1
|
von Arx T, Janner SF, Hänni S, Bornstein MM. Radiographic Assessment of Bone Healing Using Cone-beam Computed Tomographic Scans 1 and 5 Years after Apical Surgery. J Endod 2019; 45:1307-1313. [DOI: 10.1016/j.joen.2019.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/11/2019] [Indexed: 10/26/2022]
|
2
|
von Arx T, Jensen SS, Janner SF, Hänni S, Bornstein MM. A 10-year Follow-up Study of 119 Teeth Treated with Apical Surgery and Root-end Filling with Mineral Trioxide Aggregate. J Endod 2019; 45:394-401. [DOI: 10.1016/j.joen.2018.12.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/04/2018] [Accepted: 12/15/2018] [Indexed: 10/27/2022]
|
3
|
von Arx T, Janner SF, Hänni S, Bornstein MM. Scarring of Soft Tissues Following Apical Surgery: Visual Assessment of Outcomes One Year After Intervention Using the Bern and Manchester Scores. INT J PERIODONT REST 2016; 36:817-823. [PMID: 27740642 DOI: 10.11607/prd.3010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The successful outcome of apical surgery is usually defined by absence of clinical signs and symptoms and resolution of previous periapical radiolucencies. However, little attention is given to soft tissue scarring. The present study evaluated the severity of gingival and mucosal scarring 1 year following apical surgery of 52 teeth. Clinical pictures taken at the 1-year examination were rated by three observers using specific scarring scores. The overall repeatability of the two scores was high (85.3%), whereas the overall reproducibility was relatively low (44.2%). None of the tested variables proved significant for influencing scar severity.
Collapse
|
4
|
von Arx T, Janner SF, Hänni S, Bornstein MM. Evaluation of New Cone-beam Computed Tomographic Criteria for Radiographic Healing Evaluation after Apical Surgery: Assessment of Repeatability and Reproducibility. J Endod 2016; 42:236-42. [DOI: 10.1016/j.joen.2015.11.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/22/2015] [Indexed: 10/22/2022]
|
5
|
von Arx T, Janner SFM, Hänni S, Bornstein MM. Agreement between 2D and 3D radiographic outcome assessment one year after periapical surgery. Int Endod J 2015; 49:915-25. [PMID: 26356580 DOI: 10.1111/iej.12548] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 09/06/2015] [Indexed: 11/30/2022]
Abstract
AIM To compare 2D with 3D radiography in assessing the treatment outcome 1 year after periapical surgery. METHODOLOGY In this prospective study, periapical radiographs (PA) and cone beam computed tomography (CBCT) were performed 1 year after periapical surgery. Three calibrated observers independently evaluated the radiographs for the presence and type of periapical radiolucencies. Ratings in PA were compared to those in bucco-lingual and mesio-distal CBCT images (coronal and sagittal planes), and the ratings of the latter two were also compared between each other. Further, maximum size diameters of radiolucencies were measured on CBCT scans, and the calculated means were correlated with the types of radiolucency. Statistical analysis was completed using Friedman rank sum tests, the Wilcoxon signed rank test and the Pearson correlation coefficient. RESULTS A total of 61 roots in 54 patients were eligible for the final assessment. On average, the intra-observer ratings were identical in 59.6% when comparing PA and CBCT (kappa 0.112 to 0.192). A very high intra-observer agreement (93.4%) was noted when comparing bucco-lingual and mesio-distal CBCT ratings (kappa 0.797 to 1). Interobserver agreement was higher for PA (68.8%) than for CBCT (bucco-lingual 45.9%, mesio-distal 47.5%), but without reaching significant differences. The calculated mean size of persistent radiolucencies in CBCT scans correlated well with the assigned types of radiolucency. CONCLUSION CBCT images showed in nearly a third of the evaluated cases a worse situation than PA. There is a need to define criteria to assess the 'radiographic healing' in CBCT following periapical surgery.
Collapse
Affiliation(s)
- T von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - S F M Janner
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - S Hänni
- Department of Preventive, Pediatric and Restorative Dentistry, School of Dental Medicine, University of Bern and Private Practice limited to Endodontology, Bern, Switzerland
| | - M M Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
6
|
von Arx T, Jensen SS, Hänni S, Friedman S. Five-Year Longitudinal Assessment of the Prognosis of Apical Microsurgery. J Endod 2012; 38:570-9. [DOI: 10.1016/j.joen.2012.02.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 02/06/2012] [Indexed: 11/27/2022]
|
7
|
von Arx T, Hänni S, Jensen SS. Clinical Results with Two Different Methods of Root-end Preparation and Filling in Apical Surgery: Mineral Trioxide Aggregate and Adhesive Resin Composite. J Endod 2010; 36:1122-9. [DOI: 10.1016/j.joen.2010.03.040] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 03/30/2010] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
|
8
|
Baumgart M, Hänni S, Suter B, Schaffner M, Lussi A. [Dens invaginatus. Review of the literature and diagnostic and therapeutic guidelines]. Schweiz Monatsschr Zahnmed 2009; 119:697-714. [PMID: 19694190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Dens invaginatus is a clinically relevant malformation of teeth resulting from an infolding of enamel and dentine into the dental structure during tooth formation, hence the former denomination "dens in dente". The dens invaginatus shows multiple morphological variations of crown and root formation. This frequently leads to caries, pulpal and periodontal involvement with necrosis and loss of attachment. Therefore, early diagnosis and prevention are of utmost importance. Due to the complexity of the malformation, treatment options in former days were limited. This article presents a profound review of the literature regarding etiology, epidemiology and histology. It discusses clinical appearance and diagnosis and it provides guidelines for decision-making and treatment of invaginated teeth.
Collapse
Affiliation(s)
- Manuela Baumgart
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin Universität Bern
| | | | | | | | | |
Collapse
|
9
|
Hänni S, von Arx T. [Injuries to permanent teeth--Part 4: Therapy of crown fractures]. Schweiz Monatsschr Zahnmed 2008; 118:737-755. [PMID: 18800565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Diagnostic and therapeutic interventions following dental injuries are not part of the routine practice in the dental office. Quite often, these patients are emergency cases who seek treatment after normal office hours. The objective of this and the future papers is to present the current treatment concepts in dental traumatology at the School of Dental Medicine, University of Berne. The fruitful cooperation in the field of dental traumatology between the Department of Oral Surgery and Stomatology, and the Department of Conservative Dentistry (including pediatric dentistry and endodontology) is based on the interdisciplinary approach that has been established five years ago. Following discussion and evaluation of such treated cases, and considering current clinical and experimental references, the said concepts have been worked out. The present paper describes the therapeutic concepts of crown fractures.
Collapse
Affiliation(s)
- Stefan Hänni
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern Freiburgstrasse 7, 3010 Bern.
| | | |
Collapse
|
10
|
von Arx T, Jensen SS, Hänni S. Clinical and Radiographic Assessment of Various Predictors for Healing Outcome 1 Year After Periapical Surgery. J Endod 2007; 33:123-8. [PMID: 17258628 DOI: 10.1016/j.joen.2006.10.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 09/20/2006] [Accepted: 10/09/2006] [Indexed: 11/16/2022]
Abstract
This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).
Collapse
Affiliation(s)
- Thomas von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland, and Deparatment of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Glostrup, Denmark.
| | | | | |
Collapse
|
11
|
von Arx T, Chappuis V, Hänni S. [Injuries to permanent teeth. Part 3: Therapy of root fractures]. Schweiz Monatsschr Zahnmed 2007; 117:134-48. [PMID: 17346000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Diagnostic and therapeutic interventions following dental injuries are not part of the routine practice in the dental office. Quite often, these patients are emergency cases who seek treatment after normal office hours. The objective of this and the future papers is to present the current treatment concepts in dental traumatology at the School of Dental Medicine, University of Berne. The fruitful cooperation in the field of dental traumatology between the Department of Oral Surgery and Stomatology, and the Department of Conservative Dentistry (including pediatric dentistry and endodontology), is based on the interdisciplinary approach that has been established four years ago. Following discussion and evaluation of such treated cases, and considering current clinical and experimental studies, the said concepts have been worked out. The present paper describes the therapeutic approach for root fractures.
Collapse
Affiliation(s)
- Thomas von Arx
- Klinik für Oralchirurgie und Stomatologie, Zahnmedizinische Kliniken der Universität Bern.
| | | | | |
Collapse
|
12
|
Abstract
AIM To evaluate the haemostatic efficacy and the histologic tissue responses after the application of different haemostatic agents used in periradicular surgery. METHODOLOGY The study was conducted in the calvarium of six rabbits. Standardized bone defects (diameter 4 mm) were trephined, and different haemostatic agents were applied and compared with control defects: bone wax (left for 10 min), Stasis (ferric sulphate, left for 5 s), Expasyl (aluminium chloride, left for 2 min and left permanently in situ), and a combination of Expasyl (2 min) and Stasis (5 s). The sites were photographed before the application and after the removal of the haemostatic agents. Three independent examiners judged the initial and final bleeding (on the photographs) using a bleeding score for each site and treatment. The results were compared using Wilcoxon's signed rank test. For the histologic analysis, three animals were killed after 3 weeks and three animals after 12 weeks. Transverse, nondecalcified sections were stained with combined basic fuchsin and toluidine blue for descriptive histology. RESULTS The most efficient haemorrhage control was provided by Expasyl in combination with Stasis and by Expasyl alone, whereas bone wax had the weakest bleeding reduction effect. The histologic analysis after 3 weeks demonstrated an inflammatory and foreign body tissue response towards all haemostatic agents. At 12 weeks, this tissue response was less pronounced but still present in sites treated with bone wax or Expasyl. In general, the inflammatory tissue reactions were limited to the bone defects, and never extended into the surrounding tissues. CONCLUSIONS Expasyl alone or in combination with Stasis appeared to be the most efficient of tested agents to control the bleeding within the bony defects created in a rabbit calvarium model.
Collapse
Affiliation(s)
- T von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland.
| | | | | | | |
Collapse
|
13
|
von Arx T, Chappuis V, Hänni S. [Injuries to permanent teeth. Part 2: Therapy of avulsion]. Schweiz Monatsschr Zahnmed 2005; 115:1057-73. [PMID: 16342645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The present paper describes the current treatment philosophy of dislocated or avulsed permanent teeth at our school. Splinting and medication (root canal treatment, systemic antibiotics, etc.) are targeted to minimize the initial inflammatory reaction and to reduce post-traumatic complications such as pulp necrosis and/ or external root resorption.
Collapse
Affiliation(s)
- Thomas von Arx
- Klinik für Oralchirurgie und Stomatologie Zahnmedizinische Kliniken der Universität Bern, Bern.
| | | | | |
Collapse
|
14
|
von Arx T, Winzap-Kälin C, Hänni S. [Injuries to permanent teeth. Part 1: diagnosis of the tooth injury]. Schweiz Monatsschr Zahnmed 2005; 115:133-43. [PMID: 15771335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Diagnostic and therapeutic interventions following dental injuries are not part of the routine practice in the dental office. Quite often, these patients are emergency cases who seek treatment after normal office hours. The objective of this and the future papers is to present the current treatment concepts in dental traumatology at the School of Dental Medicine, University of Berne. The fruitful cooperation in the field of dental traumatology between the Department of Oral Surgery and Stomatology, and the Department of Conservative Dentistry (including pediatric dentistry and endodontology), is based on the interdisciplinary approach that has been established four years ago. Following discussion and evaluation of such treated cases, and considering current clinical and experimental references, the said concepts have been worked out. The present paper describes the diagnostic measures following injuries to the permanent teeth. Subsequent papers will illustrate our therapeutic concepts of injuries to the periodontal and dental hard tissues of permanent teeth.
Collapse
Affiliation(s)
- Thomas von Arx
- Klinik for Oralchirurgie und Stomatologie, Zahnmedizinische Kliniken der Universität Bern, Freiburgstrasse 7, 3010, Bern.
| | | | | |
Collapse
|
15
|
Abstract
AIM This paper describes the initial experiences following the introduction of a rotary engine-driven preparation technique into the undergraduate endodontic programme at the Zurich University Dental Centre. METHODS Forty third-year students practised the ProFile.04 (PF.04) technique between January and July 2001 in a preclinical course. Between November 2001 and February 2002, 20 of these students (Group A) root-treated 51 teeth in their clinical course using either PF.04, the balanced force technique (BFT) or a combination of both. The second group of 20 students (Group B) similarly treated another 36 randomly selected teeth between April and July 2002. Types of teeth treated by the students and the canal preparation techniques were recorded. The students also completed a short questionnaire, evaluating their opinions of the new course. RESULTS Of the 87 teeth endodontically treated during the clinical course, 34, 14 and 39 were shaped using PF.04 alone, a combination of PF.04 and BFT and BFT alone, respectively. No rotary instruments were fractured during the 1-year clinical course, although some instruments were fractured during the preclinical laboratory course. Overall, the students rated the rotary technique as positive. CONCLUSION A rotary technique was successfully introduced into an undergraduate endodontic programme (this will be continued in the foreseeable future). However, the continuity between the preclinical and the clinical courses was poor as a result of the constraints of the general teaching programme.
Collapse
Affiliation(s)
- S Hänni
- Division of Endodontics, Department of Preventive Dentistry, Periodontology and Cariology, Zurich University, Switzerland; and Endodontic Division, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, USA
| | | | | | | |
Collapse
|
16
|
|