Regenerative endodontic treatment of an immature permanent canine - A case report of a 13-year follow-up.

Data on long term survival and tooth stability after regenerative endodontic treatment are missing. The purpose of the present report is to describe regenerative endodontic treatment of a permanent mandibular canine with extensive coronal hypoplasia, immature root, and a periapical radiolucency. The regenerative endodontic treatment was initiated by irrigation of the root canal, followed by three weeks of triple antibiotic paste dressing and the creation of a blood clot scaffold covered with mineral trioxide aggregate. A one year clinical and radiographic follow-up demonstrated healing of the periapical radiolucency and the tooth remained stable and sound for almost thirteen years post treatment.

Outcomes of Calcium Hydroxide with Iodoform Pulpectomies in Primary Teeth.

Purpose: To assess retrospectively the success rate of calcium hydroxide with iodoform as a filling material in pulpectomies of primary molars with irreversible pulpitis or pulp necrosis, and to evaluate factors that affect outcomes.
Methods: This study consisted of records of 73 patients with primary molars treated with pulpectomy with high quality radiographs. Treatment was considered successful clinically if the tooth was not extracted and radiographs showed a decrease or no change in preexisting pathologic radiolucent defects.
Results: Follow-up ranged from three to 39 months (median: 21.5 months). The success rate of teeth restored with a stainless steel crown (SSC) on the same appointment (88.9 percent) was higher than for teeth that received a temporary restoration (P =0.001). There was no statistically significant difference between the success rate and the extent of resorption of root canal filling material. Primary second molars had a higher success rate than first molars (P =0.018). No difference was found between the level of pulpectomy filling and treatment success (P =0.17).
Conclusion: Pulpectomies done with calcium hydroxide and iodoform had an overall success rate of 74 percent. If restored with an SSC, the success rate increased to 88.9 percent. Resorption of the paste did not affect the success rate.

A Randomized Controlled Clinical Trial Comparing Tricalcium Silicate and Formocresol Pulpotomies Followed for Two to Four Years.

Purpose: Tricalcium silicate (Biodentine), a new synthetic inorganic restorative cement, has shown a high rate of success in pulpotomy treatments, with few side effects. The purpose of the present randomized clinical control trial was to evaluate the long-term success of pulpotomies in human primary molars using tricalcium silicate versus formocresol. Methods: Healthy two- to 10-year-olds were treated with pulpotomies on primary molars as part of their scheduled regular dental treatment. Pulp dressing alternated randomly between tricalcium silicate and formocresol. Data were analyzed at follow-up periods up to 48 months. Results: Thirty-seven (51.4 percent) teeth with tricalcium silicate and 35 (48.6 percent) teeth with formocresol in 58 healthy children (31 boys and 27 girls) were studied. The overall success rate of the pulpotomies in this study was 94.4 percent. Tricalcium silicate was successful in 97.3 percent (36 out of 37) of the cases, and formocresol in 91.4 percent (32 out of 35). No association was found between success and type of tooth or time range from treatment to last follow-up. Conclusion: Tricalcium silicate shows a higher (though not statistically significant) success rate than formocresol in human primary molars pulpotomies followed for two to four years.

Auriculotemporal nerve syndrome (Frey's syndrome): A literature review and case report.

Frey's syndrome in children is rare and often erroneously attributed to food allergy. A description of a case of Frey's syndrome in a child and a review of the literature is provided. Awareness of this condition is important for the pediatric dentist to avoid unnecessary medical procedures and provide reassurance to the dental team in the setting of this benign condition.

Caries Progression Rate in Primary Teeth: A Retrospective Study.

OBJECTIVES: The rate of caries progression in primary teeth has rarely been studied, with most studies on early childhood caries reporting the percentage of lesions that remain at a certain stage of disease over a period of time. The aim of the present study was to examine the prevalence and behavior of proximal and occlusal carious lesions in primary teeth among children from low socio-economic status. STUDY DESIGN: This retrospective study was based on bite-wing radiographs of 95 children aged 5-12 taken at 6-12 months intervals, with a follow-up period of at least three years. One hundred thirty-five teeth and 141 tooth surfaces were examined. The degree of proximal surfaces and occlusal caries advancement was scored and statistical analyses (Mann-Whitney, Kruskal-Wallis and Kaplan-Meier analysis) were performed to evaluate caries progression rate. RESULTS: The results revealed that approximately 0.8 years were required for a carious lesion to progress from the outer enamel to the dentino-enamel junction, and an additional 1.4 years for it to reach the inner part of the dentin. CONCLUSIONS: The caries progression rate found in the present study is more rapid than previously found and affects more the lower socio economic population.

Post-and-Core Restoration of Severely Damaged Permanent Posterior Teeth in Young Adolescents.

PURPOSE: This retrospective study evaluated the survival rates of postendodontic severely decayed posterior permanent teeth in young adolescents. MATERIALS AND METHODS: A total of 48 teeth (patient age range: 8.8-16.9 years) restored with a Kurer post- and core-system (Anchor System, Kurer K4) were assessed. Follow-up appointments 1 to 6 years posttreatment included radiographs and a clinical examination. RESULTS: A total of 5 teeth (10.4%) were extracted, and 13 restorations (27%) required repair. Average restoration-to-failure time was 27 months (SD 12.2 months). CONCLUSION: In view of these findings, clinicians should consider post-and-core restorations an alternative to extractions of endodontically treated severely damaged teeth in adolescents.

Pink Spot - Literature Review and Case Report.

BACKGROUND: Pink spots in teeth were first described by Mummery in 1920, and were related to resorption. Resorption is a pathologic process that often eludes the clinician with its varied etiologic factors and diverse clinical presentations. Resorption can be generally classified as internal and external resorption. Internal resorption has been described as a rare occurrence as compared to external resorption. CASE REPORT: This article describes a pink spot that was diagnosed as a progressing resorption process. Early diagnosis enabled a successful management of the lesion. CONCLUSION: Early diagnosis and treatment of an internal resorption, clinically seen as a pink spot, in a primary central incisor may prevent its fast progress and subsequent loss.

Pediatric intraoral high-flow arteriovenous malformation: a diagnostic challenge.

Arteriovenous malformations (AVMs) are rarely reported in the dental pediatric literature. They may develop adjacent to primary molars and can be life-threatening due to their potential for massive bleeding. The most common symptom associated with documented cases of AVMs is spontaneous gingival bleeding. Other clinical signs include pain, erythematous gingiva, resorption and mobility of teeth, soft tissue discoloration, facial swelling, and asymmetry. Radiographically, AVMs are osteolytic lesions. The purpose of this report was to describe the challenge of diagnosis of a high-flow arteriovenous malformation located in the primary maxillary molar region, which was misdiagnosed as a dentoalveolar abscess adjacent to previously treated primary molars. A decision to extract a tooth with gingival swelling and associated spontaneous bleeding should be made after the differential diagnosis of a vascular malformation has been ruled out.

Cytotoxicity and proliferative effects of Iodoform-containing root canal-filling material on RAW 264.7 macrophage and RKO epithelial cell lines.

OBJECTIVE: The present study investigated the effect of the Iodoform-containing root canal filling material on the viability of cultured macrophages and epithelial cells, and on cytokine secretion. DESIGN: The effect of Endoflas F.S. on the proliferation of a RAW 264.7 macrophage cell line and on a RKO epithelial cell line, and on the production of tumour necrosis factor alpha (TNFα) from macrophages was examined. Cell vitality was evaluated using a colourimetric XTT (sodium 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)-carbonyl]-2H-tetrazolium inner salt) assay. The presence of cytokines was determined by two-site enzyme-linked immunosorbent assay (ELISA). RESULTS: Direct exposure of Endoflas F.S. and its media, up to a dilution of 1/8, decreased the viability of macrophages and epithelial cells by ∼70% compared to control media (P<0.05). Media dilution from 1/16 to 1/1024 demonstrated a proliferative effect, increasing cell viability by about 60% compared to media without Iodoform-containing root canal filling material. CONCLUSIONS: Direct and indirect exposure to high concentrations of iodoform-containing root canal filling material showed a cytotoxic effect on macrophages and epithelial cells, while low concentrations induced cell proliferation.