The effect of ultrasonics on sealer distribution and sealing of root canals.

The purpose of this study was to compare the ultrasonic and hand methods of sealer placement using three types of sealers: Sultan "Grossman's formula," AH-26, and CRCS. The effect of these methods on radiographic density, sealer distribution, and on the apical seal of the different sealers was evaluated. The in vitro experiment was carried out using human extracted mandibular incisors and mesio-buccal roots of maxillary first and second molars. Following standardized canal instrumentation, 120 single canal mandibular incisors were randomly assigned to six groups, depending on the type of sealer and method of sealer placement (hand versus ultrasonic). An additional ten teeth were used as controls. In the molar groups 40 canals were randomly assigned to two groups, with the method of sealer placement as the variable. Eight canals were used as controls. Postsealer analyses using radiographic density scores transformed to mm of sealer indicated that ultrasonics was superior to manual placement only for CRCS. Taken together, our investigation suggests that ultrasonics may enhance the placement of some sealers (i.e. CRCS) but not of others (i.e. AH-26 or Sultan). Method of sealer placement had no effect on apical leakage and therefore apparently on apical seal.

Canines erupted through grafted alveolar cleft defects in patients with alveolar clefts: a pulp testing evaluation study.

An electric pulp tester (EPT) was used to evaluate the pulpal response of erupted canines in 75 patients: 16 patients with unilateral cleft palate who received autogenous bone grafts to correct their alveolar cleft defects before canine eruption; 35 patients without cleft palate whose canines erupted spontaneously, but who required orthodontic treatment for alignment; and 24 patients without clefts whose canines required surgical uncovering and orthodontic assistance for eruption. Thirty-one percent of the erupted canines in the patients with grafted unilateral clefts did not respond to EPT, whereas all canines in the contralateral noncleft side responded to EPT. There was no clinical or radiographic evidence of pulpal pathosis of the canines that had erupted through the grafted alveolar clefts. However, these teeth had a high incidence of nonresponsiveness to pulp stimulation, therefore necessitating close follow-up in case they show eventual signs of pulpal degeneration that may require endodontic intervention.

Porous hydroxylapatite granules and blocks as alveolar ridge augmentation materials: a preliminary report.

Porous hydroxylapatite (PHA) blocks and granules were used in the augmentation of 30 maxillary and mandibular ridges in 28 patients. The postoperative evaluation period was 2 years in all cases. The patients were evaluated clinically and radiographically, and by patient questionnaires. An increased incidence of dehiscence was noted with the blocks as compared with the granules. Overall prosthodontic assessment showed 95% improvement among the granule cases when compared with the preoperative ridge, and 88% improvement noted among the block cases. Patient rating of their general satisfaction with their dentures showed 82% improvement in the granule patients, and 55% in the block cases. Radiographically, the granules showed an average decrease of 8%. The results of this study show that PHA granules can be used as satisfactory alveolar ridge augmentation material, while the blocks show an increased number of complications and should be used only in very selected cases.

Nonporous hydroxylapatite granules as an extracranial and extranasal augmenting material in dogs: technique and initial findings.

The purpose of this study was to evaluate the use of nonporous hydroxylapatite (HA) granules as an extracranial and extranasal augmentation material in dogs. Clinical evaluation revealed that the HA granules became stable within 6 weeks and lost some of the augmented height. Histologic evaluation revealed no evidence of inflammation, bone resorption, or bone formation; also the granules were separated from other granules and the cranial surface by a layer of collagen fibers. This study concluded that nonporous HA granules are a practical extracranial and extranasal augmentation material, but its final augmentation contour is difficult to predict and control because of the consistency of the material. Either researchers need to develop a better method to stabilize HA granules in extracranial and extranasal applications or they need access to an HA block material that maintains better augmented contour.

Periodontal evaluation of canines erupted through grafted alveolar cleft defects.

Two to eight years after receiving autogenous iliac crest grafts for treatment of alveolar cleft defects, eighteen patients who had unilateral cleft palate were evaluated for their periodontal status. When cleft-associated canines were compared with contralateral control canines, no statistically significant differences were found between specific surface values for plaque index, gingival index, or probing depths. Attachment loss was found to be greater (less than 0.72 mm) on the mesio-facial, facial, and mesio-palatal surfaces of the cleft-associated canines than on the control canines. Fifty-six per cent of the cleft-associated canines required surgical exposure and 44% also required orthodontic assistance to erupt to a functional occlusion. Osseous grafting of alveolar cleft defects resulted in satisfactory clinical periodontal support for cleft-associated canines.