Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Aug 2000.> Search Strategy (You Saved Citations 1-300 From Set 32): ----------------------------------------------------------------------------- 1 "root canal".mp. 4822 2 apicoectomy.mp. 1008 3 apicectomy.mp. 78 4 pulpectomy.mp. 809 5 endont:.mp. 7 6 (pulp adj3 extirpation:).mp. 75 7 Endodontics/ 815 8 Apicoectomy/ 983 9 Dental implantation, endosseous, endodontic/ 407 10 exp Root canal therapy/ 9841 11 (endodont: adj3 treatment).mp. 1145 12 (endodont: adj3 therapy).mp. 716 13 (pulp adj3 therapy).mp. 159 14 endodont:.ti,ab. 5988 15 or/1-14 14593 16 exp cohort studies/ 364432 17 prognosis/ 159858 18 exp mortality/ 109455 19 exp morbidity/ 104471 20 (natural adj history).ti,ab. 14498 21 prognos$.ti,ab. 126536 22 course.ti,ab. 191211 23 predict$.ti,ab. 233041 24 exp "Outcome assessment (health care)"/ 101532 25 outcome$1.ti,ab. 169832 26 (inception adj cohort$1).ti,ab. 370 27 disease progression/ 12534 28 exp survival analysis/ 27464 29 or/16-28 1165792 30 15 and 29 1253 31 limit 30 to (human and yr=1980-2000) 973 32 limit 31 to yr=1990-2000 694 33 from 32 keep 1-300 300 *************************** <1> UI - 20308818 AU - Caldwell RE AU - Freilich MM AU - Sandor GK IN - Hospital for Sick Children, Toronto, Ontario. TI - Two radicular cysts associated with endodontically treated primary teeth: rationale for long-term follow-up. SO - Ontario Dentist 1999 Oct;76(8):29-33 AB - Although radicular cysts are relatively rare, they do occur. In addition, it appears that these lesions present in association with endodontically treated primary teeth. As shown in this paper and previous reports, cysts can be associated with a variety of pulp therapies. These lesions can lead to bony expansion and resorption. Radicular cysts may also cause displacement and damage to the developing permanent dentition. Given the severity of these sequelae it is prudent to recommend regular radiographic examination of primary teeth that have undergone pulp therapy. <2> UI - 20285585 AU - Finucane D AU - Kinirons MJ IN - Department of Paediatric Dentistry, School of Dentistry, Queen's University of Belfast, Northern Ireland, UK. TI - Non-vital immature permanent incisors: factors that may influence treatment outcome. SO - Endodontics & Dental Traumatology 1999 Dec;15(6):273-7 AB - This study examines the treatment of non-vital immature permanent incisors using the calcium hydroxide apexification technique. The objectives of the present study were to determine the speed and location of barrier formation and those factors discernible at presentation and during treatment which may be related to it. Forty-four non-vital immature incisors undergoing calcium hydroxide apexification were reviewed in detail. All cases were reviewed every 8-12 weeks for up to 18 months, or until apexification occurred. Details of the time and nature of the injuries and treatment were recorded. The degree of apical development prior to treatment was assessed, and barrier formation, location and time were noted. Mean time to barrier formation was 34.2 weeks (range 13-67 weeks). The strongest predictor of rapid barrier formation was the rate of change of calcium hydroxide and a barrier also formed more rapidly in cases with narrower initial apical width. There was evidence of displacement and a higher mean time for barrier formation in half of the cases. The presence of an abscess was the weakest predictor of rapid barrier formation and the effect was not significant (P = 0.280). The barrier was located at the apex in 28 cases (63.6%) and the distance from the barrier to the apex for the remaining 16 (36.4%) varied from 1 mm to 5 mm. The number of placements of calcium hydroxide varied from 1 to 4 with a mean of 1.9, and there was a higher mean number of calcium hydroxide placements in the cases where the barrier was located at the apex. <3> UI - 20285581 AU - Hulsmann M AU - Schinkel I IN - Department of Operative Dentistry, University of Gottingen, Germany. TI - Influence of several factors on the success or failure of removal of fractured instruments from the root canal. SO - Endodontics & Dental Traumatology 1999 Dec;15(6):252-8 AB - The influence of several factors on the success rate of removal procedures of fractured endodontic instruments was evaluated postoperatively. In 105 teeth with 113 fragments removal attempts were undertaken using a wide range of techniques and instruments. All cases were analyzed with special regard to the following factors: type of tooth and root canal, site of fragment in relation to root canal curvature, length of fragment, and type of fractured instrument. Success of treatment was defined as removal or complete bypassing of the fragment. Of 82 instruments in molars (maxillary: 32, mandibular: 50), 56 were removed or bypassed (max.: 26, mand.: 30). Of 16 fragments in premolars (max.: 12, mand.: 4), 8 could be removed or bypassed (max.: 6, mand.: 2). Of 14 fragments in canines and incisors (max.: 7, mand.: 7), 13 could be removed completely (max.: 6, mand.: 7). When the fragment was localized before the curvature 2 of 18 cases failed, when localized inside the curvature 13 of 31 cases failed and when localized beyond the curvature 15 of 33 cases failed. Anatomical factors favorable for removal were: straight canals, incisors and canines, localization before the curvature, length of fragment more than 5 mm, localization in the coronal or mesial third of the root canal, reamer or lentulo spirales. In molars removal procedures were most successful in the palatal canals of maxillary molars. <4> UI - 20285580 AU - Potocnik I AU - Bajrovic F IN - Department of Restorative Dentistry and Endodontics, University of Ljubljana, Slovenia. TI - Failure of inferior alveolar nerve block in endodontics. [Review] [36 refs] SO - Endodontics & Dental Traumatology 1999 Dec;15(6):247-51 AB - Analgesia is essential for successful completion of modern dental procedures. Standard inferior alveolar nerve block (IANB) is the primary method used to achieve mandibular analgesia. Difficulty experienced in obtaining satisfactory analgesia after IANB, especially of an acutely inflamed mandibular molar, remains a common clinical problem. Even when a proper technique is employed, clinical studies show that IANB fails in approximately 30% to 45% of cases. The reasons for failure are not fully understood. Anatomical considerations and abnormal physiological responses in the presence of inflammation as explanations for IANB failure are discussed in this paper. [References: 36] <5> UI - 20285574 AU - Sidaravicius B AU - Aleksejuniene J AU - Eriksen HM IN - Stomatological Clinic, University of Vilnius, Lithuania. TI - Endodontic treatment and prevalence of apical periodontitis in an adult population of Vilnius, Lithuania. SO - Endodontics & Dental Traumatology 1999 Oct;15(5):210-5 AB - Apical periodontitis is prevalent in many Western populations and is frequently detected in connection with inferior quality of endodontic treatment. However, information about endodontic conditions from eastern European countries is limited. The aim of the present investigation was to study the prevalence of apical periodontitis and the quality of endodontic treatment in 35-44-year-old Lithuanians. The prevalence of apical periodontitis was 70%. An overall success rate of 65% was found for root-filled teeth while 56% of pulp amputations (pulpotomies) were considered successful based on a radiographic evaluation. The quality of the root fillings showed little impact on the treatment results, except for over-extended fillings, which were associated with a high number of failures. <6> UI - 20285628 AU - Leonard RH Jr AU - Haywood VB AU - Eagle JC AU - Garland GE AU - Caplan DJ AU - Matthews KP AU - Tart ND IN - Department of Diagnostic Sciences and General Dentistry, University of North Carolina School of Dentistry, Chapel Hill, USA. Ralph:Leonard@dentistry.unc.edu TI - Nightguard vital bleaching of tetracycline-stained teeth: 54 months post treatment. SO - Journal of Esthetic Dentistry 1999;11(5):265-77 AB - PURPOSE: The purpose of this longitudinal whitening study was to determine the stability, post-treatment side effects, and patient satisfaction after 6 months of active treatment of tetracycline-stained teeth with 10% carbamide peroxide at 0 and 54 months post treatment. MATERIALS AND METHODS: Twelve patients who completed the study (80%) were contacted and asked to participate in a survey concerning their whitening experience. Subjects were asked whether there had been any change in the shade of their teeth after treatment, and if they had experienced any side effects that they believed were treatment-related. Eight of the twelve patients underwent clinical examination. RESULTS: Ten patients (83%) reported no obvious shade change or only a slight darkening not noticed by others. Two (17%) reported a slight darkening that is probably noticeable by other people, but no one reported moderate darkening or significant darkening back to original shade. All respondents (n = 12) denied having to have a crown or root canal that they believed was treatment-related. Examiners who compared preoperative and post-treatment photographs and Vita shade values were in agreement with the patient's perceptions of shade change. The degree of improvement was significant for both the immediate (0 mo) and the 54-month post-treatment comparison with the pretreatment shade (p < .005 and p < .01 respectively). CLINICAL SIGNIFICANCE: Results of this nightguard vital bleaching study indicate that tetracycline-stained teeth can be whitened successfully using extended treatment time, and that shade stability may last at least 54 months after treatment. Patients who participated in this study were overwhelmingly positive about the procedure in terms of shade retention and lack of post-treatment side effects. <7> UI - 20285618 AU - Garattini G AU - Crozzoli P AU - Brenna F IN - Universita degli Studi di Milano, Italy. TI - Bilateral dental fusion of the upper central incisors: a multidisciplinary approach. SO - Journal of Esthetic Dentistry 1999;11(3):149-54 AB - The multidisciplinary treatment of a case of bilateral dental fusion of the upper central incisors with maxillary constriction, crowding, and palatal inversion of one of the lateral incisors is reported. The rarity with which this anomaly appears, along with its complex characteristics, often make it extremely difficult to treat. It requires the involvement of different specialists to find the most suitable treatment for each individual patient. CLINICAL SIGNIFICANCE: This particular case of bilateral dental fusion required the involvement of orthodontists, periodontists, endodontists, and restorative specialists. For the individual evaluation of these extremely complex cases, the esthetic and functional results to be reached must be assessed compared to treatment times and biologic and economical costs. The long-term prognoses of these complex therapies also must be borne in mind. <8> UI - 20282494 AU - Uyehara MY AU - Davis RD AU - Overton JD IN - 81st Dental Squadron, Keesler AFB, MS 39534, USA. TI - Cuspal reinforcement in endodontically treated molars. SO - Operative Dentistry 1999 Nov-Dec;24(6):364-70 AB - This in vitro study compared the ability of horizontal pins and a dental adhesive to reinforce the facial cusps of endodontically treated mandibular molars. Seventy-two mandibular molars were divided into six groups and mounted in acrylic blocks (n = 12). In Groups 1-5 standardized endodontic access and instrumentation in the coronal one-third of each root canal were completed. In Groups 1-4 the lingual cusps were reduced, leaving the buccal cusps intact. The facial cusps of the teeth in each group received one of the following modes of reinforcement: Group 1--no reinforcement; Group 2--dentin adhesive (Amalgambond Plus); Group 3--two horizontal TMS Minim pins; Group 4--two horizontal TMS Minim pins and Amalgambond Plus. Teeth in Group 5 were prepared for and restored with a complete cuspal coverage amalgam restoration using four vertical TMS Minim pins. Group 6 consisted of intact natural teeth. Using an Instron Universal Testing Machine, the lingual slope of the facial cusp of each specimen was loaded to failure using a compressive force applied at an angle 60 degrees to the long axis of the tooth. The mean fracture strengths for all groups were analyzed using a one-way ANOVA and Student-Newman-Keuls multiple range test (alpha = 0.05). Fracture patterns and modes of failure were also evaluated. RESULTS: The intact teeth (Group 6) were significantly more fracture resistant than all other groups, with the exception of Group 4 (combination of pins and adhesive). Group 1 (non-reinforced teeth) was significantly weaker than all other groups. Groups 2-4 (specimens with reinforced cusps) were not significantly different from each other. The use of horizontal pins or a combination of horizontal pins plus dentin adhesive for cuspal reinforcement resulted in significantly more teeth demonstrating favorable fracture patterns than did the use of adhesives alone. CONCLUSION: The buccal cusps of endodontically treated mandibular molars reinforced with a combination of horizontal pins and dentin adhesive were not significantly weaker than intact teeth. Of the restored teeth, those which had buccal cusps reinforced with horizontal pins and those treated with complete cuspal coverage amalgam restorations exhibited the most favorable restorative prognosis following cusp fracture. <9> UI - 20258302 AU - Kane AW AU - Sarr M AU - Faye B AU - Wadji N TI - [Long term evaluation of results of endodontic treatments of dental pulp necrosis (74 cases obturated by the monoconal technique]. [French] SO - Dakar Medical 1998;43(2):216-9 AB - Various factors may affect the outcome of root canal therapy. In this study 74 endodontocally treated pulpless teeth were evaluated: (43 with periapical radiolucency and 31 without periapical lesions). These 74 non surgical treatment were performed in 60 patients (26 men and 34 women) by undergraduated students. The overall success rate was 71.62%; the rate of success for cases with no periapical radiolucency exceeded 80% whereas only 62.8% of the cases with perapical radiolucency had undergone partial resolution or complete resolution. Only 17.1% of lesions demonstrated complete radiographic resolution 12 to 16 months after the endodontic treatment. Reasons that may explain the low success rate are lake of asepty, root canal preparation and root canal filling technique. <10> UI - 20274749 AU - Walton TR IN - University of Sydney, Faculty of Dentistry, Australia. twalton@mail.usyd.edu.au TI - A 10-year longitudinal study of fixed prosthodontics: clinical characteristics and outcome of single-unit metal-ceramic crowns. SO - International Journal of Prosthodontics 1999 Nov-Dec;12(6):519-26 AB - PURPOSE: The purpose of this study was to report on the clinical characteristics and outcome of 688 single-unit metal-ceramic crowns placed in a specialist prosthodontic practice between January 1984 and December 1992. MATERIALS AND METHODS: Clinical and laboratory techniques were standardized and patients were recalled by the author between June and December of 1993. The outcome of all crowns was allocated to one of 6 fields in this assessment period. RESULTS: Clinical review examination by the author covered 87% of the crowns. Of these, 52% had been in service for 5 to 10 years and 48% for less than 5 years but more than 1 year; 67% of the crowns were placed on vital teeth and 94% were given a "good prognosis" rating at examination. The repair and failure rates of crowns in the 5 to 10 years in clinical service group were both 3%. Crowns on nonvital teeth in the same grouping had a significantly greater failure rate (5%) than crowns on vital teeth (1%), and anterior teeth had a significantly greater retreatment rate than posterior teeth. Retreatment for all 25 crowns occurred within 66 months after cementation. Tooth fracture accounted for 56% of retreatments, while caries and loss of retention accounted for only 24% of retreatments; 2% of initially vital teeth were endodontically treated during the survey period. CONCLUSION: Single-unit metal-ceramic crowns have a high expectancy of exceeding 10 years of clinical service when the described clinical and laboratory protocol is applied. <11> UI - 20205734 AU - Pohl Y AU - Filippi A AU - Tekin U AU - Kirschner H IN - Department of Oral Surgery and Dental Policlinic, Justus-Liebig-University, Giessen, Germany. TI - Periodontal healing after intentional auto-alloplastic reimplantation of injured immature upper front teeth. SO - Journal of Clinical Periodontology 2000 Mar;27(3):198-204 AB - BACKGROUND/AIMS: Conventional endodontic treatment results in high complication quota when performed in immature teeth. Intentional reimplantation with extraoral insertion of an endodontic implant (auto-alloplastic reimplantation) is an alternative. METHOD: In a retrospective study, the healing of 40 teeth reimplanted intentionally according to this method in patients aged 7 to 15 years was evaluated. Clinical tests (palpation, percussion sound, periotest values) and radiographical examinations were used to determine the type of periodontal healing (inflammatory resorption/periodontitis apicalis; replacement resorption/ankylosis; normal healing). RESULTS: Mean lifetime of the replanted teeth was 59.2+/-42.5 months, estimated survival time on the basis of the Kaplan-Meier analysis was 99.5 months. 17 teeth (42.5%) were classified as failures, mostly due to inflammatory resorption or periodontitis apicalis. Further investigations demonstrated that success rate and retention period of intentionally replanted teeth depend on the preoperative condition of the pulp. Teeth with preoperative infection suffered frequently from inflammatory resorption or periodontitis apicalis after being replanted (14 of 28 teeth). Estimated survival time according to Kaplan-Meier was 75.5 months. In contrast, inflammations or progressive resorptions were not observed in teeth without preoperative infection of the pulp. All these 12 teeth showed normal periodontal healing and regular tooth mobility. In the absence of any pathology in clinical or radiological findings after an average functional period of 72.3 months, the prognosis can be presumed excellent. Estimated survival time of 148.3 months according to Kaplan-Meier differs significantly from survival time of teeth infected preoperatively. CONCLUSIONS: From the results of this investigation, it may be concluded that an infection of the pulp - due to delay of treatment or attempts at endodontic therapy - should be avoided before intentional replantation of immature front teeth with pulp necrosis. Periodontal healing of the autologous root is not impaired by the insertion of posts made of Al2O3-ceramics or titanium. The inserted posts do not ankylose. Orthodontic movement of auto-alloplastically replanted teeth is possible. <12> UI - 20258333 AU - Kane AW AU - Cisse D AU - Faye D AU - Toure B AU - Sarr M IN - Departement Odontostomatologie, Faculte de Medecine, Pharmacie et Odontostomatologie, UCAD, Dakar, Senegal. TI - [Importance of the number of treatment sessions in the success of root canal therapy]. [French] SO - Dakar Medical 1999;44(1):109-13 AB - Root canal therapy is usually performed in single or multiple-visit treatment. The choice of single or multiple visit depend on dentist and patient available time. In general dentistry, multiple-visit is widely chosen by dentist whereas endodontic speciality recommend single-visit. In this study we analyzed 120 root canal therapy performed by students, to determine the number of visits needed to achieve treatment from endodontic-cavity-access to root canal filling and its possible, influence in the successful rate. Results showed that globally, 60% of treatments were performed in multiple-visit. Results showed also hat 89.3% of anteriors teeth were performed in single-visit but there is a higher rate of fail: 31.78%. Nevertheless, these results do not condemn endodontic single visit therapy. <13> UI - 20262474 AU - Hulsmann M AU - Gambal A AU - Bahr R IN - Department of Operative Dentistry, Zentrum ZMK, University of Gottingen, Germany. TI - An evaluation of root canal preparation with the automated Excalibur endodontic handpiece. SO - Clinical Oral Investigations 1999 Jun;99(2):70-8 AB - The aim of this study was to evaluate several parameters for automated root canal preparation with the Excalibur handpiece compared with hand instrumentation. The parameters investigated were straightening of curved canals, cleaning ability, working safety (loss of working length, instrument separation, perforation), cross sectional diameter before and after enlargement, and working time. Sixty curved root canals were prepared using the Excalibur handpiece and 30 curved canals with conventional hand instruments to ISO-size 35. The Excalibur left significantly less debris and smear layer on the root canal walls, but hand preparation resulted in fewer unprepared regions. Root canal curvature was well maintained by either technique; the degree of straightening depended on original root canal curvature rather than on the preparation technique. The Excalibur removed significantly more dentin. In the coronal part of the root canal, hand instruments produced significantly more round and oval cross sections; in the middle and apical part no differences could be detected. Working time was shorter for hand preparation, but the difference was not significant. Manual instrumentation proved to be safe; no instrument fracture, perforation or loss of working length could be observed, whereas automated preparation resulted in one perforation and two cases of loss of working length. <14> UI - 20262479 AU - Stoll R AU - Sieweke M AU - Pieper K AU - Stachniss V AU - Schulte A IN - Philipps-Universitat Marburg, Medizinisches Zentrum fur ZMK, Abt. Zahnerhaltung, Germany. stoll@mailer.uni-marburg.de TI - Longevity of cast gold inlays and partial crowns--a retrospective study at a dental school clinic. SO - Clinical Oral Investigations 1999 Jun;99(2):100-4 AB - From 1963 to 1993, 890 patients were treated with 3518 cast gold restorations by students and postgraduate dentists. The longevity of these restorations was studied retrospectively using the patient files. Longevity was calculated using the method described by Kaplan and Meier. After the observation period, 111 (3.2%) of the examined restorations were not in place anymore. The most frequent reasons for failure were caries (33.7%), lack of retention (32.7%), endodontic treatment (29.6%), insufficient marginal adaptation (3.1%) and extraction (1%). The cumulative survival rate and a 95% interval of confidence was calculated for all restorations and for each of the locations and surfaces included in the trial. The 10-year survival rate for occlusal inlays was, 76.1% (12.1) for MO inlays 88.3% (4.2), for DO inlays 83.4% (4.6), for MOD inlays 87.5% (2.4), for partial crowns 86.1% (3.3) and 85.7% (1.7) for all restorations. Based on the statistical method used, the cast gold restorations demonstrated satisfactory longevity results. <15> UI - 20222951 AU - Perez M AU - Fernandez I AU - Marquez D AU - Bretana RM IN - Clinica Estomatologica Docente de Bauta, Provincia Habana; and Centre of Biomaterials of Havana University, Havanna, Cuba. TI - Use of N-butyl-2-cyanoacrylate in oral surgery: biological and clinical evaluation. SO - Artificial Organs 2000 Mar;24(3):241-3 AB - N-butyl-2-cyanoacrylate based tissue adhesive, Tisuacryl, was employed as a nonsuture method for closing wounds in oral surgery. One hundred thirty patients were treated with the adhesive and 30 with suture. The surgical procedures were apicectomy, extraction of molars, and mucogingival grafting. The studied product was well tolerated by the tissue and permitted immediate hemostasis and normal healing of incisions. When Tisuacryl was used as dressing material for donor sites and mucosal ulcerations, pain relief was observed. <16> UI - 20247911 AU - Silverstein LH AU - Moskowitz ME AU - Kurtzman D AU - Shatz PC AU - Gornstein RA IN - Medical College of Georgia, Augusta, USA. TI - Prosthetic considerations with periodontal root resective therapy, Part 2. Hemisections. SO - Dentistry Today 1999 Sep;18(9):86-9 AB - When a root and the overlying anatomic crown are removed as a unit, this procedure is referred to as a hemisection. Hemisection of a maxillary or mandibular molar is often a means of retaining teeth needed for restorative abutments or occlusal support. This treatment can yield predictable results using proper diagnostic, endodontic, surgical, and prosthetic techniques. <17> UI - 20232888 AU - Culbreath TE AU - Davis GM AU - West NM AU - Jackson A IN - Department of Fixed Prosthodontic and Restorative Dentistry, Howard University College of Dentistry, Washington, USA. TI - Treating internal resorption using a syringeable composite resin. SO - Journal of the American Dental Association 2000 Apr;131(4):493-5 AB - BACKGROUND: Internal resorption is a pathological process initiated within the pulp space with the loss of dentin. It often is described as an oval shaped enlargement of the root canal space and usually is asymptomatic and detectable by routine radiographs. Treatment of internal resorption has included several materials--gutta-percha, zinc oxide eugenol and amalgam alloy. These materials do not provide strength to the tooth structure. CASE DESCRIPTION: A 29-year-old woman was referred to a dental clinic for treatment of a large internal resorptive defect in the coronal and middle one-third of the maxillary left central incisor root with no apparent periapical pathosis, as well as a large periapical radiolucency at the apex of the maxillary left lateral incisor that was associated with a necrotic pulp. The authors used a dual-cure syringable composite resin in conjunction with a bonding agent within the defect to treat it. CLINICAL IMPLICATIONS: This technique seals the dentinal tubules and strengthens the remaining tooth structure. It also improves the outcome of resorptive defects and reduces operators' chair time. <18> UI - 20228597 AU - Aqrabawi J IN - Faculty of Dentistry, University of Jordan, Amman-Jordan. TI - Five-year follow-up of successful intentional replantation. SO - Dental Update 1999 Nov;26(9):388-90 AB - Intentional replantation has been practised for many years as a treatment modality for pulpless teeth. Although the success ratio for intentional replantation is far below that for routine or surgical endodontics, one should consider this procedure as an alternative to tooth extraction. Two cases of mandibular second molars which were treated with intentional replantation and retrograde fillings are reported in this article. At the 5-year recall visit, the radiographs showed no evidence of pathological changes. <19> UI - 20221859 AU - Aqrabawi J IN - Faculty of Dental Medicine, University of Jordan, Amman, Jordan. TI - Sealing ability of amalgam, super EBA cement, and MTA when used as retrograde filling materials. SO - British Dental Journal 2000 Mar 11;188(5):266-8 AB - OBJECTIVE: To compare apical microleakage of MTA following reverse retrograde root filling with that following amalgam and EBA retrofilling. DESIGN: Prospective random control trial. SETTING: It was conducted at the University of Jordan in 1998. MATERIALS AND METHODS: The root canals of 79 extracted teeth were instrumented and obturated with vertically condensed gutta-percha. Each tooth was apically resected and the apex was prepared ultrasonically to 3 mm depth and the root surface isolated with nail varnish. Teeth were divided randomly into three groups of 25 teeth each. First group was retrofilled with amalgam, second group with EBA and the third group with MTA. Following immersion in 1% methylene blue dye for 72 hours, the roots were sectioned and the depth of dye penetration was evaluated by a stereomicroscope at x10 magnification. INTERVENTIONS: Super EBA is a reinforced zinc oxide cement based on a mixture of 32% eugenol and 68% ethoxy benzoic acid (EBA). MTA is a mineral trioxide aggregate cement (MTA) based on a mixture of sterile water. MAIN OUTCOME MEASURES: The sealing effectiveness of the retrograde filling materials used in this study was determined by their ability to inhibit dye penetration. RESULTS: 56% of the group filled with amalgam and 20% of the group filled with EBA showed dye leakage beyond the retrofilling material whereas the MTA group showed none, two samples from MTA group were eliminated because of their fractured roots. The chi-squared test revealed a statistically significant difference among all three groups (P < 0.05). CONCLUSION: MTA cement provides a better seal than amalgam and EBA cement when used as retrograde filling, but the extrapolation of this result into a clinical practice may be questionable. <20> UI - 20221855 AU - Hollows P AU - Fasanmade A AU - Hayter JP IN - Leicester Royal Infirmary NHS Trust. philip@phollows.fsnet.co.uk TI - Ameloblastoma--a diagnostic problem. SO - British Dental Journal 2000 Mar 11;188(5):243-4 AB - A 50-year-old female was referred by her dental practitioner. She had a periapical radiolucency associated with the lower right second premolar tooth. The tooth was root treated and subsequently apicected. Tissue curetted at the time of surgery was shown to be a solid ameloblastoma which was managed initially by marginal excision. Histopathological examination of the resection specimen demonstrated tumour at the inferior margin. A segmental resection of the mandible with an immediate reconstruction using a free tissue transfer of the iliac crest was therefore performed. The case shows the need for vigilance in dealing with periapical pathology and underlines the importance of sending all tissue specimens for histopathological analysis. <21> UI - 20228614 AU - Germain LP IN - Louisiana State University School of Dentistry, Department of Endodontics, New Orleans 70115, USA. bsk.nolaQix.netcom.com TI - Mineral trioxide aggregate: a new material for the new millennium. SO - Dentistry Today 1999 Jan;18(1):66-7, 70-1 AB - A midroot strip perforation can be a difficult problem to treat. Surgical treatment is arduous and has a poor prognosis. Variable success has been seen with the classic repair materials for nonsurgical treatment. Mineral trioxide aggregate seems to have incredible promise for sealing these defects with a good long-term prognosis. <22> UI - 98073570 AU - Sussman HI IN - Department of Periodontics, New York University College of Dentistry, USA. TI - Cortical bone resorption secondary to endodontic-implant pathology. A case report. SO - New York State Dental Journal 1997 Nov;63(9):38-40 AB - A single implant was inserted to replace the mandibular right lateral incisor in a 50-year-old Caucasian woman. After one month, an endodontic lesion formed on the adjacent canine, which went on to engulf the fixture. Even though endodontic therapy was instituted expeditiously on the canine, the implant exfoliated spontaneously the following month. There was a large radiolucency afterwards, suggesting resorption of both the labial and lingual cortical plates. A follow-up radiograph four months later revealed a residual detect along with delayed wound repair. <23> UI - 20228679 AU - Harrison JW AU - Svec TA IN - Baylor College of Dentistry, Texas A&M University System, Dallas, USA. TI - The hopeless tooth: when is treatment futile?. SO - Quintessence International 1999 Dec;30(12):846-50 AB - The decision to place a tooth in the hopeless category is by no means a simple one. There is always the possibility of being wrong, the possibility that this tooth may prove to be the exception and, against all odds, survive as a functioning component of the masticatory apparatus. These are the decisions that make us dentists rather than technicians. <24> UI - 20144768 AU - Lin H AU - Wang J AU - Yan W IN - School of Stomatology, Beijing Medical University. TI - [A three-year clinical evaluation of five light-cured composite resins in fillings of posterior teeth]. [Chinese] SO - Chung-Hua Kou Chiang i Hsueh Tsa Chih Chinese Journal of Stomatology 1997 Jul;32(4):242-5 AB - In order to study the clinical performance and the evaluation method of light-cured composite resin in filling for posterior teeth, two evaluation methods were used to evaluate 5 light-cured posterior composite resin fillings in 169 adult posterior class I cavity. Results showed that each evaluation method has its own advantages. The curative effect was declined with time in this study. Failures and defects were mainly occurred after 3 years. Secondary caries, loss of fillings and marginal stainings were the main reasons of failures. Compared with the effect of 1 year, the success rate after 3 years declined significantly, and further long-term clinical observation is needed. <25> UI - 20131017 AU - Reppel R AU - Goldbecher C AU - Schubert J IN - Klinik und Poliklinik fur Mund-, Kiefer- und Gesichtschirurgie, Martin-Luther-Universitat Halle-Wittenberg, Halle, Deutschland. TI - [The preparation of retrocavities in apicoectomies]. [German] SO - Mund-, Kiefer- und Gesichtschirurgie 2000 Jan;4(1):30-4 AB - The purpose of this in vitro and in vivo study was to compare the quality of retrograde cavities and retrofilling using various retrograde techniques (microhead, ultrasonic). The quality was evaluated on the basis of dye penetration, macroscopic control, and both light microscopic and scanning electron microscopic examination. A total of 40 extracted teeth with a single canal were analyzed. The clinical result was evaluated in 25 patients with root-filled teeth and the indication of apicoectomy. Statistical analysis indicated that the seal was significantly better with ultrasonically prepared cavities than with microhead preparation. Retrofillings prepared ultrasonically also showed significantly fewer peripheral fissures. The scanning electron microscopic examination, however, demonstrated peripheral fissures in all filled teeth. Furthermore, the cavities prepared ultrasonically had a smoother surface and a lower smear layer. This preparation produced a more pleasing final result. The advantages of better accessibility during the preparation, namely, more precise preparation of the retrofilling and only minor substance loss were confirmed clinically. Using the ultrasonic equipment, absolutely sterile working conditions are present. <26> UI - 20194176 AU - Saunders WP AU - Chestnutt IG AU - Saunders EM IN - University of Glasgow Dental School. TI - Factors influencing the diagnosis and management of teeth with pulpal and periradicular disease by general dental practitioners. Part 1. SO - British Dental Journal 1999 Nov 13;187(9):492-7 AB - OBJECTIVE: To identify factors influencing the diagnosis and management of periradicular disease by general dental practitioners. DESIGN: The study was conducted in two stages. 1. Analysis of recent returns to the Scottish Dental Practice Board. 2. Data collection via a postal questionnaire distributed to 617 general dental practitioners in Scotland (33% of practitioners registered with the Dental Practice Board). RESULTS: 417 (69%) questionnaires were completed and returned. The majority of respondents undertook root canal treatment and the number of cases treated had increased in the last five years. The vast majority of the respondents (89.3%) were confident in their diagnosis of periradicular disease and 77.1% were confident of their treatment of the disease. A referral system for treatment was used by 31% of respondents of whom the majority used a specialist in a hospital. Over 50% of the respondents undertook surgical root canal treatment. Only 40% of respondents followed up their completed cases for longer than six months. Constraints on the provision of treatment included the time available and the low level of fees. CONCLUSIONS: Current arrangements for the treatment of periradicular disease in general dental practice are less than optimal. The fiscal arrangements for the provision of these treatments must be developed to encourage a high standard of treatment to be performed thereby maximising the likelihood of success. In addition, efforts to inform patients of the benefits of the treatment of periradicular disease should be increased. <27> UI - 20121154 AU - Nagase M IN - First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokyo Medical and Dental University. TI - [A clinical study on treatment results of apicoectomy]. [Review] [35 refs] [Japanese] SO - Kokubyo Gakkai Zasshi - the Journal of the Stomatological Society, Japan 1999 Dec;66(4):339-50 AB - In this study, the treatment results of apicoectomy with orthograde filling were compared with those of apicoectomy with retrograde gutta-percha filling and retrograde sponge gold filling. The long-term follow-up results of the teeth treated by apicoectomy are presented, and the possible prognostic factors are discussed. The healing process of the apical bone cavity was analyzed with standard X-ray techniques and image analysis system. One hundred nineteen teeth were apicoectomized with orthograde filling, 196 teeth with retrograde gutta-percha root filling and 42 teeth with sponge gold filling. There was no significant correlation between the treatment results and the sex or age of the patients, kinds of teeth, preoperative radiolucent areas, the number of operations or histopathological diagnosis of apical lesion. The success rate of apicoectomy with orthograde filling or apicoectomy with retrograde gutta-percha root filling was significantly higher than that with retrograde sponge gold filling. The filling materials and the operation method were considered to be the most important factors for a successful outcome. Bone reconstruction was found to start from the periphery of the bone cavity and the bone defect became gradually reduced in a star-like pattern. At 4 months after operation, in the successful cases, the area of bone cavity decreased 46-64% compared with before operation, but in the unsuccessful cases, the area did not change or increased 75-120%. Thus at 4 months after operation, it is possible to determine whether or not apicoectomy is successful. [References: 35] <28> UI - 20174150 AU - Liewehr FR IN - Endodontic Residency Program, U.S. Army Dental Activity, Fort Gordon, GA 30905-5650, USA. TI - Endodontics and dental readiness. SO - Military Medicine 2000 Feb;165(2):127-30 AB - The primary mission of the Dental Corps--maintaining the dental health of our soldiers at an optimum level to ensure their readiness to deploy and fight--is more important than ever in today's downsized, high-operational-tempo Army. A review of the literature indicates that 20 to 25% of all soldiers will report on dental sick call during a 1-year deployment, and approximately half will require endodontic intervention. This could cost a division more than 18,000 man-days of combat effectiveness in a theater of battle, an unacceptable loss. Approximately three-fourths of these sick call visits could be prevented if selected conditions were identified and treated before deployment. Endodontic conditions, which result in the majority of dental sick call complaints, should be given priority for treatment in garrison, and the identified soldier should be placed in dental fitness class 3 until the tooth is definitively treated. <29> UI - 20190734 AU - Seltzer S IN - Department of Endodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA. TI - Long-term radiographic and histological observations of endodontically treated teeth. SO - Journal of Endodontics 1999 Dec;25(12):818-22 AB - Endodontic therapy was performed on 14 teeth in juveniles with inflamed or necrotic pulps. The patients were recalled at 6-month intervals for radiological and clinical examinations. After 1 yr, periapical surgery was performed on six teeth. After 18 months, 5 more patients were subjected to periapical surgery and, after 2 1/2 years, 3 more patients had periapical surgery. A small block section containing the root tip and surrounding tissues was removed from all of the patients. Radiographs showed reductions in size, but not elimination, of periapical lesions. Histological examinations revealed that most root canals were overfilled. Inflammation persisted around zinc oxide-eugenol particles beyond the tooth apexes. In addition, gutta-percha overfilling enhanced the proliferation of cell rests of Malassez. In some cases, dentin filings were found at and beyond the tooth apexes. The formation of new hard tissue was stimulated by the presence of dentin chips. <30> UI - 20190733 AU - Kvist T AU - Reit C IN - Department of Endodontology and Oral Diagnosis, Faculty of Odontology, Goteborg University, Sweden. TI - Results of endodontic retreatment: a randomized clinical study comparing surgical and nonsurgical procedures. SO - Journal of Endodontics 1999 Dec;25(12):814-7 AB - Information of "success" rates after surgical or nonsurgical endodontic retreatment is abundant but inconclusive. Reported healing frequencies vary between 45% and 90%. The present study was designed to find any systematic difference between the methods. Nonsurgical and surgical retreatment was randomly assigned to 95 endodontically "failed" cases. The outcome of the procedures was clinically and radiographically recorded, and followed for 4 years. At the 12-month recall, a statistically significant (p < 0.05) higher healing rate was observed for cases surgically retreated. At the final 48-month examination, no such difference was found. These findings may be explained by (a) slower healing dynamics in the nonsurgical group and (b) the event of late "failures" in the surgical group. Within the latter category, four cases classified as healed after 1 yr failed at the final follow-up. Conclusively, this study failed to show any systematic difference in the outcome of surgical and nonsurgical endodontic retreatment. Surgical retreatment seems to result in more rapid periapical bone fill, but also may imply a higher risk of "late failures." From a scientific point of view, the length of the follow-up period is very important and may strongly influence the conclusions made. <31> UI - 20174316 AU - Bindl A AU - Mormann WH IN - Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland. bindl@zzmk.unizh.ch TI - Clinical evaluation of adhesively placed Cerec endo-crowns after 2 years--preliminary results. SO - Journal of Adhesive Dentistry 1999;1(3):255-65 AB - PURPOSE: Non-vital endodontically treated posterior teeth with complete loss of coronal hard tissues were prepared with a circular equigingival butt margin and central retention cavity of the entire pulp chamber ("endo-preparation"). Computer-generated ceramic corono-radicular restorations (Cerec endo-crowns) were bonded to these preparations. The purpose of this study was to evaluate the survival rate and the clinical quality of CAD/CIM endo-crowns after 2 years. MATERIALS AND METHODS: 19 Cerec endo-crowns (4 premolars and 15 molars) in 13 patients were examined using modified USPHS criteria at baseline and after an average time of 26 months. The ratings of the two examinations were compared. RESULTS: The service time of the 19 endo-crowns was 14 to 35.5 (mean +/- SD: 26 +/- 6) months. One molar endo-crown failed after 28 months because of recurrent caries. CONCLUSION: The overall clinical quality of the Cerec endo-crowns was very good, and so far, the clinical concept appears feasible. <32> UI - 20162444 AU - Waterhouse PJ AU - Nunn JH AU - Whitworth JM IN - Department of Child Dental Health, The School of Dentistry, Newcastle upon Tyne. TI - An investigation of the relative efficacy of Buckley's Formocresol and calcium hydroxide in primary molar vital pulp therapy. SO - British Dental Journal 2000 Jan 8;188(1):32-6 AB - OBJECTIVE: To compare the clinical and radiological outcomes following two different, single visit vital pulp therapy techniques, in cariously exposed primary molar teeth. SETTING: A paediatric dental clinic within the Dental Hospital, Newcastle upon Tyne, UK. SUBJECTS: Fifty two child patients were sequentially enrolled in the clinical investigation, 26 males and 26 females with an age range of 3.3-12.5 years. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). The total number of teeth treated was 84. DESIGN: Recruitment was on the basis of strict inclusion criteria. Coronal pulp amputation was prescribed only in teeth with vital, cariously exposed pulp tissue. Treatment was undertaken between October 1994 and December 1996. All cases were reviewed using predefined clinical and radiological criteria. The statistical tests used were logistic regression of a triple nested data structure, chi-squared analysis of equality of treatment and probability of success with relation to subject age. RESULTS: Eighty-four cariously exposed primary molars required vital pulp therapy. Forty six (55%) teeth were included in the F group and 38 (45%) allocated to the C group. Five teeth were lost to follow-up, leaving 79 teeth: forty four (56%) in group F and 35 (44%) in group C. Eighty four percent (37/44) of teeth treated with formocresol and 77 percent (27/35) treated with calcium hydroxide were classed as clinically and radiographically successful at the cut-off date, December 1997, after a mean clinical review of 22.5 months (range 6.1-38.5 months) and a mean radiographic review of 18.9 months (range 1.3-36.9 months). CONCLUSION: This investigation confirms the clinical efficacy of a one-fifth dilution of Buckley's Formocresol as an agent in pulp treatment of cariously exposed, vital primary molar teeth. However, calcium hydroxide in its pure, powder form is a clinically acceptable alternative when combined with strict selection criteria for this method of restorative care. There was a statistically insignificant difference in successful clinical and radiological outcome between the two treatment groups. Success was unrelated to the duration of time taken to achieve haemostasis and the presence or absence of bleeding after placement of the medicament. <33> UI - 20134693 AU - McLaren EA AU - White SN IN - School of Dentistry, University of California-Los Angeles, Los Angeles, Calif., USA. TI - Survival of In-Ceram crowns in a private practice: a prospective clinical trial. SO - Journal of Prosthetic Dentistry 2000 Feb;83(2):216-22 AB - STATEMENT OF PROBLEM. Prior reports on some all-ceramic crown systems have indicated high failure rates through fracture. PURPOSE. This study prospectively evaluated the survival of infiltrated alumina crowns (In-Ceram) in a private practice. MATERIAL AND METHODS. All the In-Ceram crowns placed in a prosthodontic practice since its introduction in 1990 were serially included. Patients were recalled at 6 monthly intervals. Those who did not attend in the previous 6 months were contacted by telephone and a series of answers to standardized questions recorded. The few patients who were lost to follow-up or who died were removed from the study from the time of last contact. RESULTS. A total of 408 crowns in 107 patients were followed for periods from 1 to 86 months. As the 3-year data combined a meaningful period of service with a large sample size, these data were focused on. The 3-year survival rate was 96% for a sample size of 223. Three-year data indicated that core fracture and porcelain fracture occurred at rates of approximately 0.6% and 0.3% per year, respectively. Otherwise sound restorations were removed at a rate of approximately 0.3% per year for esthetic, endodontic, or prosthetic reasons. Anterior crowns tended to have a slightly higher 3-year survival rate (98%) than premolars or molars (94%). CONCLUSION. Clinical failure rate of In-Ceram crowns was low. Crowns were lost because of core fracture, porcelain fracture, and removal without failure. Failure tended to be more common for molar and premolar crowns than for anterior crowns. <34> UI - 20144639 AU - Behnia A AU - Strassler HE AU - Campbell R IN - Department of Endodontics, Dental School, University of Maryland at Baltimore 21201, USA. TI - Repairing iatrogenic root perforations. SO - Journal of the American Dental Association 2000 Feb;131(2):196-201 AB - BACKGROUND: Post preparation is an integral part of restoring endodontically treated teeth in indicated cases. Iatrogenic perforation of the root can result from preparing post space and can severely compromise the prognosis of the tooth. CASE DESCRIPTION: Two years after a patient's maxillary lateral incisor was restored with a post-retained composite resin, he went to a dental school emergency clinic with a chief complaint of soft-tissue swelling adjacent to the tooth. The authors took a periapical radiograph that revealed evidence of a circumscribed radiolucent lesion associated with the distal midroot area and a periapical radiolucency. Based on the radiograph, the authors suspected that the canal preparation for the post and the post placement had perforated the root at the base of the post. CLINICAL IMPLICATIONS: The authors used a combined surgical and orthograde approach with a biocompatible restorative material and a clear, plastic light-transmitting post to repair the iatrogenic perforation. <35> UI - 20152134 AU - Tamse A AU - Fuss Z AU - Lustig J AU - Kaplavi J IN - Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. TI - An evaluation of endodontically treated vertically fractured teeth. SO - Journal of Endodontics 1999 Jul;25(7):506-8 AB - For this survey, 92 vertically fractured endodontically treated teeth were evaluated clinically and radiographically before and after extraction. The maxillary second premolars (27.2%) and mesial roots of the mandibular molars (24%) were the most fractured teeth. In 67.4% of the teeth, a solitary buccal pocket was present; in 34.8%, a fistula frequently appeared closer to the gingival margin than to the apical area. A lateral radiolucency or a combination of lateral and periapical radiolucency was found in more than half of the cases. The general practitioners correctly diagnosed vertical root fracture in only one-third of the 92 fractured teeth in this survey. <36> UI - 20152056 AU - Certosimo FJ AU - Milos MF AU - Walker T IN - Comprehensive Dentistry Department, Naval Dental School, Bethesda, MD, USA. TI - Endodontic working length determination--where does it end?. [Review] [30 refs] SO - General Dentistry 1999 May-Jun;47(3):281-6; quiz 287-8 AB - Obtaining a correct working length is critical to the success of endodontic therapy. Failure to identify this crucial measurement can result in untoward treatment outcomes, which may include increased patient discomfort, possible infection or cyst development, and extrusion or intra-canal medication into the periradicular tissue. This article reviews the classical and current terminology, philosophies, and techniques that are used at present to determine endodontic working length accurately, and describes their clinical application. Recent clinical advances such as the electronic apex locator, direct digital radiography, and the surgical operating microscope also are discussed. [References: 30] <37> UI - 20113835 AU - Bader JD AU - Shugars DA AU - White BA AU - Rindal DB IN - Sheps Center for Health Services Research, University of North Carolina, Chapel Hill 27599-7590, USA. jim:bader@unc.edu TI - Development of effectiveness of care and use of services measures for dental care plans. SO - Journal of Public Health Dentistry 1999 Summer;59(3):142-9 AB - OBJECTIVES: Standardized measures to assess clinical aspects of the performance of managed dental care plans are not available. This project sought to develop and evaluate measures for effectiveness of care and use of services that could be calculated using a plan's administrative data. METHODS: Two panels of stake holders representing dental plans, purchasers, and dental providers participated in a modified Delphi process to refine initial sets of effectiveness of care and use of services measures modeled after HEDIS measures for medical care. The refined measures were then pilot tested in two dental health maintenance organizations. RESULTS: The development process resulted in specification of seven effectiveness of care measures assessing disease activity classification, and prevention and outcomes for caries, periodontal disease, and tooth loss. Six use of services measures focusing on prophylaxes, third molar surgery, preventive, restorative, prosthetic, surgical, and endodontic care also were specified. Pilot testing of the measures indicated reasonable reliability and sensitivity, but also demonstrated the need for supervision or auditing of the process. CONCLUSIONS: These standardized measures for dental care plan performance are available for immediate use. However, because the measures depend on diagnostic information (periodontal probing data and diagnoses associated with restorative treatments) in the administrative data set, their adoption will require changes in most plans' data systems and data collection policies. <38> UI - 20099341 AU - Holan G IN - Department of Pediatric Dentistry, Hebrew University--Hadassah Faculty of Dental Medicine, Jerusalem, Israel. TI - Conservative treatment of severely luxated maxillary primary central incisors: case report. [Review] [10 refs] SO - Pediatric Dentistry 1999 Nov-Dec;21(7):459-62 AB - The treatment and follow-up evaluation of two orally luxated maxillary primary central incisors in a three-year-old girl is described. The injured teeth were displaced into a cross-bite with their mandibular opposing teeth. They were repositioned shortly after the injury and splinted with composite resin for two weeks. Oral hygiene instructions and antibiotic therapy were prescribed. Two weeks after the injury a necrotic pulp was removed and the root canals filled with a resorbable paste. Thirty months after the injury, the teeth and the surrounding tissues were clinically and radiographically asymptomatic and physiologic root resorption could be noted. The permanent successors erupted soon after natural exfoliation of the injured primary teeth. Only mild hypocalcified defects were observed on the permanent incisors. [References: 10] <39> UI - 20096860 AU - Wu MK AU - Wesselink PR AU - Walton RE IN - Department of Cariology, Endodontology, Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. M.Wu@acta.nl TI - Apical terminus location of root canal treatment procedures. [Review] [50 refs] SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 2000 Jan;89(1):99-103 AB - The apical termination of root canal treatment is considered an important factor in treatment success. The exact impact of termination is somewhat uncertain; most publications on outcomes are based on retrospective findings. After vital pulpectomy, the best success rate has been reported when the procedures terminated 2 to 3 mm short of the radiographic apex. With pulpal necrosis, bacteria and their byproducts, as well as infected dentinal debris may remain in the most apical portion of the canal; these irritants may jeopardize apical healing. In these cases, better success was achieved when the procedures terminated at or within 2 mm of the radiographic apex (0 to 2 mm). When the therapeutic procedures were shorter than 2 mm from or past the radiographic apex, the success rate for infected canals was approximately 20% lower than that when the procedures terminated at 0 to 2 mm. Clinical determination of apical canal anatomy is difficult. An apical constriction is often absent. Based on biologic and clinical principles, instrumentation and obturation should not extend beyond the apical foramen. [References: 50] <40> UI - 20096390 AU - Wei PC AU - Geivelis M AU - Chan CP AU - Ju YR IN - Department of Periodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan. TI - Successful treatment of pulpal-periodontal combined lesion in a birooted maxillary lateral incisor with concomitant palato-radicular groove. A case report. SO - Journal of Periodontology 1999 Dec;70(12):1540-6 AB - Palato-radicular groove (PRG) is a common developmental anomaly of maxillary incisors, whereas PRG associated with a birooted maxillary incisor is relatively infrequent. The clinical significance of PRG is related to the incidence of localized periodontitis with or without pulpal pathosis, depending on the depth, extent, and complexity of the groove. Successful treatments of PRG in single-rooted incisors have been reported in the literature. However, treatment of PRG in birooted incisors has often been ineffective. This case report describes a pulpal-periodontal combined lesion occurring on a birooted maxillary left lateral incisor with concomitant PRG in a 13-year-old boy which was successfully treated by conventional endodontic therapy in combination with periodontal treatment including accessory root resection, radiculoplasty and bone grafting. Seven-year follow-up is included in this report. The basis of a successful result is accurate diagnosis and elimination of inflammatory irritants and contributory factors. Awareness of the existence of this abnormality by the clinician is important. <41> UI - 20116153 AU - Seidman D TI - A general dentist's viewpoint of two new endodontic techniques. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1999 Oct;20(10):921-4, 926, 928 passim; quiz 934 AB - Over 3 years ago, two new endodontic techniques were developed. The first was a straightforward, comprehensive approach for root canal instrumentation. The second was a simple and predictable obturation system. The combination of these systems lead to impressive results that were easily attained. The instrumentation method uses existing armamentarium, allowing nearly any canal to be shaped to ideal form to precisely match a tapered gutta percha point. The root canal sealer technique incorporates controlled placement of a modified epoxy-resin cement that allows for a thoroughly sealed, single-cone root canal fill. The results rival other available systems. This article presents a stepwise guide to achieve stress-free, successful case results that general dentists and endodontists desire. <42> UI - 20101130 AU - Mannocci F AU - Ferrari M AU - Watson TF IN - Department of Endodontics, University of Siena, Italy. TI - Intermittent loading of teeth restored using quartz fiber, carbon-quartz fiber, and zirconium dioxide ceramic root canal posts. SO - Journal of Adhesive Dentistry 1999;1(2):153-8 AB - PURPOSE: The purpose of the investigation was to compare the performances of teeth restored with quartz fiber, carbon-quartz fiber, and zirconium-dioxide posts covered with all-ceramic crowns when subjected to a cyclic loading test performed in a wet environment. MATERIALS AND METHODS: Forty single-rooted human lower premolars having similar dimensions were endodontically treated and mounted in acrylic resin blocks with a simulated periodontal ligament. The teeth were divided into three experimental groups and one control group. Post holes 8 mm long were prepared in the roots of the experimental groups in which quartz fiber, carbon-quartz fiber, and zirconium dioxide posts were cemented. In the control group, no posts were used. The crown buildup was made with composite resin. The teeth were covered with all-ceramic crowns and intermittently loaded at an angle of 45 degrees to the long axis of the tooth at a frequency of two loads per second. RESULTS: Only one failure (root fracture + post fracture) was observed in each of the fiber post groups, while in the zirconium dioxide post group, six failures were observed (one crown fracture and 5 root fractures + post fractures). The Kaplan-Meier analysis of the three experimental groups showed that the survival rate of zirconium dioxide posts was significantly lower than that of both types of fiber post. All the experimental groups showed a survival rate higher than that of the control group. CONCLUSION: Fiber posts reduced to a minimum the risk of root fractures of teeth restored with composite cores and Empress crowns under the present experimental conditions (intermittent loading in a wet environment). <43> UI - 20101149 AU - Swift EJ Jr AU - Trope M IN - Department of Operative Dentistry, University of North Carolina School of Dentistry, Chapel Hill 27599-7450, USA. Ed:Swift@dentistry.unc.edu TI - Treatment options for the exposed vital pulp. SO - Practical Periodontics & Aesthetic Dentistry 1999 Aug;11(6):735-9; quiz 740 AB - The exposure of dental pulp generally occurs as the result of accidental trauma or preparation techniques utilized during the restoration of carious lesions. While frank carious exposures are optimally treated with pulpectomy and root canal therapy, the ideal treatment of mechanically exposed pulps has remained controversial. This article describes the indications, clinical techniques, and prognosis for direct pulp capping and partial pulpotomy. <44> UI - 20065233 AU - Sae-Lim V IN - Department of Restorative Dentistry, National University of Singapore, Singapore. TI - A case report of a vital replanted tooth with unfavourable extra-alveolar condition: a 10-year follow-up. SO - Annals of the Academy of Medicine, Singapore 1999 Sep;28(5):753-6 AB - This case report describes the survival of a maxillary left central incisor after an avulsion injury under unfavourable extra-alveolar condition, when the patient was 9 years old. At subsequent clinical follow-ups, the tooth maintained vitality 10 years after the injury. There was sign of gradual obliteration of the root canal space. Concomitantly, the replanted tooth manifested typical characteristics of ankylosis with minimally detectable resorption complication. <45> UI - 20099924 AU - Haas DA IN - Faculty of Dentistry, University of Toronto. TI - Local and systemic therapeutics for the control of endodontic pain. [Review] [6 refs] SO - Alpha Omegan 1997 Winter;90(4):73-6 AB - Endodontic pain is best managed by eliminating the source as completely as possible. When it is determined that drugs are required, judicious use of local anesthetics and nonopioid analgesics can be beneficial and provide the first course of action. When it is determined that the pain will not be managed by these measures alone, the addition of an opioid analgesic may be considered with the understanding that more adverse side effects attend their use. [References: 6] <46> UI - 20101047 AU - Rodrigues JS AU - Damle SG IN - Dept of Pedodontics & Preventive Dentistry, Nair Hospital Dental College, Mumbai. TI - An epidemiological study on the prevalence of dental caries and treatment need in 12-15 year old children in Bhiwandi (Maharashtra). SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1998 Sep;16(3):84-9 AB - An epidemiological survey of the prevalence of dental caries and treatment need in the powerloom township of Bhiwandi revealed a prevalence level of 56.93%. The overall mean DMFT score was 1.25 +/- 1.34. Decayed teeth accounted for the largest component of the reported DMF teeth followed by an almost equal proportion of missing and filled teeth. Single surface restorations were the most frequent type of treatment required, followed by the two or more surface restorations, extractions and pulp therapy. <47> UI - 20101063 AU - Berman LH TI - Endodontics in the '90s: old dogma and new tricks ... can we be re-taught?. SO - MSDA Journal 1997 Summer;40(3):121-4 AB - Endodontics has gone through many changes in the past several years. Electronic apex locators and surgical microscopes have taken a lot of the guess work out of doing root canal. Digital radiograpy has expanded our diagnostic abilities. Ultrasonic intrumentation and the advent of new filing systems have increased the efficacy of canal cleaning. There have also been some major refinements in how we can now obturate canals. Apicoectomies can now be performed with refined ultrasonic root end preparations, and we have increased our ability to better seal root ends with new filling materials. The result is that endodontic procedures can now be performed more expediently and with a more predictable outcome. This article is written from the perspective of a full-time practicing endodontist, and describes the various changes occurring within the specialty of endodontics. <48> UI - 20067062 AU - Anusavice KJ IN - Department of Dental Biomaterials, University of Florida, Gainesville 32610-0446, USA. kanusavice@dental.ufl.edu TI - Does ART have a place in preservative dentistry?. [Review] [17 refs] SO - Community Dentistry & Oral Epidemiology 1999 Dec;27(6):442-8 AB - The ART technique consists of hand excavating carious tissue and placing a highly viscous glass ionomer cement as a restoration material and as a sealant. Although the results of several studies are promising, the retention rates of these restorations for primary teeth are not impressive. Materials and methods that yield greater success rates are needed to improve long-term caries management outcomes. In principle, ART should yield outcomes similar to those associated with preservative dentistry, including the potential for minimal surgical intervention, conservation of sound tooth structure, avoidance of pain and need for local anesthetic injections, reduced risk for subsequent endodontics and tooth extraction, and increased survival time of the affected teeth. The ideal direct-filling ART material would be biocompatible and tooth colored; "forgiving" in its handling properties; insensitive to moisture or desiccation; hardenable without special equipment; able to form stable bonds to enamel and dentin; able to seal marginal gaps against bacteria; capable of releasing fluoride or remineralization and antibacterial agents when demineralization is most likely; and resistant to chemical attack. The highly viscous glass ionomer materials currently used for ART meet several of this criteria, though they may be deficient in their ability to seal marginal gaps against bacteria and in their sensitivity to desiccation. Furthermore, although they release fluoride over the lifetime of the restoration, this fluoride release alone may not prevent caries progression in all cases. It is necessary for cases of high caries risk to use chlorhexidine in conjunction with fluoride to achieve caries arrest and remineralization of adjacent areas of the affected teeth. Thus, while the ART technique offers some benefits in restoring function and reducing the rate of caries progression, it is unlikely that current materials will be able to arrest caries progression completely in high-risk persons. [References: 17] <49> UI - 20065041 AU - Sim CK IN - Mount Elizabeth Medical Centre, Singapore. TI - Endodontic interappointment emergencies in a Singapore private practice setting: a retrospective study of incidence and cause-related factors. SO - Singapore Dental Journal 1997 Aug;22(1):22-7 AB - One thousand and sixteen consecutive records of patients treated by the author for endodontic treatment was surveyed for the incidence of endodontic interappointment emergencies (EIE) and the major factors contributing to it. The overall incidence of EIE was 3.15% and unrelated to the patients' sex or tooth location. Caucasians were more likely to experience flare-ups than Chinese (p < 0.01). Patients < 20 years and > 60 years were less likely to experience EIE (p < 0.05). EIE was significantly higher in necrotic teeth than in vital teeth (p < 0.01). A clinical diagnosis of necrotic pulp with acute apical abcess (NP/AAA) increased the incidence of flare-ups significantly (p < 0.05). Retreatment cases also had a higher incidence of EIE and this was statistically significant (p < 0.01). The possibility of EIE was the highest after the first visit (p < 0.01) and this was reduced significantly with subsequent visits. <50> UI - 20037893 AU - Debeljak A AU - Sorli J AU - Music E AU - Kecelj P IN - Clinical Department for Respiratory Diseases and Allergy Golnik, Slovenia. TI - Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998. SO - European Respiratory Journal 1999 Oct;14(4):792-5 AB - The authors reviewed their experience with therapeutic bronchoscopy for removal of tracheobronchial foreign bodies in the adult. Bronchoscopy records and collection of foreign bodies in the endoscopic department were retrospectively examined. Among 37,466 bronchoscopies performed between 1974-1998, 62 (0.2%) were performed for the removal of tracheobronchial foreign bodies. Medical history was suggestive of foreign body aspiration in 33 patients and the chest radiograph was suggestive in 10 patients. The procedure was performed with the flexible bronchoscope in 42 patients (68%), rigid bronchoscope in 4 (6%), and with both in 16 (26%) patients. Foreign bodies were found in the right bronchial tree on 42 occasions, in the left on 20 and in the trachea once. In 39 patients, inflammatory granulations were found around the foreign body. The origins of the foreign bodies included: bone fragments (n=31), vegetable (n=10), broncholith (n=8), a part of dental prosthesis (n=7), endodontic needle (n=2), a metallic (n=2), or plastic (n=1) particle, a tracheostomy tube (n=1) and a match (n=1). In one patient, 2 foreign bodies were found. The foreign bodies were successfully removed in all but 2 patients (3%). The most useful instruments for removal were alligator forceps and the wire basket. Foreign bodies in the tracheobronchial system are rare in adults. They can be successfully removed in the majority of patients under either flexible or rigid bronchoscopy. <51> UI - 20023996 AU - Fietz RJ TI - Predictably restoring endodontically treated teeth [letter]. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1999 Oct;65(9):484-5 <52> UI - 99437103 AU - Forgie AH AU - Pine CM AU - Longbottom C AU - Pitts NB IN - Unit of Dental and Oral Health, Dundee Dental Hospital and School, UK. a.h.forgie@dundee.ac.uk TI - The use of magnification in general dental practice in Scotland--a survey report. SO - Journal of Dentistry 1999 Sep;27(7):497-502 AB - OBJECTIVES: This study had two aims, first, to quantify the level of the use of magnification in general dental practice in Scotland and second, to determine the current and potential areas of clinical use of magnification by general dental practitioners. METHODS: A questionnaire was sent to all general dental practitioners in Scotland with a Health Board list number (n = 1790). The questionnaire asked the practitioners about their experience of magnification and their opinions on possible areas for clinical use. An information sheet and a prepaid envelope were included with the questionnaire. RESULTS: One thousand two hundred and eighty (72%) of the dentists replied to the questionnaire. Nine percent of the respondents routinely used magnification. The level of routine use of magnification by practitioners increased with time since qualification. The suggested areas of clinical use of magnification by all the respondents were crown and bridge work, diagnosis and radiography. The routine users of magnification had a more positive view of magnification than non-users. CONCLUSIONS: Routine use of magnification was associated with the length of time the practitioner had been qualified and the attendance at a course at which magnification was discussed. The perceived uses of magnification depended on the experience of the practitioner with magnification. It was considered suitable for all clinical procedures except orthodontics and prosthodontics. <53> UI - 99408160 AU - Ahlqwist M AU - Bengtsson C AU - Hakeberg M AU - Hagglin C IN - Department of Oral Diagnostic Radiology, Goteborg University, Sweden. Margareta. Ahlqwist@adm.gu.se TI - Dental status of women in a 24-year longitudinal and cross-sectional study. Results from a population study of women in Goteborg. SO - Acta Odontologica Scandinavica 1999 Jun;57(3):162-7 AB - The aim of the study was to describe dental health status among middle-aged and elderly women over a 24-year period. Because of the design of the study it was possible to make both longitudinal and cross-sectional comparisons. The study started in 1968-69 with a combined medical and dental examination of women aged between 38 and 60 years. New dental examinations of these same women were performed in 1980-81 and again in 1992-93, and included new cohorts of 38-year-old women on both occasions. In the cross-sectional perspective, it was shown that the number of edentate individuals decreased significantly during the 24-year period. Among dentate women, the number of remaining teeth and restored teeth increased significantly cross-sectionally. However, the youngest age group, women of 38 years, showed a lower number of restored teeth in the latest study (in 1992-93). There was also a lower number of crowns, root-fillings, and pontics in the latest study for the youngest age group. The two older age groups studied cross-sectionally showed similar numbers in all studies. In the longitudinal study, there was a decrease with time in incidence of edentulism. Among the dentate women in the longitudinal study the number of restored teeth related to those remaining was high (range 76-90%) and did not change much between the studies in the different age groups. There was a clear tendency during the 24-year period in all age groups for more teeth to be restored with crowns rather than different fillings. In conclusion, this population study, with a follow-up of 24 years, shows that dental status improved in that fewer individuals lost all their teeth and younger age groups have more remaining teeth and fewer restorations than previously. <54> UI - 99448356 AU - Koton D TI - The prevention of endodontic failures. [Review] [40 refs] SO - SADJ 1999 Feb;54(2):109-13 <55> UI - 99167121 AU - Sekhar LN AU - Schessel DA AU - Bucur SD AU - Raso JL AU - Wright DC IN - Department of Neurological Surgery, George Washington University Medical Center, Washington, District of Columbia 20037, USA. TI - Partial labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions of the petroclival area. SO - Neurosurgery 1999 Mar;44(3):537-50; discussion 550-2 AB - OBJECTIVE: To study the value of an improvement of the presigmoid petrosal approach to the petroclival area by the addition of partial labyrinthectomy and petrous apicectomy and to document hearing and other results. METHODS: Thirty-six consecutive patients treated by this technique during a 2-year period were studied prospectively. The lesions treated included 33 petroclival neoplasms (25 meningiomas, 5 chordomas, 1 chondrosarcoma, 1 trigeminal schwannoma, and 1 epidermoid cyst) and 3 vertebrobasilar aneurysms. The patients underwent clinical, radiological, and neuro-otological examinations. RESULTS: There was no perioperative mortality. Cranial nerve deficits involving Cranial Nerves III, IV, V, and VI occurred in 17 patients (47%) postoperatively. Cerebrospinal fluid leak occurred in 12 patients (33%). Four of these patients were treated by lumbar drainage, two patients were treated by lumboperitoneal shunt, and six patients required reoperation and repacking of the middle ear. Hydrocephalus occurred in five patients (13.9%). There was one case of meningitis and another of systemic sepsis. All 36 patients underwent postoperative audiometric evaluation. When serviceable hearing was present preoperatively (Gardner-Robertson Grades I or II), it was determined to be preserved at postoperative follow-up in 81% of the patients (26 of 32 patients). CONCLUSION: The partial labyrinthectomy petrous apicectomy approach provided improved access to neoplasms of the clivus and petrous apex and the posterior cavernous sinus area and to vertebrobasilar aneurysms in the midclival area. This improvement in access permits more controlled and thorough treatment of these lesions, with reduced brain retraction and acceptable morbidity with respect to auditory function. <56> UI - 99381468 AU - Moule AJ AU - Kahler B IN - Brisbane Endodontic Research Group, Queensland. TI - Diagnosis and management of teeth with vertical root fractures. [Review] [54 refs] SO - Australian Dental Journal 1999 Jun;44(2):75-87 AB - Vertical fractures in teeth can present difficulties in diagnosis. There are, however, many specific clinical and radiographical signs which, when present, can alert clinicians to the existence of a fracture. In this review, the diagnosis of vertical root fractures is discussed in detail, and examples are presented of clinical and radiographic signs associated with these fractured teeth. Treatment alternatives are discussed for both posterior and anterior teeth. [References: 54] <57> UI - 99381495 AU - Telli C AU - Gulkan P AU - Raab W IN - Department of Endodontics, Hacettepe University, Faculty of Dentistry, Ankara, Turkey. TI - Additional studies on the distribution of stresses during vertical compaction of gutta-percha in the root canal. SO - British Dental Journal 1999 Jul 10;187(1):32-7 AB - OBJECTIVE: This study was designed to investigate the effect of certain pathological alterations of the dental structures (diminishing bone support, internal resorption, root perforation, periapical lesion) on stress distribution during root canal filling procedures by the warm vertical compaction technique. DESIGN: The computer stress analyses were done for a maxillary canine tooth model which was based on dimensions recovered from a human cadaveric maxilla scanned by CT. METHODS: The finite element method was used to calculate the stresses generated during root canal filling procedures by warm vertical compaction technique. Patterns of stress distribution associated with various alterations in dental structures were investigated. For this purpose 60 cases were simulated. The hypothetical force of 10 N is taken as a unit representation. For other magnitudes of applied force, the corresponding stresses would be scaled directly because the calculations were made for linear materials. RESULTS AND CONCLUSION: It is found that, when diminishing bone support and internal resorption are concurrently simulated, a marked increase in stress magnitudes occur (maximum von Mises stress 5.37 N/mm2). However, these values still remain much below the most frequently reported tensile strength of dentine (50-100 N/mm2). If dentist's handwork is transformed into equivalent edge tractions on gutta-percha, then stresses in dentine, even when they are corrected for 3-kg applied force, appear to remain below fracture strengths of this material. This result leads us to conclude that when warm vertical compaction technique is skillfully performed and inadvertent undue force is not applied, a premature root fracture in a large rooted maxillary anterior tooth with straight root canal anatomy is not likely to occur, even for the unfavourable conditions simulated in our model. This result, like all results derived from modelling applications, is of course contingent upon agreement between the way in which the clinical operations are performed and the way in which they are mirrored for computer representation. We believe that the approach described here avoids the spurious stresses that have been reported in similar investigations. <58> UI - 99354687 AU - Gutmann ME AU - Gutmann JL IN - Caruth School of Dental Hygiene, Baylor College of Dentistry, Dallas, TX 75266-0677, USA. TI - The dental hygienist as a co-therapist in the endodontic practice. SO - Journal of Endodontics 1999 Apr;25(4):272-4 AB - This paper explores the potential contributions to patients, the practice, the endodontist, and the dental hygienist that may be realized by the employment of one or more dental hygienists to serve as endodontic co-therapists in the delivery of endodontic treatment. An endodontic co-therapist is an individual who participates with the endodontist in the assessment, planning, implementation, and evaluation of treatment much like the periodontal co-therapist relationship that exists between periodontists and dental hygienists. Dental hygienists are ideal individuals for this role because of their education in basic, clinical, and behavioral sciences. Suggestions are provided for which services could be delegated by the endodontist to the dental hygienist during each phase of care. Advantages of this contemporary approach to the delivery of endodontic treatment are also addressed. <59> UI - 99337992 AU - Goldstein S AU - Sedaghat-Zandi A AU - Greenberg M AU - Friedman S IN - SUNY Stony Brook School of Dental Medicine, Department of Endodontics, USA. TI - Apexification & apexogenesis. SO - New York State Dental Journal 1999 May;65(5):23-5 AB - When there is pulpal involvement of permanent teeth with incompletely formed roots, techniques for the induction of apical closure should be completed before endodontic therapy is begun. Apexification is a method of inducing a calcified barrier at the apex of a nonvital tooth with incomplete root formation. Apexogenesis refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end. <60> UI - 99337993 AU - Bruder GA 3rd AU - Mastromihalis N AU - Foroughi K AU - Friedman S IN - SUNY at Stony Brook School of Dental Medicine, USA. TI - Perforation repairs. SO - New York State Dental Journal 1999 May;65(5):26-7 AB - Management of instrument perforations in the periodontal ligament space during endodontic or restorative procedures is an ongoing problem in dentistry. The introduction of microscopes, new instruments and materials has resulted in more controllable and predictable surgical and nonsurgical outcomes. This paper discusses some of the newer techniques and materials used to manage perforations effectively. <61> UI - 99337995 AU - Mastromihalis N AU - Goldstein S AU - Greenberg M AU - Friedman S IN - State University at Stony Brook School of Dental Medicine, Department of Endodontics, USA. TI - Applications for guided bone regeneration in endodontic surgery. SO - New York State Dental Journal 1999 May;65(5):30-2 AB - Regeneration of apical bony defects remains a significant problem in endodontic surgery. When a resorbable membrane is placed over a defect, it acts as a barrier between the defect and the overlying gingival tissue. This barrier membrane provides sufficient time for bone to regenerate while preventing the faster growing connective tissue from invaginating into the area. When new tissue replicates the structure and function of the lost tissue, then apical regeneration has occurred. <62> UI - 99308088 AU - Delbem AC AU - Cunha RF AU - Percinoto C AU - da Silva LB IN - Department of Pediatric Dentistry, School of Dentistry, State Paulista University-UNESP, Aracatuba, Brazil. TI - Severe lateral luxation and root fracture: report of a case with 5-year follow-up. SO - Endodontics & Dental Traumatology 1999 Apr;15(2):91-3 AB - A case of severe lateral luxation and root fracture in upper incisors is reported. Treatment involved the repositioning and fixation of the injured teeth and endodontic treatment with calcium hydroxide. The importance of long-term follow-up is emphasized. <63> UI - 99305369 AU - Kramer N AU - Frankenberger R AU - Pelka M AU - Petschelt A IN - University of Erlangen-Nuremberg, Germany. kraemer@dent.uni-erlangen.de TI - IPS Empress inlays and onlays after four years--a clinical study. SO - Journal of Dentistry 1999 Jul;27(5):325-31 AB - OBJECTIVE: Ceramic inlays are used as esthetic alternatives to amalgam and other metallic materials for the restoration of badly damaged teeth. However, only limited clinical data are available regarding adhesive inlays and onlays with proximal margins located in dentine. In a prospective, controlled clinical study, the performance of IPS Empress inlays and onlays with cuspal replacements and margins below the amelocemental junction was examined. MATERIALS AND METHODS: Ninety-six IPS Empress fillings were placed in 34 patients by six clinicians. The restorations were luted with four different composite systems. The dentin bonding system Syntac Classic was used in addition to the acid-etch-technique. At baseline and after 6 months, one, two and four years after placement the restorations were assessed by two calibrated investigators using modified USPHS codes and criteria. A representative sample of the restorations was investigated by scanning electron microscopy to evaluate wear. RESULTS: Seven of the 96 restorations investigated had to be replaced (failure rate 7%; Kaplan-Meier). Four inlays had suffered cohesive bulk fractures and three teeth required endodontic treatment. After four years in clinical service, significant deterioration (Friedman 2-way Anova; p < 0.05) was found to have occurred in the marginal adaptation of the remaining restorations. Seventy-nine percent of the surviving restorations exhibited marginal deficiencies, independent of the luting composite. Neither the absence of enamel margins, nor cuspal replacement significantly affected the adhesion or marginal quality of the restorations. CONCLUSION: After four years, extensive IPS Empress inlays and onlays bonded with the dentin bonding system Syntac Classic were found to have a 7% failure rate with 79% of the remaining restorations having marginal deficiencies. <64> UI - 99308080 AU - Zmener O AU - Banegas G IN - Department of Adult Dental Care, Faculty of Odontology, University of Buenos Aires, Argentine Republic. TI - Clinical experience of root canal filling by ultrasonic condensation of gutta-percha. SO - Endodontics & Dental Traumatology 1999 Apr;15(2):57-9 AB - Ninety human teeth with a total of 181 prepared root canals were filled with the use of ultrasonically energized spreaders as an aid for lateral condensation of gutta-percha cones. The results were evaluated on the basis of clinical and radiographic criteria. Adequate fillings were found in 93% of the canals and the overall success rate was 93%. All of the recalled patients were clinically comfortable. <65> UI - 99340737 AU - Stockton LW IN - Department of Restorative Dentistry, Faculty of Dentistry, University of Manitoba, USA. TI - Vital pulp capping: a worthwhile procedure. [Review] [43 refs] SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1999 Jun;65(6):328-31 AB - Despite the progress made in the field of pulp biology, the technique and philosophy of direct vital pulp capping remains a controversial subject. Clinicians are well aware of the immediate and long-term success rates after root canal therapy, but are less certain of the success of vital pulp capping. Researchers have demonstrated that exposed pulps will heal and form reparative dentin. It is realized now that the variable prognosis of vital pulp capping is predominately a restorative issue. The factors that can produce a successful vital pulp cap are discussed in conjunction with two popular techniques. [References: 43] <66> UI - 99294526 AU - Izumi Y AU - Taniguchi T AU - Maruyama Y AU - Sueda T IN - Department of Periodontology, Kagoshima University Dental School, Japan. izumiyu@dentb.hal.kagoshima-u.ac.jp TI - Effective periodontal treatment in a patient with type IIA von Willebrand's disease: report of a case. SO - Journal of Periodontology 1999 May;70(5):548-53 AB - von Willebrand's disease (vWD) is one of the most common hereditary hemorrhagic disorders. A mild to moderate deficiency of factor VIII and von Willebrand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45-year-old woman with type IIA vWD was referred for periodontal therapy because of an episode of gingival hemorrhage and percussion pain of teeth :18 and :47. The periodontal findings included probing depths ranging from 2 to 6 mm, horizontal bone loss, and Class II furcation involvement of tooth :46. After consultation with a hematologist, apically positioned flap surgery and hemisection were performed on tooth :46 following completion of oral hygiene instruction, scaling and root planing, and endodontic therapy. The patient was given 500 units of factor VIII including vWf multimer 30 minutes before surgery. After healing of the periodontal tissue, prosthodontic treatment was undertaken on the posterior mandibular sextants. At follow-up, the probing depths ranged from 2 to 3 mm, and gingival bleeding on probing was minimal. The patient's children all had vWD. They had mild to moderate periodontitis with probing depths ranging from 2 to 5 mm and gingival bleeding on probing. With the combined efforts of the periodontist and hematologist, effective periodontal treatment can be provided to patients with von Willebrand's disease. <67> UI - 99240165 AU - Chan CP AU - Lin CP AU - Tseng SC AU - Jeng JH IN - Dental Department, Chang Gung Memorial Hospital, Taipei, Taiwan. TI - Vertical root fracture in endodontically versus nonendodontically treated teeth: a survey of 315 cases in Chinese patients. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1999 Apr;87(4):504-7 AB - OBJECTIVE: The purpose of this study was to compare endodontically versus nonendodontically treated teeth with respect to clinical features, including patient age and gender and tooth types of vertical root fractures. STUDY DESIGN: A total of 315 consecutive cases of vertical root fracture occurring in 274 Chinese patients during a 1 3-year period were reviewed. Age and gender, as well as tooth type and root distribution of vertical root fractures, were presented and compared in endodontically versus nonendodontically treated teeth. RESULTS: Most patients (87%) had 1 fractured tooth; the others had 2 or 3 fractured teeth. Of all vertical root fractures, 40% occurred in nonendodontically treated teeth. In comparison with those in endodontically treated teeth, vertical root fractures in nonendodontically treated teeth tended to occur in patients with a higher mean age (55 years vs. 51 years) and were more frequent in male patients (78% vs. 58%). Vertical root fractures occurred in nonendodontically treated teeth more often in molars (84% vs. 53%), less often in premolars (16% vs. 33%), and seldom in anteriors (1 tooth vs. 27 teeth). CONCLUSIONS: Vertical root fractures in nonendodontically treated teeth are not uncommon and comprise a large proportion of such fractures in Chinese patients. Differences between endodontically and nonendodontically treated teeth in patient age and gender, as well as in tooth types of vertical root fractures, were demonstrated. <68> UI - 99240163 AU - Testori T AU - Capelli M AU - Milani S AU - Weinstein RL IN - School of Dentistry, S. Paolo Hospital, University of Milan, Italy. TI - Success and failure in periradicular surgery: a longitudinal retrospective analysis. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1999 Apr;87(4):493-8 AB - The objective of the present study was to compare the success rates of 2 different periapical surgical techniques, the traditional technique with rotary instruments and the ultrasonic technique, which uses ultrasonic retrotips. A longitudinal retrospective study was carried out on 302 apices (181 teeth) that had undergone periapical surgery. Surgical outcome was evaluated by 2 independent operators using standardized periapical radiographs. Each radiographic finding was classified into 1 of 4 groups: complete healing, incomplete healing, uncertain healing, and unsatisfactory outcome (failure). An SAS statistical analysis system was used for data management and analysis. Prognostic factors were determined by means of the Fisher exact test. Complete healing after 4.6 years (the average follow-up period) was observed in 68% of the teeth treated through the use of the standard technique and 85% of those treated through the use of the ultrasonic technique. The success rate increased as the follow-up period lengthened (68.4% at 2 years vs 80% at 6 years). The success rate was higher in maxillary (77.9%) than in mandibular (66.1%) teeth. A comparison between the retrofilling materials was not feasible because all teeth in the standard technique group were retrofilled with amalgam and all teeth in the ultrasonic group were retrofilled with Super-EBA. <69> UI - 99287067 AU - Fuzzi M AU - Rappelli G IN - SAOS-FUZZI@mail.asianet.it TI - Ceramic inlays: clinical assessment and survival rate. SO - Journal of Adhesive Dentistry 1999;1(1):71-9 AB - PURPOSE: This study evaluates the clinical behavior of ceramic inlays placed during the past decade. MATERIALS AND METHODS: One hundred eighty-two inlays were examined in 66 patients. The interval between placement and assessment was on average 5.9 years +/- 2.7, ranging from 2 to 11.7 years. Restorations still present at the time of evaluation were clinically assessed according to modified USPHS criteria. Kaplan-Meier statistical analysis was used to assess the survival rate. RESULTS: According to USPHS criteria, good results were obtained for color match, marginal discoloration, recurrent caries, contour, and marginal integrity. Six inlays failed: four for endodontic reasons, one due to recurrent caries, and the other due to fracture. The results indicate that a success rate of 95% could be predicted at 11.5 years. CONCLUSION: The lack of recurrent caries, the only slight changes in marginal discoloration and color match, combined with the excellent longevity prove that ceramic inlays are a valuable tool for the restoration of posterior teeth. <70> UI - 99284952 AU - Koch MJ IN - Department of Conservative Dentistry, Ruprecht-Karls University, Heidelberg, Germany. TI - Formaldehyde release from root-canal sealers: influence of method. SO - International Endodontic Journal 1999 Jan;32(1):10-6 AB - AIM: To examine formaldehyde release from three different root-canal sealers: one phenol resin, one epoxy resin and one paraformaldehyde containing zinc oxide eugenol cement. METHODOLOGY: Formaldehyde was measured from freshly mixed material and from specimens allowed to set for 2 days or 2 weeks. Different mixing ratios and sample sizes were tested. Analysis was performed by reacting formaldehyde with acetylacetone and ammonia to form diacetyldihydrolutidine, which was revealed by spectrophotometry. RESULTS: Analysis revealed that mixing ratio, time after mixing and surface:weight ratios of specimens had different influences on the formaldehyde release from different materials. CONCLUSIONS: From the results of this study it is difficult to define a standardized in-vitro test that can be applied universally for the definitive determination of formaldehyde release from endodontic sealers. Prediction of in-vivo formaldehyde release from endodontic sealers is difficult. <71> UI - 99284954 AU - Blum JY AU - Cohen A AU - Machtou P AU - Micallef JP IN - School of Dentistry, University of Montpellier, France. TI - Analysis of forces developed during mechanical preparation of extracted teeth using Profile NiTi rotary instruments. SO - International Endodontic Journal 1999 Jan;32(1):24-31 AB - AIM: The aim of this study was to analyse the vertical forces and torque developed in the root canal system of extracted teeth during mechanical preparation using ProFile NiTi instruments. METHODOLOGY: Instrument wear and fracture is in great part due to the repeated application of forces and torque during the course of root-canal preparation but research into the direct relationship has been hampered by the lack of adequate measuring devices. Measurements of these forces and torque were made with a new force analyser device, the Endographe, that was equipped with a holder to record and generate graphs of the vertical forces and torque exerted during the preparations. These preparations was performed by endodontists or students either with a series of instruments of increasing size or with the crown-down pressureless technique. RESULTS: The mean values for the endodontists of the generated vertical forces and torque varied, respectively, from 4 to 6N and from 7.105 to 12.105 Nm for the step-back technique and from 2.9 to 4.2 N and from 18.105 to 20.105 Nm for the crown-down technique. This suggested that the crown-down technique generated lower stresses (lower torque and lower vertical forces), although these findings also depend on the shape of individual canals. The students initially showed wide variations in generated forces, with significantly lower vertical force the torque values. By the end of the experimental sessions their values were similar to those of the endodontists, which indicated improvement in the efficiency of manipulation. CONCLUSIONS: Further work is needed to investigate the relationship between the force and the torque data from this study and the incidence of instrument fracture with the two techniques, as the clinical implications are considerable. It must be noted, however, that the Endographe is unable to take into account the cutting efficiency of the instruments. The use of graphs provides a new approach to the analysis of mechanical preparation. <72> UI - 99294554 AU - von Arx T AU - Kurt B IN - Department of Oral & Maxillofacial Surgery, State Hospital, Lucerne, Switzerland. vonarx@uthscsa.edu TI - Root-end cavity preparation after apicoectomy using a new type of sonic and diamond-surfaced retrotip: a 1-year follow-up study. SO - Journal of Oral & Maxillofacial Surgery 1999 Jun;57(6):656-61 AB - PURPOSE: This study evaluated the outcome of periradicular surgery using a new set of retrotips for root-end cavity preparation. PATIENTS AND METHODS: Forty-three patients who had 50 consecutively treated teeth with periradicular pathology were enrolled in this prospective study. After apicoectomy, root-end cavity preparation was performed, using diamond-surfaced retrotips driven by a sonic handpiece; EBA-cement was used as the root-end filling material. Healing assessment was based on clinical and radiographic criteria. RESULTS: At the 1-year follow-up, 82% of the reexamined surgical cases presented with successful healing. Fourteen percent of the treated teeth were deemed as improved (partial healing), and 4% were classified as failures. CONCLUSION: The new retrotips were found to be ideal for root-end cavity preparation. They simplify the surgical approach to root ends where the working space is limited by restricted access. Root-ends prepared with this new sonoabrasive technique yielded excellent results at the 1-year follow-up examination. <73> UI - 99300497 AU - Peters O AU - Barbakow F IN - Department of Preventive Dentistry, Cariology and Periodontology, University of Zurich, Switzerland. TI - Apical transportation revisited or 'where did the K-file go'?. SO - International Endodontic Journal 1999 Mar;32(2):131-7 AB - CASE REPORT: This case report describes the outcome of a number of retreatments on a failed root filling in a maxillary first molar. The patient wanted all amalgams replaced by tooth-coloured Cerec restorations, including one in a symptomless maxillary molar. This tooth had a pulpotomy or a poorly done root-canal treatment 10 years earlier. The molar was root-canal retreated before placing the Cerec restoration and the palatal canal was filled 5 mm short of the radiographic apex. About 1 year later the patient presented with pain. Suspecting that a second mesiobuccal canal (MB-2) had not been located, a second non-surgical retreatment was instituted. MB-2 was not found and the palatal canal was retreated a third time, setting the working length 2 mm short of the radiographic apex. Because pain persisted palatally an apicectomy was performed and the tooth became symptomless. The resected palatal root apex was subsequently serially cross-sectioned, photographed and the canals analysed. Obvious apical transportation occurred during the cleaning and shaping procedures. Analyses of the canals showed that despite the retreatments, 11% of the canal cross-sectional area remained uncleaned although 7% of the root area was 'shaped'. Radiographically, the obturated palatal canal appeared reasonably well centred. However, this was disproved by the cross-sections, indicating that in this case, the clinician did not know where the K-Files had 'gone'. Apically, the obturated canal was certainly not within the natural canal. The pain located palatally was probably due to inadequate cleaning and shaping of the apical part of the root canal and its accessory canals. <74> UI - 99300498 AU - Tidwell E AU - Witherspoon DE AU - Gutmann JL AU - Vreeland DL AU - Sweet PM IN - Department of Restorative Sciences, Texas A & M University Baylor College of Dentistry, Dallas 75246, USA. TI - Thermal sensitivity of endodontically treated teeth. SO - International Endodontic Journal 1999 Mar;32(2):138-45 AB - CASE REPORTS: The problem of thermal sensitivity following non-surgical root-canal treatment is explored and case reports are presented. Possible causes for post-treatment discomfort from endodontic and restorative aetiologies are discussed, as are the mechanisms to explain the patients' painful experiences. Treatment of this problem may vary from the simple replacement of a defective restoration to a more extensive non-surgical retreatment of the case, despite radiographic evidence of an acceptable root filling and normal periradicular tissues. <75> UI - 99300499 AU - Caliskan MK AU - Turkun M AU - Gomel M IN - Department of Endodontics, School of Dentistry, Ege University, Izmir, Turkey. TI - Surgical extrusion of crown-root-fractured teeth: a clinical review. SO - International Endodontic Journal 1999 Mar;32(2):146-51 AB - AIM: In this clinical study combined surgical and endodontic treatment was performed in 20 cases of crown-root fracture and the outcomes reviewed. METHODOLOGY: Surgical treatment involved a conventional extraction and stabilization technique. Root canal treatment using calcium hydroxide was performed. Before root canal obturation, a calcium hydroxide dressing was maintained for 3 months. RESULTS: Follow-up examinations, which varied between 6 and 36 (mean 14.5) months, showed that there were no radiographic and clinical signs of progressive root resorption, marginal bone loss or periapical disease in all except one case. CONCLUSIONS: The favourable results of this study demonstrate that surgical extrusion in teeth with crown-root fractures may be an alternative treatment to orthodontic extrusion. <76> UI - 99256531 AU - Ne RF AU - Witherspoon DE AU - Gutmann JL IN - Department of Restorative Sciences, Graduate Endodontics, Texas A & M University System, Baylor College of Dentistry, Dallas 75214, USA. TI - Tooth resorption. [Review] [49 refs] SO - Quintessence International 1999 Jan;30(1):9-25 AB - Tooth resorption is a common sequela following injuries to or irritation of the periodontal ligament and/or tooth pulp. The course of tooth resorption involves an elaborate interaction among inflammatory cells, resorbing cells, and hard tissue structures. The key cells involved in resorption are of the classic type, which include osteoblasts and odontoclasts. Types of tooth resorption include internal resorption and external resorption. There are two types of internal resorption: root canal (internal) replacement resorption and internal inflammatory resorption. External resorption can be classified into four categories by its clinical and histologic manifestations: external surface resorption, external inflammatory root resorption, replacement resorption, and ankylosis. External inflammatory root resorption can be further categorized into cervical resorption with or without a vital pulp (invasive cervical root resorption) and external apical root resorption. Other variations of resorption include combined internal and external resorption and transient apical breakdown. [References: 49] <77> UI - 99241424 AU - Loshkarev VP AU - Bauchenkova EV TI - [The use of the TefGen membrane in periodontology]. [Russian] SO - Stomatologiia 1999;78(2):57-8 AB - A nonabsorbed TefGen barrier membrane was left for 21 days for bone defect regeneration and preventing epithelial ingrowth after open curettage in 15 patients. No wound infection, inflammation, or pain at the site of operation was recorded in any of the cases, which confirms absolute biocompatibility of the membrane. In none of the cases was the membrane lost during the immediate postoperative period (21 days). Membranes were removed without intervention, with a sharp instrument (probe); this demonstrates the advantages of TefGen over other nonabsorbed membranes which require primary closing. X-Ray photographs after 3 months showed repair of osteoid structures in osseous pouches without loss of bone profile at the site of intervention and no mobile teeth. <78> UI - 99241425 AU - Lapshin SD TI - [Experience in using hydroxyapatite in operative dentistry practice]. [Russian] SO - Stomatologiia 1999;78(2):59-61 AB - Hydroxyapol, hapcol and colapol were used to repair the postoperative defects in the jaws in 83 patients of different sex and age. Ossification of bone cavities was more rapid and complete than in the reference group. Complications observed in 7 patients resulted from strategic or technological errors. <79> UI - 99159745 AU - Danin J AU - Linder LE AU - Lundqvist G AU - Ohlsson L AU - Ramskold LO AU - Stromberg T IN - Department of Cariology and Endodontics, Karolinska Institutet, Huddinge University Hospital, Sweden. TI - Outcomes of periradicular surgery in cases with apical pathosis and untreated canals. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1999 Feb;87(2):227-32 AB - OBJECTIVE: Surgical management is intended to eliminate or block infection originating in the root canals. The root end is customarily sealed to prevent pathogenic products remaining in the root canal from reaching the periradicular tissues. The purpose of this study was to evaluate the microbiologic and radiographic outcomes of surgical treatment of periradicular pathosis associated with teeth with necrotic pulps. STUDY DESIGN: One tooth from each of 10 patients was root-end resected and root-end filled without prior root canal treatment. One year postoperatively, the outcomes were assessed radiographically and the root canals were sampled for bacteria. RESULTS: Radiographic examination showed complete or incomplete (scar tissue) healing in 5 teeth and uncertain healing in the other 5 teeth. Bacteriologic samples from the root canals were positive in 9 of the 10 cases. CONCLUSIONS: In teeth with necrotic pulps, treatment of periradicular pathosis by surgery and root-end filling may show radiographic evidence of satisfactory healing 1 year postoperatively. However, viable bacteria may persist in the canals, constituting a potential risk factor for recurrence of periradicular pathosis. <80> UI - 99204516 AU - Eggert C AU - Peters O TI - [Procedural challenges in endodontics. Continuing education course (CEC) 6 May 98 (news)]. [German] SO - Schweizer Monatsschrift fur Zahnmedizin 1999;109(2):206-8 <81> UI - 99160666 AU - Sirimai S AU - Riis DN AU - Morgano SM IN - Goldman School of Dental Medicine, Boston University, Boston, Mass. 02118, USA. TI - An in vitro study of the fracture resistance and the incidence ofvertical root fracture of pulpless teeth restored with six post-and-coresystems. SO - Journal of Prosthetic Dentistry 1999 Mar;81(3):262-9 AB - STATEMENT OF PROBLEM: Posts and cores are often required with pulpless teeth to provide retention and resistance form for complete crowns. Nevertheless, conventional posts may increase the potential for root fracture. PURPOSE: This study compared the resistance to vertical root fracture of extracted teeth treated with post-core systems that were modified with polyethylene woven fibers (Ribbond) with those treated with conventional post-and-core systems. MATERIAL AND METHODS: Canal instrumentation was performed for 60 maxillary central incisors, and complete crown preparations were made. The coronal portion of each tooth was amputated, and 6 post-and-core systems were studied. Specimens were mounted in acrylic resin blocks with a layer of polyvinyl siloxane covering the roots. Loads were applied at an angle of 130 degrees and measured with a universal testing machine. Results were analyzed statistically with 1-way analysis of variance with Student-Newman-Keuls grouping and chi-square analysis. RESULTS. Cast posts and cores resulted in significantly higher failure thresholds than all others, except for prefabricated, comparably sized, parallel-sided posts with composite cores. All failures in the group with cast posts involved fracture of the teeth, whereas 70% of the teeth with comparably sized parallel-sided posts and composite cores failed as a result of tooth fractures and 30% experienced core fractures. The woven fiber post-core system was significantly lower in strength than all others, and exhibited significantly fewer vertical root fractures. CONCLUSIONS: Polyethylene woven fiber and composite resin without a prefabricated post resulted in significantly fewer vertical root fractures, but mean failure load was the lowest. Smaller diameter prefabricated posts combined with the polyethylene woven fiber and composite cores improved resistance to failure. Traditional cast posts and cores were the strongest of the 6 post-core systems. <82> UI - 99174812 AU - Raghoebar GM AU - Vissink A IN - Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands. g.m.raghoebar@kchir.azg.nl TI - Results of intentional replantation of molars. SO - Journal of Oral & Maxillofacial Surgery 1999 Mar;57(3):240-4 AB - PURPOSE: This study evaluated the treatment outcome of intentional replantation of molars. PATIENTS AND METHODS: Twenty-nine patients were treated with intentional replantation because conventional apicoectomy was not possible. The success rate was judged by clinical and radiographic parameters. RESULTS: One molar (3%) had to be removed because of pain and mobility 4 weeks postsurgery, and three molars (11%) had to be removed during the first year because of periodontal problems. Four molars (14%) showed periodontal problems or root resorption, but are still in function and causing no obvious problems to the patients. Twenty-one molars (72%) were successfully treated. CONCLUSION: Intentional replantation is a reliable and predictable treatment for those cases in which conventional apicoectomy is hampered because of anatomic limitations or patient factors. <83> UI - 99449863 AU - Sumi Y AU - Nakamura Y AU - Mitsudoh K AU - Ueda M IN - The National Chubu Hospital, Division of Dental Surgery, Obu-City, Japan. TI - Application of titanium-alloy endodontic implants in conjunction with periradicular surgery. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1999 Oct;88(4):484-7 AB - OBJECTIVE: To evaluate the outcome of placement of titanium-alloy endodontic implants in conjunction with periradicular surgery. STUDY DESIGN: Twenty-four teeth were treated with endodontic implants with corresponding periradicular surgery by using SuperEBA cement (Harry J Bosworth Co, Skokie, Ill) as a sealer. The results of the endodontic implant surgery were evaluated clinically and radiographically from 2 to 4 years after treatment. RESULTS: Twenty-two teeth were treated successfully, whereas 2 teeth were treated unsuccessfully, for a success rate of 92%. CONCLUSIONS: Titanium-alloy endodontic implants in conjunction with periradicular surgery may provide good short-term results. Sealing between the endodontic implant and the dentin is likely an important factor for success. <84> UI - 99459714 AU - Petersson K AU - Soderstrom C AU - Kiani-Anaraki M AU - Levy G IN - Department of Endodontics, Malmo University, Sweden. kerstin.petersson@od.mah.se TI - Evaluation of the ability of thermal and electrical tests to register pulp vitality. SO - Endodontics & Dental Traumatology 1999 Jun;15(3):127-31 AB - The aim of the present study was to evaluate the ability of thermal and electrical tests to register pulp vitality. Sensitivity, specificity, negative predictive value and positive predictive value were calculated by comparing the test results with a "gold standard". The thermal tests studied were a cold test (ethyl chloride) and a heat test (hot gutta-percha). For the electrical test, the Analytic Technology Pulp Tester was used. The examined teeth were 59 teeth with unknown pulpal status in need of endodontic treatment and 16 intact teeth, all with radiographically normal periapical bone structures. In total 46 teeth with vital pulps and 29 teeth with necrotic pulps were tested. This gave a disease prevalence of 39%. The gold standard was established by direct pulp inspection of the 59 teeth in need of endodontic treatment. In the 16 intact teeth the pulp was judged as vital. The number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) test results was calculated for each method as compared to the gold standard. Based on this, the sensitivity, specificity, positive predictive value and negative predictive value were calculated for each method. The sensitivity was 0.83 for the cold test, 0.86 for the heat test and 0.72 for the electrical test. The specificity was 0.93 for the cold test, 0.41 for the heat test and 0.93 for the electrical test. The positive predictive value was 0.89 for the cold test, 0.48 for the heat test and 0.88 for the electrical test, and the negative predictive value was 0.90 for the cold test, 0.83 for the heat test and 0.84 for the electrical test. This indicated that the probability of a non-sensitive reaction representing a necrotic pulp was 89% with the cold test, 48% with the heat test and 88% with the electrical test. It also indicated that the probability of a sensitive reaction representing a vital pulp was 90% with the cold test, 83% with the heat test and 84% with the electrical test. <85> UI - 99459715 AU - Poi WR AU - Sonoda CK AU - Salineiro SL AU - Martin SC IN - Department of Surgery and Integrated Clinic, Faculty of Dentistry, Universidade Estadual Paulista-UNESP, Aracatuba, Sao Paulo, Brasil. TI - Treatment of root perforation by intentional reimplantation: a case report. SO - Endodontics & Dental Traumatology 1999 Jun;15(3):132-4 AB - Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. In this paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8-year follow-up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforation/instrument retrieval. <86> UI - 99459716 AU - Casterline AC IN - Dental Department, Phoenix Indian Medical Center, Indian Health Service, Arizona, USA. TI - Replantation of avulsed central incisor with advanced periodontal disease: a case report. SO - Endodontics & Dental Traumatology 1999 Jun;15(3):135-7 AB - This paper describes the case of a 31-year-old woman with advanced periodontal disease who lost a tooth due to trauma. The avulsed tooth had minimal bony support of only 4-5 mm. The patient described was under good periodontal maintenance. The tooth was kept moist, and replantation occurred within an hour of avulsion. The tooth was returned to its position, splinted, and later endodontically treated. After 2 years the tooth appears and functions normally as it did before avulsion. <87> UI - 20018816 AU - Fuss Z AU - Lustig J AU - Tamse A IN - Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. TI - Prevalence of vertical root fractures in extracted endodontically treated teeth. SO - International Endodontic Journal 1999 Aug;32(4):283-6 AB - AIM: The aim of this study was to evaluate the prevalence of vertical root fractures (VRF) in extracted endodontically treated teeth and to correlate the findings to previous studies and surveys. METHODOLOGY: Root-canal-treated teeth were referred for extraction from a public dental clinic. The endodontic therapy had been completed by a variety of dentists. Each tooth was evaluated following extraction by the oral surgeon who performed the procedure: the exact aetiology for the clinical diagnosis that led to the extraction was recorded. RESULTS: The major reasons for extraction were restorative (43.5%) and endodontic (21.1%), followed by vertical root fractures (10.9%). CONCLUSIONS: The relatively high prevalence of vertical root fractures in this survey compared with previous clinical and radiographic surveys was probably related to the difficulties in making a clinical diagnosis of vertical fractures before extraction. <88> UI - 20018805 AU - Hamilton RS AU - Gutmann JL IN - Department of Restorative Sciences, Texas A & M University Health Science Center, Baylor College of Dentistry, Dallas 75246, USA. TI - Endodontic-orthodontic relationships: a review of integrated treatment planning challenges. [Review] [131 refs] SO - International Endodontic Journal 1999 Sep;32(5):343-60 AB - Literature review There is a paucity of information on the concise relationship between endodontics and orthodontics during treatment planning decisions. This relationship ranges from effects on the pulp from orthodontic treatment and the potential for resorption during tooth movement, to the clinical management of teeth requiring integrated endodontic and orthodontic treatment. This paper reviews the literature based on the definition of endodontics and the scope of endodontic practice as they relate to common orthodontic-endodontic treatment planning challenges. Literature data bases were accessed with a focus on orthodontic tooth movement and its impact on the viability of the dental pulp; its impact on root resorption in teeth with vital pulps and teeth with previous root canal treatment; the ability to move orthodontically teeth that were endodontically treated versus nonendodontically treated; the role of previous tooth trauma; the ability to move teeth orthodontically that have been subjected to endodontic surgery; the role of orthodontic treatment in the provision for and prognosis of endodontic treatment; and, the integrated role of orthodontics and endodontics in treatment planning tooth retention. Orthodontic tooth movement can cause degenerative and/or inflammatory responses in the dental pulp of teeth with completed apical formation. The impact of the tooth movement on the pulp is focused primarily on the neurovascular system, in which the release of specific neurotransmitters (neuropeptides) can influence both blood flow and cellular metabolism. The responses induced in these pulps may impact on the initiation and perpetuation of apical root remodelling or resorption during tooth movement. The incidence and severity of these changes may be influenced by previous or ongoing insults to the dental pulp, such as trauma or caries. Pulps in teeth with incomplete apical foramen, whilst not immune to adverse sequelae during tooth movement, have a reduced risk for these responses. Teeth with previous root canal treatment exhibit less propensity for apical root resorption during orthodontic tooth movement. Minimal resorptive/remodelling changes occur apically in teeth that are being moved orthodontically and that are well cleaned, shaped, and three-dimensionally obturated. This outcome would depend on the absence of coronal leakage or other avenues for bacterial ingress. A traumatized tooth can be moved orthodontically with minimal risk of resorption, provided the pulp has not been severely compromised (infected or necrotic). If there is evidence of pulpal demise, appropriate endodontic management is necessary prior to orthodontic treatment. If a previously traumatized tooth exhibits resorption, there is a greater chance that orthodontic tooth movement will enhance the resorptive process. If a tooth has been severely traumatized (intrusive luxation/avulsion) there may be a greater incidence of resorption with tooth movement. This can occur with or without previous endodontic treatment. Very little is known about the ability to move successfully teeth that have undergone periradicular surgical procedures. Likewise, little is known about the potential risks or sequelae involved in moving teeth that have had previous surgical intervention. Especially absent is the long-term prognosis of this type of treatment. During orthodontic tooth movement, the provision of endodontic treatment may be influenced by a number of factors, including but not limited to radiographic interpretation, accuracy of pulp testing, patient signs and symptoms, tooth isolation, access to the root canal, working length determination, and apical position of the canal obturation. Adjunctive orthodontic root extrusion and root separation are essential clinical procedures that will enhance the integrated treatment planning process of tooth retention in endodontic-orthodontic related cases. [References: 131] <89> UI - 20018811 AU - Manogue M AU - Brown GA AU - Nattress BR AU - Fox K IN - Division of Restorative Dentistry, Leeds Dental Institute, England, UK. TI - Improving student learning in root canal treatment using self-assessment. SO - International Endodontic Journal 1999 Sep;32(5):397-405 AB - AIM: This paper reports the first attempts to implement a new course in endodontology for undergraduate dental students based upon independent, reflective learning and self-assessment. METHODOLOGY: The responses were analysed of two successive cohorts of third-year students to laboratory courses in (i) the restoration of teeth with crowns and (ii) endodontology and root canal treatment. The major changes introduced to the endodontology course were a substantial reduction in the number of formal lectures, the introduction of a series of structured tutorials, time for private study and the use of self-assessment in practical classes. RESULTS: The evidence indicates that the new approach increased student confidence in practical skills, although the time available for operative practice was actually reduced; there was a perceived increase in problem-solving ability; and that students felt encouraged to pursue greater understanding. Reports from tutors suggested that students' self-assessments became more accurate as the courses proceeded. Seven experimental learning points were derived from the study. These included the importance of careful planning, well-designed assessment procedures and the creation of a climate of trust and openness. CONCLUSIONS: The task of developing fully the students' skills of accurate self-assessment remains a challenge. <90> UI - 99456240 AU - Keltjens HM AU - Creugers TJ AU - van't Hof MA AU - Creugers NH IN - Department of Occlusal Reconstruction and Oral Function, College of Dental Science, Faculty of Medical Sciences, University of Nijmegen, The Netherlands. secr:of@dent.kun.nl TI - A 4-year clinical study on amalgam, resin composite and resin-modified glass ionomer cement restorations in overdenture abutments. SO - Journal of Dentistry 1999 Nov;27(8):551-5 AB - OBJECTIVE: To assess the performance of three different filling materials in overdenture abutment teeth. METHODS: In 49 patients amalgam, resin composite and resin-modified glass ionomer cement were used to seal the root canal orifices of 155 overdenture abutment teeth. After initial preparation of the cavities, the three restorative materials were randomly assigned to the abutment teeth using a number of balancing criteria. All patients were reviewed every six months and received the same preventive regimen. Survival was assessed at two levels: Sorig (survival of the restoration independent from eventual maintenance treatments) and Scomp (restorations survived even without maintenance treatments). RESULTS: The calculated overall survival percentage of the original restorations (Sorig) after four years was 63 +/- 6% (mean +/- SE). Calculation for the overall complete survival (Scomp) revealed a percentage survival of 57 +/- 6%. At both levels, the differences between the survivals of the investigated materials were not statistically significant (p-values > 0.05). Two abutments were lost, severe caries was the reason for one extraction and another abutment tooth was extracted for periodontal reasons. CONCLUSIONS: The results of this study did not point out a superior restorative material for the seal of root canal orifices of overdenture abutments. The distribution of failures over the patients indicates a certain patient dependency. <91> UI - 99459817 AU - Trope M AU - Delano EO AU - Orstavik D IN - Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill 27599-2707, USA. TI - Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. SO - Journal of Endodontics 1999 May;25(5):345-50 AB - This study was performed to evaluate radiographic healing of teeth with apical periodontitis, treated in one visit or in two visits (a) with or (b) without calcium hydroxide as an intracanal disinfecting medicament. The patients were assigned one of the three treatment groups by the throwing of a die. The Periapical Index (PAI) Scoring Method was used to compare differences in periapical status from the beginning of treatment to a 52-wk follow-up evaluation. Overall, the periapical status of the treated teeth improved significantly after 52 wk (p < 0.0001). A PAI score of 1 or 2 was considered as representing a "good" periapical status while 3, 4, or 5 was a "bad" status. When base line PAI scores were controlled for, the calcium hydroxide group showed the most improvement in PAI score (3, 4, or 5 to 1 or 2), followed by the one-step group (74% vs. 64%). The teeth that were left empty between visits had clearly inferior healing results. Power statistics were conducted to determine the numbers required for significant differences between the groups, and it was shown that large experimental groups on the order of hundreds of patients would be required to show significant differences. <92> UI - 99459822 AU - Caplan DJ AU - Reams G AU - Weintraub JA IN - Department of Dental Ecology, University of North Carolina, Chapel Hill 27599-7450, USA. TI - Recommendations for endodontic referral among practitioners in a dental HMO. SO - Journal of Endodontics 1999 May;25(5):369-75 AB - This study assessed the effect of patients' presenting conditions on general practitioners' (GPs') self-reported endodontic referral patterns, and compared GPs' perceived indications for referral with those of endodontists. The study was based on a self-administered, confidential survey distributed to 79 GPs and 7 endodontists who provide care to members of one Dental HMO in the Pacific Northwest. GPs were most likely to recommend referral for teeth they felt needed surgical retreatment, but GPs and endodontists did not always agree on indications for referral. Compared with GPs, endodontists were more likely to recommend referral for patients with complex problems, but not necessarily technically difficult teeth. Compared with those with less experience, GPs with more than 10 yr both in dentistry and at this HMO were more likely to recommend (a) referring difficult cases rather than performing endodontic therapy themselves and (b) extracting perforated or root-fractured teeth prior to obturation rather than continuing treatment. Indications for referral that maximize favorable dental outcomes need to be identified. <93> UI - 99459810 AU - Mayhew RB AU - Svee TA AU - Johnson CW AU - Markins SR IN - Department of Health Promotion and Dental Care Delivery, University of Texas Health Science Center-Houston, USA. TI - Quality of obturation in student cases instructed by endodontic versus general dentistry faculty. SO - Journal of Endodontics 1999 Jun;25(6):461-3 AB - Endodontic literature suggests that only about 60% of endodontic therapy meets current technical standards and that general dentists may be making a significant contribution to this compromised care. If so, where in the continuum of dental education does this begin. This study evaluated the quality of obturation in mandibular molars provided on the one hand by 3rd year dental students instructed by endodontic faculty, and on the other hand by 4th year students instructed by general dentistry faculty, versus the quality of obturation achieved by endodontic residents who served as a control for both groups. Final radiographs were chosen from students in all three groups so that there were 22 samples per group. Three evaluators rank-ordered the radiographs. In order of excellence, the results were: (a) residents, (b) 3rd year students, and (c) 4th year students. There was no significant difference between the 3rd year students or the residents, only between residents and 4th year students (p < 0.05). The reasons for this outcome may range from dental school objectives to the private practice procedures of the general dentists who instructed the 4th year students. <94> UI - 99412929 AU - Abbott P TI - Endodontic management of combined endodontic-periodontal lesions. [Review] [54 refs] SO - Journal of New Zealand Society of Periodontology 1998;(83):15-28 AB - Endodontic-periodontal lesions can provide many challenges to clinicians. Although there may be difficulties in establishing a correct diagnosis, this is the most important phase of their management as the diagnosis will determine the type and sequence of treatment required. In general, if the root canal system is infected, endodontic treatment should be commenced prior to any periodontal therapy in order to remove the intra-canal infection before any cementum is removed. This avoids several complications and provides a favourable situation for tissue repair. The endodontic treatment can be completed before periodontal treatment is provided except where there is a "combined endodontic-periodontal lesion with communication"--in these cases, the root canals should be medicated until the periodontal treatment has been completed and the overall prognosis has been reassessed as being favourable. The use of non-toxic intra-canal therapeutic medicaments is essential to destroy bacteria and to encourage tissue healing. [References: 54] <95> UI - 99300474 AU - Abou-Rass M IN - Department of Endodontics, School of Dentistry, University of Southern California, Los Angeles, USA. TI - Long-term prognosis of intentional endodontics and internal bleaching of tetracycline-stained teeth. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1998 Oct;19(10):1034-8, 1040-2, 1044 passim AB - A total of 112 severely tetracycline-stained teeth in 20 patients were treated by endodontics and nonthermal internal bleaching. All teeth were healthy, intact, and had no history of trauma. The patients were monitored for 5 to 15 years. Excellent, permanent esthetic results were obtained with no side effects. The quality of endodontic treatment and lingual access restoration were important factors in the longevity of the bleaching results. <96> UI - 99254464 AU - Marques MD AU - Moreira B AU - Eriksen HM IN - Department of Preventive Dentistry, Faculty of Dentistry, University of Porto, Portugal. TI - Prevalence of apical periodontitis and results of endodontic treatment in an adult, Portuguese population. SO - International Endodontic Journal 1998 May;31(3):161-5 AB - The present epidemiological study is derived from a random sample of 322 residents of the Porto area, aged 30-39 years. Prevalence of apical periodontitis and results of endodontic treatment were evaluated from orthopantomograms, available from 179 of a total of 197 individuals attending for examination. The results indicated a prevalence of apical periodontitis in 27% of this population. The quality of a majority (54%) of the 69 root fillings observed were found to be inadequate, (i.e. short and/or poorly condensed), but only 15 (22%) of the endodontically treated teeth presented with apical periodontitis. <97> UI - 99254463 AU - Nair PN IN - Department of Oral Structural Biology, Centre of Dental and Oral Medicine, University of Zurich, Switzerland. TI - New perspectives on radicular cysts: do they heal?. [Review] [54 refs] SO - International Endodontic Journal 1998 May;31(3):155-60 AB - During the past few decades several authors have perpetuated the notion that nearly half of all periapical lesions are radicular cysts. A few studies, based on meticulous serial sectioning of periapical lesions retrieved in toto, have shown that the actual incidence of radicular cyst is only about 15% of all periapical lesions. Equally significant was the discovery in 1980 and recent confirmation that radicular cysts exist in two structurally distinct classes namely, those containing cavities completely enclosed in epithelial lining (periapical true cysts) and those containing epithelium-lined cavities that are open to the root canals (periapical pocket cysts). From a clinical point of view a periapical pocket cyst may heal after conventional root canal therapy whereas an apical true cyst is less likely to be resolved without surgical intervention. [References: 54] <98> UI - 99218798 AU - Jimena ME IN - U.P. Manila College of Dentistry. TI - Endodontic needs of geriatric patients in private practice. SO - Journal of the Philippine Dental Association 1998 Mar-May;49(4):5-21 AB - Twenty-five (25) teeth of fifteen (15) elderly patients endodontically treated in a private clinic for the span of three (3) years were evaluated in terms of success and failure of treatment. The attitudes of the patients towards endodontics were determined. Also, medical, dental and radiographic records were reviewed. Of the fifteen (15) patients. 53.3% belonged to age group 60 to 69 years old and the other half belonged to the 70 years and above age bracket. Majority were female, married and college graduates. Premolars constituted 40% of the teeth treated. Post, core and PFM crowns were the most common restoration for both anterior and posterior teeth. Success rate of root canal treatment was a high 84%. Patients gave a more positive attitude to the endodontic treatment mentioning relief of pain, appreciation of better food and self-esteem. Calcification was the most common problem encountered during the treatment. Quality radiograph, proper instrumentation, appropriate techniques and chemical adjuncts are recommended. Likewise, proper patient management, needed rapport and patience have to be stressed. <99> UI - 99123959 AU - Jansson LE AU - Ehnevid H IN - Department of Periodontology, Public Dental Service at Skanstull, Stockholm County, Stockholm, Sweden. leif.jansson@ftv.ssl.se TI - The influence of endodontic infection on periodontal status in mandibular molars. SO - Journal of Periodontology 1998 Dec;69(12):1392-6 AB - The purpose of the study was to investigate the influence of an endodontic infection on periodontal probing depth and presence of furcation involvement in periodontally-involved mandibular molars. All first and second mandibular molars in 100 patients were selected if at least one was root-filled or had a possible periapical radiolucency. The sample consisted of patients from a referral population at a periodontal clinic which represented an adult population with a mean age between 50 and 60 years. For mandibular molars with periapical destruction at both roots, mean periodontal probing depth was significantly greater compared to teeth without periapical destruction. Horizontal furcation depths > or =3 mm were significantly more frequent at mandibular molars with periapical destruction. It is suggested that a root canal infection in periodontitis-involved molars may potentiate periodontitis progression by spreading of endodontic pathogens through patent accessory canals and dentinal tubules. In conclusion, an endodontic infection in mandibular molars was found to be associated with additional attachment loss in the furcation area, and may thus be considered to be one of several risk factors influencing the prognosis of molars in periodontitis-prone patients. <100> UI - 99139126 AU - Birch S AU - Gafni A AU - Markham B AU - Marriott M AU - Lewis D AU - Main P IN - Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. TI - Health years equivalents as a measurement of preferences for dental interventions. SO - Community Dental Health 1998 Dec;15(4):233-42 AB - OBJECTIVE: To test the feasibility and importance of measuring preferences among treatment choices using Healthy Years Equivalents (HYE). DESIGN: Development of scenarios for alternative approaches to caries treatment. Completion of category rating and standard gamble questions elicited in personal interviews. SETTING: The provision of dental care to children in a public-funded dental health clinic. PARTICIPANTS: Random sample of the adult population of Hamilton, Ontario. MAIN OUTCOME MEASURES: The percentage of the sample unable to complete the interviews, time taken to perform interviews, ease of understanding of interviews, correlation between rank ordering and HYE scores. RESULTS: Ninety-six per cent of the sample were able to complete the HYE exercise. Inconsistencies between HYE scores and rank orders implying preference reversal occurred in 6% of those completing HYE scores for the two scenarios. The additional time taken by the HYE was of the order of 17 minutes but increased with the age of the subject. Where problems occurred, they were related to the method of measurement or the sensitivity of the chosen scale as opposed to additional requirements of the HYE. There was some evidence that HYEs and QALYs produced different scores even in the context of chronic constant health states. CONCLUSIONS: HYEs are a feasible and important practical method of measuring preferences among interventions. Alternative utility-based approaches, such as willingness to pay, may be required to detect differences in modest improvements in temporary health states. <101> UI - 99085625 AU - Pettiette MT AU - Wright JT AU - Trope M IN - Department of Endodontics, UNC School of Dentistry, Chapel Hill 27599, USA. TI - Dentinogenesis imperfecta: endodontic implications. Case report. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1998 Dec;86(6):733-7 AB - Dentinogenesis imperfecta is a hereditary disorder resulting in defective dentin in both the primary and secondary dentitions. The complications of dentinogenesis imperfecta are difficult to manage and provide a challenge to the dentist. This case report concerns treating an African American patient with dentinogenesis imperfecta who appeared for treatment with endodontic pathosis. It illustrates the need for appropriate and timely restorative treatment to prevent pulpal pathosis. Also demonstrated is the difficulty of endodontically treating dentinogenesis imperfecta teeth because of pulpal obliteration and abnormal dentin mineralization. Early and correct diagnosis of dentinogenesis imperfecta is imperative to enable appropriate preventive interventions and optimal dental treatment. Although pulpal pathosis is rarely reported with dentinogenesis imperfecta, endodontic treatment is occasionally necessary and has a guarded prognosis if initiated after pulp canal obliteration has occurred. <102> UI - 99136497 AU - Vinckier F AU - Peumans M AU - Declerck D AU - Aelbrecht M AU - Joachum H AU - Reekmans K AU - Vandelaere I IN - Afdeling conserverende tandheelkunde, Eenheid kindertandheelkunde en bijzondere tandheekunde, School voor Tandheelkunde, Mondziekten en Kaakchirurgie, U.Z. Leuven-K.U. Leuven. TI - [Definitive injuries to the teeth. Lesions of hard tissue and pulp]. [Review] [53 refs] [French] SO - Revue Belge de Medecine Dentaire 1998;53(2):29-91 AB - Tooth infraction and enamel fracture are the most simple traumatic crown lesions. When necessary the lesions can be covered with composite material. Follow-up of the traumatized tooth is necessary since pulp necrosis and obliteration can develop. In case of an uncomplicated fracture involving enamel and dentine immediate protection of the dentinal wound is important for the preservation of tooth vitality. In case of a negative vitality test, an endodontic treatment will be performed in case of a tooth with open apex only when supplemental clinical and or radiological signs of pulp necrosis are present. When a complicated enamel-dentine fracture is present, an endodontic treatment will be performed when root formation is complete. In case of a wide open apex, a pulp capping, partial pulpotomy or cervical pulpotomy will be performed in order to preserve vitality of pulpal tissues at the level of the root. Crown root fractures can be superficial, deep or vertical. In case of a superficial localisation of the fracture line, restoration with composite material or with the fractured tooth segment is indicated. Deep crown-root fractures can only be restored when the fracture line is localized not deeper than at 1/3 of the length of the root. In case of a vertical fracture, extraction is the only possibility. Root fractures on immature teeth are in most cases unilateral and have a good prognosis. In teeth with completed root formation, fractures at the level of the cervix have a poor prognosis. The fractured segment will be removed. Only when the remaining root segment is long enough, this part can be maintained. In case of a fracture at the mid-root level, repositioning and rigid splinting for a period of 8 weeks is necessary. When the tooth becomes non-vital, endodontic treatment is performed on the coronal part. Root fracture in the apical part does not necessary result in enhanced tooth mobility and immobilisation is not always necessary. Healing of a root fracture is only possible when the tooth is immobilized for a sufficiently long period. Regular control of tooth vitality is necessary since pulp necrosis can lead to an inflammatory reaction at the level of the fracture line. [References: 53] <103> UI - 99136498 AU - Vinckier F AU - Declerck D AU - Verhaeghe V AU - Vanassche K IN - Afdeling conserverende tandheelkunde Eenheid kindertandheelkunde en bijzondere tandheelkunde School voor Tandheelkunde, Mondziekten en Kaakchirurgie U.Z.Leuven-K.U.Leuven. TI - [Injuries to the permanent teeth. Periodontal lesions]. [Review] [52 refs] [French] SO - Revue Belge de Medecine Dentaire 1998;53(3):105-51 AB - Tooth luxations are relatively common. In case of concussion or subluxation the tooth is not displaced. The treatment will consist of relief of the tooth. Most frequent complications are pulp necrosis and obliteration of pulpal tissues. In case of extrusive luxation pulpal tissues and the periodontal ligament are injured. When tooth mobility is increased flexible splinting should be considered. Endodontic treatment is necessary after extrusive luxation of a tooth with completed root formation. Teeth with open apex often show pulpal obliteration after extensive luxation. Lateral luxation is more complex than extrusive luxation since the alveolar bone is also damaged. Repositioning and splinting of the tooth are necessary. When the apical foramen in closed, endodontic treatment will be necessary. Teeth with incomplete root formation will develop pulp obliteration. Following lateral luxation, external root resorption and loss of marginal bone are not infrequent. Intrusive luxation is the type of trauma with most unfavorable prognosis. All intruded teeth will become necrotic and external root resorption and marginal bone loss are frequent. There is no consensus regarding the therapeutic approach. Orthodontic extrusion or surgical mobilisation are possible options. In case of avulsion, both the pulpal tissues and the periodontal ligament are disrupted. Preservation of the vitality of the periodontal ligament covering the root will determine the prognosis of the reimplanted tooth. Therefore the tooth will be repositioned as soon as possible. When this is not possible, milk or a specific solution are most appropriate for tooth conservation. When the reimplanted tooth has complete root formation, devitalization will be performed one week after after repositioning. In case of a tooth with open apex revascularisation can be awaited. Healing of the periodontal ligament will determine prognosis. When a normal ligament is obtained during healing or when surface resorption is obtained, the tooth can be preserved for a long period. When progressive replacement resorption (ankylosis) develops, most teeth can remain in position for about 10 years. When inflammatory resorption develops, the tooth will be lost within a short time. [References: 52] <104> UI - 99136499 AU - Vinckier F AU - Declerck D IN - Afdeling conserverende tandheelkunde Eenheid kindertandheelkunde en bijzondere tandheelkunde School voor Tandheelkunde, Mondziekten en Kaakchirurgie U.Z.Leuven-K.U.Leuven. TI - [Fractures of the alveolar process]. [French] SO - Revue Belge de Medecine Dentaire 1998;53(3):152-8 AB - Fractures of the alveolar bone plate or processus alveolaris can easily be diagnosed by clinical examination and radiological check-up. These fractures require repositioning and rigid fixation. Pulp degeneration and resorption can be avoided when endodontic treatment is carried out early on. <105> UI - 99138103 AU - Robertson A IN - Department of Pedodontics, Faculty of Odontology, Goteborg University, Sweden. TI - A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries. SO - Endodontics & Dental Traumatology 1998 Dec;14(6):245-56 AB - This paper is a review of the clinical findings from my thesis "Pulp survival and hard tissue formation subsequent to dental trauma". Traumatic injuries in children and adolescents are a common problem, and the prevalence of such injuries has increased over the last 10-20 years. The purpose of the present investigations was to evaluate the long-term results following uncomplicated crown fractures and luxations involving subsequent pulp canal obliteration. A total of 241 patients with 545 injured teeth were available for clinical examination, of whom 102 answered a questionnaire and were interviewed before oral examination. In addition, 82 permanent incisors presenting with pulp canal obliteration were followed for a period of 7 to 22 years (mean 16 years). The findings showed little pulpal response to crown fracture and subsequent restorative procedures as long as there was no concomitant periodontal injury (15-year follow-up). Approximately every fourth resin composite filling was rated as unacceptable at clinical examination. The interview showed that half of the individuals were dissatisfied with the color and/or anatomic form of the composite restoration. Pulp canal obliteration was found in all luxation categories, and 69% of the teeth demonstrated yellow crown discoloration. According to the survival curve the 20-year pulp survival rate diagnosed radiographically was 84%. Although the risk of pulp necrosis increased with time, routine endodontic intervention of teeth with ongoing pulp canal obliteration of the root canal did not seem justified. <106> UI - 99116638 AU - Frazier KB IN - Department of Oral Rehabilitation, School of Dentistry, Medical College of Georgia, Augusta, USA. TI - Nightguard bleaching to lighten a restored, nonvital discolored tooth [published erratum appears in Compend Contin Educ Dent 1998 Sep;19(9):864]. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1998 Aug;19(8):810-3 AB - Traditional techniques to lighten discolored endodontically treated teeth have used bleaching materials that had to be applied and directly monitored by dentists. These bleaching techniques have been associated with cervical resorption in nonvital teeth, and the treatment outcome is often difficult to predict. This article describes the use of nightguard bleaching to obtain an esthetic result for a restored nonvital tooth that had been treated with limited success with traditional office-based bleaching procedures. <107> UI - 99108808 AU - Glassman GD AU - Serota KS IN - Faculty of Dentistry, University of Toronto, Ontario, Canada. TI - Endoesthetics. Rehabilitation of the endodontically treated tooth. SO - Dental Clinics of North America 1998 Oct;42(4):799-811, xii AB - This article discusses the restoration of the endodontically-treated tooth as it relates to infrastructure and superstructure. Like any structure, it is only as sound as the base upon which it rests. The combination of endodontics and sophisticated developments in adhesive dentistry are considered in the attainment of predictable clinical success. <108> UI - 99121506 AU - Nevins A AU - Crespi P IN - Department of Dentistry, Long Island Jewish Medical Center, New Hyde Park, NY, USA. TI - A clinical study using the collagen gel Zyplast in endodontic treatment. SO - Journal of Endodontics 1998 Sep;24(9):610-3 AB - The use of a collagen gel as a hard tissue induction material in fractured and undeveloped teeth is reviewed. Three of four cases demonstrate a modest amount of hard tissue formation within the pulp space previously occupied by the collagen gel. Limitations in positive results, compared with a previous animal study and one clinical case report, are probably due to the pre-existence of infection in the present study. <109> UI - 99017568 AU - Ottl P AU - Lauer HC IN - Department of Prosthodontics, School of Dentistry, ZZMK (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany. TI - Success rates for two different types of post-and-cores. SO - Journal of Oral Rehabilitation 1998 Oct;25(10):752-8 AB - The objective of our follow-up study was to evaluate the success of two different types of partially prefabricated post-and-core systems following crown placement. Two hundred and thirty-seven Permador posts and 49 Radix posts were evaluated clinically. Radiological follow-up was performed for 230 Permador posts and 47 Radix posts. The restorations had been in situ for an average of 3.9 years (Permador posts) and 2.3 years (Radix posts), respectively. Root canal fillings were evaluated as to their length, their homogeneity and their flushness with the walls of the root canal. The post-and-cores were evaluated for their orientation in the root canal and for the length of the inserted post relative to the length of the root. The position of the post was classified as centric in 78.0% of the restorations followed, and eccentric in 19.5%, while 2.5% showed a root perforation. The minimal requirement that the length of the post-and-core should at least be equal to the length of the clinical crown was met in 85% of the cases. Eighteen (6.3%) of the 286 teeth examined had to be extracted. There were significant correlations between insertion periods, horizontal bone loss, length of the root canal filling, and position of the post on one hand and tooth loss on the other. <110> UI - 99009729 AU - Kovalenko EL TI - [The results of treating periapical periodontitis with ultraviolet irradiation of the root canal and the use of gentamycin]. [Russian] SO - Likarska Sprava 1998 Jul-Aug;(5):136-9 AB - Intracanal UV irradiation combined with the use of gentamycin 0.1% solution was tried in the treatment of 151 teeth diagnosed as acute and exacerbated chronic periodontitis. The method reduces duration of the course of treatment 1.6-fold as compared to conventional drug therapy, ensuring a favourable outcome of treatment in 90% of observations. Besides, this treatment option is well tolerated by the patients; it is harm-free, with no contraindications being known. <111> UI - 99083380 AU - Trairatvorakul C TI - Apexification of a primary central incisor: 6-year follow-up. SO - Pediatric Dentistry 1998 Nov-Dec;20(7):425-7 <112> UI - 99095214 AU - McLean A TI - Predictably restoring endodontically treated teeth. [Review] [55 refs] SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1998 Dec;64(11):782-7 AB - Endodontically treated teeth can be restored with a wide range of techniques of varying complexity. This paper presents a straightforward technique for the restoration of endodontically treated teeth that meet certain standards. Criteria are provided for the utilization of crowns, composite resins, cast gold post cores, amalgam or composite build-ups, and passive, parallel, small diameter stainless steel posts to restore these teeth. Consideration is given to ferrule design and its importance in achieving success. [References: 55] <113> UI - 99073035 AU - Harn WM AU - Chen YH AU - Yuan K AU - Chung CH AU - Huang PH IN - Dental Department, National Cheng Kung University Hospital, Taiwan, ROC. TI - Calculus-like deposit at apex of tooth with refractory apical periodontitis. SO - Endodontics & Dental Traumatology 1998 Oct;14(5):237-40 AB - It is generally accepted that bacteria in or outside the root canal are the reason for apical periodontitis and endodontic failures. This case report presents a 60-year-old woman with a periapical lesion and a fistulous tract which did not respond to conventional root canal treatment. During periapical surgery, granulomatous tissue was removed and a calculus-like deposit was observed on the root surface. A radicular cyst was diagnosed. Nine months after this calculus-like deposit had been removed and the cyst enucleated, complete recovery of the bone had occurred. It is suggested that the presence of the calculus-like deposit at the apex of the tooth or its effects may in part have delayed the healing of the periapical inflammation in spite of apparently adequate endodontic treatment. <114> UI - 98434289 AU - Mayfield L AU - Soderholm G AU - Norderyd O AU - Attstrom R IN - Lund University, Faculty of Odontology, Malmo, Sweden. TI - Root conditioning using EDTA gel as an adjunct to surgical therapy for the treatment of intraosseous periodontal defects. SO - Journal of Clinical Periodontology 1998 Sep;25(9):707-14 AB - The aim of this clinical study was to compare the treatment outcome following root surface conditioning using an EDTA gel preparation in conjunction with surgical therapy with that following conventional flap surgery in periodontal intraosseous defects. 36 patients, each of them contributing one intraosseous defect > or =4 mm in depth participated. Defect sites had a probing pocket depth > or =5 mm and bled on probing following hygienic treatment phase. No furcation involvement or endodontic complications were present. In the EDTA group, 18 consecutive patients, defects were treated by root conditioning with EDTA gel for 3 minutes in combination with surgical therapy. In the control group, 18 patients, conventional flap surgery was performed without root conditioning. Chlorhexidine rinsings 0.2% were prescribed following surgery for 2-3 weeks with modified oral hygiene instruction. A strict recall program was implemented including professional prophylaxis and oral hygiene reinforcement every 4-6 weeks until 6-month re-evaluation. Baseline probing pocket depths and defect depths of 7.1+/-1.3 mm and 6.9+/-1.6 mm in the EDTA group and 7.6+/-1.9 mm and 6.6+/-1.7 mm, respectively, in the control group were measured. 6-month clinical results showed a significant probing attachment level gain of 1.8+/-1.5 mm and 1.0+/-1.7 mm in the EDTA and control groups respectively. A probing bone gain of 1.0+/-1.3 mm in the EDTA group was measured with a non-significant gain of 0.4+/-1.2 mm in the control group. Radiographic analysis confirmed these results. There were no statistically significant differences in treatment outcome between the group treated by root conditioning in combination with flap surgery and conventional flap surgery alone. <115> UI - 98425748 AU - Fuzzi M AU - Rappelli G IN - SAOS-FUZZI@mail.asianet.it TI - Survival rate of ceramic inlays. SO - Journal of Dentistry 1998 Sep;26(7):623-6 AB - OBJECTIVES: The aim of the present study was to evaluate the survival rate of ceramic inlays provided in a practice environment by one of the authors over the past decade. METHODS: 183 inlays were examined in 67 patients. The interval between placement and assessment was, on average, 4 years (s.d. 2.75 years) and varied from 4 months to 10 years. Kaplan-Meier survival-type curves were used to assess the survival rate. RESULTS: Five inlays failed: four due to endodontic reasons and one due to fracture. Four failures were in permanent molar teeth while the other was in a premolar tooth. A success rate of 97% at 10 years was estimated. CONCLUSIONS: The clinical durability of the resin-bonded ceramic inlays investigated was satisfactory. <116> UI - 99073047 AU - Hargreaves KM TI - Case 5. Refractory toothache. SO - Journal of Endodontics 1998 Nov;24(11):699-702 <117> UI - 99073051 AU - Yatsushiro JD AU - Baumgartner JC AU - Tinkle JS IN - Department of Endodontology, Oregon Health Sciences University, School of Dentistry, Portland, USA. TI - Longitudinal study of the microleakage of two root-end filling materials using a fluid conductive system. SO - Journal of Endodontics 1998 Nov;24(11):716-9 AB - A comparison of the microleakage of mineral trioxide aggregate (MTA) and a high copper admix amalgam (Valiant PhD) in root-end preparations was made using a fluid conductive device. Thirty-three bilaterally matched pairs of extracted, single-rooted teeth were prepared and obturated using lateral compaction of gutta-percha. The root-ends were resected and 3-mm-deep class I cavity preparations were made. The root-end preparations were filled with either amalgam or MTA. Guttapercha coronal to the root-end fillings was removed leaving only the amalgam or MTA present as a barrier to fluid movement. In the fluid-conductive device, the root canals were filled with a phosphate-buffered saline solution at a pressure of 10 psi. The flow of fluid was measured and compared at 1, 2, 3, 4, 8, 12, 16, 20, and 24 wk. The results showed amalgam to have significantly higher microleakage after 4 wk and higher variability compared with the MTA group. <118> UI - 99073061 AU - Dalton BC AU - Orstavik D AU - Phillips C AU - Pettiette M AU - Trope M IN - Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill 27599, USA. TI - Bacterial reduction with nickel-titanium rotary instrumentation. SO - Journal of Endodontics 1998 Nov;24(11):763-7 AB - The purpose of this study was to compare intracanal bacterial reduction on teeth instrumented with 0.04 tapered nickel-titanium (NiTi) rotary instrumentation to bacterial reduction when using a stainless-steel K-file step-back technique using sterile saline irrigation. Forty-eight patients with apical periodontitis were randomly assigned treatment type. The canals were sampled before, during, and after instrumentation. The samples were incubated anaerobically for 7 days at 37 degrees C, colony-forming unit numbers calculated, and a log transformation performed to normalize the counts. Teeth exhibiting apical periodontitis were uniformly infected, whereas vital control teeth were not. A similar and uniform reduction occurred with progressive filing, regardless of technique (p < 0.0001). There was no detectable difference in colony-forming unit count after NiTi rotary or stainless-steel hand instrumentation (p = 0.42). Neither technique could predictably render canals free of bacteria. The results of this study indicate NiTi rotary and stainless-steel hand K-file step-back instrumentation techniques were not significantly different in their ability to reduce intracanal bacteria. <119> UI - 98453130 AU - Akiyama Y AU - Fukuda H AU - Hashimoto K IN - Department of Dentistry and Oral Surgery, Hitachi Taga Hospital, Hitachi-city, Japan. TI - A clinical and radiographic study of 25 autotransplanted third molars. SO - Journal of Oral Rehabilitation 1998 Aug;25(8):640-4 AB - This paper is a report on 25 autotransplantations of third molars with complete root formations. The study consists of 23 patients in whom 25 third molars were transplanted. The mean age was 29.6 years (range 20-54). In nine cases third molars were directly transplanted into the new socket. In 11 cases the sockets were widened and made deeper with a bur. In five cases the recipient beds were made by splitting osteotomy of the alveolar region. The transplanted third molars were stabilized with silk sutures, resin, wire splint or circumferential wiring for 1-6 weeks. Two-three weeks after transplantation, the root canals were treated and filled. After operation, the marginal and the periapical conditions were examined clinically and radiographically. The transplanted teeth clinically appeared to become firmer with the passage of time. Progressive root resorption was not found and good results were obtained. This study shows that autotransplantation of third molars with complete root formation produces an acceptable result using the procedures outlined. <120> UI - 99040473 AU - Frajlich SR AU - Goldberg F AU - Massone EJ AU - Cantarini C AU - Artaza LP IN - Department of Endodontics, School of Dentistry, University of El Salvador-Asociacion Odontologica Argentina, Buenos Aires. TI - Comparative study of retreatment of Thermafil and lateral condensation endodontic fillings. SO - International Endodontic Journal 1998 Sep;31(5):354-7 AB - The aim of the present study was to evaluate the possibility of retreating teeth obturated with: (i) Thermafil with plastic carrier, (ii) Thermafil with metallic carrier and (iii) laterally condensed gutta-percha. The following aspects were analysed: removal of obturation, time required for removal, remaining filling material and apical extrusion during reinstrumentation. Thirty human teeth with a single canal were instrumented up to a size 45 K-type file, divided into three groups of 10 teeth each and obturated with Thermafil with plastic carrier (group 1), Thermafil with metallic carrier (group 2), and laterally condensed gutta-percha (group 3) with AH26 as the sealer. Reinstrumentation was performed manually after 30 days storage using Hedstroem files and xylene as a solvent. The average time needed to remove the obturation was 12 min 1 s for group 1, 14 min 36 s for group 2 and 11 min 26 s for group 3. Although no statistically significant differences were observed between groups 1 and 2, and 1 and 3 (P > 0.05), the differences between groups 2 and 3 were significant (P < 0.05). The amount of remaining filling material was significantly higher in group 2 when compared with groups 1 and 2 (P < 0.01). Although the lowest incidence of apical extrusion during reinstrumentation was found in group 3, the differences among groups were not statistically significant. <121> UI - 99040471 AU - Fava LR TI - Acute apical periodontitis: incidence of post-operative pain using two different root canal dressings. SO - International Endodontic Journal 1998 Sep;31(5):343-7 AB - A clinical study using non-vital maxillary central incisors exhibiting acute apical periodontitis was carried out to evaluate the incidence of post-operative pain after biomechanical preparation and dressing with a calcium-hydroxide paste or a corticosteroid-antibiotic solution. Sixty teeth from 48 patients were prepared and dressed on the first visit and re-evaluated clinically 7 days later. No difference was observed in the incidence of post-operative pain between the two groups. <122> UI - 99040446 AU - Alavi AM AU - Gulabivala K AU - Speight PM IN - Department of Conservative Dentistry, Eastman Dental Institute for Oral Health Care Sciences, University of London, UK. TI - Quantitative analysis of lymphocytes and their subsets in periapical lesions. SO - International Endodontic Journal 1998 Jul;31(4):233-41 AB - The relative proportions of lymphocytes and their subsets in periapical lesions associated with untreated teeth and endodontically treated teeth were compared. Nine periapical lesions associated with previously untreated teeth and six persistent lesions associated with previously root treated teeth which had good quality root canal fillings and coronal seals were selected from a total of 41 samples. Clinical and radiographic features of each lesion were recorded. Serial frozen sections were stained using immunohistochemical methods and monoclonal antibodies against CD20, CD3, CD4 and CD8 to identify B, T, T helper (Th) and T suppressor (Ts) lymphocytes, respectively. Ten microscopic fields, representing the most dense cellular inflammatory infiltrate were selected per specimen and cell numbers were estimated, as a proportion of lesion area, using a point counting method. The periapical lesions associated with untreated teeth had a denser inflammatory cell infiltrate. The proportion of total lymphocytes was significantly higher in the untreated group of lesions (P < 0.01). The proportions of B (P < 0.01), T (P < 0.001) and Th cells (P < 0.01) were significantly higher in untreated teeth. The ratios of Th/Ts cells (P < 0.05) and T/total lymphocytes (P < 0.01) were also significantly different between the two types of lesion. The results show a difference in the inflammatory cell infiltrate and relative proportions of T, B and T helper cells in the two groups of lesions. This indicates that future studies of periapical lesions should take into account the clinical history of the associated teeth. <123> UI - 99040460 AU - Von Arx T AU - Kurt B AU - Ilgenstein B AU - Hardt N IN - Department of Oral and Maxillofacial Surgery, State Hospital, Lucerne, Switzerland. TI - Preliminary results and analysis of a new set of sonic instruments for root-end cavity preparation. SO - International Endodontic Journal 1998 Jan;31(1):32-8 AB - The introduction of microinstruments for root-end cavity preparation has clearly improved the surgical technique in periradicular surgery with apicectomy. The new generation of sonic and ultrasonic root-end preparation devices, usually termed 'retrotips', has simplified the preparation of a sufficiently deep cavity that follows the original path of the root canal. The present paper describes the use of a new set of diamond-surfaced retrotips driven by a sonic handpiece. For clinical evaluation a prospective study was carried out, with assessment of pre-, intra- and postoperative data in 50 teeth (43 patients). This paper analyses: (i) the applicability of the new retrotips; (ii) the quality of the root-end filling assessed radiographically; (iii) the immediate postoperative course. Access with the retrotips to the resected root-end was found to be excellent in 80% of the treated teeth. The postoperative radiographs showed a root-end filling of at least 3 mm in 70% of the resected teeth. Healing was uneventful in all cases and most patients presented without any symptoms after 5 days and 10 days. The long-term treatment outcome will be reported in a future paper. <124> UI - 99028978 AU - McLean A TI - Criteria for the predictably restorable endodontically treated tooth. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1998 Oct;64(9):652-6 AB - This paper outlines criteria which allow the clinician to identify endodontically treated teeth that can be restored with a high level of predictability. The intent of the article is not to preclude the restoration of teeth that do not meet these criteria; it is to provide a science-based approach for identifying those teeth with a high probability of long-term success upon restoration. For an endodontically treated tooth not requiring a post, the requirements are for biologic width + ferrule length, (i.e. 4.5 mm of supra-bony solid tooth--dentin a minimum of 1 mm thick after preparation). A tooth requiring a post needs, in addition, enough root length to allow a 4 mm apical seal and a post length--apical to the crown margin, equal to the length of the crown. It is essential to assess the functional loads to which the restored tooth would be subjected. Teeth that are endodontically treated, or are likely to be in future, should be avoided as abutments supporting precision attachment RPDs, distal extension RPDs or cantilever FPDs. <125> UI - 99009621 AU - Coulter ID AU - Marcus M AU - Freed JR IN - School of Dentistry, University of California, Los Angeles 90095-1668, USA. TI - Consistency across panels of ratings of appropriateness of dental care treatment procedures. SO - Community Dental Health 1998 Jun;15(2):97-104 AB - OBJECTIVE: To report on a study investigating the consistency across different consensus panels of ratings of appropriateness for dental procedures. RESEARCH DESIGN: The study conducted four consensus panels to determine, under various conditions, the appropriateness of five options for patients: no treatment; filling; crown; root canal with a filling or crown; extraction. The patients were categorised according to age; regular versus irregular use of dental care; degree of caries; degree of pain; degree of periodontal disease. PARTICIPANTS: The panellists were dentists enrolled in a continuing education programme on assessing the quality of dental care. The panellists were all individuals employed by various dental plans to evaluate the quality of care plans operating in California. RESULTS: The results indicate that the method does distinguish the dimensions of appropriateness used by the panellists in making their decisions, and that it is possible to substantially increase consensus among a diverse group of dentists and across separate panels on some procedures. However, it also showed that the process is sensitive to varying panels and that different variables had different outcomes in the ratings from the various panels. CONCLUSION: The consensus panel method holds some promise for determining the appropriateness of dental care. However the results of this study question whether it results in consistent ratings across different panels. <126> UI - 98441539 AU - Moiseiwitsch JR AU - Trope M IN - Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, USA. TI - Nonsurgical root canal therapy treatment with apparent indications for root-end surgery. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1998 Sep;86(3):335-40 AB - The recent introduction of the surgical microscope to the practice of endodontics, especially for surgery, has allowed clearer visualization of the periapex during root-end resection and filling. However, despite this and other technologic advances, it has not been demonstrated that in the absence of thorough canal debridement the success rate of periapical surgery has improved over the 50% to 60% demonstrated in most long-term prognosis studies. Therefore it remains important to fully instrument and obturate the root canal system with conventional therapy before surgery is considered; this considerably improves the long-term prognosis. Each of the case reports in this article involves a situation in which conventional treatment was performed when a surgical approach might have been considered as the treatment of choice. Surgery should not be considered to be the primary treatment when root canal treatment or retreatment may be readily achieved. Indeed, the operating microscope and other technical aids will probably allow more cases to be treated and retreated conventionally that might otherwise have required surgical intervention. <127> UI - 98386568 AU - Lilly JP AU - Cox D AU - Arcuri M AU - Krell KV IN - University of Iowa College of Dentistry, Department of Endodontics, Iowa, USA. TI - An evaluation of root canal treatment in patients who have received irradiation to the mandible and maxilla. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1998 Aug;86(2):224-6 AB - OBJECTIVE: The purpose of this study was to evaluate the success and failure of root canal treatment performed in areas of previous irradiation and to examine any cases of osteoradionecrosis associated with such treatment. STUDY DESIGN: A retrospective analysis was done on 22 teeth that had root canal treatment after radiation therapy. Strict radiographic and clinical criteria were used to determine success and failure. RESULTS: There was a mean follow-up period of 19 months. Of 22 cases, 20 (91%) were considered successful. Both failures occurred with a diagnosis of pulpal necrosis. There were no occurrences of osteoradionecrosis. CONCLUSIONS: Our study showed that root canal treatment in previously irradiated patients may be successful. In addition, treatment approaches, as well as the criteria for success and failure, should be the same for irradiated patients as for those who have not received radiation treatment. <128> UI - 98454219 AU - Agro F AU - Marchionni L AU - De Ponte FS AU - Favaro R AU - Carassiti M AU - Cataldo R IN - Department of Anaesthesiology and Intensive Care, University School of Medicine, Rome, Italy. TI - Campus Bio-Medico technique for nasolaryngeal ventilation with reinforced laryngeal mask in dental surgery: a patient report. SO - Journal of Craniofacial Surgery 1998 Jul;9(4):383-7 AB - The authors report the usefulness of a prototype nasal laryngeal mask airway (LMA) used successfully in a disabled 20-year-old woman with severe psychomotor retardation and a compromised airway with predictable indexes of impossible tracheal intubation in direct laryngoscopy. A 16-ch Foley catheter was inserted through the patient's left nostril and guided through her mouth. A size-3 reinforced LMA was positioned and connected to the distal end of the catheter. The LMA-reinforced tube was removed in a retrograde fashion by pulling the catheter up with the patient breathing spontaneously. The duration of the entire operation was 3 hours 20 minutes, and the patient was able to breathe spontaneously and at a 98% saturation average. Nasal reinforced LMA seems to be an interesting solution in patients undergoing 1-day dental or maxillofacial surgery, but is especially appropriate when nasotracheal intubation is too invasive or technically impossible. <129> UI - 99007436 AU - Silverstein LH AU - Shatz PC AU - Amato AL AU - Kurtzman D IN - Medical College of Georgia, School of Dentistry, Department of Periodontics, Atlanta, USA. TI - A guide to diagnosing and treating endodontic and periodontal lesions. SO - Dentistry Today 1998 Apr;17(4):112-5 <130> UI - 99007435 AU - Weathers AK Jr AU - Wahl P TI - Taking the mystery out of endodontics, Part 1: Instant diagnosis and predictable case selection. SO - Dentistry Today 1998 Apr;17(4):104-11 <131> UI - 99004980 AU - Liou EJ AU - Huang CS IN - Department of Craniofacial Dentistry, and Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan. lioueric@ms19.hinet.net TI - Rapid canine retraction through distraction of the periodontal ligament. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1998 Oct;114(4):372-82 AB - The process of osteogenesis in the periodontal ligament during orthodontic tooth movement is similar to the osteogenesis in the midpalatal suture during rapid palatal expansion. A new concept of "distracting the periodontal ligament" is proposed to elicit rapid canine retraction in 3 weeks. It is called dental distraction. Fifteen orthodontic patients (26 canines, including 15 uppers and 11 lowers) who needed canine retraction and first premolar extraction were included. At the time of first premolar extraction, the interseptal bone distal to the canine was undermined with a bone bur, grooving vertically inside the extraction socket along the buccal and lingual sides and extending obliquely toward the socket base. Then, a tooth-borne, custom-made, intraoral distraction device was placed to distract the canine distally into the extraction space. It was activated 0.5 to 1.0 mm/day immediately after the extraction. The anchor units were the second premolar and first molar. Cephalometric and periapical x-rays were taken before and after the canine retraction. Both the upper and lower canines were distracted bodily 6.5 mm into the extraction space within 3 weeks. New alveolar bone was generated and remodeled rapidly in the mesial periodontal ligament of the canine during and after the distraction. It became mature and indistinguishable from the native alveolar bone 3 months after distraction. During the distraction, 73% of the first molars did not move mesially and 27% of them moved less than 0.5 mm mesially within 3 weeks. The radiographic examination revealed that apical or lateral surface root resorption of the canine was minimal. No periodontal defect or endodontic lesion was observed throughout and after distraction. We concluded that the periodontal ligament could be rapidly distracted without complications. The rapid orthodontic tooth movement through distracting the periodontal ligament cannot be emulated by current conventional orthodontic concepts and methods. <132> UI - 99009760 AU - Pettini F AU - Mastromarco P AU - Pettini P IN - Cattedra di Odontoiatria Conservatrice, Universita degli Studi, Bari. TI - [Antibacterial activity of endodontic medications]. [Review] [32 refs] [Italian] SO - Minerva Stomatologica 1998 Jul-Aug;47(7-8):309-14 AB - BACKGROUND: The successful outcome of endodontic treatment depends on the elimination of bacteria present inside the root canal system. In the pulpal chronic infection, intracanal medicaments are necessary to obtain the sterilization. This study evaluated the antibacterial activities of some intracanal medicaments. METHODS: The bacteria used were: Staphylococcus aureus, Streptococcus viridans, Escherichia coli, Bacteroides fragilis and Candida albicans; the medicaments used were: Stomidros, Stomilex, Endoidros and Cresatina. Wells were punched in plates and filled with the medicaments to be tested. The diameters of the areas of bacterial inhibition were measured and recorded after 24.48 hours and 7 days. RESULTS AND CONCLUSIONS: The most important result of this study is the demonstration of the inefficiency of medicaments like calcium hydroxide against Candida albicans. The Cresatina showed antibacterial activity against all bacteria used. [References: 32] <133> UI - 98405785 AU - Dumfahrt H AU - Moschen I IN - Clinical Department of Prosthetic Dentistry, University of Innsbruck, School of Medicine, Austria. TI - A new approach in restorative treatment of external root resorption. A case report. SO - Journal of Periodontology 1998 Aug;69(8):941-7 AB - This case report describes the treatment of an external root resorption with extensive loss of tooth structure and bone at the labial surface of an upper left central incisor. The area of bone loss and root resorption was surgically exposed and an impression was taken using curing silicone. An individual ceramic insert was fabricated, allowing endodontic retreatment through an artificial root canal. The insert was incorporated using a dentin bonding system and a dual curing luting composite. Following endodontic retreatment and internal bleaching, a ceramic veneer was bonded to the tooth to obtain good esthetics and to improve stability. Twenty months after surgical treatment no further root resorption could be detected radiographically. A shallow residual pocket but no bleeding on probing was found. <134> UI - 98431190 AU - Chalifoux PR TI - Esthetic restoration of endodontically treated teeth: factors that affect prognosis. SO - Journal of Esthetic Dentistry 1998;10(2):75-83 AB - Restoration of endodontically treated teeth involves a complex system of components and component interfaces designed to resist force. Dental materials, forces on teeth, clinical circumstances, and restorative design determine restoration success. A new classification evaluates number of canals, amount of remaining tooth surface, chamber space, canal quality, and canal orientation. <135> UI - 98416902 AU - Saunders WP AU - Saunders EM IN - University of Glasgow Dental School. TI - Prevalence of periradicular periodontitis associated with crowned teeth in an adult Scottish subpopulation [see comments]. CM - Comment in: Br Dent J 1999 Jan 9;186(1):9-10 SO - British Dental Journal 1998 Aug 8;185(3):137-40 AB - OBJECTIVE: To examine the periradicular status of crowned teeth in an adult population in Scotland. DESIGN: Examination of full-mouth periapical radiographs from 319 consecutive adult patients (7596 teeth) attending Glasgow and Dundee Dental Hospitals for clinical examination. METHODS: The periradicular status of teeth with a crown present was assessed to determine the presence of a radiolucency which may indicate pulpal disease. RESULTS: 63.3% (n = 202) of patients had at least one tooth that was crowned. The total number of crowns assessed was 802, of which 458 (57.1%) were vital preparations, and 87 (19.0%) of these had radiographic signs of periradicular disease. The majority of the teeth (62.0%) had distinct widening of the periodontal membrane space which is considered to be an early sign of periapical disease. 42.9% (n = 344) of the crowned teeth had previous root canal treatment of which 50.8% (175) had evidence of a periradicular radiolucency. CONCLUSIONS: Pulpal damage may occur during procedures to provide a crown which may require subsequent root canal treatment. Radiographic follow-up of crowned teeth should be undertaken routinely. <136> UI - 98376674 AU - Fredriksson M AU - Astback J AU - Pamenius M AU - Arvidson K IN - Department of Prosthetic Dentistry, Faculty of Odontology, Karolinska Institutet, Stockholm, Sweden. TI - A retrospective study of 236 patients with teeth restored by carbon fiber-reinforced epoxy resin posts. SO - Journal of Prosthetic Dentistry 1998 Aug;80(2):151-7 AB - STATEMENT OF PROBLEM: The Composipost dowel is made of stretched, aligned carbon fibres embedded in an epoxy-resin matrix. It is widely used in Europe and Canada for the restoration of endodontically treated teeth and was introduced in the United States 2 years ago as the C-Post dowel. PURPOSE: This retrospective study evaluated treatment outcome of the Composipost system after 2 to 3 years. MATERIAL AND METHODS: A total of 236 patients treated during a 1-year period by seven Swedish dental practitioners were included. Of those, 146 patients consented and data were collected from the dental records of the remaining patients. Thus, the material comprised 236 teeth restored with carbon fiber-reinforced epoxy resin post, 130 maxillary and 106 mandibular teeth, with a mean restoration time of 32 months (range 27 to 41). Periodontal conditions, radiographic signs, and prosthodontic results were recorded. RESULTS: Five teeth (2%) had been extracted for reasons unrelated to the Composipost system. Periodontal conditions such as plaque accumulation, gingival health, bleeding on probing, and pocket depth around the teeth with Composipost dowels were similar to the control teeth. No dislodgment or root or post fractures were observed clinically or on radiographs. Radiographic examination of bone height measured from the apex to the bone margin mesially and distally showed differences on the mesial side but not on the distal surface (p < 0.05) between the Composipost-treated teeth and the controls. CONCLUSIONS: Promising results after 2 to 3 years of clinical service indicate that this system can be a viable alternative to conventional post-and-core systems. <137> UI - 98310360 AU - Glendor U AU - Halling A AU - Andersson L AU - Andreasen JO AU - Klitz I IN - Department of Oral and Maxillofacial Surgery, Central Hospital, Vasteras, Sweden. TI - Type of treatment and estimation of time spent on dental trauma--a longitudinal and retrospective study. SO - Swedish Dental Journal 1998;22(1-2):47-60 AB - The consequences of traumatic tooth injuries (dental trauma) are time-consuming and costly treatment and follow-ups, of which our knowledge is scarce. Consequently the aim of the present study was to measure the total time of treatment of uncomplicated and complicated traumas to primary and permanent teeth. The study was performed in three steps based on a randomly selected sample of Danish children and adolescents living in the municipality of Copenhagen, Denmark: (I) A descriptive analysis of traumas affecting 106 children and adolescents all born in 1970 and randomly chosen among the total number of patients treated. Treatments took place between 1972 and 1988. (II) A study of the time and frequency of different types of emergency and planned treatment estimated by 14 dentists employed by the municipal dental service. (III) Calculation of the total treatment time on the basis of the results from (I) and (II). The most common traumas were luxations of primary teeth and fractures of permanent teeth. The most frequent treatments dealt with were uncomplicated crown fractures and luxations followed by other different diagnoses of complicated traumas. The treatment time for primary teeth for uncomplicated traumas were used mostly for information, while the time for complicated traumas was used for follow-ups. The treatment time for traumas to permanent teeth was dominated by follow-ups, irrespective of the complication status. Only 3% of uncomplicated traumas of permanent teeth resulted in endodontic treatment, compared to 67% with complicated traumas. Uncomplicated traumas to primary teeth required a total of 2.5 visits and 0.8 hrs treatment time, while 4.3 visits and 1.6 hrs per individual were used for complicated traumas. For permanent teeth with uncomplicated traumas 9.2 visits and 3.2 hrs were required, and for complicated traumas 16.4 visits and 8.5 hrs per individual. The respective treatment times for complicated traumas for primary and permanent teeth were 2.0 and 2.7 times higher, compared to the corresponding uncomplicated traumas. There were no gender differences in type of injury and number of visits for injuries to primary and permanent teeth. <138> UI - 98306825 AU - Joshi RI AU - Bhatti SA TI - Research problems in primary care [letter; comment] [see comments]. CM - Comment on: Br Dent J 1998 Jan 10;184(1):6, Comment in: Br Dent J 1998 Aug 8;185(3):110-1 SO - British Dental Journal 1998 May 23;184(10):470 <139> UI - 98354750 AU - Nivet V AU - Braticevic A AU - Gigon S AU - Delcampe P AU - Peron JM IN - Service de chirurgie maxillo-faciale et stomatologie, hopital Charles Nicolle, C.H.U. de Rouen. TI - [Therapeutic management of traumatic avulsion of permanent teeth]. [French] SO - Revue de Stomatologie et de Chirurgie Maxillo-Faciale 1998 Jun;99(2):63-9 AB - Management of avulsed permanent teeth requires perfect knowledge of the different parameters influencing the short and mid-term and above all long-term prognosis. Based on a review of the literature and the analysis of 50 cases cared for in our unit enables us to propose, in accordance with the extra oral delay and the degree of dental maturation, a protocol for the different emergency situations. This clarification emphasizes the contribution of new preserving solutions which allow reimplantation delays up to 24 hours without effect on prognosis. <140> UI - 98375371 AU - Sorensen JA AU - Choi C AU - Fanuscu MI AU - Mito WT IN - Clinical Research Center, Oregon Health Sciences University, Portland 97201-3097, USA. TI - IPS Empress crown system: three-year clinical trial results. [Review] [24 refs] SO - Journal of the California Dental Association 1998 Feb;26(2):130-6 AB - The IPS Empress system is a highly esthetic hot pressed glass ceramic material for fabrication of single crowns. Adhesive cementation of the system not only contributes to the esthetics but is necessary for increased strength of the crown. The purpose of this prospective clinical trials was to evaluate the longevity of 75 adhesively cemented Empress full crowns. An additional aim was to assess the adhesive cementation methodology and potential side effects. At the three-year point, one molar crown fractured for a 1.3 percent failure rate. The resin cementation technique that was employed exhibited a low incidence of microleakage with few clinical side effects. There was a 5.6 percent incidence of post-cementation sensitivity, with all symptoms subsiding by eight weeks. None of the crowns in the study required endodontic therapy. [References: 24] <141> UI - 98307313 AU - Bjorndal L AU - Thylstrup A IN - Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. Lars.Bjoerndal@odont.ku.dk TI - A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: a 1-year follow-up study. SO - Community Dentistry & Oral Epidemiology 1998 Apr;26(2):122-8 AB - This study reports results from a practice-based study in which deep carious lesions were treated by general dental practitioners using stepwise excavation. The material comprised 94 teeth with deep carious lesions which the clinicians considered would result in pulp perforation if treated by a single and terminal excavation. At the first visit excavation of the peripheral dentine was completed. The outermost part of the central and necrotic dentine was gently removed with a sharp excavator. Standardized assessments of the dentine colour and consistency were made before application of a calcium hydroxide-containing base material and temporary filling. The final excavation was completed after a treatment interval ranging from 2 to 19 months, with a median of 6 months. Reassessments of the dentine colour and consistency were made before complete removal of demineralized dentine. The central dentine was significantly browner and less softened after the sealing period. After removal of the dark-brownish dentine during the final excavation, the colour and consistency of the exposed central dentine was found to resemble that of the completely excavated peripheral dentine. Only five cases resulted in pulp perforation during the final excavation. The high success rate of teeth surviving the final treatment without pulp exposure after 1 year of observation shows that it was possible for dentists in general practice to administer and manage the treatment of deep carious lesions, a process which may prolong tooth survival compared with conventional endodontic techniques. <142> UI - 98358449 AU - Rosenberg PA AU - Babick PJ AU - Schertzer L AU - Leung A IN - Division of Surgical Sciences, New York University College of Dentistry, NY, USA. TI - The effect of occlusal reduction on pain after endodontic instrumentation. SO - Journal of Endodontics 1998 Jul;24(7):492-6 AB - One hundred seventeen patients with posterior teeth requiring endodontic treatment were studied. Specific clinical findings were recorded, including pulp, vitality, preoperative pain, sensitivity to percussion, and the presence of a periradicular radiolucency. Excluded from the study were teeth with restorations to be maintained, greater than class I mobility, pocket depths > 5 mm, endodontic retreatments, and patients taking pain altering medications. Teeth were randomly assigned to 1 of 3 groups: (i) total occlusal reduction, (ii) simulated occlusal reduction (nonfunctional cusp reduction), or (iii) control (occlusion untouched). After canal instrumentation, a questionnaire was used by patients to record pain responses over a 48-h post-operative period. Responses were tabulated using a chi(2) test (p = < 0.05), and a statistically valid profile of patients most likely to benefit from occlusal reduction was developed. Occlusal reduction should prevent postoperative pain in those patients whose teeth initially exhibit pulp vitality, percussion sensitivity, preoperative pain, and/or the absence of a periradicular radiolucency. <143> UI - 98358448 AU - Nusstein J AU - Reader A AU - Nist R AU - Beck M AU - Meyers WJ IN - Division of Endodontics, Ohio State University, College of Dentistry, Columbus 43210, USA. TI - Anesthetic efficacy of the supplemental intraosseous injection of 2% lidocaine with 1:100,000 epinephrine in irreversible pulpitis. SO - Journal of Endodontics 1998 Jul;24(7):487-91 AB - The purpose of this study was to determine the anesthetic efficacy of a supplemental intraosseous injection of 2% lidocaine with 1:100,000 epinephrine in teeth diagnosed with irreversible pulpitis. Fifty-one patients with symptomatic, vital maxillary, and mandibular posterior teeth diagnosed with irreversible pulpitis received conventional infiltrations or inferior alveolar nerve blocks. Pulp testing was used to determine pulpal anesthesia after "clinically successful" injections. Patients who were positive to the pulp tests, or were negative to the pulp tests but felt pain during endodontic access, received an intraosseous injection using 1.8 ml of 2% lidocaine with 1:100,000 epinephrine. The results demonstrated that 42% of the patients who tested negative to the pulp tests reported pain during treatment and required supplemental anesthesia. Eighty-one percent of the mandibular teeth and 12% of maxillary teeth required an intraosseous injection due to failure to gain pulpal anesthesia. Overall, the Stabident intraosseous injection was found to be 88% successful in gaining total pulpal anesthesia for endodontic therapy. We concluded that, for posterior teeth diagnosed with irreversible pulpitis, the supplemental intraosseous injection of 2% lidocaine (1:100,000 epinephrine) was successful when conventional techniques failed. <144> UI - 98262619 AU - Fanibunda K AU - Whitworth J AU - Steele J IN - Department of Oral & Maxillofacial Surgery, Dental School, Newcastle upon Tyne. TI - The management of thermomechanically compacted gutta percha extrusion in the inferior dental canal. SO - British Dental Journal 1998 Apr 11;184(7):330-2 AB - Endodontic material inadvertently forced into the inferior dental canal during root-canal therapy can cause damage to the underlying nerve. The effect of toxic filling materials on nervous tissues has been well publicised, however, the thermal and pressure changes produced by chemically bland materials has not been adequately highlighted. In the case reported, thermoplasticised gutta percha was inadvertently introduced into the canal during endodontic treatment of a lower molar. Factors affecting the outcome are discussed and guidelines are presented for the management of such a case with reference to surgery against observation. <145> UI - 98234255 AU - Garlock JA AU - Pringle GA AU - Hicks ML IN - I.B. Bender Division of Endodontics, Albert Einstein Medical Center, Philadelphia, PA, USA. TI - The odontogenic keratocyst: a potential endodontic misdiagnosis. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1998 Apr;85(4):452-6 AB - Odontogenic keratocysts manifest themselves as radiolucencies that can appear anywhere in the maxilla or mandible, including periradicular areas; they may thus masquerade as lesions of endodontic origin. This retrospective study examined 239 odontogenic keratocysts received by the Oral Pathology Laboratory at Temple University School of Medicine over a 3-year period. Twenty-one (9%) of the cysts received were located periradicularly; of these 21, 12 (57%) were associated with nonvital or endodontically treated teeth and thus mimicked lesions of endodontic origin. Because of its aggressive nature and tendency to recur, the periradicular odontogenic keratocyst should be included in the differential diagnosis of lesions that are refractory to endodontic treatment. <146> UI - 98272406 AU - Soderfeldt B AU - Palmqvist S IN - Centre for Oral Health Sciences, Lund University, Malmo, Sweden. TI - A multilevel analysis of factors affecting the longevity of fixed partial dentures, retainers and abutments. SO - Journal of Oral Rehabilitation 1998 Apr;25(4):245-52 AB - There is a methodological problem in analysis of data belonging to different hierarchical levels, e.g. patient, arch, and tooth. A method for multilevel modelling (MLM) that resolves this problem is available. This method which is presented in this article, was used to reanalyse previously published long-term treatment results concerning the longevity of fixed partial dentures, retainers and abutments. The main results were consistent, indicating that no great faults were committed when using the conventional logistic regression method. There were, however, differences when calculating the combined risks for various situations. The conventional method was found to over- and underestimate probabilities of survival in different cases, compared to the MLM method. Especially when the most negative factors were combined, the conventional method had a tendency to underestimate the risk. For example, if an abutment had the combination 'endodontically treated'; 'FPD placed by 'another dentist''; 'distal abutment'; and 'marginal bone loss > 50%'; the probability of the tooth remaining after 18-23 years was only 20% according to the MLM method but 35% according to the conventional method. It was concluded that MLM is the method of choice for many situations in dental research where data belonging to different levels are to be analysed. <147> UI - 98239230 AU - Blomlof L AU - Lindskog S IN - Public Dental Service, County Council of Stockholm, Sweden. TI - Cervical root resorption associated with guided tissue regeneration: a case report. SO - Journal of Periodontology 1998 Mar;69(3):392-5 AB - Root surface resorption, ankylosis (replacement resorption) and alveolar bone resorption are not uncommon sequelae to periodontal healing in both animal and human trials whether the treatment objective is regenerative, preventive, or conservative. The present report describes a case with progressive cervical root resorption in a patient who received periodontal regenerative treatment with guided tissue regeneration (GTR). A 46-year-old woman was referred for treatment of severe periodontitis. Remaining radiographic attachment was less than 50%. Following a period of 18 months, during which non-surgical and surgical therapies were performed, angular defects were diagnosed on radiographs and recurrent bleeding periodontal pockets (6 mm) were found in the proximal areas of 24 and 25. Root caries was not present. Periodontal surgery with GTR was performed in this area. No immediate postsurgical complications were noted. Two years later, clinical and radiographic examinations revealed gingival recession with bleeding periodontal pockets (6 mm) which had partly uncovered severe proximal cervical resorptions in 25. Root surface caries was not present. Following surgical inspection, the root of 25 was removed. The root was subsequently prepared for histological analysis. Resorption cavities covered almost the entire cervical proximal surface of the root above intact infracrestal cementum and were covered by numerous CD68+, both mononuclear and multinucleated cells. In a central area as indicated on the radiographs, the cavities penetrated into the root canal. There was no evidence of root caries. <148> UI - 98307219 AU - Bonilla ED IN - Department of Restorative Dentistry, University of California, Los Angeles, USA. prosthod@ucla.edu TI - Fabrication of an amalgam core using a customized acrylic resin shell. SO - Quintessence International 1998 Mar;29(3):143-9 AB - This article describes a build-up technique that uses a customized acrylic resin shell for restoring endodontically treated molars that are involved in three-unit fixed partial denture design. The shell confines the amalgam without impinging on the periodontium to ensure a proper core foundation, an ideal tooth preparation, and a more predictable final restoration. <149> UI - 98307141 AU - Weiger R AU - Axmann-Krcmar D AU - Lost C IN - Department of Conservative Dentistry, School of Dental Medicine, University of Tubingen, Germany. TI - Prognosis of conventional root canal treatment reconsidered. [Review] [44 refs] SO - Endodontics & Dental Traumatology 1998 Feb;14(1):1-9 AB - In endodontic literature, the so-called success rate of conventional root canal treatment is reported to range between 70% and 95%. This has been calculated as the percentage of successfully treated teeth of all teeth followed up or included in the clinical trial. This approach, however, does not allow for valid assertions on the prognosis of root canal treatment as the individual observation times are not considered. This article discusses some methodological and statistical aspects of how to design a prognostic study which focuses on the outcome of endodontic therapy and of how to analyse the data appropriately. Methodologically, the response variable should preferably be the individual time required for the occurrence of an event, e.g., success or failure of endodontic therapy, which should clearly be defined on the basis of widely accepted criteria in endodontology. Event times can appropriately be analysed by the Kaplan-Meier method, which estimates the probability that the event will not occur within a fixed time. This probability, together with the approximate 95% confidence interval (CI), permits an evaluation of the prognosis of a particular treatment. Two data sets were re-analysed to clarify the rationale behind the analysis of event times. Accordingly, the probability that an endodontically induced lesion will completely heal, e.g., within the first 3 years after root canal therapy ranges between 0.87 (CI: 0.74-1.00) and 0.89 (CI: 0.80-0.98). In this situation, the simple calculation of success rates would overestimate the chance of complete periapical healing within the first years after therapy but underestimate it over longer observation periods. Another example was used to analyse the time to occurrence of periapical pathosis associated with root canal treated teeth not diseased periapically. In this case the chance of recording a successful endodontic treatment is initially underestimated by the percentage of successful cases of all teeth integrated in the study but is markedly overestimated for longer observation periods. Potential risk factors affecting the outcome of the endodontic therapy and thereby the event times can adequately be determined by applying the Cox's or Aalen's regression model. [References: 44] <150> UI - 98305325 AU - Shimauchi H AU - Takayama S AU - Imai-Tanaka T AU - Okada H IN - Department of Periodontology and Endodontology, Osaka University Faculty of Dentistry, Japan. TI - Balance of interleukin-1 beta and interleukin-1 receptor antagonist in human periapical lesions. SO - Journal of Endodontics 1998 Feb;24(2):116-9 AB - Interleukin-1 beta (IL-1 beta) has been considered as a major potent mediator of bone resorption and implicated in the development of human periapical lesions. Among naturally occurring interleukin-1 (IL-1) inhibitors, IL-1 receptor antagonist (IL-1ra) is a 22 kDa protein that shares homology with IL-1 beta and IL-1 alpha, binds to IL-1 receptor with similar affinity to IL-1, and has no known agonist properties. In this study, we measured the periapical exudate (PE) levels of IL-1 beta and IL-1ra from human periapical lesions. PE samples were collected from root canals during routine endodontic treatments, and the enzyme-linked immunosorbent assay was used to measure PE-IL-1 beta and IL-1ra. Detectable levels of both IL-1 beta and IL-1ra were found in 25 of 29 clinical samples. Relatively high levels of IL-1ra compared with IL-1 beta (mean IL-1ra:IL-1 beta ratio = 128:7; range: 0.9 to 495.4), and significantly positive correlation between IL-1ra and IL-1 beta levels was found. The PE-IL-1ra:IL-1 beta ratios obtained from symptomatic lesions were significantly lower than those from asymptomatic lesions. These results suggest that IL-1ra-mediated IL-1 antagonism occurred to block locally produced IL-1 activity, and the balance of IL-1 to IL-1ra production may be crucial in the development of periapical lesions. <151> UI - 98305320 AU - Osorio RM AU - Hefti A AU - Vertucci FJ AU - Shawley AL IN - Department of Estomatoquirurgica, University of Carabobo, Venezuela. TI - Cytotoxicity of endodontic materials. SO - Journal of Endodontics 1998 Feb;24(2):91-6 AB - An in vitro cell culture model of human gingival fibroblasts and L-929 cells was used to measure the cytotoxicity of currently used root canal sealers Endomet, CRCS, and AH26 and root-end filling materials Amalgam, Gallium GF2, Ketac Silver, mineral trioxide aggregate (MTA), and Super-EBA. Cytotoxic effects were assessed using the MTT assay for mitochondrial enzyme activity and the CV assay for cell numbers. Using inserts culture and L-929 fibroblasts. All-Bond-2 was also evaluated. The statistical analysis of results showed that CRCS was the least cytotoxic sealer followed by Endomet and AH26. Among root-end filling materials, MTA was not cytotoxic; Gallium GF2 displayed little cytotoxicity; and Ketac Silver, Super-EBA, and Amalgam showed higher levels of cytotoxicity. All Bond-2 also displayed a high degree of cytotoxicity. CRCS was the best root canal sealer and MTA the best root-end filling material. The outcome was favorable also for Gallium GF2 as a retrofilling material. <152> UI - 98305297 AU - Dummer PM AU - al-Omari MA AU - Bryant S IN - Department of Restorative Dentistry, Dental School, University of Wales College of Medicine, Cardiff, UK. TI - Comparison of the performance of four files with rounded tips during shaping of simulated root canals. SO - Journal of Endodontics 1998 May;24(5):364-71 AB - A total of 160 simulated canals of various angles and positions of curvature were prepared by hand using either Mani Flexile Files, Mani SEC-O Files, Maillefer Flexofiles, or Zipperer Flexicut Files. After orifice enlargement, each file type was used to prepare 40 canals employing a balanced force motion and a modified double-flared technique. Pre- and postoperative images of the canals were taken with a videocamera, and stored and manipulated in a computer with image analysis software. The presence of canal aberrations and the amount of material removed as a result of preparation were determined from composite images of superimposed pre- and postoperative views. Significant differences (p < 0.001) in preparation time were observed, with Flexile Files being quickest and SEC-O Files being slowest. Overall, Flexofiles and Flexicut Files deformed significantly more (p < 0.001) than Flexile and SEC-O Files. The incidence of canal blockage was not influenced by instrument type, but the incidence of apical extrusion was significantly greater (p < 0.001) with SEC-O Files. SEC-O Files created significantly fewer (p < 0.001) and significantly narrower (p < 0.001) zips, with significantly less (p < 0.001) removal of material from the outer aspect of the curve and thus significantly less (p < 0.001) transportation. Flexicut Files created the widest canals apically, with the greatest removal of material from the outer aspect of the curve and the most transportation. Flexofiles created significantly more (p < 0.001) perforations. Under the conditions of this study, obvious differences between instruments were highlighted with SEC-O Files preparing canals more safely and with least destruction. The unique rounded tip of the SEC-O Files may have had an influence on the outcome. <153> UI - 98305298 AU - Weine FS IN - Loyola University, Chicago, IL, USA. TI - The C-shaped mandibular second molar: incidence and other considerations. Members of the Arizona Endodontic Association. SO - Journal of Endodontics 1998 May;24(5):372-5 AB - Although its most common configuration is two roots and three canals, the mandibular second molar may have many different combinations. Cooke and Cox were the first to describe a single-rooted mandibular second molar with a continuous slit connecting some or all of the canals. If sectioned horizontally through the main portion of the root, this slit had the shape of the letter "C." Other papers were written and lectures were presented on this and similar entities, but its frequency and significance have remained the object of speculation because large numbers of these teeth have not been categorized. By combining the efforts of an endodontic study club, 811 endodontically treated mandibular second molars were evaluated. Sixty-two of these (7.6%) were identified as C-shapes. Other aspects of this configuration were also investigated. <154> UI - 98305313 AU - Rud J AU - Rud V TI - Surgical endodontics of upper molars: relation to the maxillary sinus and operation in acute state of infection. SO - Journal of Endodontics 1998 Apr;24(4):260-1 AB - Findings in 200 cases of root resection of first maxillary molars showed perforation to the sinus in half of the cases. In 42% of the cases, the first maxillary molar had root resection performed in a subacute or acute state of infection. Only two cases developed postoperative sinusitis. Antibiotic treatment was indicated preoperatively in 3% and postoperatively in 5%. Postoperative symptoms, such as pain and swelling, were usually moderate, possibly because of a nontraumatizing operation technique, a careful removal of infected tissue, and a good drainage by loose suturing. <155> UI - 98321029 AU - Versteeg CH AU - Sanderink GC AU - Lobach SR AU - van der Stelt PF IN - Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - Reduction in size of digital images: does it lead to less detectability or loss of diagnostic information? [see comments]. CM - Comment in: Dentomaxillofac Radiol 1998 Sep;27(5):312 SO - Dento-Maxillo-Facial Radiology 1998 Mar;27(2):93-6 AB - OBJECTIVES: To analyse the effect of reduction in size of digital images on diagnostic outcome. METHODS: A series of 100 Visualix III (Gendex Dental Systems, Milano, Italy; Dentsply, Des Plaines, IL, USA) images was made of size 10 and 15 endodontic files in upper and lower (pre)molars. Three forms of image were created: (a) the original images, (b) reduced to one-half (containing one-quarter of the information of the original, and (c) zoomed-in, half-size images (magnification 2:1; original image size but with only one-quarter of the original information). Seven radiologists were asked to rate the position of the tip of the file, using a five-point confidence scale. ROC data were analysed by means of MANOVA statistics. RESULTS: A significant difference was found between the three image modalities for both size 10 (P < 0.005), and size 15 (P < 0.021) files. CONCLUSIONS: Reduction in size of digital images may cause less detectability as well as loss of diagnostic information. <156> UI - 98221440 AU - Ruddle CJ IN - Advantage Endodontics, Santa Barbara, Calif., USA. ruddlec@aol.com TI - Nonsurgical endodontic retreatment. [Review] [16 refs] SO - Dentistry Today 1998 Feb;17(2):64, 66-71 <157> UI - 98250884 AU - Marais JT IN - Department of Restorative Dentistry, Faculty of Dentistry, University of Pretoria, South Africa. TI - Failure of apicoectomy surgery and successful endodontic retreatment. SO - Journal of the Dental Association of South Africa 1998 Jan;53(1):13-20 AB - The optimal way to address endodontic failures is to retreat the root canal system first and only then to consider apical surgery. Unfortunately, in practice, it is often not done in this way. Patients are subjected to apical surgery, without any attempts at retreatment. A series of cases is presented illustrating failures of apicoectomy and successful endodontic retreatment. <158> UI - 98256830 AU - Albashaireh ZS AU - Alnegrish AS IN - Department of Restorative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan. TI - Postobturation pain after single- and multiple-visit endodontic therapy. A prospective study. SO - Journal of Dentistry 1998 Mar;26(3):227-32 AB - OBJECTIVES: This prospective study was conducted to determine whether there is any significant difference in the incidence of postobturation pain after single- and multiple-visit root canal treatment (RCT). METHODS: The frequency of postobturation pain was recorded and evaluated over an observation period of 30 days in 291 of 300 consecutive patients receiving RCT. The patients were assigned randomly and consecutively into either single- or multiple-visit groups. The canals of all teeth were prepared and filled by a single operator using the step-back and lateral condensation techniques. The data were analysed statistically to determine the relationship, if any, between the pain experienced and pulpal vitality, tooth type, pre-operative pain, and the sex and age of the patient. RESULTS: Nine of the 300 patients were excluded from the analysis as they failed to attend for postoperative reviews. A significantly higher incidence (P < 0.01) of postobturation pain was found in the multiple-visit group (38%) than in the single-visit group (27%) within 24 h of obturation. The incidence of pain decreased thereafter, with all patients being sysmptom free at the end of the observation period. No significant correlation was found between postobturation pain and any other factor, with the exception that teeth which had nonvital pulp prior to treatment were associated with a significantly greater (P < 0.005) incidence of postobutration pain. CONCLUSIONS: Pain was significantly higher in the multiple-visit RCT group and significantly associated with the treatment of the nonvital pulp. <159> UI - 98219214 AU - Filippi A AU - Pohl Y AU - Tekin U IN - Department of Oral Surgery, Justus-Liebig University of Giessen, Germany. TI - Transplantation of displaced and dilacerated anterior teeth. SO - Endodontics & Dental Traumatology 1998 Apr;14(2):93-8 AB - The therapy of dilacerated permanent anterior teeth usually involves surgically removing the tooth. Subsequently, orthodontic methods for closing the space or keeping it open are preferred until the patient reaches an age when definitive implantological or prosthetic treatments may be used. Anterior tooth transplantation should be considered as an alternative to surgically extracting the tooth. This study describes a period of investigation covering 3 years during which neither replacement resorption nor inflammatory resorption was diagnosed in the five transplanted teeth. The clinical tooth mobility was similar to that of the adjacent teeth. In spite of the vertical loss of bone shown radiographically no pathologically enlarged pockets or recessions have been found. It is not yet possible to make any comments on the prognosis for the long term. <160> UI - 98219210 AU - Bader G AU - Lejeune S IN - Service de chirurgie buccale, Centre Hospitalier Regional Universitaire de Rennes, France. TI - Prospective study of two retrograde endodontic apical preparations with and without the use of CO2 laser. SO - Endodontics & Dental Traumatology 1998 Apr;14(2):75-8 AB - This article covers a 4-year study that reports 320 cases in which endodontic surgery was performed for residual apical lesions or lesions that could not be treated in a conventional way. Four groups of 80 teeth each were formed and they were followed up after a 12-month interval. The first group comprised cases treated with a micro bur, retrograde filling and IRM; the second, cases treated at the apical and radicular portions with a CO2 laser; the third, cases in which the retrograde cavity was prepared with an ultrasonic device instead of a micro bur; and the fourth group comprised cases treated in a similar way to the second group, i.e., cases treated at the apical and radicular portions, but with a CO2 laser instead of a micro bur. After 12 months, the results showed a better prognosis with ultrasonic treatment. Regardless of technique, the CO2 laser did not improve the healing process. <161> UI - 98219206 AU - Stockton L AU - Lavelle CL AU - Suzuki M IN - Faculty of Dentistry, University of Manitoba, Winnipeg, Canada. TI - Are posts mandatory for the restoration of endodontically treated teeth?. [Review] [103 refs] SO - Endodontics & Dental Traumatology 1998 Apr;14(2):59-63 AB - In this era of fiscal and professional accountability, variations in the utilization of posts to improve the retention of crowns or other restorations on endodontically treated teeth are no longer acceptable. This practice ignores not only the potential for root perforations during post space preparations, but also the adhesive properties of modern resin-based materials. Since the retention of restorations hinges on many other factors, the placement of posts does not necessarily assure service quality and may even lead to deleterious changes. The need to reappraise the utilization of posts in the restoration of endodontically treated teeth cannot be overstated. [References: 103] <162> UI - 98186118 AU - Hokett SD AU - Hoen MM TI - Inflammatory cervical root resorption following segmental orthognathic surgery. A case report. SO - Journal of Periodontology 1998 Feb;69(2):219-26 AB - An unusual case of bilateral inflammatory external/internal root resorption developed in the maxillae of a 28 year-old female approximately 4 years following routine segmental orthognathic surgery. The patient experienced dental pain in a tooth adjacent to a segmental osteotomy cut 8 months postsurgery, however, the tooth later became asymptomatic. A definitive diagnosis of inflammatory cervical root resorption was not established until nearly 4 years later on routine dental examination. The external/internal resorptive lesions were located 4 to 6 mm apical to the connective tissue attachment on 3 of the 4 tooth roots adjacent to osteotomy cuts. Two of the affected teeth required non-surgical root canal therapy due to pulpal communication with the resorptive defects. The lesions were accessed by flap surgery, thoroughly debrided, and obturated with an intermediate restorative material until definitive restorative therapy could be completed. All sites healed uneventfully and the patient has been closely observed for approximately 2 years without symptoms or recurrence of the resorptive lesions. Dental health care providers should be alert to the possible occurrence of inflammatory root resorption in sites adjacent to osteotomy cuts over extended periods of time. Routine radiographic examination may be beneficial in the postoperative management of the segmental orthognathic surgery patient. <163> UI - 98211085 AU - Bell GW IN - Oral & Maxillofacial Surgery Department, City General Hospital, Carlisle. TI - A study of suitability of referrals for periradicular surgery [see comments]. CM - Comment in: Br Dent J 1998 Feb 28;184(4):176 SO - British Dental Journal 1998 Feb 28;184(4):183-6 AB - OBJECTIVE: To determine if the clinical and radiographic presentation of patients referred by their general dental practitioner requesting periradicular surgery fulfilled a set of predetermined guidelines as to the appropriateness of the procedure. DESIGN: Multicentre prospective study. SETTING: Maxillofacial departments of district general hospitals. METHOD: Consecutive analysis of referrals within four hospitals over a 1-year period between 1995 and 1996. RESULTS: From 205 referrals, mostly of patients in the 30 to 40 years age group, 79.5% (n = 163) of referrals failed to meet the criteria, mainly because of an unsatisfactory root canal filling, but also due to obvious coronal microleakage and adjacent teeth contributing to the disease process not yet having received endodontic treatment. In only 6.3% (n = 13) of patients had there been an attempt to retreat the pulp space infection by conventional means. CONCLUSION: The majority of referrals in this study did not fulfil the guideline criteria on the provision of periradicular surgery. The factors influencing failure in endodontics and periradicular disease did not appear to have been appreciated, or were not acted upon. Conventional retreatment of the pulp space needs to be considered or attempted prior to referral for surgery. <164> UI - 98211082 AU - Whitworth J IN - Dental School, University of Newcastle upon Tyne. TI - Most referrals for periradicular surgery do not match the accepted guidelines [comment]. CM - Comment on: Br Dent J 1998 Feb 28;184(4):183-6 SO - British Dental Journal 1998 Feb 28;184(4):176 <165> UI - 98134962 AU - Sundqvist G AU - Figdor D AU - Persson S AU - Sjogren U IN - Endodontics Department, Umea University, Sweden. TI - Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1998 Jan;85(1):86-93 AB - OBJECTIVE: The purposes of this study were to determine what microbial flora were present in teeth after failed root canal therapy and to establish the outcome of conservative re-treatment. STUDY DESIGN: Fifty-four root-filled teeth with persisting periapical lesions were selected for re-treatment. After removal of the root filling, canals were sampled by means of advanced microbiologic techniques. The teeth were then re-treated and followed for up to 5 years. RESULTS: The microbial flora was mainly single species of predominantly gram-positive organisms. The isolates most commonly recovered were bacteria of the species Enterococcus faecalis. The overall success rate of re-treatment was 74%. CONCLUSIONS: The microbial flora in canals after failed endodontic therapy differed markedly from the flora in untreated teeth. Infection at the time of root filling and size of the periapical lesion were factors that had a negative influence on the prognosis. Three of four endodontic failures were successfully managed by re-treatment. <166> UI - 99264645 AU - Hulsmann M IN - Department of Operative Dentistry, Zentrum ZMK, University of Gottingen, Germany. TI - Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. [Review] [132 refs] SO - International Endodontic Journal 1997 Mar;30(2):79-90 AB - Dens invaginatus is a malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. Affected teeth show a deep infolding of enamel and dentine starting from the foramen coecum or even the tip of the cusps, and which may extend deep into the root. Teeth most affected are maxillary lateral incisors and bilateral occurrence is not uncommon. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth. Aetiology, prevalence, classification, and therapeutic considerations including root canal therapy, apical surgery and prevention of pulpal involvement are reviewed. [References: 132] <167> UI - 99264653 AU - Sauveur G AU - Roth F AU - Sobel M AU - Boucher Y IN - UFR d'Odontologie, Universite Paris 7, France. TI - Surgical treatment of a periradicular lesion on an invaginated maxillary lateral incisor (dens in dente). SO - International Endodontic Journal 1997 Mar;30(2):145-9 AB - The complex anatomy of invaginated teeth make their root canal treatment difficult. Moreover, this treatment may compromise the future of the tooth if it is destined to support a post-retained coronal restoration. This case reports the successful surgical root canal treatment of an invaginated tooth using a retrograde filling with gutta-percha. After surgical exposure of the root-end and cleaning of the root canal, the gutta-percha was compacted in the root canal which had been coated previously with a zinc oxide-eugenol cement. The gutta-percha was then cold-burnished. Periapical radiographic examination after 1, 2, 3, 6 and 12 months showed periapical healing with osseous formation. This procedure, resulting in minimal loss of hard tissues, permitted subsequent restoration of the tooth. <168> UI - 99264728 AU - Kooner DS TI - MGDS log diary case report. SO - Primary Dental Care 1997 May;4(2):53-6 AB - This log diary describes the treatment provided to Mrs ED, a 55-year-old female who presented with a 'broken front cap'. She also requested a complete course of treatment. This case report includes details of the treatment provided: Emergency/immediate treatment. Full history and examination and special investigations. Diagnosis and treatment planning. Provision of periodontal and restorative treatment. Crown lengthening and extractions. Provision of milled crowns and a post core and crown. Provision of upper and lower partial cobalt chrome dentures. <169> UI - 98248853 AU - Zaatar EI AU - al-Kandari AM AU - Alhomaidah S AU - al-Yasin IM IN - Benied Al Ghar Dental Center, State of Kuwait. TI - Frequency of endodontic treatment in Kuwait: radiographic evaluation of 846 endodontically treated teeth. SO - Journal of Endodontics 1997 Jul;23(7):453-6 AB - A retrospective study was conducted to evaluate the radiographic films of 846 endodontically treated teeth at Benied Al Ghar Dental Center in Kuwait. The most frequently treated tooth was the mandibular first molar (17.4%). The number, percentage, and distribution of the roots, root canals, and apical foramina were reported by individual tooth. The clinical findings were compared to the results of previously related in vitro and in vivo studies. <170> UI - 98248841 AU - Chau JY AU - Hutter JW AU - Mork TO AU - Nicoll BK IN - Branch Dental Clinic, New London, CT, USA. TI - An in vitro study of furcation perforation repair using calcium phosphate cement. SO - Journal of Endodontics 1997 Sep;23(9):588-92 AB - Furcation perforations created in the pulpal floors of 30 extracted human molars were repaired with either light-cured glass ionomer cement (GI), calcium phosphate cement (CPC), or light-cured glass ionomer cement placed over a CPC matrix (M). After the cement was set, the teeth were immersed in India Ink for 48 h, dried, and sectioned longitudinally. Dye penetration into the furcation repair was independently evaluated by three board-certified endodontists. There was no significant difference in the mean extent of dye leakage among the three experimental groups. The use of CPC, with its enhanced biocompatibility, potential for osteoconduction, and sealing ability, may improve the prognosis of teeth with furcation perforations. <171> UI - 98138279 AU - al-Omari MA AU - Bryant S AU - Dummer PM IN - Department of Restorative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan. TI - Comparison of two stainless steel files to shape simulated root canals. SO - International Endodontic Journal 1997 Jan;30(1):35-45 AB - The aim of this study was to compare the shaping ability of two stainless steel files using simulated canals. A total of 80 simulated canals of various angles and positions of curvature were prepared by hand using either Mani K-Files or Micro Mega K-Files. Following orifice enlargement each file type was used to prepare 40 canals employing a linear filing motion and an anticurvature stepback technique. Pre- and post-operative longitudinal images of the canals were taken with a video camera and stored and manipulated in a computer with image analysis software. The presence of canal aberrations and the amount of material removed as a result of preparation were determined from composite images of superimposed pre- and post-operative views. Overall, canal preparation with Mani K-Files was significantly quicker (P < 0.005) and was associated with fewer instrument failures. Zips and elbows were observed in 70% of specimens with significantly more (P < 0.05) occurring following preparation with Micro Mega K-Files. Mani K-Files created significantly more (P < 0.01) danger zones. Micro Mega K-Files created significantly wider (P < 0.001) zips with significantly more (P < 0.01) resin removed from the outer aspect of the curves and, thus, significantly more (P < 0.01) transportation. Canal shape had a significant influence on preparation time (P < 0.001), the incidence of zips (P < 0.05) and danger zones (P < 0.005), the width of zips (P < 0.001) and transportation at the zips (P < 0.001). Under the conditions of this study, Mani K-Files were more effective than Micro Mega K-Files and produced canals with better shapes. Original canal shape had a substantial influence on the outcome of shaping procedures. <172> UI - 98138280 AU - Barbakow F AU - Lutz F IN - Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland. TI - The 'Lightspeed' preparation technique evaluated by Swiss clinicians after attending continuing education courses. SO - International Endodontic Journal 1997 Jan;30(1):46-50 AB - This survey evaluated acceptance of the Lightspeed canal preparation (LS) technique by Swiss practitioners. The technique was introduced to Switzerland in June 1994 and 10 other continuing education (CE) courses were held at the Zurich Dental School by July 1995. Acceptance was assessed by posting questionnaires to the CE course attendees. Of the 305 questionnaires posted, 177 (58%) were returned. Of the CE participants 80% had used the technique with 60% finding the method easier and 43% finding it quicker than their usual preparation techniques. Of the respondents 58% used the technique on all tooth types and 76% of the LS users had fractured an instrument at least once. Amongst others, fractures were caused by too much pressure (25%), incorrect insertion angles (17%) and by a complicated root morphology (15%). Fractures occurred high up on the instrument shaft (74%) and near the tip (7%). Working lengths were claimed by 62% to be easier to maintain by LS than their usual preparation techniques. Among the respondents 52% obturated LS prepared canals more easily and quickly compared with their usual preparation techniques. Only 10% of LS users would not recommend the technique, but those who would suggested that proper tuition was necessary to minimize the risk of instrument fracture. The LS technique was positively assessed by clinicians who attended the CE courses in Switzerland where endodontics is not accepted as a specialty. <173> UI - 98138283 AU - Rees JS IN - Department of Restorative Dentistry, Dental School, University of Wales College of Medicine, Cardiff, UK. TI - Conservative management of a large maxillary cyst. [Review] [15 refs] SO - International Endodontic Journal 1997 Jan;30(1):64-7 AB - This article describes the treatment of a large maxillary cyst by root canal treatment and decompression using a hollow drain made from surgical suction tubing. The rationale behind the use of this technique is reviewed and its advantages highlighted. [References: 15] <174> UI - 98159148 AU - Blomlof L AU - Jansson L AU - Appelgren R AU - Ehnevid H AU - Lindskog S IN - Department of Periodontology, Public Dental Service at Skanstull, Stockholm, Sweden. TI - Prognosis and mortality of root-resected molars. SO - International Journal of Periodontics & Restorative Dentistry 1997 Apr;17(2):190-201 AB - The purpose of the present study was to compare tooth mortality of root-resected molars with that of root-filled, single-rooted teeth. Survival rates were 68% for root-resected molars and 77% for root-filled single-rooted teeth over a 10-year period. This difference was not statistically significant. Ten-year survival of root-resected molars in patients with radiographic attachment loss in single-rooted teeth of greater than 6 mm was 56% while survival was as high as 89% for root-resected molar patients with radiographic attachment loss in single-rooted teeth less than or equal to 6 mm. In conclusion, the prognosis of root-resection is not poorer than the prognosis of single-rooted teeth with an equal susceptibility to periodontitis, if endodontic conditions and maintenance care are optimal. <175> UI - 98148824 AU - Pilot TF AU - Pitts DL IN - Department of Endodontics, University of Washington, Seattle 98195-7448, USA. TI - Determination of impedance changes at varying frequencies in relation to root canal file position and irrigant. SO - Journal of Endodontics 1997 Dec;23(12):719-24 AB - This study was conducted on 10 anterior and premolar teeth that were scheduled for endodontic treatment. After length of tooth determination, a series of test K-file handles were locked at lengths varying from 3 mm short to 0.5 mm long of the foramen. Samples of impedance were taken at each length with a digital signal processor at six different frequencies and for each of seven different irrigants or canal conditions. A total of five different root canal irrigants were used in each tooth (RC Prep, 70% isopropyl alcohol, 14.45% EDTA sodium solution, normal saline, and 5.25% NaOCl), along with two variations of a dry canal. The greatest impedance changes occurred +/- 0.25 mm from the foramen. No significant difference was noted in prediction error at different frequencies (p > 0.05); however, prediction error was significant with respect to different irrigants (p < 0.02). Conductive irrigants demonstrated less change of electrical characteristics with length than nonconductive irrigants, thus allowing a greater prediction of file position in relation to the foramen using electrically nonconductive irrigants. <176> UI - 98248873 AU - Taylor JK AU - Jeansonne BG AU - Lemon RR IN - LSU Medical Center, School of Dentistry, Department of Endodontics, New Orleans, LA 70119, USA. TI - Coronal leakage: effects of smear layer, obturation technique, and sealer. SO - Journal of Endodontics 1997 Aug;23(8):508-12 AB - Coronal microleakage may be a major factor in the etiology of treatment failure. This study examined the effect of obturation technique, sealer, and the presence of smear layer on coronal microleakage. Two hundred extracted human teeth were assigned to 20 treatment groups. Groups were examined with the smear layer present or smear layer removed (17% REDTA). Access cavities were exposed to artificial saliva then Pelikan Ink. Teeth were cleared and linear dye penetration measured. When all groups with the smear layer removed were compared with all groups with the smear layer present, significantly less leakage was seen when the smear layer was removed. Ultrafil displayed significantly more leakage than all other groups. Vertical compaction of lateral condensation and Thermafil obturations significantly reduced leakage. AH-26 displayed significantly less leakage than Roth's 811 sealer. These results indicate that removal of the smear layer, the use of AH-26, and vertical compactin have cumulative effects in reducing coronal leakage. <177> UI - 98248879 AU - Rud J AU - Rud V AU - Munksgaard EC IN - Department of Dental Materials, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. TI - Effect of root canal contents on healing of teeth with dentin-bonded resin composite retrograde seal. SO - Journal of Endodontics 1997 Aug;23(8):535-41 AB - Healing results were compared among 551 infected roots apically sealed with a dentin-bonded resin composite (Gluma-Retroplast). These roots contained either 1) root filling to apex after resection, 2) insufficient root filling, or 3) empty root canals with necrotic pulp remnants. At 2- to 4-yr follow-up, complete bone healing was found to be 92%, 85%, and 81% in groups 1, 2, and 3, respectively. The results from groups 1 and 3 were significantly different, and the results from group 2 did not differ significantly from that of groups 1 or 3. Reasons for "Failures" were found to be mainly loose filling or uncovered canal. After 21 roots classified as "Failures" were reoperated, 76% of these showed "Complete Healing" after 1 yr. <178> UI - 98250866 AU - Fuss Z AU - Weiss EI AU - Shalhav M IN - Department of Endodontology, The Maurice and Gabriela Goldshleger School of Dental Medicine, Tel Aviv University, Israel. TI - Antibacterial activity of calcium hydroxide-containing endodontic sealers on Enterococcus faecalis in vitro. SO - International Endodontic Journal 1997 Nov;30(6):397-402 AB - Antimicrobial activity of endodontic sealers is an important factor in the prognosis of root canal treatment. The aim of this study was to analyse the antimicrobial activity of calcium hydroxide-containing endodontic sealers, Sealapex (SA) and CRCS compared to a ZOE-containing sealer, Roth's cement. The sealers were mixed and placed on the side wall of microtitre plate wells. A 10 microL suspension of Enterococcus faecalis was added to the surface of the sealers 1 h, 24 h, or 7 days after mixture. Bacteria were allowed to come into contact with the sealers for 1 h at 37 degrees C. Fresh media was then added and bacterial growth was measured every 30 min for 16 h. The results showed that in 1-hour-old mixture, CRCS and Roth's cement had a significantly better antimicrobial effect than SA. In 24-hour-old mixtures, ZOE-based sealer showed a more potent antimicrobial activity than calcium hydroxide-containing sealers, whereas SA showed a significantly better antimicrobial effect in the 7-day-old mixture. The antimicrobial activity of each tested sealer changes differently with the time interval between mixing and testing, suggesting different physicochemical properties and potentially diverse clinical applications. <179> UI - 98250870 AU - Ricucci D AU - Langeland K IN - Department of Restorative Dentistry and Endodontology, School of Dental Medicine, University of Connecticut Health Centre, Farmington, USA. TI - Incomplete calcium hydroxide removal from the root canal: a case report. [Review] [19 refs] SO - International Endodontic Journal 1997 Nov;30(6):418-21 AB - This case demonstrates failure of root canal treatment of a maxillary central incisor following incomplete mechanical removal of a Ca(OH)2 intracanal dressing and subsequent resorption of the material from the apical portion of the root canal. Retreatment some 4 years later involved the removal of the contents of the root canal and permanent obturation by lateral condensation of cold gutta-percha with a sealer. Follow-up showed complete periradicular bone healing with a lamina dura evident. An explanation of the processes involved is offered, based upon histopathological and microbiological evidence in the literature. [References: 19] <180> UI - 98263584 AU - Douthitt JC IN - Texas A&M University System, Baylor College of Dentistry, USA. TI - Guided tissue regeneration in surgical endodontics: improving the prognosis of periradicular surgery. [Review] [36 refs] SO - Texas Dental Journal 1997 Oct;114(10):8-12 <181> UI - 98229344 AU - Nair PN IN - Institute of Oral Structural Biology, University of Zurich, Switzerland. TI - Apical periodontitis: a dynamic encounter between root canal infection and host response. [Review] [208 refs] SO - Periodontology 2000 1997 Feb;13:121-48 <182> UI - 98221451 AU - Chalfin H AU - Kellert M TI - Restorative endodontics: anatomy of a failure. [Review] [23 refs] SO - Dentistry Today 1997 May;16(5):54, 56, 58-61 <183> UI - 98221452 AU - Ruddle C IN - Advanced Endodontics, Santa Barbara, Calif., USA. TI - Endodontic overfills: good? Bad? Ugly?. [Review] [10 refs] SO - Dentistry Today 1997 May;16(5):62-5 <184> UI - 98219191 AU - Tataryn RW TI - Specialty endodontics: diagnostic challenges, Part 1. SO - Dentistry Today 1997 Aug;16(8):60-4 <185> UI - 98187020 AU - Fox K AU - Youngson CC IN - Division of Restorative Dentistry, Leeds Dental Institute. TI - Diagnosis and treatment of the cracked tooth. [Review] [33 refs] SO - Primary Dental Care 1997 Sep;4(3):109-13 AB - This review paper discusses the recognised factors which predispose to cracked-tooth syndrome. In addition, common presenting symptoms and the various methods to aid clinical diagnosis of this problem are examined. The incidence of the condition is reported and the prognosis of the various forms of fracture, as suggested by clinical presentation, are outlined with reference to the available literature. Benefits and relative demerits of traditional and more modern treatment options are presented and recommendations made for future research. [References: 33] <186> UI - 98219199 AU - Barrett EJ AU - Kenny DJ IN - Department of Dentistry, Hospital for Sick Children, Toronto, Ontario, Canada. TI - Survival of avulsed permanent maxillary incisors in children following delayed replantation. SO - Endodontics & Dental Traumatology 1997 Dec;13(6):269-75 AB - The purpose of this study was to identify the variables that significantly influenced the survival of incisors replanted after extended extra-alveolar duration at The Hospital for Sick Children, Toronto, Canada, between June 1988 and December 1993. Survival analysis was used to identify variables that significantly influence the retention of replanted incisor teeth. Survival was defined as the time that elapsed between the replantation of an avulsed incisor and the time it was finally lost. Information on 9 variables was collected for 38 patients (25 males; 13 females) and 52 replanted permanent maxillary incisors. The mean extra-alveolar duration for the sample was 123 min. The mean follow-up interval was 942 days (range: 364-2126 days). Incisors replanted with open apices had a significantly decreased survival compared with teeth with mature apices (P = 0.04; relative risk 4.2). There was also a significant association between increased survival and obturation of the root canal with gutta-percha and sealer (P = 0.006; relative risk 10.0). A trend towards improved survival of replanted incisors was found for children older than 11 years old at the time of replantation (P = 0.09; relative risk 2.8). These results are consistent with previous studies and may assist clinicians and parents in the decision-making process associated with the management of avulsed teeth in children. <187> UI - 98207541 AU - Roulet JF IN - Universitatsklinikum Charite, Medizinische Fakultat, Humboldt-Universitat zu Berlin, Abt. fur Zahnerhaltung und Praventivzahnmedizin, Germany. TI - Longevity of glass ceramic inlays and amalgam--results up to 6 years. SO - Clinical Oral Investigations 1997 Feb;1(1):40-6 AB - Ceramic inlays are discussed as one option for the substitution of amalgam restorations. The purpose of this study was to determine the longevity of glass ceramic inlays and amalgam restorations placed by the author: 123 class I and class II Dicor inlays placed with adhesive techniques and 163 amalgam class I and class II restorations were investigated. The observation time for the inlays varied from 4 to 82 months. The inlays were clinically investigated using modified USPHS criteria and documented photographically. Kaplan-Meier statistics were used to calculate the survival rate. From the 123 evaluated inlays 12 inlays (9.7%) failed: 7 due to fractures, 4 because of endodontic problems and 1 inlay was replaced due to persisting postoperative pain. All fractures could be explained by case selection errors. According to the Kaplan-Meier method, the estimated success rate after 6 years was 76% for the Dicor inlays and 87% for the amalgam restorations (control group). The difference was not statistically significant. It was concluded that Dicor inlays may be used as a successful alternative to amalgam. <188> UI - 98207547 AU - Samaranayake LP AU - Stassen LF AU - Still DM IN - Oral Biology Unit, Faculty of Dentistry, University of Hong Kong. TI - A microbiological study of pre- and postoperative apicoectomy sites. SO - Clinical Oral Investigations 1997 Jun;1(2):77-80 AB - There is little information on the microbiology of periapical lesions, and no data on the residual microbial flora in the periapex, if any, after apicoectomy procedures. Hence, 64 patients treated by apicoectomy procedures were prospectively studied to assess the bacterial flora in the periapex and to evaluate the residual bacteria in postoperative apicoectomy sites. Of the 64 lesions studied, 14 (22%) were sterile and 50 (78%) yielded bacteria preoperatively. Bacteria could be recovered from 28 (56%) of the latter lesions after apicoectomy and curettage. A total of 105 bacterial strains was isolated from 50 lesions, yielding a range of 1-4 (mean 2.1) species per sample. The isolates comprised 84 (80%) facultative anaerobes and 21 (20%) strict anaerobes. A polymicrobial growth was obtained from 39 lesions whilst 11 lesions yielded pure cultures. On detailed microbiological analyses of 29 lesions, 40% of the isolates were identified as alpha-haemolytic streptococci, half of which were Streptococcus sanguis; anaerobic streptococci were the predominant anaerobes. None of the organisms or group(s) of organisms emerged as recalcitrant colonisers which were difficult to dislodge after surgical debridement. These data indicate that the majority of periapical lesions harbour a variety of flora which cannot be eradicated despite thorough apicoectomy procedures. <189> UI - 98211203 AU - Weiger R AU - Hitzler S AU - Hermle G AU - Lost C IN - Department of Conservative Dentistry, University of Tubingen, Germany. TI - Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population. SO - Endodontics & Dental Traumatology 1997 Apr;13(2):69-74 AB - The objective of this study was to determine the periapical status and the quality of root canal fillings and to estimate the endodontic treatment needs in a German population. Clinical and radiographic data and the operative procedures performed were evaluated on 323 patients coming to a dental surgery in Stuttgart, Germany, in 1993. In 182 individuals at least one tooth exhibited a root canal filling, a necrotic pulp or an irreversible pulpitis. Out of the 7897 teeth examined, 215 (2.7%) had a root canal treatment (category A), 122 being non-endodontically treated (1.5%) did not respond to the sensitivity test (category B) and 53 (0.7%) were diagnosed as having irreversible inflamed pulp tissue (category C). The prevalence of teeth associated with radiographic signs of periapical pathosis was 61% in the group of root canal filled teeth and 88% in the group of pulpless and non-endodontically treated teeth. Using the level and the density of the root canal filling as criteria for evaluating the technical standard, only 14% of the endodontic treatments of non-apicectomized teeth were qualified as adequate. The minimal endodontic treatment need is 2.3% related to all examined teeth when the root canal filled teeth with clinical symptoms of periapical periodontitis (category A) and those of categories B and C are included. The real endodontic treatment need is suggested to be larger when considering that the technical quality of the obturation is poor in most symptomless endodontically treated teeth associated with a periapical lesion. In the case of retreatment of these teeth, the endodontic treatment need would then be calculated at 3.7%. <190> UI - 98211204 AU - Caliskan MK AU - Turkun M IN - Department of Endodontics, Ege University, Bornova-Izmir, Turkey. TI - Prognosis of permanent teeth with internal resorption: a clinical review. SO - Endodontics & Dental Traumatology 1997 Apr;13(2):75-81 AB - This study was performed in order to report the clinical features of internal resorption cases and evaluate their prognosis after endodontic treatment. Twenty-seven patients with 28 teeth with internal resorption were referred to our clinic and 20 teeth were treated endodontically. Sixteen teeth had non-perforating internal resorption and were treated by conventional root canal therapy. The remaining 4 teeth had perforating internal resorption and were initially treated by remineralization therapy with calcium hydroxide. The teeth treated by conventional root canal therapy showed clinical and radiographic evidence of healing. However, the remineralization therapy was successful in only one case. The three failed cases were subsequently treated by endodontic surgery. The surgical therapy was unsuccessful in one case due to extensive loss of marginal alveolar bone and increased tooth mobility. <191> UI - 98211210 AU - Barrett EJ AU - Kenny DJ IN - Department of Dentistry, Hospital for Sick Children, University of Toronto, Canada. TI - Avulsed permanent teeth: a review of the literature and treatment guidelines. [Review] [83 refs] SO - Endodontics & Dental Traumatology 1997 Aug;13(4):153-63 AB - Dental trauma represents one of the few situations where dentists are called upon to make unscheduled diagnostic and treatment decisions in an area that is outside their routine experience. Since patients who sustain an avulsion present infrequently, except in child-oriented or emergency-based practices, clinicians often make diagnostic and management decisions based upon their previous rare treatment experiences. Clinicians also rely on published guidelines for this aspect of their practice and expect these standards to be up-to-date and based on current research information. None of the current protocols has been tested by a prospective longitudinal outcome study in humans. Nevertheless, current guidelines have become the standard for clinical practice around the world. An effort must be made to develop treatment protocols that are based upon the biological mechanisms that underlie periodontal wound healing. [References: 83] <192> UI - 98138294 AU - Bogaerts P TI - Treatment of root perforations with calcium hydroxide and SuperEBA cement: a clinical report. [Review] [31 refs] SO - International Endodontic Journal 1997 May;30(3):210-9 AB - Iatrogenic root perforations sometimes occur during root canal treatment or when preparing the root canal for a post. The inflammation in the periradicular tissues caused by root perforation reduces the prognosis of the involved tooth. The situation may be further complicated if by coronal leakage, microorganisms are allowed to infect the canal and the periradicular region. This clinical report presents a nonsurgical technique, based on the internal matrix concept, using both calcium hydroxide and SuperEBA together to repair root perforations. The author has experienced good clinical results with this perforation repair technique. [References: 31] <193> UI - 98138305 AU - Sjogren U AU - Figdor D AU - Persson S AU - Sundqvist G IN - Faculty of Odontology, Umea University, Sweden. TI - Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis [published erratum appears in Int Endod J 1998 Mar;31(2):148]. SO - International Endodontic Journal 1997 Sep;30(5):297-306 AB - This study investigated the role of infection on the prognosis of endodontic therapy by following-up teeth that had had their canals cleaned and obturated during a single appointment. The root canals of 55 single-rooted teeth with apical periodontitis were thoroughly instrumented and irrigated with sodium hypochlorite solution. Using advanced anaerobic bacteriological techniques, post-instrumentation samples were taken and the teeth were then root-filled during the same appointment. All teeth were initially infected; after instrumentation low numbers of bacteria were detected in 22 of 55 root canals. Periapical healing was followed-up for 5 years. Complete periapical healing occurred in 94% of cases that yielded a negative culture. Where the samples were positive prior to root filling, the success rate of treatment was just 68%--a statistically significant difference. Further investigation of three failures revealed the presence of Actinomyces species in each case; no other specific bacteria were implicated in failure cases. These findings emphasize the importance of completely eliminating bacteria from the root canal system before obturation. This objective cannot be reliably achieved in a one-visit treatment because it is not possible to eradicate all infection from the root canal without the support of an inter-appointment antimicrobial dressing. <194> UI - 98138306 AU - Kontakiotis EG AU - Wu MK AU - Wesselink PR IN - Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - Effect of sealer thickness on long-term sealing ability: a 2-year follow-up study. SO - International Endodontic Journal 1997 Sep;30(5):307-12 AB - Long-term sealing ability of root-canal sealer is of clinical importance. We compared the performance of five sealers and a dentine bonding agent, at thicknesses of 0.05 mm (thin layer) and 0.3 mm (thick layer), in 212 standard human root specimens, before and after storage in water for 2 years. Thick layers of Roth and Pulp Canal Sealer EWT (PCS-EWT) allowed more leakage than did thin layers (P = 0.0000, 0.0358 for Roth and PCS-EWT, respectively) whereas no significant difference was found between the thin and thick layers for AH26, Ketac-Endo, Sealapex and J&J Bonding Agent. The pooled results of the thin and thick layers, which have clinical relevance, showed that after storing the specimens in water for 2 years, AH26, Sealapex, Ketac-Endo and PCS-EWT leaked more than before storage in water (P = 0.0008, 0.0000, 0.0035, 0.0257 for AH26, Sealapex, Ketac-Endo and PCS-EWT respectively), and that J&J Bonding Agent allowed less leakage and PCS-EWT more leakage than the other four sealers (P = 0.0000). <195> UI - 98211254 AU - Gound TG IN - University of Nebraska, College of Dentistry, Lincoln 68588, USA. TI - Dens invaginatus--a pathway to pulpal pathology: a literature review. [Review] [44 refs] SO - Practical Periodontics & Aesthetic Dentistry 1997 Jun-Jul;9(5):585-94; quiz 596 AB - Dens invaginatus is the most common dental anomaly in a group of dental anomalies, related by their embryologic development and by the fact that their defects provide a potential pathway for bacteria to cause pulpal pathology. It occurs when the inner enamel epithelium invaginates into the dental papilla prior to calcification. It exists in erupted teeth as an enamel-lined tract, which either ends in a blind sac inside the crown or root or exits into the periodontal ligament. The lining may be incomplete in areas and may not protect the pulp. Methods of providing preventive treatment for teeth with dens invaginatus are described. When pulpal pathosis occurs, the dens may displace the pulp and complicate access cavity preparation and subsequent endodontic treatment, adversely affecting the prognosis. The learning objective of this article is to present treatment planning considerations and suggestions. [References: 44] <196> UI - 98156291 AU - Sundh B AU - Odman P IN - Department of Prosthetic Dentistry, Faculty of Odontology, Goteborg University, Sweden. Bo.Sundh@odontologi.gu.se TI - A study of fixed prosthodontics performed at a university clinic 18 years after insertion. SO - International Journal of Prosthodontics 1997 Nov-Dec;10(6):513-9 AB - This study obtained information on the long-term efficiency of prosthetic rehabilitation with fixed partial dentures performed by undergraduate students. From a list of discharged patients treated from 1975 to 1976 by undergraduate students at a dental school, 101 were recalled for free clinical examinations after 6, 11, and 18 years. A total of 163 fixed partial dentures were inserted. The majority (85%) of the fixed partial dentures were acrylic resin veneer-gold restorations; 15% were metal ceramic restorations. During this study period, 14 individuals died, leaving 138 fixed partial dentures to be examined. Of these, 35 (25%) were removed after a mean of 11 years in function, which left 75% in place and functioning after 18 years. The main causes for removal included caries, periodontitis, root fracture, and endodontic complications. Fewer metal ceramic restorations than acrylic resin veneer-gold restorations were removed. The removal rate for abutments with cast posts and cores was higher than the removal rate of total abutments. There was no difference in removal frequency between fixed partial dentures with moderate cantilever extensions and those with end-supported extensions. <197> UI - 98194570 AU - Cosci F AU - Cosci B TI - A 7-year retrospective study of 423 immediate implants. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1997 Sep;18(9):940-2, 944, 946 passim AB - This article reports the results of a study conducted from 1989 to 1995 of 423 hydroxyapatite-coated implants used for immediate tooth replacement after extraction in 353 patients with an age range from 15 to 68 years. The implants replaced teeth that were extracted because of periodontal disease, root fractures, and endodontic problems. Bone defects relative to the implant were treated with bone regeneration procedures using polytetrafluoroethylene (PTFE) membranes and resorbable collagen membranes with and without augmentation material (hydroxyapatite--188 cases, demineralized freeze-dried bone allograft--208 cases, and 27 cases without augmentation material). Histologic evaluation confirmed viability of the regenerated bone. The length of implants ranged from 8 mm to 18 mm, and a total of 284 PTFE and 139 collagen membranes were used. During the 1-year follow-up, 1 implant was lost and an additional implant failed during the 7-year follow-up, with a final success rate of 99.53%. <198> UI - 98195868 AU - Deutsch AS AU - Musikant BL AU - Cohen BI IN - Essential Dental Laboratories, South Hackensack, New Jersey, USA. TI - Rational predictable posthole preparation. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1997 Jun;18(6):626-30, 632 AB - Restoration of the endodontically treated tooth is a common occurrence in everyday dental practice. Unfortunately, clinical posthole preparation seems to be a random technique. Even for a prefabricated post supplied with matching drills, the task is often difficult or not straightforward. Some questions inevitably arise. How long should the posthole be? How wide should the canal be prepared? How can the proper width be maintained so that the prefabricated post does not strip in the canal and lose its retention? If it is decided to use a cast post, what is the best posthole preparation to maximize retention? Is there an easy way to avoid perforating the root while preparing the canal for the post? Clinically, how can the posthole be prepared quickly, easily, and predictably every time? These key questions must be addressed when preparing the posthole. <199> UI - 98136789 AU - Robertson A IN - Department of Pedodontics, Faculty of Odontology, Goteborg University, Sweden. TI - Pulp survival and hard tissue formation subsequent to dental trauma. A clinical and histological study of uncomplicated crown fractures and luxation injuries. SO - Swedish Dental Journal - Supplement 1997;125:1-65 AB - Traumatic injuries in children and adolescents are a common problem, and the prevalence of such injuries has increased over the last 10-20 years. The purpose of the present investigation was to evaluate long-term results following uncomplicated crown fractures and luxations involving subsequent pulp canal obliteration. A total of 198 patients with 488 injured permanent teeth were available for clinical examination (15 year follow-up), of which 102 also answered a questionnaire and were interviewed before oral examination. Further, 82 permanent incisors presenting with pulp canal obliteration (PCO) were followed for a period of 7 to 22 yr. (mean 16 yr.). The histological evaluation of luxation injuries was performed on 123 primary teeth from 98 patients. In the experimental study (crown fractures), 64 monkey permanent maxillary and mandibular central incisors and canines were subjected to different treatment alternatives at the time of fracture. The findings in the follow-up study showed very little pulpal response to crown fracture and subsequent restorative procedures as long as there was no concomitant periodontal injury. Approximately every fourth resin composite restoration was rated unacceptable at the clinical examination. The interview showed that half of the individuals were dissatisfied with the color and/or anatomic form of the composite restoration. PCO was found in all luxation categories, and according to the survival curve, the 20-year pulp survival rate diagnosed with X-ray was 84%. Although the risk for pulp necrosis (PN) increased with time, routine endodontic intervention of teeth with ongoing PCO of the root canal did not seem justified. The histological study showed that changes in dentin were represented by occlusion of the dentinal tubules and deposition of tertiary dentin. The tertiary dentin were classified as either dentin-like, bone-like or fibrotic. In the experimental study, few changes were observed in the pulp 3 months after crown fractures, irrespective of treatment alternative. <200> UI - 98127161 AU - Nedley MP AU - Powers GK IN - University of Detroit Mercy, Michigan, USA. TI - Intentional extraction and reimplantation of an immature invaginated central incisor. SO - ASDC Journal of Dentistry for Children 1997 Nov-Dec;64(6):417-20 <201> UI - 98159174 AU - Haney JM AU - Leknes KN AU - Wikesjo UM IN - Advanced Education Program in Periodontics, Loma Linda University, California, USA. TI - Recurrence of mandibular molar furcation defects following citric acid root treatment and coronally advanced flap procedures. SO - International Journal of Periodontics & Restorative Dentistry 1997 Dec;17(6):528-35 AB - This report concerns long-term (4 to 5 years) clinical evaluation of 22 resolved (complete bone closure) mandibular Class 2 furcation defects following coronally advanced flap procedures and citric acid root treatment with or without adjunctive implantation of freeze-dried, demineralized allogeneic bone. Sixteen buccal furcation sites in 12 patients were available for the follow-up evaluation. The furcation involvement was independently evaluated by a panel of three examiners, each using three furcation index systems. Oral hygiene standards, gingival health, probing depth, clinical attachment level, gingival recession, tooth vitality, and detectable caries or root resorption were also recorded. Mean attachment level at the furcation sites was 5.8 +/- 2.9 mm, compared to 4.5 +/- 2.2 mm and 3.5 +/- 1.3 mm over the prominence of the mesial and distal roots, respectively. The clinical examination further revealed that 12 out of 16 sites exhibited recurrent Class 2 furcation involvement. Of the 16 teeth examined, one had received endodontic treatment, while the remaining 15 responded within the normal range to pulp testing. One tooth had developed caries in the furcation region. No teeth demonstrated periradicular pathology. The results of this study question the long-term stability of furcation bone regeneration following coronally advanced flap procedures. <202> UI - 98131420 AU - Friedman S IN - Department of Endodontics, Faculty of Dentistry, University of Toronto. TI - Success and failure of initial endodontic therapy. [Review] [58 refs] SO - Ontario Dentist 1997 Jan-Feb;74(1):35-8 <203> UI - 98176316 AU - Saunders EM AU - Saunders WP IN - Dental School, University of Dundee. TI - The challenge of preparing the curved root canal. SO - Dental Update 1997 Jul-Aug;24(6):241-4, 246-7 AB - Heavily restored teeth which become pulpally involved are now often root canal treated rather than extracted. While this is laudable it has a significant impact on the practice of endodontics today. The curved calcified canal can prove very difficult to prepare to its natural shape by conventional techniques and there is always the likelihood of iatrogenic damage. To compensate for this many clinicians tend to under-prepare these canals, perhaps leaving them inadequately cleaned and certainly remarkably difficult to fill to length. The purpose of this article is to outline the stages of and the rationale behind a hand instrumentation preparation method which uses the balanced force method of movement of files from canal entrance to apical constriction. In the authors' experience this technique has gone a long way towards solving the problem of cleaning and shaping the fine curved canal. With some practice, but no extra expense, the technique described will not only speed up canal preparation but will also make it more predictable. <204> UI - 98145158 AU - Martin JA AU - Bader JD IN - Permanente Dental Associates, Portland, OR 97322-2099, USA. TI - Five-year treatment outcomes for teeth with large amalgams and crowns. SO - Operative Dentistry 1997 Mar-Apr;22(2):72-8 AB - For 4735 posterior complex amalgams and crowns placed in adults with continuous dental HMO coverage, all additional treatment received over the subsequent 5 years was determined. The restorations were placed under routine clinical conditions by 74 different dentists among a broad spectrum of insured dental patients. Treatment outcomes were described in terms of a hierarchical classification of additional treatments. At the extremes, a successful outcome was defined as no additional treatment or an additional one- or two-surface restoration on the same tooth, and a catastrophic outcome as extraction or endodontic treatment. Due to clinical protocols, teeth with guarded to poor prognosis prior to treatment are overrepresented in the five-surface amalgam cohort. Successful outcomes characterized 72% of four-surface amalgams, 65% of five-surface amalgams, 84% of gold crowns, and 84% of porcelain crowns. Catastrophic outcomes occurred for 10% of four-surface amalgams, 15% of five-surface amalgams, 8% of gold crowns, and 9% of porcelain crowns. <205> UI - 98138274 AU - Olson JW AU - Dent CD AU - Dominici JT AU - Lambert PM AU - Bellome J AU - Bichara J AU - Morris HF IN - Department of Veterans Affairs Medical Center, Louisville, KY 40202, USA. TI - The influence of maxillary sinus augmentation on the success of dental implants through second-stage surgery. SO - Implant Dentistry 1997 Fall;6(3):225-8 AB - An interim evaluation of the status of 102 implants placed in 42 augmented sinuses in 27 patients involved in an alternate category of the Dental Implant Clinical Research Group's long-term, randomized, prospective clinical investigation is presented. Autogeneic, allogeneic, and alloplastic sinus grafts were used, individually or mixed. Through second-stage surgery, 101 implants were found to be integrated. The mean Periotest value at uncovering was -3.36, with a standard deviation of 4.19. The results suggest that root form implants placed in augmented sinuses are successful through second-stage surgery, regardless of the augmentation material or implant design used. <206> UI - 98123508 AU - van der Vyver PJ IN - Division of Dental Materials, Faculty of Dentistry, University of Pretoria. TI - Endodontic re-treatment--indications and techniques. SO - Journal of the Dental Association of South Africa 1997 Jun;52(6):421-4 <207> UI - 98145127 AU - Peretz B AU - Yakir O AU - Fuks AB IN - Department of Pediatric Dentistry, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem, Israel. Benny@cc.huji.ac.il TI - Follow up after root canal treatment of young permanent molars. SO - Journal of Clinical Pediatric Dentistry 1997 Spring;21(3):237-40 AB - The purpose of the present study was to assess the success of root canal treatment in permanent molars of children and adolescents. Twenty-eight endodontically treated first permanent molars of 18 patients aged 8 to 16 years at the time of treatment were examined. The age of the patient at the time of treatment ranged from 8 to 16 years (mean age 12.4 +/- 2.3). The majority of the treatments were done on the mandibular teeth (67%). Nine patients had one treated molar, eight patients had two treated molars and one patient had three treated teeth. None of the patients had all four molars treated. The time elapsed from the root canal treatment until our examination ranged from 24 months to 77 months (mean time 45.1 +/- 19.1). The examination included clinical and radiological parameters as follows: sensitivity to percussion, mobility, quality of restoration (contact point reproduced, overhang, secondary caries), periapical lesions before and after treatment, external root resorption, furcation involvement and interproximal bone resorption. Treatment was considered completely successful if no pathology was found. Only 10 teeth (36%) demonstrated complete treatment success, less than previously reported. No significant differences between mandibular and maxillary teeth were found with respect to any of the variables. The results suggest that considering a number of multidisciplinary criteria for assessing success of root canal treatments in first permanent molars of children and young adolescents is essential, and provides a realistic success rate. <208> UI - 98123539 AU - Koton D IN - 10 Rosebank Medical and Dental Centre. TI - Endodontic retreatment. [Review] [39 refs] SO - Journal of the Dental Association of South Africa 1997 Jul;52(7):487-90 <209> UI - 98145095 AU - Hulsmann M IN - Department of Operative Dentistry, University of Gottingen, Germany. TI - Root canal treatment as a treatment modality for temporary tooth retention in adolescent patients. SO - Journal of Clinical Pediatric Dentistry 1997 Winter;21(2):109-15 AB - In certain cases root canal treatment may be an adequate intermediate therapy, mainly for severely traumatized teeth in adolescent patients that probably cannot be retained permanently. The treatment aims at temporary retention of otherwise hopeless teeth until definite treatment, for example insertion of bridges or dental implants, may be performed. This kind of treatment can help to avoid the application of removable prostheses in young patients. This treatment modality requires intensive information to be presented to the patients and their parents on the benefits and risks of the treatment procedures, endodontic treatment under aseptic conditions respecting the general guidelines for root canal treatment, and a strict recall regimen to avoid occurrence or increase of pathological conditions. Four cases (five teeth) of temporary tooth retention by endodontic treatment are presented. <210> UI - 98073438 AU - Abbott PV IN - School of Dentistry, University of Western Australia. TI - Lower lip paraesthesia following restoration of a second premolar tooth. Case report [see comments]. CM - Comment in: Aust Dent J 1998 Feb;43(1):59-61 SO - Australian Dental Journal 1997 Oct;42(5):297-301 AB - A forty year old female patient developed paraesthesia of the right side of her lower lip following the placement of an extensive pin-retained amalgam restoration in her lower right second premolar tooth. Radiographs indicated that the mental foramen was close to the apex of this tooth and it was assumed that postoperative pulpitis and periapical inflammation had caused the paraesthesia through the effects of pressure on the mental nerve. The paraesthesia resolved following endodontic treatment of the lower second premolar tooth and the patient has had no further signs or symptoms. <211> UI - 98093604 AU - Reisman D AU - Reader A AU - Nist R AU - Beck M AU - Weaver J IN - Ohio State University, Columbus, USA. TI - Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Dec;84(6):676-82 AB - OBJECTIVE: To determine the efficacy of a supplemental intraosseous injection of 3% mepivacaine in mandibular posterior teeth with irreversible pulpitis. Intraosseous injection pain, subjective heart rate increase, and pain ratings during endodontic treatment were also assessed. STUDY DESIGN: Forty-eight patients with irreversible pulpitis received conventional inferior alveolar nerve blocks. Electric pulp testing was used to determine pulpal anesthesia. Patients who were positive to the pulp testing, or negative to pulp testing but felt pain during endodontic treatment, received an intraosseous injection of 1.8 ml of 3% mepivacaine. A second intraosseous injection of 3% mepivacaine (1.8 ml) was given if the first injection was unsuccessful. RESULTS: Seventy-five percent of patients required an initial intraosseous injection because of failure to gain pulpal anesthesia. The inferior alveolar block was 25% successful; the first intraosseous injection increased success to 80%. A second intraosseous injection further increased success to 98%. These differences were significant (p < 0.05). Eight percent (4/48) of the initial intraosseous injections resulted in solution being expressed into the oral cavity: these were considered technique failures. CONCLUSIONS: For mandibular posterior teeth with irreversible pulpitis, a supplemental intraosseous injection of 3% mepivacaine increased anesthetic success. A second intraosseous injection, when necessary, further improved success. <212> UI - 98093605 AU - Caliskan MK AU - Turkun M IN - Department of Endodontics, Dental Faculty of Ece University, Izmir, Turkey. TI - Periapical repair and apical closure of a pulpless tooth using calcium hydroxide. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Dec;84(6):683-7 AB - A case with a wide-open apex and a large cystlike periapical lesion in an adult is presented. The lesion formed as a result of necrosis from trauma to a maxillary central incisor 12 years ago. After nonsurgical endodontic treatment with calcium hydroxide paste and a calcium hydroxide-containing root canal sealer, apical closure and significant healing of the periapical lesion within 15 months were observed. This report suggests that even large periapical lesions (likely cystic) could respond favorably to nonsurgical treatment. <213> UI - 98030654 AU - Sheehy EC AU - Roberts GJ IN - Department of Paediatric Dentistry & Orthodontics, UMDS, Guy's Dental Hospital, London. TI - Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. [Review] [46 refs] SO - British Dental Journal 1997 Oct 11;183(7):241-6 AB - OBJECTIVE: To review the use of calcium hydroxide for induction of apical barrier formation and healing in immature permanent teeth. INTRODUCTION: Pulp necrosis is a frequent complication of dental trauma in immature permanent teeth. Endodontic treatment of these teeth is often complicated. The walls of the root canals are frequently divergent and the apices immature, making debridement and obturation difficult. The aim of treatment is induction of apical healing which may be defined as apical closure through formation of mineralised tissue and repair of the periapical tissues. Calcium hydroxide is the material of choice for apical barrier formation and healing. RESULTS: The use of calcium hydroxide for apical barrier formation is successful in 74-100% of cases irrespective of the proprietary brand used. The average length of time for apical barrier formation is approximately 5 to 20 months. Control of infection and adequate cleaning of the root canal are very important for apical healing. CONCLUSIONS: While the success rate of apical barrier formation using calcium hydroxide is high, long-term follow-up of these teeth is necessary. Problems such as failure to control infection, recurrence of infection and cervical root fracture may occur. The latter is more frequent in immature luxated teeth with the least root development. [References: 46] <214> UI - 98027412 AU - Tokes L AU - Juhasz A AU - Dobo Nagy C IN - Debreceni Orvostudomanyi Egyetem, Stomatologiai Klinika, Debrecen. TI - [Comparative microleakage study of two root canal sealants: calcium hydroxide and zinc oxide eugenol]. [Hungarian] SO - Fogorvosi Szemle 1997 Oct;90(10):301-6 AB - A quantitative longitudinal study was carried out to compare the amount of microleakage using two different types of root canal sealers on straight and curved root canals. Microleakage was measured just after the setting of the sealer, one month and three months after that using fluid transport model. One month follow up results showed that in straight root canals both the ZOE containing Pulp Canal Sealer and the calciumhydroxide containing Sealapex sealers produced similar microleakage values to that values measured just after the setting of materials. One month follow up measurement resulted higher values in curved canals comparing to the straight ones in case of both the tested materials. Three months follow up measurement demonstrated worse results in the Sealapex groups than the Pulp Canal Sealer groups. With loglinear statistical analysis the following interactions were proved between variables: root canal form/microleakage, root canal form/time laps, and material/microleakage/time laps. Results of the present study are in good agreement with conclusions of recently published other studies, namely calciumhydroxide containing sealers resulted in higher microleakages than ZOE containing sealers. <215> UI - 98002963 AU - Walton RE IN - Department of Endodontics, University of Iowa College of Dentistry, Iowa City 52242, USA. TI - Endodontic considerations in the geriatric patient. [Review] [43 refs] SO - Dental Clinics of North America 1997 Oct;41(4):795-816 AB - Endodontic needs of today's and tomorrow's growing older adult population present increasing challenges for dental care providers. Biologic and anatomic differences in the dental tissues between older and younger patients must be understood and considered in treatment planning and performance for appropriate endodontic procedures. These differences generally do not contraindicate treatment, which, when performed correctly, will be successful in the elderly patient. [References: 43] <216> UI - 97469208 AU - Filippi A AU - Pohl Y AU - Kirschner H IN - Department of Oral Surgery, Justus-Liebig-University, Giessen, Germany. TI - Replantation of avulsed primary anterior teeth: treatment and limitations. SO - ASDC Journal of Dentistry for Children 1997 Jul-Aug;64(4):272-5 AB - In addition to the successful replantation of avulsed permanent teeth, the replantation of primary anterior teeth may also be indicated. The decision is based on age and stage of tooth development, development of dentition, storage of the avulsed tooth and the way it is transported to the treatment site, the appropriate in vitro treatment of the tooth before reinsertion, and the willingness of the child to cooperate. A method involving retrograde filling of the primary tooth root with calcium hydroxide after resecting the root apex has proved successful. Other commercially available root filling materials and pins are not indicated. Calcium hydroxide allows the tooth to heal in place without reaction and prevents the development of apical periodontitis. As regards any surgical intervention, the attending dentist in this case has to weigh the benefits against the risks. <217> UI - 98004981 AU - Waldman BJ AU - Mont MA AU - Hungerford DS IN - Department of Orthopaedic Surgery, Good Samaritan Hospital, Johns Hopkins University School of Medicine, Baltimore, MD 21239, USA. TI - Total knee arthroplasty infections associated with dental procedures [see comments]. CM - Comment in: Clin Orthop 1998 Sep;(354):253-4 SO - Clinical Orthopaedics & Related Research 1997 Oct;(343):164-72 AB - Total knee arthroplasties are at risk for hematogenous seeding secondary to procedures that create a transient bacteremia. To define the risk of infection associated with dental surgery, a retrospective review of the records of 3490 patients treated with total knee arthroplasty by the authors between 1982 and 1993 was performed. Sixty-two total knee arthroplasties with late infections (greater than 6 months after their procedure) were identified, and of these, seven infections were associated strongly with a dental procedure temporally and bacteriologically. These seven cases represented 11% of the identified infections or 0.2% of the total knee arthroplasty procedures performed during this period. In addition, among 12 patients referred for infected total knee arthroplasties from outside institutions, two infections were associated with a dental procedure. Five of the nine (56%) patients had systemic risk factors that predisposed them to infection, including diabetes and rheumatoid arthritis. All dental procedures were extensive in nature (average, 115 minutes; range, 75-205 minutes). Eight of the patients received no antibiotic prophylaxis. One patient had only one preoperative dose. Infections associated with dental procedures may be more common than previously suspected. Eight of these patients had no prophylactic antibiotics, and one had inadequate coverage. The authors think that patients with a total knee arthroplasty who have systemic disease that compromises host defense mechanisms against infections and who undergo extensive dental procedures should receive prophylactic antibiotics. A first generation cephalosporin, given 1 hour preoperatively and 8 hours postoperatively would provide the best prophylaxis against the organisms identified in this study. <218> UI - 97443049 AU - Kumamoto DP AU - Winters J AU - Novickas D AU - Mesa K IN - Department of Restorative Dentistry, University of Illinois at Chicago, College of Dentistry 60612-7212, USA. TI - Tooth avulsions resulting from basketball net entanglement. SO - Journal of the American Dental Association 1997 Sep;128(9):1273-5 AB - The authors conducted a survey of dentists reporting tooth avulsions from basketball net accidents. Although the number of people injured was small, the dental injuries were serious. In many cases, multiple teeth were avulsed as a result of the maxillary anterior teeth becoming entangled in the basketball net while the patients were attempting to slamdunk a basketball either on a lowered backboard or from a raised take-off area. The authors present recommendations for preventing tooth avulsions resulting from basketball net entanglement. <219> UI - 97460230 AU - Briggs PF AU - Scott BJ IN - Department of Restorative Dentistry, King's Dental Institute, London. TI - Evidence-based dentistry: endodontic failure--how should it be managed?. [Review] [24 refs] SO - British Dental Journal 1997 Sep 13;183(5):159-64 AB - OBJECTIVE: To review the evidence on the most appropriate management of failed endodontic treatment. DATA SOURCES: Appropriate articles were selected from the international literature. RESULTS: There was good evidence that conventional endodontic treatment is associated with a successful outcome in a significant proportion of cases. The results of surgical treatment are more difficult to interpret since account should be made of the status of the existing root filling. However, there is evidence of an increased success rate with a satisfactory orthograde root filling. CONCLUSIONS: It is difficult to make direct comparisons from cited studies to advance a clear argument in support of one treatment modality. However, it is judged that a conventional endodontic retreatment approach is the most appropriate in the first instance, providing access to the root canal is possible. This does not preclude a subsequent surgical approach. Teeth that are permanently restored soon after retreatment are more successful than those which are not. There are significant challenges in setting up prospective research studies to directly address the problem of the failed root filing. [References: 24] <220> UI - 97403265 AU - Vergauwen S AU - Parizel PM AU - van Breusegem L AU - Van Goethem JW AU - Nackaerts Y AU - Van den Hauwe L AU - De Schepper AM IN - Department of Radiology, Antwerp University Hospital, Edegem, Belgium. TI - Distribution and incidence of degenerative spine changes in patients with a lumbo-sacral transitional vertebra. SO - European Spine Journal 1997;6(3):168-72 AB - The purpose of this prospective study was to determine the overall incidence and distribution of lumbo-sacral degenerative changes (i.e. disc protrusion or extrusion, facet degeneration, disc degeneration, nerve root canal stenosis and spinal stenosis) in patients with and without a lumbo-sacral transitional vertebra (LSTV). The study population consisted of 350 sequential patients with low back pain and/or sciatica, referred for medical imaging. In all cases CT scans of the lumbo-sacral region were obtained. In 53 subjects (15%) and LSTV was found. There was no difference in overall incidence of degenerative spine changes between the two groups. We did find, however, a different distribution pattern of degenerative changes between patients with and those without an LSTV. Disc protrusion and/or extrusion occurred more often at the level suprajacent to the LSTV than at the same level in patients without LSTV (45.3% vs 30.3%). This was also the case for disc degeneration (52.8% vs 28%), facet degeneration (60.4% vs 42.6%) and nerve root canal stenosis (52.8% vs 27.9%). For spinal canal stenosis there was no statistically significant difference between the two categories. In conclusion, our findings indicate that an LSTV does not in itself constitute a risk factor for degenerative spine changes, but when degeneration occurs, it is more likely to be found at the disc level above the LSTV. <221> UI - 97375168 AU - Martin MV AU - Butterworth ML AU - Longman LP IN - Department of Clinical Dental Sciences, University of Liverpool. TI - Infective endocarditis and the dental practitioner: a review of 53 cases involving litigation. SO - British Dental Journal 1997 Jun 28;182(12):465-8 AB - OBJECTIVE: To review episodes of infective endocarditis involving dental procedures that have resulted in litigation and to determine if any clinical recommendations can be obtained. DESIGN: 13-year retrospective study. INTERVENTION: Patient records were analysed to identify the probable cause of infective endocarditis. All were judged to be caused by dental manipulations on the basis of dental procedure, cardiac pathology, infecting micro-organism and time between onset of infection and dental manipulation. MAIN OUTCOME MEASURES: Cases were analysed to check if appropriate national guidelines on antibiotic prophylaxis were followed. Status of patient dental records was also evaluated. RESULTS: Dental procedures implicated in infective endocarditis were exodontia (23), scaling (21), root canal therapy with extra-canal instrumentation (7) and minor oral surgery (2). No medical history was recorded in 10 patients. In a further 31 medical history was inadequate or out of date. Dentists involved with these cases failed to give prophylactic antibiotics (48), prescribed incorrect antibiotics (2), or gave antibiotics at inappropriate times (2). There was one episode of prophylaxis with amoxycillin failing despite it being given correctly. CONCLUSIONS: If litigation is to be avoided dental practitioners must keep accurate dental records, take an appropriate medical history that is kept up to date and adhere to national guidelines on antibiotic prophylaxis. <222> UI - 97391940 AU - Saunders WP AU - Saunders EM IN - University of Glasgow Dental School, United Kingdom. TI - Conventional endodontics and the operating microscope. SO - Dental Clinics of North America 1997 Jul;41(3):415-28 AB - Patients are increasingly wishing to undergo conventional endodontic treatment rather than to risk the loss of a tooth. Endodontic treatment in teeth that have been previously restored with extensive intracoronal or extracoronal restorations are often difficult to treat. The orientation of the root canals to the crown of the tooth may be lost, and this may often be compounded by the deposition of reparative dentin in the pulp chamber. The operating microscope allows better visualization of the working field, ensuring that the anatomy of the tooth is more readily inspected. This greatly enhances the clinician's ability to locate extra root canals and therefore increase the likelihood of a successful outcome. It should not be forgotten that the operating microscope also has a place in other fields of dentistry, especially restorative dentistry, and is an asset to both the specialist and the generalist. <223> UI - 97391941 AU - Ruddle CJ IN - Loma Linda University, California, USA. TI - Micro-endodontic nonsurgical retreatment. SO - Dental Clinics of North America 1997 Jul;41(3):429-54 AB - Clinicians frequently encounter endodontically treated teeth that are failing. The vast majority of these cases can be predictably retreated nonsurgically. Integration of specific technology, coupled with breakthrough techniques, are described and powerfully demonstrated. This article is designed for the dental team whose vision is to preserve strategic teeth and create endodontic excellence for its patients. <224> UI - 97391942 AU - Wong R AU - Cho F IN - Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA. TI - Microscopic management of procedural errors. SO - Dental Clinics of North America 1997 Jul;41(3):455-79 AB - This article provides the clinician with several methods of dealing with furcation and post perforation as well as separated instruments. The endodontist must first understand how to eliminate procedural accidents that can occur, then, accurately and predictably treat those teeth to which accidents have occurred. Techniques to repair furcation and post perforations and retrieval of fractured root canal instruments are presented. An in-depth description of each technique has been included. Lastly, clinicians must be cognizant of limitations in treating these difficult problems that will arise in dental practice. Active patient participation and communication must be maintained during the scope of treatment to provide patients with the highest quality of endodontic service possible. A challenging variety of problems present to even the most skilled dental practitioner over time. The ability to diagnose and treat these difficult conditions relies heavily on the ability to envision adequately the source of the problem. In the past, operating loupes and headlamps were the most effective option afforded to practitioners as a solution to magnification and illumination. Not only were these devices cumbersome to use, but also the dentist was limited to performing the entire procedure under one level of magnification. The advantages of using the microscope in the correction of procedural errors enhances the operator's ability to perform each step in a procedure with a heightened sense of knowledge. The practitioner is cognizant of the exact details of an iatrogenic development because he or she has visualized the area in great detail. The reconstruction of the tooth or removal of instruments can be carried out with confidence because the dentist has more control of the working environment than ever before. New restorative materials and instruments are available so deliberate precision can be implemented with the microscope's ability to illuminate and magnify the working field. In time, these improvements in technology and techniques will result in greater confidence and success in the prevention and treatment of procedural errors. <225> UI - 97391944 AU - Kim S AU - Rethnam S IN - Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA. TI - Hemostasis in endodontic microsurgery. SO - Dental Clinics of North America 1997 Jul;41(3):499-511 AB - There are numerous ways to achieve hemostasis. With the abundance of hemostatic agents available and with the introduction of new products, one has to make an objective decision. A good agent achieves hemostasis within a short period of time, is easy to manipulate, is biocompatible, does not impair or retard healing, must be relatively inexpensive, is reliable, and works best for the particular surgical procedure. With these purposes in mind, the following sequence is recommended to achieve hemostasis during endodontic microsurgery. I. Presurgical: Give 2 to 3 Carpules of 1:50,000 epinephrine local anesthetic with multiple infiltration sites throughout the entire surgical field. II. Surgical: A. Remove all granulation tissue. B. Place an epinephrine pellet into the bony crypt followed by dry sterile cotton pellets. Apply pressure for 2 minutes. Remove all the cotton pellets except the first epinephrine pellet. Continue with the surgical procedure and remove the epinephrine pellet before final irrigation and closure. C. Alternatively, calcium sulfate can be mixed into a thick putty and packed against the bone cavity. Because it is a biodegradable material, calcium sulfate can be left in situ. In fact, in large bone defects and through-and-through lesions, additional calcium sulfate can be placed to fill the entire bone cavity as a barrier material. Healing is more predictable with little chance of scar tissue formation. Calcium sulfate resorbs in 2 to 4 weeks. D. Small bleeding sites in the bone can be brushed with ferric sulfate solution. III. Postsurgical: Tissue compression before and after suturing cuts down on postsurgical bleeding and swelling. Hemostasis is imperative in endodontic microsurgery for better visualization, a good environment for placement of retrograde filling material, and a more efficient surgical procedure with less blood loss. <226> UI - 97391946 AU - Hsu YY AU - Kim S IN - Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA. TI - The resected root surface. The issue of canal isthmuses. [Review] [30 refs] SO - Dental Clinics of North America 1997 Jul;41(3):529-40 AB - Incomplete debridement of the canal isthmus is responsible for some surgical and nonsurgical endodontic failures. This article reviews the formation of canals isthmus and the new classification system. Recent research findings regarding the incidence of isthmus at different root end levels are included. [References: 30] <227> UI - 97391947 AU - Carr GB IN - Pacific Endodontic Research Foundation, San Diego, California, USA. TI - Ultrasonic root end preparation. SO - Dental Clinics of North America 1997 Jul;41(3):541-54 AB - Root end preparation techniques have historically been approached from the perspective of the restorative dentist. This article discusses how Black's principles for cavity design and preparation have been modified to reflect the advances in bonding chemistry. <228> UI - 97391949 AU - Watzek G AU - Bernhart T AU - Ulm C IN - Department of Oral Surgery, Dental School of the University of Vienna, Austria. TI - Complications of sinus perforations and their management in endodontics. SO - Dental Clinics of North America 1997 Jul;41(3):563-83 AB - The intimate position of the maxillary sinus to the apices of teeth creates problems if periapical inflammation occurs. This can lead to a perforation into the sinus and cause sinusitis. Persistent and complicated situations that do not respond after nonsurgical root canal treatment demand a suitable surgical therapy. Knowledge of the specific anatomic conditions, an adequate diagnosis, and an appropriate surgical procedure facilitate success rates that are comparable with those obtained in other regions, even in unfavorable initial conditions. <229> UI - 97391950 AU - Pecora G AU - Baek SH AU - Rethnam S AU - Kim S IN - Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA. TI - Barrier membrane techniques in endodontic microsurgery. [Review] [32 refs] SO - Dental Clinics of North America 1997 Jul;41(3):585-602 AB - The ultimate goal in endodontic microsurgery is the predictable regeneration of periapical tissues. One of the main concerns in treating an endodontically treated tooth which has a through-and-through osseous defect is that incomplete bone healing may be inevitable. This article reviews the use of different barrier membranes for bone regeneration. In addition, the indications, techniques, and prognosis of calcium sulfate in guided bone regeneration are presented. [References: 32] <230> UI - 97391951 AU - Kratchman S IN - Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA. TI - Intentional replantation. SO - Dental Clinics of North America 1997 Jul;41(3):603-17 AB - A list of what was once advocated when performing a replantation versus what is done now follows: 1. It used to be advocated always to curettage the socket after removing the tooth. Now clinicians know not to touch the walls of the socket and only to aspirate gently the apical region if needed. 2. After removal, the tooth used to be held in gauze, desiccating viable PDL cells. Now the tooth is kept bathed in an emesis basin filled with HBSS, which maintains the viability of the PDL for 30 minutes. 3. All clinicians were able to do was visual inspection; now the microscope is used to illuminate and magnify the working area. 4. Splinting was done on every case; now clinicians rarely splint after replantation. 5. Narcotic pain medication was prescribed routinely; now clinicians premedicate with chlorhexidine rinse, anti-inflammatory medication, and sometimes antibiotics, rarely using narcotics. With increased understanding of the periodontium and improved techniques, replantation should no longer be viewed as a treatment of last resort, but rather a successful treatment alternative. <231> UI - 97391952 AU - Koch K IN - School of Dental Medicine, Harvard University, Boston, Massachusetts, USA. TI - The microscope. Its effect on your practice. SO - Dental Clinics of North America 1997 Jul;41(3):619-26 AB - A number of different areas in which the microscope can help you and your practice have been covered. The bottom-line success depends on you and your commitment. If you make an honest, sincere effort, you will find yourself rejuvenated, and your practice will become more successful and endodontics more enjoyable. <232> UI - 97385910 AU - Walsh LJ IN - Department of Dentistry, University of Queensland Dental School. TI - Serious complications of endodontic infections: some cautionary tales. [Review] [32 refs] SO - Australian Dental Journal 1997 Jun;42(3):156-9 AB - While endodontic (dentoalveolar) abscesses can cause significant morbidity, in susceptible individuals they can pose life-threatening problems. This paper provides an overview of the more serious sequelae of endodontic abscesses, and provides examples of 'high risk' situations in practice in which these serious complications are more likely to occur. [References: 32] <233> UI - 97364511 AU - Sumi Y AU - Hattori H AU - Hayashi K AU - Ueda M IN - Division of Dental and Oral Surgery, Komaki-City Hospital, Japan. TI - Titanium-inlay--a new root-end filling material. SO - Journal of Endodontics 1997 Feb;23(2):121-3 AB - To obtain better results following periradicular surgery, we have developed a Titanium-Inlay with SuperEBA cement as a sealer as a new root-end filling material. This was combined with an ultrasonic root-end preparation technique. The preliminary results suggest that the surgical method we adopted is simple and the results are predictable. The material and technique are presented in this article. <234> UI - 97364503 AU - Pruett JP AU - Clement DJ AU - Carnes DL Jr IN - Department of Endodontics/Dental School, University of Texas Health Science Center, San Antonio 78284-7898, USA. TI - Cyclic fatigue testing of nickel-titanium endodontic instruments. SO - Journal of Endodontics 1997 Feb;23(2):77-85 AB - Cyclic fatigue of nickel-titanium, engine-driven instruments was studied by determining the effect of canal curvature and operating speed on the breakage of Lightspeed instruments. A new method of canal curvature evaluation that addressed both angle and abruptness of curvature was introduced. Canal curvature was simulated by constructing six curved stainless-steel guide tubes with angles of curvature of 30, 45, or 60 degrees, and radii of curvature of 2 or 5 mm. Size :30 and :40 Light-speed instruments were placed through the guide tubes and the heads secured in the collet of a Mangtrol Dynamometer. A simulated operating load of 10 g-cm was applied. Instruments were able to rotate freely in the test apparatus at speeds of 750, 1300, or 2000 rpm until separation occurred. Cycles to failure were determined. Cycles to failure were not affected by rpm. Instruments did not separate at the head, but rather at the point of maximum flexure of the shaft, corresponding to the midpoint of curvature within the guide tube. The instruments with larger diameter shafts, :40, failed after significantly fewer cycles than did :30 instruments under identical test conditions. Multivariable analysis of variance indicated that cycles to failure significantly decreased as the radius of curvature decreased from 5 mm to 2 mm and as the angle of curvature increased greater than 30 degrees (p < 0.05, power = 0.9). Scanning electron microscopic evaluation revealed ductile fracture as the fatigue failure mode. These results indicate that, for nickel-titanium, engine-driven rotary instruments, the radius of curvature, angle of curvature, and instrument size are more important than operating speed for predicting separation. This study supports engineering concepts of cyclic fatigue failure and suggests that standardized fatigue tests of nickel-titanium rotary instruments should include dynamic operation in a flexed state. The results also suggest that the effect of the radius of curvature as an independent variable should be considered when evaluating studies of root canal instrumentation. <235> UI - 97347777 AU - Arutiunov SD TI - [The principles of designing stump pin inserts in pathological tooth abrasion]. [Russian] SO - Stomatologiia 1997;76(3):51-4 AB - A total of 278 patients aged 40 to 67 with pathological abrasion of hard dental tissues were treated. Decreased occlusion height was diagnosed in 152 (54.67%) of these. In 146 patients abutment teeth under permanent dentures were fixed with cast stump pin insertions. Complications occurred in 9.6% cases: perforation of the wall of the root canal (1.14%), failure of cementing (3.98%), fracture of the root (1.14%), breaking of a fragment of the root at the neck of the tooth (2.84%), and inflammations of the marginal periodontium (0.57%). In order to prevent these complications and improve the fixation of cast stump pin insertion, we used our modifications of cast stump pin insertions (n = 394) for anterior and lateral teeth. The incidence of complications decreased more than 5 times. Follow-up of 2 to 8 years showed 1.78% of complications. <236> UI - 97391148 AU - Morgan LA AU - Baumgartner JC IN - Department of Endodontology, Oregon Health Sciences University, Portland, USA. TI - Demineralization of resected root-ends with methylene blue dye. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Jul;84(1):74-8 AB - OBJECTIVES: This study evaluated the ability of methylene blue solutions of different concentration, pH, and time exposure to remove the smear layer from resected root-ends. STUDY DESIGN: Resected root-ends were treated with either 2% methylene blue dye for intervals of 5 to 11 minutes or 1% methylene blue for 7 to 9 minutes and examined with a scanning electron microscope for smear layer removal. Two minute applications of saline solution and 50% citric acid served as controls. RESULTS: All methylene blue solutions were found to be ineffective in removing the smear layer at all time intervals tested. An experimental solution of 1% methylene blue in 50% citric acid was found to predictably remove the smear layer during a 2 minute application and retained all the favorable staining characteristics of the dye. Fifty percent citric acid solutions applied for 3 minutes appeared to overdemineralize the root-end and gave poorer results than 2 minute applications. CONCLUSIONS: Smear layer removal was pH dependent. Methylene blue solutions are clinically unsuitable for smear layer removal. <237> UI - 97369943 AU - Chen SY AU - Wang HL AU - Glickman GN IN - Department of Dentistry, Cathay General Hospital, Taipei, Taiwan, ROC. TI - The influence of endodontic treatment upon periodontal wound healing. [Review] [98 refs] SO - Journal of Clinical Periodontology 1997 Jul;24(7):449-56 AB - The interrelationship between periodontal and endodontic disease has aroused much speculation, confusion, and controversy. Pulpal and periodontal problems are responsible for more than 50% of tooth mortality today. Diagnosis is often difficult since these diseases have been studied primarily as separate entities. The toxic substances of the pulp may initiate periodontal defects through canal ramifications and patent dentinal tubules, thus impairing wound healing in regenerative procedures. Although no studies exist addressing the direct effect of pulpal infection on the outcome of guided tissue regeneration (GTR) procedures, several studies do indicate that pulpal status may play a significant role toward the end results of GTR. This review article discusses the potential influence of endodontic treatment on the long-term outcomes of GTR. Potential pathways between the pulp and periodontal ligament, which may be responsible for the failure of the regeneration of new periodontal attachment apparatus, are explored. Examination and review of the clinical and research findings in the literature relating to perio-endo lesions are made to demonstrate that a negative influence may exist between GTR outcomes and the status of the pulp. [References: 98] <238> UI - 97339066 AU - Cohen AS AU - Jacobsen EL AU - BeGole EA IN - University of the Pacific, School of Dentistry, San Francisco, Calif., USA. TI - National survey of endodontists and selected patient samples: infectious diseases and attitudes toward infection control. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Jun;83(6):696-702 AB - A survey was conducted of 591 patients from endodontic practices located in six large municipalities in the United States. A comparison was made between the self-reported incidence of transmissible diseases from patients medical histories to national statistics for the incidence of hepatitis B, herpes, tuberculosis, and HIV/AIDS. A national survey of 422 endodontists was also conducted. This survey was used to determine the beliefs and attitudes of practicing endodontists toward infection control techniques and infectious diseases. Compared with previous surveys, a trend toward increasing use of the hepatitis B vaccine, gloves, and greater acceptance of medically compromised patients was found. <239> UI - 97339068 AU - Green TL AU - Walton RE AU - Taylor JK AU - Merrell P IN - University of Iowa, Iowa City, USA. TI - Radiographic and histologic periapical findings of root canal treated teeth in cadaver. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Jun;83(6):707-11 AB - The success of root canal treatment can be subjectively evaluated both clinically and radiographically. Normally, the recall radiograph is the main factor in evaluating success or failure. OBJECTIVES: This study evaluated periapical areas of root canal treated teeth by correlating radiographic and histologic findings. STUDY DESIGN: Jaws were resected from cadavers and radiographed. Those teeth that had received root canal treatment were evaluated for success or failure based on radiographic criteria. Teeth and surrounding bone were then removed en bloc and prepared for light microscopy. Untreated teeth without periapical pathosis were examined as controls. RESULTS: Root canal treated teeth classified as failures were found to consistently have inflammatory resorptive lesions at the periapices. In contrast, those treated teeth classified as radiographically successful showed varying reactions ranging from normal uninflamed to mildly inflamed. CONCLUSIONS: Those classified as failure showed consistent inflammation. However, the majority of our examined treated teeth were radiographically normal and exhibited no periapical inflammation. <240> UI - 97328855 AU - Saunders WP AU - Saunders EM AU - Sadiq J AU - Cruickshank E IN - University of Glasgow Dental School, United Kingdom. TI - Technical standard of root canal treatment in an adult Scottish sub-population. SO - British Dental Journal 1997 May 24;182(10):382-6 AB - OBJECTIVE: To examine the periapical status, technical standard and frequency of root canal treatment in an adult population in Scotland. DESIGN: Examination of full-mouth periapical radiographs from 340 consecutive adult patients (8420 teeth) attending Glasgow and Dundee Dental Hospitals for clinical examination. METHODS: Position and quality of the root fillings were assessed together with signs of periradicular radiolucencies. The influence of the type of coronal restoration was also assessed. MAIN OUTCOME MEASURES: Pathologies associated with impacted third molars and outcomes following surgical removal of third molars. RESULTS: 54% of the patient sample had root filled teeth. 5.6% of the teeth examined radiographically had root fillings, and of these, 58.1% had radiographic signs of periapical disease. 41% of the patients had at least one non-root canal treated tooth with periapical disease. 77% of teeth with post-retained crowns had evidence of periapical pathology. CONCLUSIONS: Root fillings judged to be adequate radiographically had a reduced incidence of radiolucencies. Teeth obturated beyond the apex had more radiolucencies than those obturated flush with or within 2 mm of the radiographic apex. A high proportion of post-retained crowns were associated with periapical pathology. There is a substantial future need both for root canal treatment and for standardised treatment methods. <241> UI - 97350700 AU - Sussman HI IN - Department of Periodontics, New York University College of Dentistry, NY 10010, USA. TI - Implant pathology associated with loss of periapical seal of adjacent tooth: clinical report. SO - Implant Dentistry 1997 Spring;6(1):33-7 AB - A mandibular cuspid adjacent to two implants placed in the incisor region redeveloped periapical pathosis as a result of the inadvertent removal of the gutta-percha seal during post preparation. The root end inflammatory process communicated with the surface of an adjacent implant, resulting in endodontic-implant pathosis and subsequent removal of the implant. The osteotomy site healed uneventfully and almost complete osseous repair was observed after five months. <242> UI - 97350686 AU - Harlamb SC AU - Messer HH IN - Department of Endodontics, School of Dental Science, University of Melbourne, Australia. TI - Endodontic management of a rare combination (intrusion and avulsion) of dental trauma. SO - Endodontics & Dental Traumatology 1997 Feb;13(1):42-6 AB - Combined trauma involving intrusive luxation of one tooth and avulsion of another is rare. A case is presented involving the endodontic management of two traumatised maxillary central incisors, one of which was intrusively luxated and the other avulsed. Spontaneous re-eruption of the intruded tooth occurred, thereby avoiding the need to further traumatise the periodontal ligament with either orthodontic or surgical repositioning, and allowing endodontic therapy to be carried out uneventfully. Endodontic therapy of the avulsed tooth was completed and its prognosis is considered good. <243> UI - 97289122 AU - Mayer T AU - Basdra EK IN - Department of Restorative Dentistry, Ruprecht-Karls-University Heidelberg, Germany. TI - A combined surgical and orthodontic treatment of Class III furcations. Report of a case. SO - Journal of Clinical Periodontology 1997 Apr;24(4):233-6 AB - Oral hygiene in furcation defects of upper molars is difficult to achieve. In this case report, a combined surgical and orthodontic treatment procedure is presented to facilitate access and plaque control in furcation areas of upper molars with class-III furcation defects. After endodontic treatment and root resection in an upper 1st molar, the remaining mesiobuccal and palatal roots were separated and aligned orthodontically within the dental arch, as one-rooted teeth. The new morphological position of the roots greatly facilitated oral hygiene and may offer a better long-term prognosis. <244> UI - 97314492 AU - Hepworth MJ AU - Friedman S IN - Faculty of dentistry, University of Toronto, ON. TI - Treatment outcome of surgical and non-surgical management of endodontic failures. [Review] [30 refs] SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1997 May;63(5):364-71 AB - The principal modalities available to manage endodontic treatment failures are orthograde retreatment and apical surgery. Both modalities have specific advantages, clinical implications, and risks, and their selection involves a complex decision-making process. A review of the literature pertaining to the treatment outcome of each modality was undertaken to establish an objective reference for practitioners involved in the management of endodontic treatment failures. Based on a weighted average calculation of the results reported in the reviewed studies, the orthograde retreatment of teeth associated with apical periodontitis results in a success rate of 66 per cent, an uncertain healing rate of 11 per cent, and a failure rate of 23 per cent. Apical surgery results in a success rate of 59 per cent, an uncertain healing rate of 22 per cent, and a failure rate of 19 per cent. These figures are discussed with reference to the characteristics of the reviewed studies. It appears that many of the reviewed studies have lesser relevance today, due to the current technical improvements in both treatment and modalities. [References: 30] <245> UI - 97272681 AU - Dowker SE AU - Davis GR AU - Elliott JC IN - Royal London School of Medicine and Dentistry, U.K. s.e.p.dowker@mds.qmw.ac.uk TI - X-ray microtomography: nondestructive three-dimensional imaging for in vitro endodontic studies. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Apr;83(4):510-6 AB - Article shows the application of a laboratory x-ray microtomography system, a miniaturized form of conventional computerized axial tomography, to the study of root canal morphologic characteristics and changes in the course of root canal treatment in extracted teeth. After reconstruction of the three-dimensional images, the IDL software package (Research Systems, Inc., Colorado) was used to obtain cross-sectional slices of the tooth and three-dimensional views of rendered surfaces of constant mineral density. The root canal systems and changes in these were imaged at a resolution (cubic voxel side-length) of approximately 40 microns. <246> UI - 97258994 AU - Valderhaug J AU - Jokstad A AU - Ambjornsen E AU - Norheim PW IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, Dental Faculty, University of Oslo, Norway. TI - Assessment of the periapical and clinical status of crowned teeth over 25 years. SO - Journal of Dentistry 1997 Mar;25(2):97-105 AB - OBJECTIVES: The purpose of this study was to examine radiographically changes in the periapical status and compare the clinical status of teeth with a vital pulp and root-filled teeth restored with crowns and bridge retainers during 25 years. METHODS: During 1967/68, 114 patients received prosthodontic treatment by senior dental students at the Oslo Dental Faculty. In all, 291 teeth with a vital pulp and 106 root-filled teeth were restored with 158 prostheses. All root-filled teeth were restored with a cast dowel and core. The casts were made in a type-3 gold alloy, and cemented with zinc phosphate cement. Forty-six teeth were restored with crowns and 351 teeth with bridge retainers. Radiographs were taken preoperatively, immediately after cementation, and every fifth year. Two independent observers assessed the periapical status on the radiographs according to the PAI-index. At the 25 years examination, 32 patients (28%) with 101 restored teeth (24%) remained in the study. Survival rates of the prostheses and of the restored teeth were estimated using Kaplan-Meyer non-parametric statistics. RESULTS: The PAI-score of the periapical status deteriorated in 13 vital and four root-filled teeth. The survival rates of the fixed prostheses were not influenced by the pulp vitality of the restored tooth at the baseline. The survival rates of the restored teeth with a vital pulp and of the root-filled teeth were similar. Clinical failures were recorded on approximately one-third of the restored teeth. The main reason for tooth failure was caries (12%), and for the teeth with a vital pulp also pulpal deterioration (10%). Estimates of the proportions of crowned teeth with a vital pulp that will remain free from signs and symptoms of pulpal deterioration were 98% after five years, 92% after 10 years, 87% after 20 years and 83% after 25 years. CONCLUSIONS: The incidence of periapical lesions on radiographs of crowned teeth was low during 25 years observation. Crowned, root-filled teeth with a high quality endodontic treatment and an optimal morphology of the dowel and core have a similar survival rate as crowned teeth with a vital pulp. A high proportion of crowned teeth with a vital pulp will remain free from signs and symptoms of pulpal deterioration over 25 years. <247> UI - 97257125 AU - Hempton T AU - Leone C IN - Department of Periodontology, Tufts University School of Dental Medicine, Boston, Mass, USA. TI - A review of root resective therapy as a treatment option for maxillary molars. [Review] [30 refs] SO - Journal of the American Dental Association 1997 Apr;128(4):449-55 AB - Restorative treatment planning is often confounded when periodontal attachment loss, caries or tooth fracture involves the furcation area of the tri-rooted maxillary molars. Although such involvement invariably diminishes the long-term prognosis of the affected teeth, extraction is not always an option. Root resective therapy, which removes the involved root plus its associated crown portion (trisection), is one of several treatment modalities that can be used in such cases. This article reviews the indications and contraindications for root resective therapy, describes the techniques of surgical trisection and presents a case in which combined resective, endodontic and prosthetic management resulted in a successful outcome. [References: 30] <248> UI - 97237095 AU - Peltola JS AU - Wolf J AU - Mannik A AU - Russak S AU - Seedre T AU - Sirkel M AU - Vink M IN - Department of Dental Radiology, University of Helsinki, Finland. TI - Radiographic findings in the teeth and jaws of 14- to 17-year-old Estonian schoolchildren in Tartu and Tallinn. SO - Acta Odontologica Scandinavica 1997 Jan;55(1):31-5 AB - Panoramic radiographs were taken of 392 Estonian schoolchildren (33% boys and 67% girls) aged 14-17 years, 197 in Tartu and 195 in Tallinn. The mean number of permanent teeth was 31.5. In 14% of the children one to four teeth (excluding wisdom teeth) were missing. The frequencies of missing wisdom teeth and supernumerary teeth agreed with those in the literature, being 17% and 3%, respectively. The mean number of radiographically detected carious teeth was 1.9 in Tartu and 3.3 in Tallinn. Secondary caries was common, being found radiographically in half of the schoolchildren. Endodontic treatment had been given to 13% of the subjects in Tartu and to 46% in Tallinn, the success rates being 47% and 44%, respectively. The percentage of radiographic signs in the mandibular condyles of girls (5%) was greater than that of the boys (1%). Changes in the maxillary sinuses were found in 16% of the children. Eight odontogenic cysts, one cyst of the incisal canal, and one solitary bone cyst were found. Tumors included two odontomas, two cemento-ossifying lesions, and one osteoma in the maxillary sinus. The health status of the jaws of the Estonian schoolchildren was considered to be fairly good. <249> UI - 97189944 AU - Bishop BG AU - Donnelly JC IN - Billy Johnson Dental Clinic, U.S.Army Dental Activity, Fort Hood, TX 76544, USA. TI - Proposed criteria for classifying potential dental emergencies in Department of Defense military personnel. SO - Military Medicine 1997 Feb;162(2):130-5 AB - Dental emergencies have been well documented and evaluated. The results of dental emergencies have been lost duty time, decreased unit effectiveness, disruption of routine care, and hindrance to the military mission. The potential of dental emergencies to reduce combat effectiveness is still a major concern. The current U.S. Army and Department of Defense (DOD) military personnel dental classification system, as regulated by DOD Instruction 6410.1, places certain patients broadly into the potential emergency, class 3 category. Changes are needed to make this system more effective and predictive. In addition to various acute conditions, more emphasis should be focused on caries- and surgery-related problems to identify the majority of individuals at high risk for emergencies. Based on an extensive literature review, changes in the current system of classification are proposed. <250> UI - 97160421 AU - VanGheluwe J AU - Walton R IN - Division of Endodontics, University of Colorado School of Dentistry, Denver, USA. TI - Intrapulpal injection: factors related to effectiveness. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1997 Jan;83(1):38-40 AB - The intrapulpal injection is commonly used when conventional anesthetic techniques fail during endodontic procedures. OBJECTIVES: This was a double-blind clinical study conducted to determine whether anesthetic solution was related to an effective intrapulpal injection. STUDY DESIGN: Thirty-five intrapulpal injections were given, all with back-pressure and either saline solution or anesthetic (2% lidocaine with 1:100,000 epinephrine). RESULTS: Thirty-three of the 35 injections were effective. Statistical analysis showed no significant difference between the two solutions. CONCLUSIONS: Data indicate that an effective intrapulpal injection depends on back-pressure and is independent of the solution used. <251> UI - 99264733 AU - Walker RT IN - School of Dentistry, Faculty of Medical Sciences, University of the West Indies. TI - Endodontic disease: development and treatment. SO - Primary Dental Care 1996 Sep;3(2):53-6 AB - Endodontic disease requires the involvement of micro-organisms. Microbial contamination of the pulp-dentine complex occurs in a number of different ways. The loss of integrity of teeth and the penetration of the pulp-dentine complex by a mixed microbial flora characterises the disease processes which can lead to pulpal and periradicular inflammation and infection. Endodontology is that part of dental science which deals with the biology of the pulp-dentine complex in health and disease, an understanding of which is a prerequisite to the provision of sound conservative care. The principles of endodontic treatment require the control of micro-organisms and potential nutrients by the microbial decontamination of teeth, the denaturing of protein and the sealing of dentine to prevent recolonisation. <252> UI - 98179367 AU - Trope M IN - Department of Endodontics, University of North Carolina, Chapel Hill School of Dentistry, USA. TI - Protocol for treating the avulsed tooth. [Review] [32 refs] SO - West Virginia Dental Journal 1996 Apr;70(2):19-23 AB - Avulsion of a tooth requires decisive action by the dental practitioner. Replantation of the tooth at the earliest possible time, along with the avoidance of further periodontal damage, is paramount to achieving a successful result. The accident site, time the tooth is out of the socket, storage media and endodontic protocol influence the prognosis. Appropriate endodontic management and tooth restoration will ensure long-term success. [References: 32] <253> UI - 98201570 AU - Begotka BA AU - Hartwell GR IN - Department of Endodontics, MCV/VCU School of Dentistry, USA. TI - The importance of the coronal seal following root canal treatment. [Review] [10 refs] SO - Virginia Dental Journal 1996 Oct-Dec;73(4):8-10 AB - Although a plethora of research on coronal microleakage does not exist, the studies do confirm that a sound coronal seal is of paramount importance to the overall success of root canal treatment. Temporary restorations provide an adequate seal provided they are used correctly and only for a short time. The best rule of thumb is as follows: a properly cleaned, shaped, and obturated tooth should be permanently restored as soon as possible. If the clinician suspects coronal microleakage has occurred over a time period of 3 months or more, retreatment of the root canal should be performed before placement of a permanent restoration. The clinical significance of coronal recontamination over a time period of 1 to 3 months is more ambiguous; the existing conditions of each individual case will determine whether retreatment is necessary. Continued research, especially with in vivo models, is needed in this aspect of endodontics. [References: 10] <254> UI - 98183292 AU - Prakashchandra AU - Reddy VV IN - Department of Pedodontics & Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka. TI - Configuration of root canals in permanent mandibular first molars--an in vitro study. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1996 Mar;14(1):14-6 AB - The study attempts to show a number of variations in the root canal morphology of permanent mandibular first molar. The presence of variations increases the chance of failure of endodontic treatment. Knowledge about internal anatomy of the teeth is very essential for a favourable prognosis. <255> UI - 98183299 AU - Reddy VV AU - Fernandes IN - Pedodontics, Bapuji Dental College & Hospital, Davangere, Karnataka. TI - Clinical and radiological evaluation of zinc oxide-eugenol and Maisto's paste as obturating materials in infected primary teeth--nine months study. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1996 Jun;14(2):39-44 AB - The present study, performed in-vivo, included 30 infected primary teeth in 26 children in the age group of 3-8 years. The purpose of this study was to compare the efficacy of two obturating materials, zinc oxide-eugenol and Maisto's paste, in infected primary teeth. 30 teeth were divided into two groups of 15 teeth. Teeth in Group I were obturated using zinc oxide-eugenol and those in Group II were obturated using Maisto's paste. On clinical evaluation, teeth obturated with Maisto's paste showed 100% success. Five teeth that were overfilled with Maisto's paste showed complete resorption of excess material within 3 months while the two teeth overfilled with zinc oxide-eugenol showed incomplete resorption of the excess material even after 9 months. Zinc oxide-eugenol treated cases showed only 26.7% bone regeneration while in case of Maisto's paste, it was 93%. Complete healing of the inter-radicular pathology was seen with Maisto's paste. However, the pathology was present in 40% of the zinc oxide-eugenol treated teeth even after 9 months. Maisto's paste was thus seen to be superior to zinc oxide-eugenol both in clinical as well as radiological evaluation, done over a period of 9 months in relation to bone regeneration, healing of inter-radicular pathology and resorption of excess material. <256> UI - 98201524 AU - Benenati FW IN - Department of Endodontics, College of Dentistry, University of Oklahoma, USA. TI - Coping with cracked tooth syndrome. [Review] [8 refs] SO - Journal - Oklahoma Dental Association 1996 Winter;86(3):16-8 AB - Cracked tooth syndrome typically poses a diagnostic challenge for the dentist. Symptoms include tenderness to biting on certain foods, often poorly localized, and occasional thermal sensitivity. Knowing where to look for this entity, especially in the mandibular molar region, can be especially helpful. Treatment of the tooth depends on the degree of pulpal involvement and the extent of the crack. Cuspal coverage is required of all cracked posterior teeth that are retainable. Root canal therapy is included if symptoms persist or if pulpal pathosis exists at the outset. Cracks extending beyond the osseous crest indicate a poor prognosis. Armed with this knowledge, the dentist can overcome many cracked tooth dilemmas, resulting in satisfaction for both patient and practitioner alike. [References: 8] <257> UI - 98156242 AU - Babay NA AU - Almas K IN - Department of Preventive Dental Sciences, King Saud University College of Dentistry Riyadh, Kingdom of Saudi Arabia. TI - A four-year clinical follow-up of nonvital root resection in maxillary molar teeth. SO - Indian Journal of Dental Research 1996 Jan-Mar;7(1):29-32 AB - The aim of the study was to evaluate the success of non-vital root resected maxillary molar teeth over a period of four years. Fourteen root resected maxillary molar teeth were evaluated for mobility and probing depth in the area of root resection. Only one failure was observed over a period of four years follow-up. It was observed that removal of one root neither increase the tooth mobility nor the probing depth in most of the cases. It is concluded that non-vital root resection should be considered before molar extraction, because this treatment can provide good results with long term success, provided appropriate patient selection. This procedure can be practised by general dentists with little effort. <258> UI - 98156982 AU - Anonymous TI - Restoring endodontically treated teeth. SO - Rhode Island Dental Journal 1996 Spring;29(1):13, 15 AB - It is impossible to guarantee success in every case. However, predictably successful endodontic therapy cannot be achieved without properly designing and executing restorations with careful consideration of potential periodontal complications. When prosthetic and periodontal considerations are addressed concurrently with endodontic treatment, patients leave the office with the best possible prognosis for teeth that otherwise have been lost. The information in this article is meant to aid dentists in the restoration of endodontically treated teeth. Practitioners must always use their best professional judgement, taking into account the needs of each individual patient when choosing a restorative plan. The Dental Journal neither expressly nor implicitly warrants any positive results nor expressly nor implicitly warrants against any negative results associated with the application of this information. <259> UI - 98123706 AU - Rankow HJ AU - Krasner PR IN - Temple University, School of Dentistry, USA. TI - Endodontic applications of guided tissue regeneration in endodontic surgery. [Review] [8 refs] SO - Oral Health 1996 Dec;86(12):33-5, 37-40, 43 AB - This paper is intended to provide an overview of different endodontic applications in guided tissue regeneration. It is our expectation that using these techniques, where applicable, will increase endodontic surgical success. We have described six different clinical conditions including external resorption, root perforation, dehiscence, palatal grooves, oblique root fractures, and large periapical lesions. We believe the use of guided tissue regeneration techniques will allow us to predictably treat teeth that otherwise might be extracted. [References: 8] <260> UI - 98123702 AU - Glassman G TI - Predictably successful endodontics: focusing on quality not speed [editorial]. SO - Oral Health 1996 Dec;86(12):3 <261> UI - 98145087 AU - Gutknecht N AU - Kaiser F AU - Hassan A AU - Lampert F IN - Department of Conservative Dentistry, Periodontics and Preventive Dentistry, University of Aachen, Germany. TI - Long-term clinical evaluation of endodontically treated teeth by Nd:YAG lasers. SO - Journal of Clinical Laser Medicine & Surgery 1996 Feb;14(1):7-11 AB - It was possible for the patients to avoid surgical intervention in a number of complicated periapical endodontic situations by means of Nd:YAG laser-assisted sterilization. A WSR has only very good primary results and the long-term successes are very limited. Once a lesions has healed in the manner explained in this study, in other words, with regeneration of the periapical anatomy, there is a very good long-term prognosis. Laser technology is an instrument whose overall effects represent a decisive improvement in the efficiency of conservative endodontic treatment in fields that were previously outside our sphere of influence. <262> UI - 98114689 AU - Chong BS AU - Pitt Ford TR IN - Department of Conservative Dentistry, United Medical and Dental Schools, Guy's Hospital, London. TI - Endodontic retreatment. 2: Methods. SO - Dental Update 1996 Nov;23(9):384-7, 390 AB - The best method for retreating a tooth that has already undergone root treatment will depend on the root filling technique and material used; a combination of retreatment techniques may be required. The correct method, combined with the required equipment, skill and experience, are necessary to produce a high standard of retreatment and a successful result. In part 1 of this article, the indications and case selection for root canal retreatment were discussed; this article will now discuss the methods of retreatment available. <263> UI - 98114693 AU - Chong BS AU - Pitt Ford TR IN - Department of Conservative Dentistry, United Medical and Dental Schools, Guy's Hospital, London. TI - Endodontic retreatment. 1: Indications and case selection. SO - Dental Update 1996 Oct;23(8):320-3, 328 AB - Conventional root canal treatment, despite having a reportedly high success rate may not invariably lead to the desired healing response in clinical practice because of shortcomings in the treatment. This is the first of two articles on this subject, and will cover indications and case selection for root canal retreatment. Part 2 will discuss methods of retreatment. <264> UI - 97357644 AU - Sevast'ianova IK TI - [The development of a complex of medical rehabilitative measures in acute pulpitis of the deciduous teeth]. [Russian] SO - Stomatologiia 1996;Spec No:76 <265> UI - 97357627 AU - Kuriakina NV AU - Kuriakin VV TI - [The apitherapy of apical periodontitis]. [Russian] SO - Stomatologiia 1996;Spec No:63-4 <266> UI - 97357610 AU - Goncharov IIu AU - Bazikian EA TI - [The enhancement of osseointegration with hydroxyapol in the surgical treatment of chronic periodontitis and periapical cysts]. [Russian] SO - Stomatologiia 1996;Spec No:50-1 <267> UI - 97421421 AU - Van Doorne L AU - Vanderstraeten C AU - Rhem M AU - De Meulemeester J AU - Wackens G IN - Stomatologie et chirurgie maxillo-faciale, Bruxelles. TI - [CO2 laser sterilization in periradicular surgery: a clinical follow-up study]. [French] SO - Revue Belge de Medecine Dentaire 1996;51(1):73-82 AB - Periradicular surgery combined with final laser sterilisation was performed on 62 teeth of 50 patients by 3 trained oral surgeons, according to a well defined treatment protocol. It concerned a 5 Watt continuous wave CO2-laser. After a follow-up period ranging from 6 to 17 months all patients were recalled. 28 patients (56%) or 33 teeth (53%) could be evaluated. The success rate was determined by a questionnaire, a standard clinical examination and an X-ray evaluation. Complete surgical healing was found in 59% of the teeth and incomplete healing in 23%. Uncertain healing and unsatisfactory healing were observed in respectively 11% and 7% of the teeth. Better healing results were found in elements with one endodontic canal (67% complete healing) and when endodontic treatment was combined with the intervention (71% complete healing). Comparison of the results of the present study with comparable studies without laser sterilisation, showed however no statistical significant improvement. <268> UI - 97386099 AU - Lewis S TI - Treatment planning: teeth versus implants. SO - International Journal of Periodontics & Restorative Dentistry 1996 Aug;16(4):366-77 AB - Attempts to save natural teeth have created numerous restorative, endodontic, and periodontal techniques it has always been considered the treatment of choice to save teeth whenever possible, and extreme efforts to save teeth are often considered because of the poor treatment alternatives for replacing them. Today osseointegration provides a predictable means of replacing teeth; therefore, retaining questionable teeth may not be as necessary as in the past. This article reviews situations in which the selective extraction of compromised natural teeth or even healthy natural teeth is considered because of alternative treatment options utilizing osseointegrated implants. <269> UI - 97364528 AU - Allam CR IN - Department of Endodontics, School of Dental Medicine, St. Joseph University, Beirut, Lebanon. TI - Treatment of stripping perforations. SO - Journal of Endodontics 1996 Dec;22(12):699-702 AB - Strippings are problems that are frequent on thin and concave roots. Treatment and prognosis differ from that of a lateral root perforation because of the size, oval shape, and thin edges of the striping. We propose a two-step technique: an endodontic phase in which the root canal system is sealed with gutta-percha overflowing through the stripping perforation and a surgical second step that will allow elimination of this excess. <270> UI - 97364525 AU - Harbert H TI - One-step apexification without calcium hydroxide. SO - Journal of Endodontics 1996 Dec;22(12):690-2 AB - Slow growth calcium hydroxide apexification may be clinically impractical in some instances. This case report describes a technique and rationale for single-step use of tricalcium phosphate as an apical plug in an immature permanent root. This method permitted immediate canal obturation and placement of the permanent coronal restoration. A 7-yr follow-up confirmed that this type of apexification could be successful. <271> UI - 97350663 AU - Caliskan MK AU - Sen BH IN - Department of Endodontics, School of Dentistry, Ege University, Izmir, Turkiye. TI - Endodontic treatment of teeth with apical periodontitis using calcium hydroxide: a long-term study. SO - Endodontics & Dental Traumatology 1996 Oct;12(5):215-21 AB - The aim of this study was to evaluate clinically and radiographically the long-term results of endodontic therapy. A total of 172 mature teeth with periapical radiolucencies with and without symptoms were treated endodontically using calcium hydroxide paste as the intracanal medicament and a calcium hydroxide containing root canal sealer. In 58 teeth, the dressing was accidentally or intentionally extruded into the lesions. All cases were followed up for a period of 2-5 years. The teeth in which the dressing was extruded did not show a different healing pattern from the ones treated conventionally. The complete healing rate for all cases was 80.8% while incomplete healing had taken place in 7.6% of the cases. <272> UI - 97350669 AU - Fuss Z AU - Trope M IN - Department of Endodontology, School of Dental Medicine, Tel Aviv University, Israel. TI - Root perforations: classification and treatment choices based on prognostic factors. SO - Endodontics & Dental Traumatology 1996 Dec;12(6):255-64 AB - Root perforations are common complications of endodontic treatment or post preparation and often lead to tooth extraction. Successful treatment depends mainly on immediate sealing of the perforation and prevention of infection. Several factors affect the achievement of these goals, most important of which are: time of occurrence, size, and location of the perforation. A classification of root perforations, based on the above factors, is presented to assist the clinician in the choice of the treatment protocol which will give the best possible results when a perforation is diagnosed. <273> UI - 97350734 AU - Lin LM AU - Gaengler P AU - Langeland K IN - Department of Endodontics, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark 07103, USA. TI - Periradicular curettage. [Review] [56 refs] SO - International Endodontic Journal 1996 Jul;29(4):220-7 AB - Periradicular curettage is a part of the treatment procedure of periradicular surgery. Its main purpose is to remove pathological periradicular tissues for visibility and accessibility to facilitate the treatment of the apical root canal system, or sometimes for the removal of harmful foreign materials present in the periradicular area. Inflammatory periradicular lesions (granuloma and cysts) are the responses of the periradicular tissues to irritants from the root canal and not from the periradicular area unless medicaments and/or filling materials have been forced through the apical foramina or perforations into the periodontium. Histologically, the inflammatory periradicular lesion is similar to healing granulation tissue, which is composed of cells which have natural and specific immunological defence capability and cooperate by means of cytokines to amplify the protective mechanisms of the host. Accordingly, it is not necessary to completely curette out all the inflamed periradicular tissues during surgery, since this granulation-like tissue will be incorporated into the new granulation tissue as part of the healing process. To control the source of irritants in the root canal is far more important than to remove all periradicular tissues affected by the irritants. The successful removal of all irritants from the root canal system results in resolution of pulpally induced periradicular lesions. In the case where the periradicular lesion is caused by endodontic instruments or cytotoxic filling materials placed in the periradicular tissues, removal of these foreign objects is required for resolution of the lesion. [References: 56] <274> UI - 97350736 AU - Gomes BP AU - Lilley JD AU - Drucker DB IN - Department of Restorative Dentistry, University Dental Hospital of Manchester, UK. TI - Variations in the susceptibilities of components of the endodontic microflora to biomechanical procedures. SO - International Endodontic Journal 1996 Jul;29(4):235-41 AB - The role of the endodontic microflora in pulpal disease and in endodontic treatment failures is well established. Thus the need for effective microbial control is one of the important justifications for biomechanical procedures. However the efficacy of this stage of treatment is dependent upon the vulnerability of the involved species, which may not be uniform. The aim of this study was to investigate variations in the susceptibilities of members of the root canal microflora to routine biomechanical procedures. Forty-two root canals were investigated microbiologically. Samples were collected before and after instrumentation and the bacterial findings were compared. In 15 cases of 'primary' root canal therapy, despite changes in the population size, no significant change in the species composition of the microflora was observed. However in 27 cases 'secondary' treatment, a decrease in the number of isolations of Peptostreptococcus spp. was found (P = 0.008). When all 42 cases were considered together, significant decreases were found between first and second samples for anaerobes (P = 0.0117) and for Grampositive species (P = 0.008), especially Peptostreptococcus spp. (P = 0.02). It was therefore concluded that certain species are more resistant to the biomechanical procedures than others. <275> UI - 97350716 AU - Orstavik D IN - Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, USA. TI - Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. SO - International Endodontic Journal 1996 May;29(3):150-5 AB - Roots with and without preoperative chronic apical periodontitis were root canal treated and followed clinically and radiographically yearly for up to 4 years. Of 732 roots treated, 599 (82%) were available for evaluation at one or several recalls. Chronic apical periodontitis (CAP) was recorded with the periapical index scoring system. CAP developed in 29 of 473 (6%) of teeth without preoperative signs of disease, whereas 111 of 126 (88%) initially diseased roots showed signs of healing. The rate of healing CAP and the rate of emerging CAP were calculated, and analyses of event occurrence each year of observation were performed. Peak incidence of healing or emerging CAP was at 1 year in both instances. Risk assessments at 2, 3, and 4 years did not indicate an added risk of filled roots developing CAP during this period. Complete healing of preoperative CAP in some instances required 4 years for completion, while signs of initiated, but incomplete, healing were visible in at least 89% of all healing roots after 1 year. Risk analyses may provide relevant information in addition to or in substitution for success/failure analyses. <276> UI - 97342453 AU - Rud J AU - Rud V AU - Munksgaard EC IN - Dental Clinic, University Hospital Copenhagen, Denmark. TI - Retrograde root filling with dentin-bonded modified resin composite. SO - Journal of Endodontics 1996 Sep;22(9):477-80 AB - A retrograde root-end cover with a special resin composite (Retroplast) combined with the dentin bonding agent Gluma (Bayer AG) has been used since 1984 by the authors. Its content of silver, added to promote radiopacity, has been found to lower the working time and storage stability of the composite and might cause discolorations. Since 1990, silver has therefore been replaced with ytterbium trifluoride, which eliminates these side effects. The purpose of this study was to compare the clinical results obtained with these two resin composites and to evaluate the healing results after several years in function. Apical fillings (351) with the modified Retroplast showed the following radiographic healing pattern 1 yr after surgery: 80% complete healing, 2% scar tissue, 12% uncertain healing, and 6% failure. No significant difference in this healing pattern was found, compared with that obtained with the silver-containing Retroplast. Cases with ytterbium trifluoride classified as scar tissue and uncertain healing at 1 yr when examined at 2 to 4 yr postoperatively showed 89% complete healing. 0% scar tissue, 1% uncertain healing, and 9% failure. This result is significantly different from that obtained 1 yr after surgery. Based on calculations, it was predicted that with time 90% will become complete healing, whereas 10% will become failure. <277> UI - 97342440 AU - Welch JD AU - Anderson RW AU - Pashley DH AU - Weller RN AU - Kimbrough WF IN - Department of Endodontics, School of Dentistry, Medical College of Georgia, Augusta 30912, USA. TI - An assessment of the ability of various materials to seal furcation canals in molar teeth. SO - Journal of Endodontics 1996 Nov;22(11):608-11 AB - Ninety-seven maxillary and mandibular molar teeth were evaluated for the presence of naturally occurring furcation canals using the fluid filtration method. Only one specimen demonstrated a naturally occurring patent furcation canal. An artificial furcation canal was created with a 0.33-mm drill bit in the 96 teeth lacking naturally occurring furcation canals. Fluid filtration measurements were made before and after the artificial canal was made, and these served as the negative and positive controls for each tooth. The 96 teeth were randomly divided into eight equal groups, and the floor of the pulp chambers was sealed using 3 mm of either Tytin or Dispersalloy amalgams, Vitremer, FluoroCore, gutta-percha with sealer, Tytin with Ali-Bond 2 or Amalgambond, or Dispersalloy with Ali-Bond 2. Analysis of measured microleakage at 3 months indicated that Tytin amalgam used alone had significantly more microleakage than all other materials; however, this difference did not exist when bonding agents were used with Tytin. All materials leaked significantly less than the positive controls. <278> UI - 97342437 AU - Cohen BI AU - Deutsch AS AU - Musikant BL IN - Division of Dental Research, Essential Dental Laboratory, South Hackenasck, NJ 07806, USA. TI - Effect of power settings on temperature change at the root surface when using a Holmium YAG laser in enlarging the root canal. SO - Journal of Endodontics 1996 Nov;22(11):596-9 AB - The aim of this study was to determine the maximum amount of power, in watts, that a Holmium YAG laser could deliver via a 245-micron fiberoptic to the canal surface and still not raise the temperature (delta T) of the cementum by > 5 degrees C. Sixty single-rooted teeth were divided into three groups according to power selection (0.50, 0.75, and 1.00 W). The three main outcome variables were: change in apical temperature, change in coronal temperature, and maximum size of an endodontic file that could fit into the canal after lasing. The group means for apical delta T were: 1.00 W = 2.2 degrees C, 0.75 W = 2.68 degrees C, and 0.50 W = 1.58 degrees C. The group means for coronal delta T were: 1.00 W = 1.15 degrees C, 0.75 W = 0.99 degree C, and 0.50 W = 0.56 degree C. The group means for file size were: 1.00 W = 41.25, 0.75 W = 38.75, and 0.50 W = 40.75. The canal size was increased from a size 25 file up to approximately a size 40 file with all power groups. There were no significant differences between the groups for change in apical temperature (p = 0.32), coronal temperature (p = 0.17), or maximum file size (p = 0.86) when adjustments were made for tooth dimensions. In all groups studied, the delta T was < 5 degrees C. This represents a safe and predictable laser procedure. <279> UI - 97342469 AU - Robertson A AU - Andreasen FM AU - Bergenholtz G AU - Andreasen JO AU - Noren JG IN - Department of Pedodontics, Faculty of Odontology, Goteborg University, Sweden. TI - Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors. SO - Journal of Endodontics 1996 Oct;22(10):557-60 AB - Little long-term data are available on the frequency by which pulp canal obliteration (PCO) subsequent to trauma leads to pulp necrosis (PN). In this study, 82 concussed, subluxated, extruded, laterally luxated, and intruded permanent incisors presenting with PCO were followed for a period of 7 to 22 yr (mean 16 yr). At final clinical examination, 51% of the observed teeth responded normally to electric pulp testing (EPT). An additional 40% of the teeth although not responding to EPT were clinically and radiographically within normal limits. Yellow discoloration was a frequent finding. During the observation period, periapical bone lesions suggesting PN developed in seven teeth (8.5%). Twenty-yr pulp survival rate was 84%, as determined from life-table calculations. There was no higher frequency of PN in obliterated teeth subjected to caries, new trauma, orthodontic treatment, or complete crown coverage than intact teeth. Although the incidence of PN in teeth displaying PCO seems to increase over the course of time, prophylactic endodontic intervention on a routine basis does not seem justified. <280> UI - 97324286 AU - Tang PM AU - Chan CP AU - Huang SK AU - Huang CC IN - Department of General Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China. TI - Intentional replantation for iatrogenic perforation of the furcation: a case report. SO - Quintessence International 1996 Oct;27(10):691-6 AB - Intentional replantation is an accepted endodontic procedure for treatment of teeth in which conventional surgical endodontic treatment is contraindicated. This article presents a rare case of intentional replantation of a mandibular molar that had severe periodontal destruction resulting from iatrogenic perforation of the furcation. A 17-month follow-up evaluation revealed an asymptomatic and functional tooth with no radiographic signs of pathosis. The favorable results obtained might be attributed to the preservation of the vitality of the periodontal ligament; the absence of damaging pressure during extraction; the minimal extraoral treatment time; the use of nonrigid splinting; and the immediate repair of the perforation during a one-visit endodontic procedure. The results obtained with this tooth may indicate the possibility of a successful surgical technique for this otherwise hopeless complication of endodontic therapy. <281> UI - 97322488 AU - Abbott PV IN - Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne. TI - Failures, disasters and catastrophes--a hypothetical endodontics. [Review] [30 refs] SO - Annals of the Royal Australasian College of Dental Surgeons 1996 Apr;13:79-98 AB - Failures occur in dentistry as a result of many factors some of which can be controlled by the operator whilst others are unavoidable. The long-term success rate of endodontic treatment has often been thought to be very high although studies reported in the literature do not support this perception. The number of failures can be reduced by adhering to accepted treatment procedures and by avoiding 'short cuts'. Recent work now points to endodontic failures being largely a consequence of failures of the coronal restoration rather than being due to failure of the root canal filling itself. Disasters are usually related to operator errors and they may have detrimental effects on the outcome of treatment in the long term, eventually becoming catastrophes. Endodontic disasters will require special techniques to salvage them whereas catastrophes usually result in loss of the tooth and every effort should be made to prevent such problems from occurring. [References: 30] <282> UI - 97126526 AU - Worrall SF IN - Department of Oral/Maxillofacial and Head and Neck Surgery, North Staffordshire Hospital, Stoke-on-Trent, UK. 100010.2155@compuserve.com TI - Are postoperative review appointments necessary following uncomplicated minor oral surgery?. SO - British Journal of Oral & Maxillofacial Surgery 1996 Dec;34(6):495-9 AB - This paper reports the results of a postal survey of all current BAOMS Fellows concerning their practice and opinion on the usefulness and desirability of reviewing all patients following uncomplicated minor oral surgery. It also reports the results of a separate postal survey of 500 patients who had recently undergone third molar removal. The overwhelming majority of Fellows routinely review all their patients following third molar removal and apicectomy but not after simple exodontia. There was no excess morbidity in patients who were not offered a follow-up appointment compared to those who had been seen postoperatively after removal of their third molars. Patients not followed up in hospital postoperatively did not seek help from their doctor or dentist more frequently than patients who were followed-up. Despite the lack of evidence showing objective benefit to patients from postoperative follow-up, given the choice the majority of patients wish to be reviewed postoperatively. <283> UI - 97237876 AU - Basten CH AU - Ammons WF Jr AU - Persson R IN - Department of Periodontics, University of Washington, Seattle, USA. TI - Long-term evaluation of root-resected molars: a retrospective study. SO - International Journal of Periodontics & Restorative Dentistry 1996 Jun;16(3):206-19 AB - Thirty-two consecutively treated patients were included in this study of 49 root-resected molars that were under regular recall of 3 to 6 months for a mean of 11.5 years (2 to 23 years). Treatment modalities for all patients were very similar. Endodontic treatment was conservatively performed prior to resection with maximum preservation of tooth structure. No threaded posts were used. Provisional restorations were in place prior to periodontal therapy (pocket reduction with or without osseous surgery). Most patients were treated with complete-mouth reconstructions. Ninety-two percent of all resected molars survived an average of 12 years. Teeth failed because of recurrent caries or for endodontic and strategic reasons. If proper treatment is rendered periodontically involved molars can be maintained for a long period of time and serve successfully as abutments in complete-mouth restorations. Great care must be taken throughout the whole process of case selection, reevaluation, and endodontic, periodontal, restorative, and maintenance therapies. <284> UI - 97014458 AU - Lundberg T AU - Isaksson S IN - Department of Oral and Maxillofacial Surgery, Lanssjukhuset, Sweden. TI - A clinical follow-up study of 278 autotransplanted teeth. SO - British Journal of Oral & Maxillofacial Surgery 1996 Apr;34(2):181-5 AB - This open study was undertaken to investigate the outcome of autotransplanted teeth over a 6-year period. The subjects were 296 patients who underwent autotransplantation in the 6-year period September 1986-August 1992 and outcome was measured by considering root formation, occlusion, endodontal and periodontal complications. 18 patients were excluded because of inadequate notes or radiographs (n = 3) or because they were lost to follow-up (n = 15). The groups were divided into open apex and closed apex, and duration of follow up was 6 months-5 years. Aplasia was the indication for operation in 158 (77 percent) of the open apex group but only 10 (14 percent) of the closed apex group, whereas caries and associated disease was the most common in the latter (n = 45, 61 percent compared with 20, 10 percent). There were 24 complete failures, 12 in each group (p <0.01). Only 7 teeth in total developed full roots, and 159 showed incomplete growth. In the open apex group 112 teeth were in occlusal contact and 4 were extracted for severe infraocclusion. In the closed apex group there were 10 cases of mild infraocclusion, none of which required treatment. There were 7 cases of pulp necrosis in the open apex group, 4 of which required extraction. Two teeth in the closed apex group were extracted for endodontic reasons. Only 1 tooth (in the closed apex group) had to be extracted for periodontal reasons. Autotransplantation is a reliable method with a good prognosis for donor teeth with both open and closed apexes. The technique is applicable whatever the aetiology of the agenesis, and is worthy of consideration should there be a suitable donor tooth. <285> UI - 97117863 AU - Goncharov IIu AU - Bazikian EA AU - Ushakov AI TI - [The enhanced efficacy of endodontic endosseous and endosseous implantation using Hydroxyapol]. [Russian] SO - Stomatologiia 1996;75(5):42-4 AB - Hydroxyapol was used for intercanal-interosseous and intraosseous implantation. Operations were carried out in 62 patients with good results, this permitting the authors to recommend Hydroxyapol for practical implantations. <286> UI - 97117867 AU - Goncharov IIu AU - Bazikian EA AU - Bychkov AI TI - [The use of Hydroxyapol in filling in bone defects of the jaws and stimulating osteogenesis]. [Russian] SO - Stomatologiia 1996;75(5):54-6 AB - Hydroxyapol, a Russian biocomposite material, was used to repair defects of the jaw bones after resection of dental apices, cystectomy, and cystotomy in 102 patients. A more rapid formation of bone tissue and better stability of teeth were observed, in comparison with the patients treated traditionally, in whom the formation of a blood clot was the basis of osteointegration. Hydroxyapol is an effective means of osteogenesis, characterized by an anti-inflammatory effect. <287> UI - 97179973 AU - Caliskan MK AU - Pehlivan Y IN - Department of Endodontics, School of Dentistry, Ege University, Bornova-Izmir, Turkey. TI - Prognosis of root-fractured permanent incisors. SO - Endodontics & Dental Traumatology 1996 Jun;12(3):129-36 AB - The prognosis of 56 root-fractured permanent incisors was evaluated clinically and radiographically for 2 to 31 years. Information about initial case histories, examination and treatment of root-fractured teeth were recorded retrospectively from patient cards. Most of the root fractures occurred in the 16-20 year age group (38%) followed by the 11-15 year age group (29%). Males were involved more often than females. Fifty-two percent of the patients visited the dental clinic within the first week, while 48% did so 1 month-31 years later after the injury. The leading cause of root fractured injuries was falls (46%) and mostly involved one tooth (71%). Maxillary central incisors were the most often affected teeth (95%). The most common type of root fracture was in the middle third of the root (57%) followed by apical part (34%). About 59% of untreated or splinted teeth maintained their vitality. Healing with connective tissue was observed in 19 teeth, with calcified tissue in 15 teeth and with osseous tissue in only one tooth. There was partial or complete obliteration of the pulp space in these healed cases (62.5%). The formation of pulpal hard tissue produced no additional clinical problems. Partial or total pulp necrosis were noted in 21 (37.5%) teeth. Endodontic treatment was successful in 12 cases. The remaining 9 teeth were extracted due to the loss of marginal alveolar bone and apical periodontitis. <288> UI - 97179981 AU - Oulis CJ AU - Berdouses ED IN - Department of Paediatric Dentistry, University of Athens Dental School, Greece. TI - Dental injuries of permanent teeth treated in private practice in Athens. SO - Endodontics & Dental Traumatology 1996 Apr;12(2):60-5 AB - Although there are several epidemiological studies on dental trauma internationally, there are not many studies that record, analyse and follow different kinds of dental trauma treated in a private office, and that evaluate how parameters such as type of dental trauma, as well as time lapse until treatment might influence the final outcome and the prognosis of the teeth. The sample consisted of 242 patients, 6-17 years of age, with 369 injured teeth treated within a period of 5 years. All the case were treated by the first author and were followed for at least 3 years. The treatment modalities used were based upon the clinical examination and the history of the case and included direct and indirect pulp capping, partial pulpotomy, pulpotomy, pulpectomy and splinting. The type of trauma was classified based on WHO classification partially modified. Seventy six percent of the teeth suffered only hard tissue injuries and 22% had only periodontal ligament PDL) trauma. Of the total number of teeth class I represented 3%, class II 59%, class III 20% and class IV 2%. Of the PDL injuries 14% of the teeth suffered concussion, 69% luxation and 17% exarticulation. The highest incidence of dental trauma was observed at the age of 10. Sixty eight percent of the patients sought treatment 3 days or more after the trauma had occurred delayed treatment), while only 32% within the first 3 days (immediate treatment). The main reasons for delayed treatment were neglect (50%) and unawareness 37%). Of the teeth with delayed treatment 43% became necrotic, while only 28% of the teeth that were treated on time needed pulpectomy. Luxations caused more pulp necrosis (46%) than Class I (0%) Class II (7%) or Class III (34%) type of trauma. The data from this study suggested that a most of the dental injuries on permanent teeth were class II or III type, b) a high percentage (68%) of the patients sought treatment more than 3 days after the injury (delayed treatment), c) delayed treatment caused more necrotic teeth, d) the public should be informed of the importance of immediate treatment in an effort to improve the prognosis of the pulp, e) dentists should be informed of the appropriate treatment of dental injuries since 10.3% of the cases were mistreated. <289> UI - 97049429 AU - Drysdale C AU - Gibbs SL AU - Ford TR IN - Dental School, Guy's Hospital, London, UK. TI - Orthodontic management of root-filled teeth. [Review] [28 refs] SO - British Journal of Orthodontics 1996 Aug;23(3):255-60 AB - Orthodontists are often concerned about the prognosis of root-filled teeth, particularly when extractions are required for orthodontic treatment. This review provides guidance on assessing the quality of root fillings, as well as the factors which affect the prognosis of root-filled teeth. The implications of previous traumatic injuries and the likelihood of root resorption during orthodontic tooth movement are discussed. [References: 28] <290> UI - 97217172 AU - Trope M IN - Department of Endodontics, University of North Carolina, Chapel Hill School of Dentistry, USA. TI - Protocol for treating the avulsed tooth. [Review] [32 refs] SO - Journal of the California Dental Association 1996 Mar;24(3):43-9 AB - Avulsion of a tooth requires decisive action by the dental practitioner. Replantation of the tooth at the earliest possible time, along with the avoidance of further periodontal damage, is paramount to achieving a successful result. The accident site, time the tooth is out of the socket, storage media and endodontic protocol influence the prognosis. Appropriate endodontic management and tooth restoration will ensure long-term success. [References: 32] <291> UI - 97041594 AU - Cheung GS IN - Department of Conservative Dentistry, University of Hong Kong, Faculty of Dentistry, Hong Kong. TI - Endodontic failures--changing the approach. [Review] [30 refs] SO - International Dental Journal 1996 Jun;46(3):131-8 AB - The underlying reason for endodontic failures is almost invariably due to bacterial infection. The bacteria may be situated within a previously missed or uninstrumented portion of a root canal, infiltrate via a leaky coronal restoration and root filling, or cause contamination from an extra-radicular infection. Management of the failing root canal filling begins with the identification of the source of persistent infection. Should the infection be present within the root canal system, such as a missed canal, orthograde retreatment is the choice of treatment. This is also true for asymptomatic cases which had been inadequately obturated and which require the placement of a dowel into the canal for restorative reasons. Periapical surgery is best reserved for cases with no sign of healing after orthograde retreatment and those with extra-radicular infection. This paper discusses the relationship between endodontics and restorative dentistry, treatment planning for endodontic failures, and the reported rates of success with orthograde and surgical retreatments. [References: 30] <292> UI - 97047009 AU - Nemcovsky CE AU - Libfeld H AU - Zubery Y IN - Section of Periodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. TI - Effect of non-erupted 3rd molars on distal roots and supporting structures of approximal teeth. A radiographic survey of 202 cases. SO - Journal of Clinical Periodontology 1996 Sep;23(9):810-5 AB - Root resorption of 2nd molars in proximity to non-erupted 3rd molars has been widely reported. The purpose of this study was to determine the prevalence of root resorption in second molars adjacent to non-erupted third molars. Its association to age and gender of the patient, location and inclination of the non-erupted third molar and to distal bone support of the 2nd molars was analyzed. A radiographic survey of 202 periapical radiographs taken in patients with clinically missing third molars was conducted. 3 examiners independently evaluated the radiographs and only those cases where at least 2 observers agreed were included in this report. Statistical analysis was performed on 186 radiographs. Associations were analyzed with the Pearson chi 2 test. Radiographic evidence of root resorption was found in 45 2nd molars (24.2%) of which 12 (6.5%) showed moderate to complete root resorption. Non-erupted tooth apical position and mesio-inclination of 60 degrees or more relative to the distal root of the second molar were significantly associated with root resorption (p = 0.01368 and p = 0.0194, respectively). Resorption was positively associated with age of patient (p = 0.00606). These results may support early extraction of impacted 3rd molars especially in cases with a mesio-angulation of 60 degrees or more and an apical location in proximity to the distal root of the 2nd molar. <293> UI - 97113978 AU - Joual A AU - Rabii R AU - Aboutaeib R AU - el Moussaoui A AU - Benjelloun S IN - Service d'Urologie (Aile 5), Hopital Averroes, Casablanca, Maroc. TI - [An unusual presentation of prostate cancer]. [French] SO - Annales d Urologie 1996;30(5):262-3 AB - The authors report an uncommon case of a 74-year old man with prostatic cancer revealed by pelvic mass. Ultrasound exam and CT-scan showed a bilateral laterorectal mass with high density. Presence of such a mass in an old patient is very suggestive of lymph nodes than retroperitoneal tumor. Serum prostate specific antigen (PSA) is rather helpful in such conditions. Biopsy of the mass allows confirmation of the prostatic cancer diagnosis. Bilateral Surgical pulpectomy is performed in combination with oral hormonal therapy. Follow-up after 6 months showed a good course or ultrasound exam and PSA level. <294> UI - 97075734 AU - Deutsch WM AU - Simecek JW IN - Naval Dental Research Institute, Clinical Investigations Department, Great Lakes, IL 60088, USA. TI - Dental emergencies among Marines ashore in Operations Desert Shield/Storm. SO - Military Medicine 1996 Oct;161(10):620-3 AB - The purpose of this study was to determine the incidence of dental emergency visits for Marine Corps personnel ashore during Operations Desert Shield/Storm. We investigated the period of August 18, 1990, through April 19, 1991, during which 16 dental treatment facilities treated 4,776 dental emergencies in Marine Corps personnel. All dental treatment facilities maintained log books of dental treatment rendered, from which data were obtained. For the 35 weeks, a rate of 100.5 emergencies/1,000 Marines was calculated. The range, on a per week basis, was 1.4 to 4.6 emergencies/1,000 Marines. Caries, defective restorations, and endodontic complaints accounted for 54.3% of emergency visits. <295> UI - 97116786 AU - Decock V AU - De Nayer K AU - De Boever JA AU - Dent M IN - Department of Fixed Prosthesis and Periodontology, University of Gent Dental School, Belgium. TI - 18-year longitudinal study of cantilevered fixed restorations. SO - International Journal of Prosthodontics 1996 Jul-Aug;9(4):331-40 AB - One hundred thirty-seven cantilevered fixed partial dentures made between 1974 and 1990 were clinically and radiographically evaluated. Thirty-three of the prostheses were located in the mandible (11 in the anterior and 22 in the posterior region) and 104 were located in the maxillae (58 anterior prostheses and 46 posterior prostheses). Median duration was 84 +/- 3.6 months. During the 18 years, 41 (30%) failed. Of those that "failed," 28 (68%) were in the maxillae and 13 (32%) were in the mandible. Reasons for failure included abutment fracture (4), loosening with or without caries (18), secondary caries (9), fracture of prosthesis (2), fracture of extension (1), periodontal problems (6), and apical reaction (1). Failures occurred significantly more when endodontically treated abutments were used. More mandibular restorations failed than did maxillary units, but the difference was not significant. The prosthesis length ratio and the crown length-bone ratio did not influence the failure rate. The overall success rate of cantilever fixed prostheses was 70% over a period of 18 years. <296> UI - 97125869 AU - Muller W TI - [New dimensions in endodontics. The theoretical and practical course of 21 to 27 January 1996 in Zurs am Arlberg (Austria) (news)]. [German] SO - Schweizer Monatsschrift fur Zahnmedizin 1996;106(10):960-4 <297> UI - 97089158 AU - August DS IN - Department of Dentistry, York Hospital, PA, USA. TI - Long-term, postsurgical results on teeth with periapical radiolucencies. SO - Journal of Endodontics 1996 Jul;22(7):380-3 AB - Reported high failure rates of endodontic surgical procedures seemed to be inconsistent with the clinical impression of a high success rate. A retrospective study of endodontic surgical cases treated longer than 10 yr ago was done to look at long-term results. Forty-one teeth in 39 patients were able to be evaluated. These teeth had either an apicoectomy, an apicoectomy with a root-end amalgam, or in two cases, a root amputation. Of the 23 teeth that had an apicoectomy, 19 (82.6%) completely healed. Of the 16 teeth that had an apicoectomy followed by a root-end amalgam, 10 (62.5%) completely healed. Surgical endodontic procedures performed before the use of magnification, newer root-end filling materials, and ultrasonics, still had a high rate of success. <298> UI - 97116827 AU - Certosimo AJ AU - Archer RD IN - Naval Dental Center, Advanced Clinical Program, Norfolk, VA 23511, USA. TI - A clinical evaluation of the electric pulp tester as an indicator of local anesthesia. SO - Operative Dentistry 1996 Jan-Feb;21(1):25-30 AB - Local anesthesia is the primary method in dentistry to control patients' pain. However, several studies have shown that profound anesthesia is not always achieved. The electric pulp tester has been used to measure the level of local dental anesthesia during endodontic therapy. However, no study has been performed that evaluates the ability of the electric pulp tester to predict the efficacy of local anesthesia prior to as operative procedure. If ineffective anesthesia could be predicted, supplemental injections could be administered to alleviate the anesthetic problem. The purpose of this study was to evaluate the ability of the electric pulp tester to measure the level of local anesthesia prior to operative treatment. The study was performed in vivo on patients requiring operative therapy. All teeth were pulp tested preoperatively for vitality using the electric pulp tester. After injection of local anesthetic, traditional parameters of dental anesthesia were verified (lip numbness, mucosal sticks). Teeth were then retested with the electric pulp tester and the results recorded. The teeth were them prepared for restoration using conventional instrumentation, and the patient's level of anesthesia evaluated using a visual analog scale. The electric pulp tester readings were compared to the patient's responses using Fisher's Exact test (two-tail). The results indicate that the electric pulp tester can be a valuable tool in predicting potential anesthetic problems in operative (restorative) dentistry. <299> UI - 97003153 AU - Ramachandran Nair PN AU - Pajarola G AU - Schroeder HE IN - Institute of Oral Structural Biology, University of Zurich, Switzerland. TI - Types and incidence of human periapical lesions obtained with extracted teeth. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1996 Jan;81(1):93-102 AB - OBJECTIVES: To determine (1) the frequency of the incidence of abscess, granuloma, and radicular cyst among human periapical lesions obtained with extracted teeth; and (2) whether periapical cysts occur in two categories when histologically analyzed in relation to the root canals. STUDY DESIGN: A total of 256 lesions were analyzed. The specimens were decalcified and embedded in plastic. Serial sections or step-serial sections were prepared, and the sections were evaluated on the basis of predefined histopathologic criteria. RESULTS: The 256 specimens consisted of 35% periapical abscess, 50% granuloma, and 15% cysts. The latter occurred in two categories, the apical true cysts and the apical pocket cysts. CONCLUSIONS: These results show (1) the low incidence of radicular cysts among periapical lesions as against the widely held view that almost half of all periapical lesions are cysts; and (2) the occurrence of two classes of radicular cysts. We are of opinion that the pocket cysts may heal after root canal therapy but the true cysts are less likely to be resolved by conventional root canal treatment. <300> UI - 97003154 AU - Nohl FS AU - Gulabivala K IN - Department of Conservative Dentistry, Eastman Dental Institute, London, U.K. TI - Odontogenic keratocyst as periradicular radiolucency in the anterior mandible: two case reports. SO - Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, & Endodontics 1996 Jan;81(1):103-9 AB - The differential diagnosis of periradicular radiolucencies is broad. Unusual clinical or radiographic features or failure to resolve after quality root canal treatment should be viewed with suspicion and a biopsy specimen should be submitted for histologic examination. Two cases are reported in which the presence of radiolucent lesions could have been mistaken for those of pulpal origin but were subsequently found to be odontogenic keratocysts.