ABSTRACT
In an avulsed tooth with an open apex, a recommended procedure is to coat the root surface with topical doxycycline before reimplantation. Doxycycline, a derivative of the tetracycline family, has an antibacterial effect and anti-inflammatory qualities, and is effective in reducing inflammatory and replacement resorption following dental trauma. Treating the root surface of an avulsed closed apex tooth is a rational and recommended procedure. A case is presented in which an avulsed closed apex tooth, conditioned with topical doxycycline, was reimplanted in the socket. At follow-up, 16 months later, no clinical signs and symptoms were present and radiographic evaluation showed only superficial root surface resorption and an intact PDL.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Doxycycline/therapeutic use , Incisor/injuries , Tooth Apex/drug effects , Tooth Avulsion/surgery , Tooth Replantation/methods , Tooth Root/drug effects , Administration, Topical , Anti-Bacterial Agents/administration & dosage , Child , Cuspid/injuries , Doxycycline/administration & dosage , Female , Follow-Up Studies , Humans , Root Canal Filling Materials/therapeutic use , Root Canal Obturation/methods , Root Canal Preparation/methods , Splints , Tooth Socket/surgery , Tooth, Deciduous/injuriesABSTRACT
"Flare-ups" during or following endodontic treatment are not uncommon. A "Flare-up" refers to post-operative pain and/or swelling resulting from bacterial, mechanical or chemical irritation. Prompt diagnosis and treatment are essential for reducing patients' pain and discomfort. Prevention of bacterial, chemical or mechanical invasion to the periapical tissues is the best approach. Other treatment modalities which reduce the probability of periradicular tissue irritation should also be adopted. Etiology, prevention, diagnosis and treatment options of "flare-up" cases are discussed as well as indications for analgesics, in accordance with the severity of the pain.
Subject(s)
Root Canal Therapy/adverse effects , Toothache/drug therapy , Toothache/etiology , Analgesics/therapeutic use , Humans , Pain Measurement , Pain, Postoperative/drug therapy , Pain, Postoperative/etiologyABSTRACT
The etiologic factors for vertical fractures in endodontically treated teeth are predisposing factors, such as loss of tooth material, anatomy of the susceptible teeth, moisture loss, previous dentinal cracks, and loss of bone support; and iatrogenic factors, such as excessive removal of radicular dentin as a result of endodontic and prosthetic procedures and improper selection of dowels. Identification of susceptible teeth and roots, proper selection and cementation of dowels, and avoidance of excessive force during condensation of gutta percha and in removal of tooth structure during endodontic and prosthetic procedures, are all measures that can be taken to prevent root fractures.
Subject(s)
Dental Restoration Failure , Tooth Fractures/etiology , Tooth Fractures/prevention & control , Tooth Root/injuries , Tooth, Nonvital , Humans , Risk Factors , Root Canal Therapy/adverse effectsABSTRACT
The goal of this protocol is to provide clear instructions which simplify the process of decision making and treatment of Luxation and Avulsion. In teeth with a closed apex, one should perform root canal therapy at the second appointment in teeth with injuries of luxation and avulsion (except for injuries of subluxation and concussion). The tooth should be reimplanted at site of accident if it possible. For avulsed teeth, the preferred storage medium is milk. One should condition the roots of teeth which have been avulsed. In teeth which have not finished development, the preferred treatment is to allow the continued development of the root.
Subject(s)
Tooth Avulsion/therapy , Animals , Anti-Bacterial Agents/pharmacology , Cattle , Dental Pulp/blood supply , Humans , Milk , Neovascularization, Physiologic , Periodontal Ligament/drug effects , Periodontal Ligament/physiology , Root Canal Therapy , Tetracycline/pharmacology , Tissue Preservation , Tooth Avulsion/surgery , Tooth Replantation , Tooth Root/growth & developmentABSTRACT
AIM: To compare procedural errors occurring during preparation of root canals by junior dental students in patients using a new '8-step method' versus traditional 'serial step-back technique. METHODOLOGY: Junior dental students treated 291 root canals of maxillary and mandibular teeth in patients. A new '8-step method' was used to prepare 149 canals, whilst the traditional 'serial step-back technique' was used for 142 root canals. Instrumentation was carried out in both techniques using standardized stainless steel K-files and coronal flaring with Gates-Glidden reamers. In the apical one-third, a filing motion was used in the traditional technique: with the '8-step method,' reaming or filing motions were used in sizes up to 25 and only reaming in sizes larger than 25. All root canals were obturated with gutta-percha points and AH26 using a lateral condensation technique. Pre- and postoperative radiographs were made of each tooth. Procedural errors were recorded and statistically analysed using a binomic test for comparison of proportion. RESULTS: Significantly (P < (1.0001) more root canals maintained their original shape with no deviation (91%) with the'8-step method' compared to the traditional 'serial step-back technique' (61%). The procedural errors detected with the'8-step method' consisted of 10 canals with transportation (5%) and five with root perforations (2%); there were no canal obstructions. With the 'serial step-back technique: significantly (P < 0.0001) more errors occurred: 28 canals were transported (17%), 10 had root perforations (7%), and 16 canals were obstructed (6%). The differences in maintaining the original root canal shape between the two methods were significantly greater in molar versus anterior teeth. CONCLUSIONS: The new '8-step method' resulted in fewer procedural errors than the traditional 'serial step-back technique' when junior students prepared root canals in patients.
