The Prevalence of Pulp stones in Adult Patients of Shiraz Dental School, a Radiographic Assessment

STATEMENT OF THE PROBLEM

Pulp stones are calcifications found in the pulp chamber or pulp canals of the teeth. Its different prevalence in different population is a matter of concern.

PURPOSE

This study aimed to assess the prevalence of pulp stones in a sample of Iranian population and to report its occurrence regarding gender, dental arch, tooth type and dental status.

MATERIALS AND METHODS

Dental records of patients who attended Shiraz Dental School were selected randomly. Only bitewing and periapical radiographs of maxillary and mandibular permanent posterior teeth were studied. Teeth were classified in the case of presence or absence of pulp stones, and the prevalence was analyzed in different gender, tooth types, dental arch, and dental status (intact, carious, or restored) groups. Statistical analysis was performed using X(2) test.

RESULTS

Of the 652examined subjects, 306 (46.9%) had one or more teeth with pulp stones. Of the 8244 posterior teeth examined, 928 (11.25%) had pulp stones in the pulp chamber. These pulp stones were detected in 76(37.6%) of males and 230 (51%) of females. The frequency of pulp stones among different teeth between maxillary and mandibular arches had almost a similar pattern. Among teeth demonstrating the condition, first molars were the most prevalent, followed by second molars. In maxillary molars the frequency of occurrence (26%) was higher than mandibular molars (18.7%). No Significant difference was found between dental status and pulp stones occurrence.

CONCLUSION

The occurrence of pulp stones noted in this study was significantly higher in female, molar teeth than premolar and 1st maxillary molar than mandibular. There was no significant association between pulp stone and condition of the crown.

Survey of Endodontic Practice amongst Iranian Dentists Participating Restorative Dentistry Congress in Shiraz, November 2007

INTRODUCTION

General dental practitioners provide the majority of treatment in Iran. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists participated in 7(th) Congress of Iranian Academy of Restorative Dentistry in Shiraz /2007 in order to evaluate the quality of current practice.

MATERIALS AND METHODS

A questionnaire for this cross-sectional study was designed with the purpose of evaluating the routine endodontic treatment performed by Iranian dentists. The questionnaire made up of 24 questions with multiple-choice answers. Covering subjects are demographic and professional activity, root-canal preparation and instrumentation, choice of irrigants and disinfectants, and choice of obturation techniques.

RESULTS

A total of 247 questionnaires (49.4%) were returned. Ninety-one percent of the respondents were general dental practitioners. The results indicate that there are discrepancies between daily practice and academic teaching, especially regarding the use of rubber dam (only 0.9 % report using it as a standard procedure). Most of practitioners used manual instruments manipulated with a filing technique and few used rotary for canal preparation. The majority of the respondents prepared root canals 0.5-1 mm short of the radiographic apex. The first-choice root-canal irrigant was normal saline (55%), followed by sodium hypochlorite. Approximately, 68% used intracanal medications. The most popular obturation technique was cold lateral condensation (90%) with zinc-oxide eugenol as sealer. Most practitioners performed treatment in two visits for teeth with two or more canals. Eighty-four percent of the dentists used radiograph for determining the working length, and only 2.7% used Apex-locator.

CONCLUSION

The survey mentions the importance of continuing dental education for practitioners to update their knowledge.

Endodontic treatment of a mandibular second molar with two mesial roots: report of a case

A case of unusual root morphology is presented to demonstrate anatomic variations in mandibular second molars. The most common configuration of mandibular second molar is to have two roots with three root canals; however mandibular molars may have many different combinations. Endodontic therapy was performed in a mandibular second molar with 3 separate roots 2 located mesially and one distally. Radiographically all 3 root canals terminated with individual foramina. Three orifices or 3 independent canals were found in the 3 separate roots, indicating a rare anatomic configuration. Looking for additional roots, canals and unusual morphology is an important part of successful endodontics as the knowledge of their existence occasionally enable clinicians to treat a case that otherwise might have ended in failure.

Endodontic therapy on a dentition exhibiting multiple periapical radiolucencies associated with dentinal dysplasia Type 1

Dentinal dysplasia (DD) Type I, is a hereditary disturbance in dentine formation. In this anomaly, teeth in both primary and secondary dentitions are affected, and radiographically show short and blunted roots with obliterated root canals and periapical pathosis. Management of patients with DD has presented dentists with problems. Extraction has been suggested as a treatment alternative for teeth with pulp necrosis and periapical abscess. Follow-up and routine conservative treatment is another choice of treatment plan in DD. Another approach for the treatment of teeth with DD has included periapical surgery and retrograde filling, which is recommended in the teeth with long roots. The purpose of this report is to present an unusual case of dentinal dysplasia Type I in a 22-year-old woman showing upper and lower teeth with obliterated root canals and periapical radiolucencies. In this case, conventional endodontic treatment was performed. Postoperative radiographs and clinical evaluation demonstrated periapical healing and successful results. Based on the results of this case report, conventional endodontic treatment for cases with pulp necrosis and periapical radiolucencies in dentinal dysplasia is highly recommended.

Continued root formation of a pulpless permanent incisor following root canal treatment: a case report

AIM

To present a case of a pulpless permanent incisor that continued root formation following root canal treatment.

SUMMARY

A healthy 8-year-old girl with a history of dental trauma resulting in a coronal fracture involving enamel, dentine and pulp was referred by her general dental practitioner for treatment and evaluation of tooth 21. The tooth had a necrotic pulp and periapical rarefaction was evident radiographically. The canal was prepared, dressed with Ca(OH)2 and then filled with a rolled gutta percha cone and Roth's root canal sealer. A radiograph exposed eight years post-treatment, showed evidence of continued apical formation.

KEY LEARNING POINTS

*Teeth with necrotic pulps and periapical rarefaction may show evidence of continued apical formation after root canal treatment. *Hertwig's epithelial root sheath may be more resistant than expected to trauma and infection.

An in vitro study of coronal microleakage in endodontically-treated teeth restored with posts

Coronal microleakage has received considerable attention as a factor related to failure of endodontic treatment and much emphasis is placed on the quality of the final restoration. Posts are frequently used for the retention of coronal restorations. These can be custom-made or prefabricated. Many authors have examined coronal microleakage with respect to gutta-percha root fillings and plastic coronal restorations, but few have investigated the coronal seal afforded by various post systems. The seal provided by a cemented post depends on the seal of the cement used. The purpose of this study was to compare coronal microleakage around cast and prefabricated posts using a dye-penetration method. Sixty extracted single-rooted human teeth were chemomechanically prepared. The root canals were filled with gutta-percha and sealer and they were then prepared for standard posts. Six groups, each of 10 teeth, were restored with either cast post or prefrabricated post. The posts were cemented with either glass ionomer cement (GIC), Variolink II or Durelon. The teeth were thermocycled and placed in Indian ink for one week. They were then demineralised and rendered transparent. Linear coronal dye penetration around the post was measured and compared. The least dye-penetration was observed in roots restored with a cast post and Variolink II. Dentatus posts demonstrated the most microleakage. It appears that the dentine-bonding cements have less microleakage than the traditional, non-dentine-bonding cements and adaptation of the post with the canal may be more important than the cement used.

Coronal dye penetration of the apical filling materials after post space preparation

Forty canals of palatal and distal roots of molars were cleaned and shaped with the use of a step-back technique. Thirty canals were obturated, 10 each with lateral, vertical, and thermafil techniques. Five root canals were obturated without a root canal sealer and served as positive controls. Another five root canals were obturated, and their coronal half was sealed with sticky wax and served as negative controls. The apical 5 to 6 mm of the filling materials were exposed to india ink for 48 hours. The depth of dye penetration was measured in all groups and statistically analyzed. The apical plugs in the thermafil group had the highest degree of coronal leakage. The ANOVA test showed a significant statistical difference between coronal dye leakage between this group and those found in canals filled by lateral or vertical condensation techniques. The results indicate that the apical filling materials obtained by lateral or vertical condensation leak less than those obtained by thermafil.

A comparison of copper-loading disease in Bedlington terriers and Wilson's disease in humans

Eleven Bedlington terriers were found to have a mean hepatic copper concentration of 6,321 micrograms/g dry wt (normal, 200 micrograms/g dry wt) and renal copper concentration that was three or four times normal. Brain copper levels were normal in younger dogs, were elevated in two older dogs, and were 100 times normal in one dog that died of the disease. Increased concentrations of copper in the liver, kidney, and brain also characterize Wilson's disease. Erythrocyte survival was normal in three affected dogs, but serum glutamic-pyruvic transaminase levels were usually elevated. Unlike the hypoceruloplasminemia of patients with Wilson's disease, plasma ceruloplasmin activity was not only normal but was also slightly elevated in the terriers. Despite their normal or excessive ceruloplasmin, the Bedlington terriers could convert ionic 64Cu to radioceruloplasmin but did so only very slowly. These dogs accumulated significantly more 64Cu in their livers than normal, much like patients with Wilson's disease do before symptoms develop.