Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study.

OBJECTIVE: This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors. METHODS: The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors. RESULTS: The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05). CONCLUSION: Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

Evaluation of cases of concussion and subluxation in the permanent dentition: a retrospective study.

Objectives This study evaluated the evolution of cases of concussion and subluxation through a retrospective study of 20 years. Material and Methods Were examined clinical and radiographic records of 1,309 patients who underwent treatment of dentoalveolar trauma in the discipline of Integrated Clinic of the School of Dentistry of Araçatuba, UNESP, of which we selected 137 whose patients had concussion and subluxation injuries, with average age of 23.3 (SD - 10.96). The variables collected were: gender, age, history of previous and actual trauma, treatments performed, the presence of necrotic pulp, and time elapsed until the same trauma. The concussion and subluxation groups were subjected to statistical analyses using the SPSS 16.0 version software (α=0.05), Chi-square, and t-tests. Results Of the 301 teeth involved, 49 (16.3%) suffered concussion and 252 (83.7%), subluxation, being the upper anterior teeth the most affected (75.1%) for both conditions. Subluxation and concussion traumas were more prevalent in men aged 10 to 20 years, most caused by cycling accidents (36.2%). There was a concomitant presence of crown fracture in 21% of cases of concussion and 34.7% of subluxation. Pulp necrosis was detected in 16.3% (concussion) and 27.1% (subluxation) (p=0.12), and most occurred within 6 months after the trauma (p=0.29). The pulp necrosis shows a positive correlation with motorcycle accidents (p=0.01), direct impact (p≤0.0001), crown fracture with pulp exposure (p≤0.0001), darkening of the crown (p=0.004) and spontaneous pain (p≤0.0001); and negative correlation with indirect impact (p≤0.0001). Conclusions Although concussion and subluxation traumas are considered of minor degrees, they must be monitored, since the possibility of pulp necrosis exists, and its early treatment favors a good prognosis.

Evaluation of cases of concussion and subluxation in the permanent dentition: a retrospective study

Abstract Objectives This study evaluated the evolution of cases of concussion and subluxation through a retrospective study of 20 years. Material and Methods Were examined clinical and radiographic records of 1,309 patients who underwent treatment of dentoalveolar trauma in the discipline of Integrated Clinic of the School of Dentistry of Araçatuba, UNESP, of which we selected 137 whose patients had concussion and subluxation injuries, with average age of 23.3 (SD - 10.96). The variables collected were: gender, age, history of previous and actual trauma, treatments performed, the presence of necrotic pulp, and time elapsed until the same trauma. The concussion and subluxation groups were subjected to statistical analyses using the SPSS 16.0 version software (α=0.05), Chi-square, and t-tests. Results Of the 301 teeth involved, 49 (16.3%) suffered concussion and 252 (83.7%), subluxation, being the upper anterior teeth the most affected (75.1%) for both conditions. Subluxation and concussion traumas were more prevalent in men aged 10 to 20 years, most caused by cycling accidents (36.2%). There was a concomitant presence of crown fracture in 21% of cases of concussion and 34.7% of subluxation. Pulp necrosis was detected in 16.3% (concussion) and 27.1% (subluxation) (p=0.12), and most occurred within 6 months after the trauma (p=0.29). The pulp necrosis shows a positive correlation with motorcycle accidents (p=0.01), direct impact (p≤0.0001), crown fracture with pulp exposure (p≤0.0001), darkening of the crown (p=0.004) and spontaneous pain (p≤0.0001); and negative correlation with indirect impact (p≤0.0001). Conclusions Although concussion and subluxation traumas are considered of minor degrees, they must be monitored, since the possibility of pulp necrosis exists, and its early treatment favors a good prognosis.

Estudio histológico descriptivo de la colonización de bacterias en los túbulos dentinarios de dientes extraídos con necrosis pulpar / A descriptive histological study of bacterial colonization in the dentinal tubules of extracted teeth with pulp necrosis

Antecedentes: uno de los objetivos del tratamiento endodónticoconsiste en lograr la eliminación de los microorganismos residentes enlos conductos radiculares. Sin embargo, los microorganismos presentesen la necrosis pulpar se adaptan a las condiciones de los conductosnecróticos penetrando en los túbulos dentinarios, lo que complica elpronóstico del tratamiento. Objetivo: El propósito de esta investigaciónfue describir histológicamente las zonas de formación y distribución dela biopelícula tanto en los conductos como en los túbulos dentinarios dedientes extraídos con patología pulpo-periapical. Material y métodos:Se estudiaron 34 muestras de dientes extraídos con lesiones periapicales.Ninguno de los especímenes tenía tratamiento de conductos previo, nilesión endoperiodontal, ni fractura longitudinal o fractura de la raíz.Los dientes fueron descalcifi cados en ácido fórmico al 5% en formolamortiguado durante siete semanas. Se realizó el procedimiento histoló-gico de rutina para inclusión de las muestras en parafi na. Se obtuvieroncortes seriados longitudinales del conducto pulpar para someterlos atinción con hematoxilina y eosina, tinción de ácido peryódico de Schiff ,metenamina de plata y de Gram & Taylor Brown-Brenn para identifi carlos túbulos dentinarios, la presencia de hongos y bacterias. Resultados:De los 544 cortes estudiados, 75% (405) tuvieron colonizaciónmicrobiana. No se encontraron evidencias de la presencia de hongos.Con respecto a la profundidad de penetración de los microorganismosen los túbulos se identifi caron 194 cortes (35.6%) con presencia debacterias en 150 μm y 211 muestras (38.7%) en los que la penetraciónfue más allá de 500 μm...

Background: one of the main goals of endodontic treatment is toachieve the elimination of resident microorganisms in the root canal.However, the microorganisms involved in the pulp necrosis adapt to theconditions of necrotic canals, penetrating the dentinal tubules, whichcomplicates treatment. Objective: The purpose of this research was tohistologically describe the areas of formation and distribution of biofi lmin both the canals and the dentinal tubules of teeth extracted with pulpand periapical pathology. Material and methods: 34 samples of teethwith periapical lesions were studied. None of the specimens had priorcanal treatment, endoperiodontal injury, fracture nor longitudinal rootfracture. Teeth were decalcifi ed with 5% formic acid and buff ered withformalin for 7 weeks. Histological routine procedure for includingsamples in paraffi n was conducted. Longitudinal serial sections wereobtained of the pulp canal space for submission to staining withhematoxylin and eosin, peryodic acid Schiff , methenamine silver, andGram & Taylor Brown-Brenn, to identify dentinal tubules and thepresence of fungi and bacteria. Results: Of the 544 histological sectionsunder study 75% (405) showed microbial colonization. No evidence offungi was found. 194 histological sections (35.6%) had microorganismspenetrating the dentinal tubules to a depth of 150 microns, and 211histological sections (38.7%) had microorganisms penetrating thedentinal tubules for more than 500 μm...

Association between Sickle Cell Anemia and Pulp Necrosis.

INTRODUCTION: The purpose of this study was to evaluate the association between sickle cell anemia (SCA) and pulp necrosis (PN). METHODS: One hundred thirteen individuals with SCA (ie, the exposed group) from the Supervision of Hematology and Hemotherapy of Maranhão (HEMOMAR), Maranhão, Brazil, and 226 individuals without SCA, the sickle cell trait, or other diseases (ie, the nonexposed group) were enrolled in this study. All participants were over 16 years old and had at least 1 clinically intact permanent tooth. Patients with SCA and a history of lower alveolar nerve paresthesia and those who had suffered from vasoocclusive crises within the previous 6 months were excluded. PN of clinically intact permanent teeth without a history of orofacial trauma was diagnosed using the cold thermal test (CTT) and pulse oximetry adapted for dentistry (POD). Poisson regression was used to estimate the associations (P < .05). RESULTS: In an unadjusted analysis, the occurrence of PN in clinically intact permanent teeth was 8.33 times higher in the exposed group than in the nonexposed group (P < .001). This association remained significant after adjusting for a history of orofacial trauma and folic acid use for the CTT and POD evaluations. CONCLUSIONS: In conclusion, SCA is a potential risk factor for PN in clinically intact permanent tooth.

Frequency and distribution of teeth requiring endodontic therapy in an Argentine population attending a specialty clinic in endodontics.

OBJECTIVES: To determine the frequency and distribution of 975 teeth in need of endodontic treatment in an Argentine patient pool and to compare the results with previously published surveys. METHODS: Of the 975 teeth from 860 individuals (age range 7-86 years) were endodontically treated during 2007 by postgraduate students enrolled in a specialisation programme in Endodontics. All patients were examined clinically and radiographically. For each case, information was collected in a questionnaire including location of the affected tooth, age and gender and reasons for endodontic treatment. Data were analysed by the Student t-test, the Fisher exact test, and the chi-square test with a significance of P < 0.05. RESULTS: Of the 975 treated teeth, 543 (55.69%) were maxillary and 432 (44.30%) mandibular teeth. 635 (65.13%) were from females and 340 (34.87%) from males. Significant differences were found between the maxillary and mandibular arch (P = 0.01). Molars and premolars required significantly more frequent endodontic treatment than canines and incisors (P < 0.001). The most frequently treated tooth was the mandibular right first molar (9.12%) followed by the mandibular left first molar (7.07%). The most frequently diagnosed pathosis was irreversible pulpitis (36.00%), pulp necrosis (30.80%), apical periodontitis or the presence of easily discernible periapical radiolucent areas (27.20%). Caries (59.18%) and failure of previous endodontic treatment (26.97%) were responsible for most of the affected teeth. CONCLUSIONS: Comparison with previous surveys revealed that more females than males received endodontic treatment and that mostly molars and premolars were in need of endodontic treatment. The high number of root filled teeth requiring retreatment is in agreement with a pattern similar to that observed in other countries and supports the need for more specialists in endodontics in the Republic of Argentina.

Frequency of intrusive luxation in deciduous teeth and its effects.

The aims of this study were three-fold: First, to determine the prevalence of partial and total intrusion of the primary anterior teeth. Second, to investigate the sequelae of total and partial intrusive luxation in the primary anterior teeth and in their successors and finally, to establish whether the sequelae on both deciduous and permanent teeth were related to the child's age at the time of the intrusion. Data collected from records of 169 boys and 138 girls, all between the ages of zero and 10 years, who were undergoing treatment during the period of March 1996 to December 2004. The sample was composed of 753 traumatized deciduous teeth, of which 221 presented intrusive luxation injury. Children with ages ranging from one to 4 years were the most affected with falls being the main cause of intrusion. Of all intruded teeth 128 (57.9%) were totally intruded and 93 (42.1%) partially. Pulp necrosis/premature loss and color change were the most frequent sequelae in both total and partial intrusions. Concerning permanent dentition, the most common disturbances were color change and/or enamel hypoplasia. Both types of intrusion caused eruption disturbance. Total intrusion was the most frequent type of intrusive luxation. There was no significant correlation between the child's age at the time of intrusion and the frequency of subsequent sequela on primary injured teeth (P = 0.035), between the age at the time of injury and the developmental disturbances on permanent teeth (P = 0.140).

Nonendodontic periapical lesions: a retrospective study in Chile.

AIM: To determine the frequency with which the histopathological diagnosis of periapical lesions contributes to a change in the clinical diagnosis. METHODOLOGY: Cases having a clinical diagnosis of disease resulting from dental pulp necrosis were selected from the database of the Oral Pathology Reference Institute between 1975 and 2005. Cases with different histopathological diagnoses were determined and information about age and gender of the patient, location of associated tooth, pulp status and the histopathological diagnosis were recorded. The percentage of nonendodontic periapical lesions was then determined. RESULTS: In the 30-year period, 32,423 [corrected] biopsy specimens were received. Overall 4006 (9.13%) had a clinical diagnosis of pulpal necrosis with associated pathosis in the periradicular area. Within this group, 26 cases (0.65%) had a histopathological diagnosis of nonendodontic pathology. Keratocystic odontogenic tumour was the most frequent nonendodontic lesion (11 cases) in the periradicular region followed by central giant cell granuloma (three cases), chronic sinusitis (three cases) and one case each of the following lesions: nasopalatine duct cyst, lateral periodontal cyst, calcifying cystic odontogenic tumour, ameloblastic fibroma, squamous odontogenic tumour, cemental dysplasia, haemangioma, foreign body cell granuloma and amalgam tattoo. CONCLUSIONS: The histopathological study of periapical pathosis can occasionally reveal nonendodontic lesions. Odontogenic tumours made up the largest group.

Prevalencia del surco de desarrollo en incisivos superiores permanentes y su vinculación con problemas pulpares y periodontales / Prevalence of developmental groove in permanent upper incisors and its-

Objetivo: Establecer la prevalencia del surco de desarrollo en incisivos superiores permanentes de la población que acudió por primera vez a consulta a la Clínica Odontológica Iztacala y la Clínica de Especialización de Endoperiodontología, en un periodo de seis meses, estableciendo la dirección, profundidad y conformación de los surcos de desarrollo encontrados en dicha población, se determinó la frecuencia de problemas pulpares y periodontales relacionados con los surcos de desarrollo encontrados. Hipótesis: Si el surco de desarrollo es un factor que predispone al acúmulo de placa dentobacteriana entonces aquellos pacientes que lo presenten tendrán enfermedad periodontal, caries y/o alteración pulpar. Material y método: El diseño de la investigación fue de tipo descriptivo, prospectivo, observacional y no experimental, en relación con la evolución del fenómeno se planteó un diseño transversal y correlacional. Resultados: El promedio de las bolsas periodontales fue de 3.5 mm, lo que ayudó a establecer que la mayoría de los pacientes con esta anomalía padecen enfermedad periodontal. En cuanto a caries se observó que el 64 por ciento de los surcos la presentaban. El 51 por ciento de los pacientes presentaron pulpa sana y sólo 49 por ciento presentó una alteración pulpar, de las cuales el 36 por ciento fue pulpitis reversible, 9 por ciento pulpitis irreversible y 4 por ciento necrosis pulpar, con ello se estableció que sí existe una relación entre el surco de desarrollo y la alteración pulpar aun cuando no se tenga el mayor porcentaje, sin embargo éste es considerable. El surco de desarrollo fue más frecuente en el sexo femenino, se presenta en un porcentaje bajo del total de la población estudiada. La mayor prevalencia fue en los laterales, en su porción media. Conclusión: Esta anomalía es un factor predisponente de la caries , enfermedad periodontal y enfermedad pulpar, esta conclusión está basada en la positividad de las pruebas de correlación de Pearson...

Prevalence of Prevotella intermedia and Prevotella nigrescens in infected root canals from a Brazilian population.

The purpose of the present study was to evaluate the prevalence of Prevotella intermedia and Prevotella nigrescens in symptomatic and asymptomatic endodontic infections from a Brazilian population. DNA extracted from samples obtained from 28 cases of endodontic infection were examined by the 16S rDNA-directed Polymerase Chain Reaction (PCR) method. PCR detected P. intermedia in 7.1% of the cases (2 out of 28 teeth) and P. nigrescens in only one sample (3.6%). The low prevalence of P. intermedia and P. nigrescens as reported in the present study is probably justified for geographical reasons.