Monitoring pulp vitality after transplantation of teeth with mature roots: a case report.

AIM: To initiate discussion on the value of routine root canal treatment for transplanted teeth. SUMMARY: Autotransplantation is an accepted treatment option to replace missing teeth. It is generally considered that revascularization of the pulp following such a procedure is more favourable in teeth with immature roots. In teeth with closed apices root canal treatment is considered necessary. This paper presents a case of pulp revascularization in a transplanted tooth with mature roots and casts doubt on whether root canal treatment is essential in such situations. An alternative treatment protocol is proposed. KEY LEARNING POINTS: * Following transplantation original pulp tissue may survive the operation. * Teeth with obliterated pulp space do not become necrotic more often than those without obliteration. * Monitoring the tooth is an acceptable alternative to automatic root canal treatment for transplanted teeth. * Root canal treatment should be undertaken only upon occurrence of pathological signs.

[Intracanal medication used in general dentistry]. / Middelen voor toepassing in het wortelkanaal gebruikt door algemeen practici.

In order to investigate the use of intracanal substances during root canal treatment 400 dentists were asked to take part in a questionnaire survey. Questions related to the substances used, the reason for use and the way they were used. Studied were the possible influences by the variables 'year of graduation', 'number of patients in practice', 'dental school'. The results show a general use of sodiumhypochlorite and calciumhydroxide. Also a frequent use of substances with possible systemic side effects was reported. A positive trend is the fewer use of these medicaments by dentists who qualified more recently.

[Repair and revision 4. Cracked tooth and crown fractures: diagnostics and treatment]. / Reparatie en revisie 4. Gebarsten gebitselement: diagnostiek en behandeling.

Trauma to the teeth can result in the formation of cracks in the crown or root of the tooth. The location and the extent of these cracks determine the proper treatment choice. This treatment is oriented towards saving pulp vitality and/or tooth integrity. In this paper the diagnosis of these cracks is described as well as the desired treatment. These are discussed relative to the location of the cracks, namely in the clinical crown of the tooth, resulting in enamel infraction, cracked tooth and crown fractures, and in the root of the tooth, resulting in a vertical or horizontal root fracture.

[Cervical external root resorption]. / Cervicale externe wortelresorptie.

Cervical external root resorption is a progressive resorption process occurring at the site of the attached gingiva. It is independent on the condition of the pulp. Prerequisites for its occurrence are a damaged root surface and the presence of vascularized connective tissue. The specific stimulus for the resorption to start is still unknown. In most cases the resorption process is without clinical symptoms; diagnosis is made on radiographs. The prognosis of teeth with cervical external root resorption is low: at the time of screening too much tooth material has often been resorbed to be able to make a restoration. Only limited resorption areas with good surgical accessibility may be successfully treated. Thus, of prime importance is an early screening of the resorption process. Therefore, in interpreting radiographs one should not only look for carious or periodontal decay, but also for areas indicative for cervical external root resorption. Complete radiographs are to be advised in order to screen for possible other resorption sites.

[Success of direct pulp capping after caries excavations]. / Succes van directe pulpaoverkappingen na excaveren.

Direct pulp capping is not generally accepted as a routine dental procedure. It is claimed to be an unpredictable procedure with a low success rate. However, some clinical studies do show success of direct pulp cappings. The aim of this study was to make an inventory of the success rate of direct pulp cappings performed by dental students, and of the variables which influenced the outcome. The success rate for the first 18 months after treatment was 73.8%. Only the variable 'type of tooth' showed a statistical significant correlation: front teeth showed a higher percentage of success than premolars and molars.

[Formaldehyde in dental materials]. / Formaldehyde in tandheelkundige materialen.

The use of formaldehyde in dentistry has been discussed for years. This because of the possible systemic effects of its use. This paper addresses the possible systemic effects of the use of formaldehyde and the question in which dental products formaldehyde is a component. The indications for the use of formaldehyde as its alternatives are listed. The conclusion is that for nearly all dental indications for the use of formaldehyde good alternatives are available.

Changes in dental attitude and behavior among Dutch adults wearing complete dentures.

In 1992 a follow-up on the Dutch National Dental Survey of 1986 (DNDS) was performed. The main objective was to detect and analyze changes in oral self care, dental attendance, and oral health status. This paper will focus on the DNDS adults wearing complete dentures. Changes over a 6-yr period will be presented of: dental attendance, denture satisfaction and wearing of the complete dentures, and denture treatments. A postal questionnaire was used: 232 persons (64%) participated in the study. Analysis of Variance (ANOVA) was used to study the effect of dental and social variables on observed changes since 1986. Risk ratios (RR) were computed to clarify the actual effects of these variables. With respect to dental attendance, a shift towards visits for denture check-ups was found, thought to reflect the respondents' concern for their complete dentures (RR = 1.6). A small shift towards more visits because of denture problems was found. This was attributed to denture treatments that had taken place between 1986 and 1992 (RR = 2.8). With respect to changes in denture satisfaction, no influence of denture treatments could be noted, but a relation was found with a variable indicating the imperfection of the complete dentures as felt by the respondents (RR = 2.8). In 31% of the respondents some denture treatment had been performed since 1986. No objective dental criteria of complete dentures and denture bearing areas had influenced these denture treatment decisions, but only respondents' subjective criteria (RR = 1.9-2.9).

Cosmetic dental treatment in an adult Dutch population.

In 1992 a follow-up to the Dutch national dental survey of 1986 (DNDS) was performed. The main objective was to analyse changes in oral self care, dental attendance, and oral health status. A postal questionnaire was used: 936 persons (44 per cent response) participated in the study. This paper will focus on the results concerning cosmetic dental treatment. Stepwise regression analyses were used to study the effect of dental and social variables. Relative risks (RR) were computed to clarify the effect of these variables. Of the group of respondents, 90 persons reported having been treated with veneers on their anterior teeth. The variables indicating cosmetic dental treatment needs established during the DNDS clinical dental examination, showed a statistically significant influence. 'Objective need': RR = 2.6; 'Subjective need': RR = 2.1. Out of 877 respondents with restorations present in 1986, 19 per cent reported having one or more of them replaced by composite or porcelain. Four variables were found to have a statistically significant influence: 'Subjective need': RR = 1.7; 'Number of filled tooth surfaces': RR = 1.6; 'Number of decayed tooth surfaces': RR = 1.4; and 'Frequency of toothbrushing': RR = 1.6. Whereas the dentists' opinions had the most influence on having veneer treatments, the patients' opinions had more influence on having amalgam restorations replaced with composite or porcelain.

Caries prevalence in Dutch elderly people.

In 1986 a nationwide oral survey was carried out in the Netherlands. One of the aims of this study was to assess the prevalence of oral diseases in adults. The present paper describes the prevalence of coronal and root caries in elderly Dutch subjects (45-74 years). The oldest age group (65-74 years) had, on average, the least number of teeth remaining; the posterior oral segment contained fewer teeth than the anterior segment. The anterior segment had the higher percentage of teeth with coronal caries and the posterior segment a higher percentage of filled teeth. The reverse was the case for root caries; a higher percentage of teeth had root caries in the posterior segment and the anterior segment a higher percentage of filled teeth.

[What to do about toothache?]. / Wat te doen bij tand- en kiespijn?

This article deals with the emergency treatments for various endodontic pain complaints and for those that can mimic such complaints. A table outlining the presented pain complaints and therapies is added as a summary.