ABSTRACT
External cervical root resorption begins at the root surface as result of odontoclastic activity in the cervical area and is progressive in character. The pulp is only affected at a later stage of the process. The aetiology and pathogenesis of external cervical root resorption is not fully understood. Possible predisposing factors are, among others, orthodontic treatment, trauma, internal bleaching, damaged cemento-enamel junction, bruxism and hypoxia. A 'pink spot' often is the first clinical sign and a two-dimensional radiograph usually presents an amorphous radiolucency with undefined borders. Cone-beam computed tomography is an emerging technique aiding the diagnosis of and prognosis and treatment plans for external root resorption. An external or internal treatment approach can be chosen, depending on the size of the defect.
Subject(s)
Cone-Beam Computed Tomography/methods , Root Resorption/diagnosis , Tooth Cervix , Diagnosis, Differential , Humans , Prognosis , Root Resorption/diagnostic imaging , Root Resorption/therapyABSTRACT
Painful temporomandibular disorders (TMD pain) are common among the general population. The most common sub diagnoses are myalgia (jaw-muscle pain) and arthralgia (temporomandibular joint pain). The aetiology of TMD pain has a multifactorial nature, and its diagnosis and possible treatment often require a multidisciplinary approach. The most recent insights in the diagnosis and treatment of TMD pain are based on the multidisciplinary guideline 'Chronic Orofacial Pain' that was developed by the Dutch Society of Headache Patients and was published in 2013. Dentists are required to follow the recommendations of this guideline. The authorisation of the guideline by the relevant academic and professional associations in the Netherlands implies that restraint is advised when adopting diagnostic procedures and treatment modalities that are not or are insufficiently based on solid evidence.
Subject(s)
Craniomandibular Disorders/diagnosis , Craniomandibular Disorders/therapy , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disorders/therapy , Evidence-Based Dentistry , Humans , Netherlands , Practice Guidelines as TopicABSTRACT
Periapical laesions are a frequently occurring phenomenon, in both untreated teeth and teeth which have undergone endodontic treatment. Various factors have been found to positively influence the effectiveness of endodontic treatment, which is defined by a lack of clinical symptoms and also the absence or shrinkage of the periapical laesion. The chance of a painful exacerbation of a persistent periapical laesion is small, even if the area of the laesion has expanded, which happens in approximately 50% of the cases. The survival of endodontically treated teeth with a periapical laesion is 87% after 10 years. Restorative reasons frequently are the main reason for extraction and the presence of a periapical laesion is seldom the reason for losing a tooth. The influence of the periapical laesion on general health is still unclear.
Subject(s)
Dental Restoration, Permanent/methods , Periapical Diseases/physiopathology , Tooth, Nonvital/therapy , Bicuspid/pathology , Humans , Molar/pathology , Post and Core Technique , Root Canal Obturation , Treatment OutcomeABSTRACT
Dento-alveolar pain is common in the orofacial area. Persistent dento-alveolar pain could be experienced without an identifiable etiology with poor response to existing treatments. Confusion about the diagnosis and classification of persistent dento-alveolar pain (PDAP) disorders could explain the difficulties in treatment and unfavorable prognosis. Recently, initial steps were made to improve the taxonomy and diagnostic criteria for PDAP in order to improve clinical research and care.
Subject(s)
Alveolar Process/pathology , Facial Pain/diagnosis , Pain Perception/physiology , Peripheral Nervous System Diseases/diagnosis , Toothache/physiopathology , Alveolar Process/physiopathology , Facial Pain/etiology , Humans , Peripheral Nervous System Diseases/therapy , PrognosisABSTRACT
Dental pain is a very common pain in the orofacial area. Patients sometimes experience persistent pain following endodontic treatment. The cause of this pain can be found in the endodontically treated tooth itself when the pain persists after an inadequately performed treatment. Persistent pain is also possible after an apparently adequate endodontic treatment. Moreover the pain can have an odontogenic origin, in cases where the diagnostic procedure may have failed. A non-odontogenic cause can be located in proximate or more remote structures, which may be a question of systemic diseases or pain from neuropathic, neurovascular and/or psychogenic conditions. A thorough clinical examination forms the basis for the establishment of a valid diagnosis.
