This study was performed to prepare the quantitative method of judging the sensitive prognosis of chronic apical periodontitis as early as possible. The subjects were 25 cases with periapical radiolucencies of which were treated with endodontic treatment. Serial radiographs were taken by standardized method longitudinally. The density slice function of digital radiographic system were employed for quantitative and longitudinal assessment of the radiolucent area and the condensing osteitis simultaneously. Obtained results were as follows: 1. The amount of bone repair after endodontic treatment could be detected quantitatively by the density slice function of digital radiographic system. 2. Within the 6-week period after root canal filling, the prognosis could be evaluated by assessment both radiolucent area and condensing osteitis on digital radiographic system. 3. The pattern of bone repair showed peripheral type in most cases from the 6th week after root canal filling. 4. In longitudinal change, bone repair showed two patterns; the succeeding reduction of radiolucent area showing the increase of condensing osteitis in size till 6th week and following by static state or reduction tendency and the reduction following the initial increase of both areas. 5. Cases with pulpitis by trauma showed initial increase of condensing osteitis at 2nd week, marked reduction of radiolucent area and condensing osteitis at 6th week, and approximately normal bone state at 8th week after root canal filling.
Gingival recession is clinically manifested by an apical displacement of the gingival tissue and dentin hypersensitivity is often used to describe a painful condition in which exposed dentin is unduly sensitive to intraoral stimuli. The objects of this study were primarily to investigate the prevalence and distribution of gingival recession and hypersensitivity and secondarily to determine whether a relationship exists between gingival recession and hypersensitivity. The study population was 195 patients (102 males, 93 females) who were attended the department of periodontology, Pusan National University Hospital. 189 patients exhibited gingival recession at least more than 1 tooth, the prevalence was 96.9%. The maxillary and mandibular first premolar and mandibular incisors had the highest prevalence. The majority of patients (139 patients, 71.3%) were diagnosed as having dentin hypersensitivity. Dentin hypersensitivity was determined to 3 seconds application of cold air to the exposed root surface after isolating the test tooth and was commonest in maxillary and mandibular first premolars and mandibular incisors. Relationship between recession and hypersensitivity was analyzed using chi-square test (p=0.05), significant relation (p=0.000) was existed. Gingival recession was more severe, the prevalence of hypersensitivity was higher.
Objectives: This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment. Materials and Methods: A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours. Conclusions: Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.
Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.
Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Threrfore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingival, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1. The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. the average periodontal pocket depth is 2.0mm and 47% of frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2. With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3. With statistical significance(p<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (p>0.05). 4. The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (p<0.05). 5. With statistical significance(p<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (p>0.05).
Root surfaces affected by periodontal disease undergo various forms of changes. Cementum exposure from gingival recession may result in absorption of calcium, phosphorus, and fluoride and subsequent hypermineralization and increased radiodensity. Although some reports have suggested that inorganic content with root cementum might show various changes depending upon age or extent of periodontal disease, but no consensus can be reached regarding the the distribution of various elements. The present study examines the difference in mineral content between healthy and periodontal diseased roots by analyzing three areas per tooth along the root surface in cervico-apical direction using electron probe and scanning electron microscope. Healthy tooth that was extracted for orthodontic purpose was used as control. Experimental teeth include those with periodontal pocket depth exceeding 6mm and those with gingival recession and periodontal pocket depth of 2-4mm. Levels of Ca, P, Mg and Na were measured using wavelength dispersive x-ray spectrometer at three areas per tooth. The examined areas were located apical to cemento-enamel junction in control and periodontal ligament-depleted areas in experimental teeth. The corresponding areas were also examined with scanning electron microscope(x70) The results are as follows. 1. Minerals were detected in order of Ca, P, Mg and Na. In all root surfaces, levels of Ca and P were higher in dentin than in cementum. 2. Level of Mg was twice as high in dentin than in cementum. There was no significant difference in the level of Mg and Na between normal and periodontal diseased roots or between the various locations in the same root. 3. Level of Ca and P in the surface cementum showed no difference between normal and periodontal diseased root, although the areas in dentin with high level of either ion also showed high level of corresponding ion in cementum. 4. Difference in the Ca and P content between various locations within the same root was noted, although no coherent pattern existed. These results suggest that although the mineral content of the root cementum in periodontitis-affected tooth is affected by exogenous ions from saliva and food, but there was no difference in the mineral contents between normal and periodontally diseased root.
Objectives: This study aimed to compare the postoperative pain and clinical performance after applying three different intracanal medicaments and root canal sealers. Materials and Methods: Sixty-five patients requiring root canal treatment due to symptomatic apical periodontitis were included in this study. After a glide path preparation by using PathFile, each canal was shaped with ProTaper Next file system. After the canal cleaning and shaping procedure, the canal was dried and each intracanal medicaments were adjusted (Calcipex II, TRC-paste, Metapaste). At the next visit, the patients were requested to answer the absence of the pain after the procedure. Once the patients showed no symptom, the canal was obturated with each corresponded root canal sealers (AH plus, Radic-sealer, ADseal). The patients were recalled after 1 week, 1, 3, and 6 months to check the postoperative pain or unexpected clinical signs. One-way ANOVA and Duncan's post hoc comparison, and Chi-square test were used for statistical analysis to evaluate any differences among tested materials. Results: The average number of visits for intracanal medication was 2.69, 2.65, and 2.61 for Calcipex II, TRC-paste, and Metapaste. There were no statistically differences in post-obturation pain among three groups obturated with different root canal sealers (P > 0.05). Conclusions: Under the limitations of this study, three tested intracanal medicaments and epoxy resin root canal sealers showed clinically acceptable similar results.
Black-pigmented bacteria have been implicated in the endodontic infections. This group of microorganisms includes Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, and Prevotella nigrescens. The organisms display a wide variety of virulence factors that may be pertinent to acute endodontic infections. The aim of this study was to identify P. endodontalis, P. gingivalis, P. intermedia, and P. nigrescens by using special potency disk test, filter paper spot test, 165 rRNA gene-directed PCR, and API 32A. Microbial samples were collected from root canals of 33 intact teeth with necrotic pulp and/or apical periodontitis. Conventional laboratory methods were used for identification of the strains of black pigmented bacteria. Eighteen of 33 samples were positive for the growth of black-pigmented bacteria Five colonies were cultured from each pure cultured colonies from Brucella agar plate. Seventy seven colonies were positive for the growth of black-pigmented bacteria. Thirty three of 77(42.6%) were identifed as P. nigrescens, 10 of 77(12.9%)were P. gingivalis, 6 of 77(7.8%) were P. endodontalis, 10 of 77(12.9%) were P. intermedia. On the contrary the reference strains of P. nigrescens, experimental strains of P nigrescens was sensitive to kanamycin in special potency disk test. 165 rRNA gene PCR and API test after rapid presumptative identification methods, such as special potency disk test and filter paper spot test, would be accurate detection methods for black-pigemented bacteria.
Anaerobic black-pigmented bacteria have been implicated in the endodontic infections. This group of microorganisms includes Porphyromonas endodontalis, P. gingivalis, Prevotella intermedia, and Prevotella nigrescens. The organisms display a wide variety of virulence factors that may be pertinent to acute endodontic infections. The aim of this study was to identify P. endodontalis, P. gingivalis, P. intermedia, and P. nigrescens by using the special potency disk test, filter paper spot test, 16S rRNA gene-directed PCR, and API 32A system. Microbial samples were collected from root canals of 33 intact teeth with necrotic pulp and apical periodontitis. Conventional laboratory methods were used to identify the strains of anaerobic black pigmented bacteria. Eighteen out of 33 samples were positive for the growth of black-pigmented bacrteria. Five colonies were cultured from each pure cultured colony from Brucella agar plates. Seventy seven colonies were positive for the growth of black-pigmented bacteria. Thirty three out of 77(42.8%) were identifed as P. nigrescens, 10 out of 77(13%)were P. gingivalis, 6 out of 77(7.8%) were P. endodontalis, 10 out of 77(13%) were P. intermedia. On the contrary the reference strains of P. nigrescens, experimental strains of P. nigrescens were susceptible to kanamycin in the special potency disk test. We concluded that after rapid presumptive identification methods, such as the special potency disk test and filter paper spot test were done, 16S rRNA gene PCR and API 32A test would be accurate detection methods for black-pigemented bacteria.
There has been many attempts to develop a method that can regenerate periodontal tissues that were lost due to periodontal diseasd, but none of them was completely successful. This study was designed to investigate the healing and regeneration of periodontal tissue when bone substitutes such as porous replamineform hydroxyapatite and porous resorbable calcium carbonate were used in combination with oxidized cellulose membrane and collagen absorbable hemostat, compared to a control where only oxidized cellulose membrane or collagen absorbable hemostat were used. Chronic periodontitis was induced on mandibular premolars of and adult dog by placing orthodontic elastic ligatures for 10 weeks. After flap operation, the control group were received oxidized cellulose membrane (control- I )or collagen absorbable hemostat (control- II) only, while one experimental group was given either porous replamineform hydroxyapatite or porous resorbable calcium carbonate in addition to oxidized cellulose membrane (Experimental I-A, I-B), and another experimental group was treated by using either porous replamineform hydroxyapatite or porous resorbable calcium carbonate in addition to collagen absorbable hemostat. (Experimental II-A, II-B) After 56 weeks, healing was histologically analyzed with the following results. 1. Apical migration of junctional epithelium was observed only in areas coronal to the notch for both control and experimental group. 2. Inflammatory cell infiltration was not observed in any groups. 3. Oxidized cellulose membrane and collagen absorbable hemostat were completely resorbed. 4. Newly-formed cementum was observed up to the level where junctional epithelium was located, for both control and experimental groups. 5. Bone formation was limited of the middle portion of the notch in the control group, where as experimental groups showed bone formation up to the level of implant materials coronal to the notch. 6. Minute resorption of apically located portions of implanted materials was observed in experimental group I-B and II-B only.
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