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Singh NR, Mishra L, Pawar AM, Kurniawati N, Wahjuningrum DA. Comparative evaluation of the effect of two pulpal medicaments on pain and bleeding status of mandibular molars with irreversible pulpitis post-failure of inferior alveolar nerve block: a double-blind, randomized, clinical trial. PeerJ 2022; 10:e13397. [PMID: 35586130 PMCID: PMC9109695 DOI: 10.7717/peerj.13397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/16/2022] [Indexed: 01/14/2023] Open
Abstract
Background Complete relief of pain due to irreversible pulpitis is challenging to obtain with analgesic medications. The high incidence of an inferior alveolar nerve block (IANB) failure makes it difficult for practitioners to perform endodontic treatment without implementing other anesthetic techniques, especially mandibular molars. The aim of this study was to compare efficacies of two different quantities of paraformaldehyde based pulpal medicaments to relieve the pain and control hyperemic pulp post-failure of IANB and supplementary technique in patients experiencing this symptomatic irreversible pulpitis in the permanent mandibular tooth. Method Eighty-two participants with severe pain pre-operatively (Heft Parker Visual Analogue Scale, VAS > 114 mm) were enrolled, and pain responses were recorded at different time intervals using the Heft Parker visual analogue scale. To the patients experiencing pain even after the administration of the standard IANB and supplemental intraligamentary injection, one of the two paraformaldehyde based pulpal medicaments was placed in the pulp chamber and sealed. Participants were recalled after 24-48 h (second visit) to assess pain and bleeding reduction. Results Results showed a significant decrease in pain severity and bleeding score post medicament placement (p < .05). Hence judicious use within a recommended period, pulpal medicaments can be considered safe. Conclusion Paraformaldehyde based pulpal medicament can be used as an alternative to manage pain in patients having severe irreversible pulpitis and hyperalgesia.
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Affiliation(s)
- Naomi Ranjan Singh
- Department of Conservative Dentistry and Endoodntics, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Lora Mishra
- Department of Conservative Dentistry and Endoodntics, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endoodntics, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Nike Kurniawati
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya City, East Java, Indonesia
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya City, East Java, Indonesia
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol 2019; 89 Suppl 1:S28-S45. [PMID: 29926945 DOI: 10.1002/jper.17-0163] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/20/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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3
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Clin Periodontol 2019; 45 Suppl 20:S28-S43. [PMID: 29926497 DOI: 10.1111/jcpe.12938] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/16/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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4
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Lee CH, Choi Y, Park S. Mandibular bone necrosis after use of paraformaldehyde-containing paste. Restor Dent Endod 2016; 41:332-337. [PMID: 27847756 PMCID: PMC5107436 DOI: 10.5395/rde.2016.41.4.332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 09/28/2016] [Indexed: 11/11/2022] Open
Abstract
Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis.
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Affiliation(s)
- Chi-Hwan Lee
- Department of Conservative Dentistry, Wonkwang University School of Dentistry, Iksan, Korea
| | - Yoorina Choi
- Department of Conservative Dentistry, Wonkwang University School of Dentistry, Iksan, Korea
| | - Sujung Park
- Department of Conservative Dentistry, Wonkwang University School of Dentistry, Iksan, Korea
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5
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Justus B, Sirajuddin S, Gundapaneni V, Biswas S, MN K, MP R. Iatrogenic Damage to the Periodontium by Chemicals and Dental Materials. Open Dent J 2015; 9:223-7. [PMID: 26312092 PMCID: PMC4541370 DOI: 10.2174/1874210601509010223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/04/2015] [Accepted: 03/10/2015] [Indexed: 11/22/2022] Open
Abstract
The toxicity and tissue reactions to dental materials are receiving more attention as a wide variety of materials are used and as federal agencies demonstrate more concern in this area. A further indication of the importance of the interaction of materials and tissues is the development of recommended standard practices and tests for the biological interaction of materials.
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6
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Mandibular bone and soft tissues necrosis caused by an arsenical endodontic preparation treated with piezoelectric device. Case Rep Dent 2013; 2013:723753. [PMID: 24062957 PMCID: PMC3766612 DOI: 10.1155/2013/723753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 07/17/2013] [Indexed: 11/17/2022] Open
Abstract
This paper describes a case of wide mandibular bone necrosis associated with significant soft tissues injury after using an arsenical endodontic preparation in the right lower second molar for endodontic purpose. Authors debate about the hazardous effects of the arsenic paste and the usefulness of piezosurgery for treatment of this drug related bone necrosis.
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Chen G, Sung PT. Gingival and localized alveolar bone necrosis related to the use of arsenic trioxide paste--two case reports. J Formos Med Assoc 2012; 113:187-90. [PMID: 24630037 DOI: 10.1016/j.jfma.2012.07.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 04/04/2010] [Accepted: 07/21/2010] [Indexed: 11/30/2022] Open
Abstract
The leakage of arsenic trioxide paste from tooth fillings has been associated with widespread necrosis of the supporting periodontal tissues. This report describes two cases of arsenic trioxide paste-induced gingival and localized alveolar bone necrosis in the mandible, following the use of arsenic trioxide paste as a pulp-devitalized agent. The first case was a 54-year-old female complaining of a painful white patch on the gingival tissue of the left mandibular second molar (tooth #37) after treatment by a private dentist. She underwent completely debridement of all necrotic soft tissue with physical saline irrigation. The gingival tissue was gradually replaced with vascular tissue and completely healed after 7 weeks. The second case was a 30-year-old female complaining of severe pain and continuous gingival bleeding from the right maxillary first bicuspid (tooth #14) following treatment by a private dentist. She finally accepted debridement of the sequestrum and necrotic alveolar bone with decortication to induce active bleeding. A partial thickness gingival flap was made to cover the wound. Four weeks later, the supporting tissues had completely healed. Arsenic trioxide paste is a cytotoxic agent and may cause harmful adverse effects on adjacent periodontium and supporting hard tissue if leakage occurs, or it is used carelessly. There is no indication for the use of arsenic trioxide paste in modern dental practice.
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Affiliation(s)
- Gin Chen
- Division of Endodontics and Periodontics, Department of Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan; National Yang-Ming Medical University, College of Dentistry, Taipei, Taiwan; Chung Shan Medical University, College of Dentistry, Taichung, Taiwan.
| | - Po-Ta Sung
- Division of Endodontics and Periodontics, Department of Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
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9
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Zafalon EJ, Versiani MA, de Souza CJA, Moura CCG, Dechichi P. In vivo comparison of the biocompatibility of two root canal sealers implanted into the subcutaneous connective tissue of rats. ACTA ACUST UNITED AC 2007; 103:e88-94. [PMID: 17320427 DOI: 10.1016/j.tripleo.2006.11.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2006] [Revised: 07/19/2006] [Accepted: 11/16/2006] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the subcutaneous biocompatibility of 2 root canal sealers. STUDY DESIGN The subcutaneous implant technique recommended by the Fédération Dentaire International (FDI) was used to test Endométhasone and EndoREZ root canal sealers. These materials were placed in Teflon tubes, 1 mm in diameter and 10 mm in length, and implanted into 2 pockets created in the back of 40 Calomys callosus rodents, 20 for each material. Tissue biopsies were collected and histologically examined 15, 30, 60, and 90 days after the implantation procedure. The overall level of the inflammatory tissue response was graded as none, slight, moderate, or severe on the sealer-connective tissue interface at the opening ends of the tubes. The connective tissue response along the lateral wall outside of each tube served as a negative control. RESULTS The tissue reaction to the Endométhasone diminished with time. The EndoREZ sealer was highly toxic during all experimental periods. CONCLUSION Endométhasone root canal sealer presented biocompatibility within the analyzed periods, whereas EndoREZ showed no biocompatible behavior and caused late hypersensitive reaction.
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Affiliation(s)
- Edilson José Zafalon
- Department of Endodontics, College of Dentistry, Universidade Federal de Campo Grande, Campo Grande, Brazil
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Boonyapakorn T, Supanchart C, Reichart PA. Radiopaque lesion with peripheral radiolucency of the mandible. ACTA ACUST UNITED AC 2006; 102:713-8. [PMID: 17138170 DOI: 10.1016/j.tripleo.2006.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 01/26/2006] [Accepted: 02/22/2006] [Indexed: 11/15/2022]
Affiliation(s)
- Thacharot Boonyapakorn
- Charité, Universitätsmedizin Berlin, Campus Virchow Klinikum, Center of Dental Medicine, Department of Oral Surgery and Dental Radiology, Berlin, Germany
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Sousa CJA, Montes CRM, Pascon EA, Loyola AM, Versiani MA. Comparison of the Intraosseous Biocompatibility of AH Plus, EndoREZ, and Epiphany Root Canal Sealers. J Endod 2006; 32:656-62. [PMID: 16793475 DOI: 10.1016/j.joen.2005.12.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2005] [Revised: 11/30/2005] [Accepted: 12/01/2005] [Indexed: 11/25/2022]
Abstract
To evaluate the intraosseous biocompatibility of AH Plus, EndoREZ, and Epiphany root canal sealers as recommended by the Technical Report #9 of the Fédération Dentaire Internationale (FDI). Thirty guinea pigs, 10 for each material, divided into experimental periods of 4 and 12 weeks, received one implant on each side of the lower jaw symphysis. At the end of the observation periods, the animals were killed and the specimens prepared for routine histological examination. After analyzing both periods, the inflammatory tissue reaction to EndoREZ was considered severe. In the AH Plus group, the reaction changed from severe to moderate, while it was observed biological compatibility to Epiphany with bone formation and none to slight inflammatory reaction. It was concluded that Epiphany root canal sealer was the only material that presented intraosseous biocompatibility within the two analyzed periods.
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Affiliation(s)
- Cássio J A Sousa
- Department of Endodontics, Faculty of Dentistry, Universidade Federal de Uberlândria, Uberlândia, Minas Gerais, Brazil.
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12
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Torabinejad M, Kutsenko D, Machnick TK, Ismail A, Newton CW. Levels of Evidence for the Outcome of Nonsurgical Endodontic Treatment. J Endod 2005; 31:637-46. [PMID: 16123698 DOI: 10.1097/01.don.0000153593.64951.14] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The purpose of this systematic review was (a) to search for clinical articles pertaining to success and failure of nonsurgical root canal therapy, and (b) to assign levels of evidence to these studies. Electronic and manual searches were conducted to identify studies published between January 1966 and September 2004 with information on the success and failure of nonsurgical root canal therapy. Articles were reviewed and graded for strength of level of evidence (LOE) from one (highest level) to five (lowest level). This review resulted in the identification of 306 clinical studies related to this topic area. Six articles were randomized controlled trials (RCTs, LOE 1). This search also identified 12 low-quality RCTs (LOE 2), 14 cohort studies (LOE 2), five case-control and eight cross sectional studies (LOE 3), four low-quality cohort studies (LOE 4), and five low-quality case-control studies (LOE 4). The majority (73) of the often-quoted "success and failure" studies were case series (LOE 4). The rest of the articles were descriptive epidemiological studies (42), case reports (114), expert opinions (18), literature reviews (4), and one meta-analysis. Based on these findings, it appears that a few high-level studies have been published in the past four decades related to the success and failure of nonsurgical root canal therapy. The data generated by this search can be used in future studies to specifically answer questions and test hypotheses relevant to the outcome of nonsurgical root canal treatment.
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Affiliation(s)
- Mahmoud Torabinejad
- Department of Endodontics of the School of Dentistry, Loma Linda University, Loma Linda, California 92350, USA.
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13
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Ozgöz M, Yagiz H, Ciçek Y, Tezel A. Gingival necrosis following the use of a paraformaldehyde-containing paste: a case report. Int Endod J 2004; 37:157-61. [PMID: 14997897 DOI: 10.1111/j.0143-2885.2004.00770.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To report on an unusual case of gingival necrosis following the use of a paraformaldehyde-containing paste in root canal treatment. SUMMARY Paraformaldehyde preparations are toxic to hard and soft tissues. In an era of effective local anaesthesia, toxic devitalizing preparations have few applications. However, in a mobile world population, severe tissue injury may occasionally be encountered after the use of paraformaldehyde or other toxic agents in some parts of the world. Dentists should avoid such preparations and be alert of the features and management of local toxicity if they encounter it in practice. KEY LEARNING POINTS Paraformaldehyde-containing pastes have no application in contemporary dentistry. Dentists should avoid toxic preparations for pulp devitalization. Dentists should be aware of the features and management of tissue necrosis resulting from the use of toxic dressing materials.
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Affiliation(s)
- M Ozgöz
- Department of Periodontology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey.
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Kaplan AE, Ormaechea MF, Picca M, Canzobre MC, Ubios AM. Rheological properties and biocompatibility of endodontic sealers. Int Endod J 2003; 36:527-32. [PMID: 12887381 DOI: 10.1046/j.1365-2591.2003.00683.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM To determine the flow characteristics and subcutaneous tissue reactions to five endodontic sealers. METHODOLOGY The materials used were Procosol, AH26, Endomethasone, Sealapex and Endion. The sealers were prepared following the manufacturers' instructions, and 0.075 mL of each material was placed on a glass surface, which was then rotated 90 degrees. The samples were stored at 37 degrees C and 95% humidity. The displacement of the sealer was recorded by measuring the difference between its original position and the position recorded at 15 and 60 min. Three samples of each material were used. Two pockets were created in the back of Wistar rats, and one silicone tube, 1 mm in diameter and 1 cm in length, was implanted in each. One was filled with one of the materials under study, and the other empty tube was implanted as a control. Fourteen days after implantation, the animals were sacrificed, and samples of the skin containing the tubes were histologically processed. Histological and histomorphometric evaluations of the tissues adjacent to the open end of the tube were carried out the volume of tissue reaction was measured histomorphometrically according to standard stereological principles. Results were statistically analysed using analysis of variance and Duncan's test. RESULTS The highest flow values were obtained with Sealapex and AH26. Time significantly affected the flow and the material (P < (1001). Procosol and Endion produced the most severe histological reactions: these were outlined by fibrous tissue; AH26. Endomethasone and Sealapex produced reactions of smaller size and with more moderately defined limits. CONCLUSIONS The flow did not correlate with the degree of inflammatory response. Procosol and Endion produced the most severe tissue reactions, whereas Endomethasone, Sealapex and AH26 produced only minimum reactions.
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Affiliation(s)
- A E Kaplan
- Departments of Dental Materials, Histology and Embryology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.
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Hommez GMG, De Moor RJG, Braem M. Endodontic treatment performed by Flemish dentists. Part 2. Canal filling and decision making for referrals and treatment of apical periodontitis. Int Endod J 2003; 36:344-51. [PMID: 12752648 DOI: 10.1046/j.1365-2591.2003.00655.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM To gather information on root-canal treatment carried out by dentists working in Flanders (Belgium). METHODOLOGY A questionnaire reported in a previous study was also used to gather information on canal medicaments, canal filling, and in decision making for referrals and treatment of apical periodontitis. RESULTS Calcium hydroxide as an interappointment dressing was used by 69.7% of the respondents. Approximately one-third of the respondents did not use any intracanal medicament. Caustic products used for pulp tissue fixation were used by 66.8% of the respondents. Cavit (48.2%) and glass-ionomer (31.3%) were the temporary coronal-filling materials used most often, followed by zinc oxide-eugenol and IRM(R). Cold lateral condensation of gutta-percha was the filling technique most used by the respondents (65.8%). Single-cone gutta-percha placement (16%), paste techniques (4.9%) and silver points (3.9%) were still used. Resin-based sealers were used most often (88.6%). Paraformaldehyde containing sealers such as Endomethasone and N2 were used infrequently. Approximately half of the practitioners were satisfied with their canal-filling technique, others felt that they could do better (43.0%); 0.7% were not satisfied. In cases with apical periodontitis, the size of periapical lesions and/or the presence of a root filling influenced the choice of endodontic treatment. The most common reasons for referral of endodontic cases were: retrieval of silver points, surgery, and post removal. CONCLUSIONS The results of this study indicate that techniques and methods used for canal medication and canal filling were acceptable for the majority of the respondents. Re-treatment was underestimated as a treatment option.
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Affiliation(s)
- G M G Hommez
- Department of Operative Dentistry and Endodontology, Ghent University, Ghent University Hospital, Dental School, Gent, Belgium
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Abstract
AIM To describe some toxic effects of arsenic trioxide in the mouth, to condemn its continued use, and present a case in which a tooth was preserved despite significant bony destruction. SUMMARY A case is presented in which severe alveolar bone necrosis resulted from leak-age of an arsenical devitalization paste into the periodontium. The tooth was root canal treated before root amputation, and restored with a cuspal coverage restoration. The tooth was observed to be symptomless and functional at the one-year follow-up. KEY LEARNING POINTS * Arsenic and its compounds have no place in contemporary endodontics. * Dentists should protect their patients by avoiding the use of arsenic-containing materials and refusing to use products whose constituents are not known. * Localized bone necrosis may not require tooth extraction. Depending on the severity of the case, the tooth may be preserved by a combination of endodontic, periodontal,prosthodontic and maintenance therapies.
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Affiliation(s)
- N Ozmeriç
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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17
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Abstract
The origin of gingival inflammation is occasionally different from that of routine plaque-associated gingivitis, and such non-plaque-associated types of gingivitis often present characteristic clinical features. Examples of such forms of gingivitis are specific bacterial, viral, and fungal infections. Specific bacterial infections of gingiva may be due to Neisseria gonorrhea, Treponema pallidum, streptococci, and other organisms. The most important viral infections of gingiva are herpes simplex virus type 1 and 2 and varicella-zoster virus. Fungal infections may be caused by several fungi, the most important of these being Candida species including C. albicans, C. glabrata, C. krusei, C. tropicalis, C. parapsilosis, and C. guillermondii. Gingival histoplasmosis is a granulomatous disease caused by the fungus Histoplasma capsulatum and, as for the other specific infections of gingiva, a confirmed diagnosis may require histopathologic examination and/or culture. Atypical gingivitis may also occur as gingival manifestations of dermatological diseases, the most relevant of these being lichen planus, pemphigoid, pemphigus vulgaris, erythema multiforme, and lupus erythematosus. Non-plaque induced gingival inflammation can be caused by allergic reactions to dental restorative materials, toothpastes, mouthwashes, and foods. In addition, gingival inflammation may result from toxic reactions, foreign body reactions, or mechanical and thermal trauma.
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Affiliation(s)
- P Holmstrup
- University of Copenhagen, School of Dentistry, Denmark.
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