Cross-sectional assessment of apical dye penetration following clinical simulation of various endodontic techniques.

This study compared apical leakage in mesial roots of mandibular molars that resulted from three different instrumentation/obturation techniques performed in a simulated clinical setting: hand instrumentation by nickel-titanium files followed by cold lateral condensation of gutta-percha/sealer; rotary instrumentation followed by the Microseal system of obturation with softened gutta-percha; and rotary instrumentation followed by obturation with the Thermafil system. Lateral condensation generally was measured superior to the Thermafil method for preventing apical dye penetration while no consistent statistical differences were seen between the lateral condensation and Microseal groups.

Sensitivity of various radiographic methods for detection of oral cancellous bone lesions.

OBJECTIVE: The purpose of this study was to determine the effectiveness in diagnosing cancellous bone defects of the following radiographic methods: conventional film, digitized film, enhanced digitized film, direct digital imaging, enhanced direct digital imaging, digital subtraction, and enhanced digital subtraction. STUDY DESIGN: Mechanical lesions of varying depths were generated beneath cadaver molar and premolar mandibular tooth roots. A portfolio of radiographic images of random types and lesion sizes was presented to 20 clinicians, and their diagnoses were evaluated. RESULTS: Positive identification of lesions was significantly improved by enhanced subtraction radiography over all other forms of radiography for the 4-mm lesions and was better than all forms except enhanced digital radiography and film for the 6-mm lesions. Subtraction radiography and enhanced subtraction radiography significantly reduced false positive diagnoses at all lesion sizes in comparison with the other radiographic methods except enhanced digital radiography at the 6-mm lesion size. CONCLUSIONS: For the methods evaluated, only subtraction radiography and enhanced subtraction radiography can significantly improve the clinician's diagnostic abilities for detection of oral cancellous bone lesions through increased rates for detection of existing defects and, even more importantly, through decreased rates of defect misdiagnosis.

Treatment of the endodontic emergency: a decade later.

A questionnaire was sent to diplomates of the American Board of Endodontics to determine changing trends in the treatment of endodontic emergencies since Dorn's survey 10 yr ago. There is a definitely greater trend toward complete instrumentation of the root canals to the apex regardless of the emergency condition than there was a decade ago. The number of respondents who leave teeth open when the pulp is nonvital has dropped dramatically in the past decade. When there is no periapical involvement, over one third of the respondents are completing treatment in one visit. A decrease in the use of classic phenolic medicaments was noted with a corresponding increase in calcium hydroxide or no medication at all.

Oral hygiene for the severely handicapped: clinical evaluation of the University of Mississippi dental care system.

The study reported here was a clinical evaluation of an automatic toothbrushing device for persons with severe handicapping conditions. This device, the University of Mississippi dental care system, is designed for patients who are unable to control their arms and hands. The effectiveness of this device was compared to routine (ordinary, manual) regimens of oral hygiene through use of gingival (Loe-Silness) and plaque (Turesky) indexes (GIs, PIs). Plaque indexes for patients under routine care averaged 2.11; PIs for patients under the dental care system averaged 1.47. Based on Ebbutt's extra period changeover design model, the t-test for difference in plaque scores is significant (P less than .001). The results indicate that the University of Mississippi dental care system improves the patients' ability to independently control plaque.