakeholders. The PRISMA for Abstracts checklist contains 12 items (title, objectives, eligibility criteria, information sources, risk of bias, included studies, synthesis of results, description of the effect, strength and limitations, interpretation, funding and systematic review registration) under six sections (title, background, methods, results, discussion, other). The current article highlights the relevance and importance of the items in the PRISMA for Abstracts checklist to the specialty of Endodontology, while offering explanations and specific examples to assist authors when writing abstracts for systematic reviews when reported in manuscripts or submitted to conferences. Strict adherence to the PRISMA for Abstracts checklist by authors, reviewers, and journal editors will result in the consistent publication of high-quality abstracts within Endodontology. This article is protected by copyright. All rights reserved.

2.
Clin Oral Investig ; 21(1): 405-411, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27025212

ABSTRACT

OBJECTIVES: The objective of this study is to determine the potential for microcracks in the radicular dentin of first maxillary premolars using three different mechanized endodontic instrumentation systems. METHODS: Eighty extracted maxillary first premolars with two root canals and no externally visible microcracks were selected. Root canal instrumentation was performed with either the ProTaper file system, the WaveOne primary file, or the self-adjusting file (SAF). Teeth with intact roots served as controls. The roots were cut into segments and examined with an intensive, small-diameter light source that was applied diagonally to the entire periphery of the root slice under ×20 magnification; the presence of microcracks and fractures was recorded. Pearson's chi-square method was used for statistical analysis, and significance was set at p < 0.05. RESULTS: Microcracks were present in 30 and 20 % of roots treated with the ProTaper and WaveOne systems, respectively, while no microcracks were present in the roots treated with the SAF (p = 0.008 and p = 0.035, respectively). Intact teeth presented with cracks in 5 % of the roots. The intensive, small-diameter light source revealed microcracks that could not be detected when using the microscope's light alone. CONCLUSIONS: Within the limitations of this study, it could be concluded that mechanized root canal instrumentation with the ProTaper and WaveOne systems in maxillary first premolars causes microcracks in the radicular dentin, while the use of the SAF file causes no such microcracks. CLINICAL RELEVANCE: Rotary and reciprocating files with large tapers may cause microcracks in the radicular dentin of maxillary first premolars. Less aggressive methods should be considered for these teeth.


Subject(s)
Bicuspid/injuries , Dental Instruments , Root Canal Preparation/instrumentation , Equipment Design , Humans , In Vitro Techniques , Maxilla
3.
Int Endod J ; 50(4): 330-338, 2017 Apr.
Article in English | MEDLINE | ID: mdl-26992649

ABSTRACT

AIM: To examine whether local anaesthesia is required for treating teeth with necrotic pulps (TNP) and retreatment cases (RCs) associated with periapical lesions. METHODOLOGY: Root canal treatment was performed in TNP and RCs without the administration of local anaesthesia. Patients were assured that if they experienced pain, local anaesthesia would be provided. Eighty canals, 40 TNP and 40 RCs, were included in the study. Two length measurements were performed: one using an electronic apex locator (EAL), which was defined as the electronic length (EL), and the second, the length at which the patient first reported that a size 15 file was touching the periapical tissues, which was defined as the periodontal length (PL). The difference between these two measurements (Δ = PL - EL) was the parameter studied. Statistical analysis was conducted using two-way anova and paired t-tests. Working length (WL) was defined in this study as being 0.5 mm short of the EL. RESULTS: EL was shorter than PL in 96% of cases. The mean difference between measurements was 0.78 (±0.11) mm in the TNP group and 0.63 (±0.15) mm in the RC group; the difference was not significant. The distances between the WL and PL were thus 1.28 and 1.13 mm, respectively. In none of the 80 canals did the patient experience any pain, either during the measurements or during the instrumentation procedures. CONCLUSIONS: When EALs are used, local anaesthesia may not be required for root canal treatment in teeth with necrotic pulps and retreatment cases associated with periapical lesions.


Subject(s)
Anesthesia, Dental , Dental Pulp Necrosis/surgery , Periapical Diseases/surgery , Root Canal Therapy , Adult , Female , Humans , Male , Middle Aged , Pain/epidemiology , Pain/etiology , Pain Measurement , Retreatment , Young Adult
4.
Refuat Hapeh Vehashinayim (1993) ; 34(1): 17-24, 70, 2017 01.
Article in English | MEDLINE | ID: mdl-30699491

ABSTRACT

AIM: This study presents the use of a modern surgical endodontic technique for the treatment of altered sensation following extrusion of endodontic filling materials. CASE PRESENTATION: A patient presented with an altered sensation following a root canal treatment and extrusion of root filling material at the mandibular canine and lateral incisor. She was treated using a modern surgical technique that included removal of the extruded filling materials followed by root-end management and obturation. The treatment resulted in complete periapical and neurosensory healing. CONCLUSIONS: Modern endodontic surgery may be beneficial for patients with nerve injury due to extruded endodontic filling materials, since it enables a relatively safe removal of the irritating extruded endodontic materials, proper root-end management and preservation of the natural tooth.


Subject(s)
Dental Materials , Root Canal Obturation/methods , Root Canal Therapy/methods , Adult , Cuspid , Female , Humans , Incisor , Sensation
5.
Refuat Hapeh Vehashinayim (1993) ; 33(1): 35-44, 62, 2016 Jan.
Article in Hebrew | MEDLINE | ID: mdl-27295931

ABSTRACT

AIM: To present rational case selection criteria for the use of CBCT (Cone Beam Computed Tomography) in endodontics. MATERIALS AND METHODS: This article reviews the literature concerning the benefits of CBCT in endodontics, alongside its radiation risks, and present case selection criteria for referral of endodontic patients to CBCT. RESULTS: Up to date, the expected ultimate benefit of CBCT to the endodontic patient is yet uncertain, and the current literature is mainly restricted to its technical efficacy. In addition, the potential radiation risks of CBCT scan are stochastic in nature and uncertain, and are worrying especially in pediatric patients. CONCLUSIONS: Both the efficacy of CBCT in supporting the endodontic practitioner decision making and in affecting treatment outcomes, and its long term potential radiation risks are yet uncertain. Therefore, a cautious rational decision making is essential when a CBCT scan is considered in endodontics. Risk-benefit considerations are presented.


Subject(s)
Cone-Beam Computed Tomography/methods , Endodontics/methods , Patient Selection , Child , Cone-Beam Computed Tomography/adverse effects , Decision Making , Humans
6.
Refuat Hapeh Vehashinayim (1993) ; 32(4): 6-10, 25, 2015 Oct.
Article in Hebrew | MEDLINE | ID: mdl-26727844

ABSTRACT

This short communication is aimed to update dental practitioners regarding the recently published warning of the U.S. Food and Drug Administration (FDA) regarding the risk for severe cardiovascular complications such as myocardial infarction or stroke following the use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs).


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Myocardial Infarction/chemically induced , Stroke/chemically induced , Dentists , Humans , Risk , United States , United States Food and Drug Administration
7.
Refuat Hapeh Vehashinayim (1993) ; 31(2): 15-8, 85, 2014 Apr.
Article in Hebrew | MEDLINE | ID: mdl-25252467

ABSTRACT

AIM: To retrospectively analyze the medico-legal aspects of iatrogenic root perforations (IRP) that occurred during endodontic treatments. METHODOLOGY: A comprehensive search in a professional liability insurance database was conducted to retrospectively identify cases of IRP following root canal treatments (RCTs). The complaints were categorized as either financial risk bearing or financial nonrisk bearing, and related demographic and endodontic variables were analyzed. RESULTS: One hundred and twenty cases of patients with IRP were identified. Twenty six cases (22%) were elective RCTs, and 94 cases (78%) were endodontic treatments performed due to pathologic processes (p < 0.05). Sixty cases (50%) were identified in mandibular molars, significantly more than other tooth locations (P < 0.05). In 102 cases (85%) the outcome was extraction, and in 18 cases (15%) the outcome was an additional treatment (p < 0.05). For both the cases with outcome of extraction and for the cases with an additional treatment, the complaints were judged as financial risk bearing in 95% of the cases. CONCLUSIONS: latrogenic root perforation is a complication of root canal treatment and may result in tooth extraction and in legal actions against the treating practitioner. Mandibular molars are more prone to medico-legal claims related to root perforations. The patient should be informed of the risks during RCT and should get information on alternative treatments and their risks and prognosis


Subject(s)
Iatrogenic Disease/epidemiology , Malpractice/statistics & numerical data , Root Canal Therapy/adverse effects , Tooth Root/injuries , Adult , Databases, Factual , Endodontics/legislation & jurisprudence , Endodontics/statistics & numerical data , Female , Humans , Israel , Male , Malpractice/legislation & jurisprudence , Middle Aged , Molar , Retrospective Studies , Tooth Extraction/statistics & numerical data
8.
Oral Maxillofac Surg ; 18(1): 43-52, 2014 Mar.
Article in English | MEDLINE | ID: mdl-23306948

ABSTRACT

INTRODUCTION: The aim of this retrospective investigation was to evaluate the postoperative quality of life after endodontic surgery in maxillary molars when a sinus membrane perforation occurred and platelet concentrates were used. MATERIALS AND METHODS: Included patients were treated by microsurgical endodontic treatment in molar and premolar maxillary regions between 2007 and 2010. Patients who fulfilled the inclusion criteria were screened. Data from the quality of life questionnaire were analyzed. The use of plasma rich in growth factors (PRGF) (test group) was compared with a control group when a Schneiderian membrane perforation occurred during endodontic surgery performed with a modern technique in maxillary molars and premolars. RESULTS: A total of 20 patients (12 in the control group and eight in the test group) fulfilled the inclusion criteria. No differences were evaluated at baseline for clinical parameters. Significantly improved patients' quality of life was observed in the test group considering symptoms as swelling, bad breath or taste, and pain. Functional activities were less impaired in the test group and swelling was significantly higher in the control group. In the test group, pain was significantly lower than the control group during the first 6 days after surgery and also, the consumption of painkillers was lower for patients belonging to the test group even if it was not statistically significant. DISCUSSION: In general, a small sinus membrane perforation (less than 6 mm) during endodontic surgery did not cause severe complications. The use of platelet concentrates could be effective in reducing the impact on patients' quality of life, decreasing pain and surgery side effects as well as swelling.


Subject(s)
Intercellular Signaling Peptides and Proteins/blood , Intercellular Signaling Peptides and Proteins/therapeutic use , Microsurgery , Paranasal Sinuses/injuries , Postoperative Complications/therapy , Quality of Life , Tooth, Nonvital , Adult , Bicuspid/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Molar/surgery , Pain Measurement , Postoperative Care , Retrospective Studies , Surveys and Questionnaires
9.
Int Endod J ; 45(1): 7-11, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21895703

ABSTRACT

AIM: To analyse the medico-legal aspects of vertical root fracture (VRF) following root canal treatment (RCT). METHODOLOGY: A comprehensive search in a professional liability insurance database was conducted to retrospectively identify cases of VRF following RCT. The complaints were categorized as either financial risk bearing or financial nonrisk bearing, and related demographic, prosthetic and endodontic variables were analysed. RESULTS: Seventy-seven legal cases of patients with VRFs following RCT were identified. Most of the cases were either in premolars or in mandibular molar teeth (P<0.05). Poor-quality root filling was associated with an extended delay of diagnosis (P<0.05). The presence of a post significantly increased the financial risk assessment (P<0.05). CONCLUSIONS: Poor quality root fillings complicate the diagnosis of VRF, which in turn extends the time for achieving an accurate diagnosis and increasing the medico-legal risk. Premolar and mandibular molar teeth were more prone to medico-legal claims related to VRF following RCT. Post should be placed only when essential for additional core support to avoid medico-legal risk.


Subject(s)
Dentists/legislation & jurisprudence , Liability, Legal , Root Canal Therapy/adverse effects , Tooth Fractures/etiology , Tooth Root/injuries , Tooth, Nonvital/complications , Bicuspid/pathology , Delayed Diagnosis/legislation & jurisprudence , Female , Humans , Israel , Male , Malpractice/legislation & jurisprudence , Middle Aged , Molar/pathology , Post and Core Technique/adverse effects , Retrospective Studies , Risk Assessment
10.
Int Endod J ; 45(1): 35-41, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21899565

ABSTRACT

AIM: To test and compare the efficacy of five methods for the removal of root filling material and to test the hypothesis that radiographs fail to represent the real extent of remaining material on canal walls. METHODOLOGY: Fifty maxillary anterior single-rooted teeth with straight root canals were selected. The coronal third of each root canal was prepared with Gates-Glidden drills to number 3, whilst the apical two-thirds were prepared with manual K-files to size 40. Root fillings were performed using lateral compaction with gutta-percha and AH-26. After full setting, the coronal third of the root filling was removed with Gates-Glidden drills and the teeth divided into five groups (n=10). The remaining root filling material was then removed with either Hedström files and chloroform (25 µL), using size 40 as the last file, SafeSider files, using a NiTi Pleezer reamer with a 0.06 taper followed by size 40 reciprocating file, with or without chloroform, or ProTaper Universal retreatment files (D2, D3) with or without chloroform. Reaching working length with no more gutta-percha on the last file was defined as the endpoint for all procedures. The presence of remaining filling material was first evaluated radiographically and then by the microscopic evaluation of split roots. The time required to accomplish the procedure was also recorded. anova and anova with repeated measures were used for statistical analysis of the results. RESULTS: Overall, 11-26% of the canal wall remained covered with filling material; no significant difference was found between the groups. The mechanized methods were faster than manual removal of filling material (P < 0.01); the use of solvent did not speed up the mechanized procedures. Radiographic evaluation failed to adequately and reliably detect the extent of filling material remaining on the canal walls, which was later observed by microscopic evaluation. CONCLUSIONS: All methods left root canal filling material on the canal walls. Radiographic evaluation failed to detect the extent of remaining root filling material, which could only be detected using microscopy.


Subject(s)
Dental Pulp Cavity/pathology , Root Canal Filling Materials/chemistry , Root Canal Preparation/methods , Bismuth/chemistry , Chloroform/chemistry , Dental Alloys , Dental Cements/chemistry , Dental Pulp Cavity/diagnostic imaging , Epoxy Resins/chemistry , Equipment Design , Gutta-Percha/chemistry , Humans , Humidity , Materials Testing , Microscopy , Nickel , Polyvinyls/chemistry , Radiography, Dental, Digital , Retreatment , Root Canal Irrigants/chemistry , Root Canal Preparation/instrumentation , Silver/chemistry , Solvents/chemistry , Surface Properties , Temperature , Time Factors , Titanium/chemistry , Zinc Oxide/chemistry
11.
Refuat Hapeh Vehashinayim (1993) ; 28(1): 20-30, 77, 2011 Jan.
Article in Hebrew | MEDLINE | ID: mdl-21667562

ABSTRACT

Teeth replacement in the esthetic zone is a considerable challenge. Dental implants are usually the preferred treatment alternative for tooth replacement. The present review discusses several clinical issues concerning implant placement in the esthetic area. It is still unclear whether raising a flap at the time of implant placement enhances alveolar crest remodeling. However, a flapless surgical procedure could avoid changes in the free gingival margin and maintain the the attached gingiva width. A submarginal approach not involving the free gingival margin can be applied to treat bone defects with the GBR technique. Implants should be placed as palatal as possible while maintaining optimal restoration emergence profile and the horizontal bone defect filled with a non resorbable material such as bovine bone mineral. Thick periodontal biotype and coronally positioned free gingival margin usually lead to better results. Immediate implant placement in presence of a periapical lesion may be performed, however, sites should be thoroughly debrided prior to implant placement.


Subject(s)
Dental Implantation, Endosseous/methods , Dental Implantation/methods , Dental Prosthesis, Implant-Supported , Adult , Animals , Bone Remodeling , Bone Substitutes , Cattle , Dental Implants, Single-Tooth , Female , Gingiva/surgery , Humans , Male , Surgical Flaps
12.
Refuat Hapeh Vehashinayim (1993) ; 28(4): 25-9, 36, 2011 Oct.
Article in Hebrew | MEDLINE | ID: mdl-22471158

ABSTRACT

In certain clinical conditions when endodontic treatment is either impractical or unlikely to improve the previous results, tooth extraction and replacement with a dental implant becomes a viable alternative. Although the presence of active infection has long been considered a major contraindication to the insertion of implants immediately following tooth extraction, several articles assessing this treatment modality reported excellent and promising results. The aim of this literature review is to evaluate and discuss the clinical outcome of implants placed immediately following extraction in endodontically infected sockets. A Medline and EMBASE search was performed to identify articles published from 1966 to 2010 using the keywords "dental implants", "immediate implant", "extraction socket", "infected teeth", "infected site", "infected socket". No restrictions were placed regarding the study design. Only clinical articles with at least 6 months of follow-up were included. The available relevant literature concerning this topic was limited, and based on relatively low level of evidence study designs with limited follow-up periods. However, the data analysis of the selected articles showed that an immediate implant insertion in endodontically infected sites following tooth extraction and careful debridement of the socket, could be a predictable viable technique. Additional large scaled, well-designed studies are required in order to further assess the clinical applications of this treatment alternative.


Subject(s)
Dental Implantation/methods , Dental Pulp Diseases/microbiology , Tooth Socket/microbiology , Debridement , Dental Implants , Humans , Time Factors , Tooth Extraction
13.
Refuat Hapeh Vehashinayim (1993) ; 27(1): 37-46, 75, 2010 Jan.
Article in Hebrew | MEDLINE | ID: mdl-20597259

ABSTRACT

Modern dental practice offers a wide variety of treatment alternatives and modalities. With the wider scale of treatment options, new dilemmas emerged. A common dilemma is the decision whether to preserve the natural tooth by endodontic treatment, or to extract the tooth and replace it with a single dental implant. The clinician needs to remember that the basic goal of dental implants is to replace missing teeth, and not present teeth. Prosthodontic, periodontal, and esthetic considerations should be integrated in the treatment planning process. Long-term prognosis, the capabilities offered by the modern endodontic treatment, the alternatives in case of treatment failure, post treatment quality of life and patient's preferences should all be recognized and incorporated in the dentist decision making. An important factor is the communication between the prosthodontist and the endodontist before and during the treatment in order to avoid possible risks or treatment failure. The integration of these factors would assist the clinician to achieve a rational treatment plan for the benefit of the patient.


Subject(s)
Dental Implants/adverse effects , Dentition , Preservation, Biological/methods , Tooth Extraction/adverse effects , Decision Making , Follow-Up Studies , Humans , Patient Care Planning , Patient Preference , Quality of Life
14.
Refuat Hapeh Vehashinayim (1993) ; 27(3): 18-22, 61, 2010 Jul.
Article in English | MEDLINE | ID: mdl-21485416

ABSTRACT

The use of magnification devices in endodontics is becoming more and more common, with the aim of improving the quality of treatment. The common magnification systems used in modern endodontics are the surgical operation microscope, fiber-optic endoscope, and surgical loupes. The benefits of using magnification devices for conventional endodontic treatment include the increased visualization of the treatment field, enhanced possibilities in locating canals, aid in the removal of separated instruments, diagnosis of root and tooth fractures, perforation repair, and case documentation. In endodontic surgery, the use of magnification improves the ability to locate, clean, and fill the root canal system, thus achieving a predictable outcome. Further evidence-based research might better clarify the advantages and limitations of using magnification in endodontic practice.


Subject(s)
Endodontics/methods , Lenses , Quality of Health Care , Dental Equipment , Dentistry, Operative/instrumentation , Endodontics/instrumentation , Endodontics/standards , Endoscopes , Humans , Microscopy/instrumentation , Microsurgery/methods , Root Canal Therapy/instrumentation , Root Canal Therapy/methods
15.
Refuat Hapeh Vehashinayim (1993) ; 26(2): 31-8, 47, 2009 Apr.
Article in Hebrew | MEDLINE | ID: mdl-20162985

ABSTRACT

Root perforation is an artificial communication between the root canal system to supporting tooth tissues or to the oral cavity. The etiology of the perforation can be mechanical errors during dental procedures or pathological processes. Infection of the perforation site affects the prognosis of the treated root perforation, which is influenced by time between occurrence of the perforation and appropriate treatment, size, and location of the perforation. Careful treatment planning and operative techniques are imperative to prevent root perforations.


Subject(s)
Dental Pulp Cavity/injuries , Periodontal Diseases/etiology , Tooth Diseases/surgery , Tooth Injuries/etiology , Tooth Root/injuries , Dental Pulp Cavity/diagnostic imaging , Humans , Periodontal Diseases/diagnostic imaging , Radiography , Tooth Diseases/therapy , Tooth Injuries/diagnostic imaging , Tooth Root/diagnostic imaging
16.
Refuat Hapeh Vehashinayim (1993) ; 26(3): 39-51, 71, 2009 Jul.
Article in Hebrew | MEDLINE | ID: mdl-20162991

ABSTRACT

The purpose of treatment of perforations is to achieve a tight and permanent seal that will prevent bacteria and their by-products in the root canal from entering into the surrounding periodontal tissues. It is important to consider the type of perforation according to the classification for selection of the proper material and technique for each case. Modern techniques for treatment of perforations by orthograde and surgical approach result in prolonged survival of the tooth.


Subject(s)
Periodontal Diseases/epidemiology , Tooth Diseases/epidemiology , Tooth Root/injuries , Bone Diseases/diagnostic imaging , Bone Diseases/epidemiology , Humans , Periodontal Diseases/diagnostic imaging , Radiography , Tooth Diseases/diagnostic imaging , Tooth Root/diagnostic imaging
17.
Int Endod J ; 41(5): 431-5, 2008 May.
Article in English | MEDLINE | ID: mdl-18312378

ABSTRACT

AIM: To evaluate, ex vivo, the effect of maintaining apical patency on the original canal shape during preparation of curved roots by two different techniques. METHODOLOGY: Forty extracted human maxillary and mandibular molars were evaluated. Occlusal surfaces were ground and roots sectioned to the level of the cemento-enamel junction to allow only one root to remain for evaluation in each tooth. Specimens were divided into four experimental groups (10 canals each): Group 1--root canals prepared using the balanced force technique with stainless steel K-files, and patency established with size 10 K-files between each instrument; Group 2--same as Group 1 but without the use of a patency file; Group 3--canals instrumented with LightSpeed instruments and patency established with size 10 K-files between each instrument; and Group 4--same as Group 3 but without the use of a patency file. Specimens were mounted and a series of radiographs taken. Initial and post-preparation digital images were superimposed and the distance between two central axes at 1, 2 and 4 mm from the working length (WL) was measured to obtain an indication of the degree of apical transportation. Results were subjected to statistical analysis using two-way analysis of variance (ANOVA). RESULTS: No significant differences were found in degree of apical transportation at different levels of the root canal (P > 0.05) nor in loss of WL between groups (P > 0.05). CONCLUSION: In this laboratory study, maintaining apical patency did not influence canal transportation in the apical 4 mm.


Subject(s)
Dental Pulp Cavity/anatomy & histology , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Tooth Apex/anatomy & histology , Dental Instruments/adverse effects , Humans , Molar , Root Canal Preparation/adverse effects
18.
Int Endod J ; 41(6): 469-75, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18363702

ABSTRACT

AIM: To assess bacteria in the apical portion of the root end after 45 degrees root-end resection in teeth with persistent periapical lesions. METHODOLOGY: The study included 27 apical root segments from patients with persistent periapical lesions. Histological sections of the coronal part of the amputated root segment were stained with Brown and Brenn to detect the presence of bacteria in the main root canal and/or in irregular root spaces and dentinal tubules. The quality of each root canal filling was evaluated using preoperative radiographs of filling, length of root filling as assessed from the distance between its apical end and the radiographic apex, diameter of apical preparation, and presence of apical perforations or deviations from the root canal. Two endodontists, blinded to the bacteriological results, independently evaluated the radiographs. RESULTS: Bacteria were present in 23 (85.2%) specimens: five in only the main canal (21.7%), 10 in only the dentinal tubules and irregular spaces (43.5%), and eight in both irregular spaces and dentinal tubules and in the main root canal (34.8%). No correlation was found between the technical quality of the root filling assessed radiographically and bacterial presence in the central canal or irregular areas. CONCLUSIONS: Infected irregular areas were found in the root tips of teeth with persistent periapical lesions. This was found regardless of the radiographic quality of the root filling. Diagonal, 45 degrees root-end resection may expose such contaminated irregularities to the periapical tissue.


Subject(s)
Dental Pulp Cavity/microbiology , Dentin/microbiology , Periapical Abscess/microbiology , Root Canal Therapy , Tooth Root/microbiology , Bacteria/isolation & purification , Colony Count, Microbial , Dental Pulp Cavity/diagnostic imaging , Dental Pulp Cavity/pathology , Dentin/pathology , Humans , Mandible , Maxilla , Periapical Abscess/diagnostic imaging , Periapical Abscess/pathology , Radiography , Tooth Crown/diagnostic imaging , Tooth Crown/microbiology , Tooth Crown/pathology , Tooth Root/diagnostic imaging , Tooth Root/pathology
19.
Refuat Hapeh Vehashinayim (1993) ; 23(1): 13-7, 68, 2006 Jan.
Article in Hebrew | MEDLINE | ID: mdl-16599328

ABSTRACT

A correct and quick diagnosis of endodontically treated vertically fractured teeth is important for two main reasons: (1) the differential diagnosis between the clinical and radiographic appearance of periodontal disease and endodontic failures, and (2) the delay in making the correct diagnosis will result in rapid loss of supporting bone, especially on the buccal side. Typical clinical signs in the maxillary and mandibular premolars and mesial root of the mandibular molars, which are the most susceptible roots and teeth, for fracture are a highly located sinus tract and a deep bony defect along the root facing the fracture line. In the maxillary and mandibular premolars and the mesial root of mandibular molars, typical bony radiolucencies are the halo, vertical and periodontal types. Radiolucency in the bifurcation was typical in vertical root fractures of mandibular molars.


Subject(s)
Tooth Fractures/diagnosis , Tooth Root/injuries , Humans , Molar/diagnostic imaging , Molar/injuries , Molar/pathology , Radiography, Dental , Sensitivity and Specificity , Tooth Fractures/diagnostic imaging , Tooth Fractures/pathology , Tooth Root/diagnostic imaging , Tooth Root/pathology , Tooth, Nonvital/diagnostic imaging , Tooth, Nonvital/pathology
20.
Int Endod J ; 36(5): 372-9, 2003 May.
Article in English | MEDLINE | ID: mdl-12752652

ABSTRACT

AIM: Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. CASE REPORT: Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. KEY LEARNING POINTS: Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.


Subject(s)
Fused Teeth/therapy , Root Canal Therapy/methods , Adolescent , Bicuspid/abnormalities , Child , Dental Pulp Cavity/abnormalities , Dental Pulp Necrosis/therapy , Female , Humans , Male , Molar/abnormalities , Pulpitis/therapy , Root Canal Preparation/methods , Tooth, Supernumerary/therapy
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