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Dao V, Mallya SM, Markovic D, Tetradis S, Chugal N. Reprint of: Prevalence and Characteristics of Root Resorption Identified in Cone-Beam Computed Tomography Scans. J Endod 2023; 49:692-702. [PMID: 37315998 DOI: 10.1016/j.joen.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Root resorption is a destructive process that compromises tooth structure and can result in tooth loss. Often it remains asymptomatic and is an incidental finding on radiographic examinations. The purpose of this study was to determine prevalence and characteristics of root resorption in patients referred for cone-beam computed tomography (CBCT) imaging for a variety of indications. METHODS The study included CBCT scans of 1086 consecutive patients referred for CBCT imaging over an 18-month period. A total of 1148 scans were acquired. Data were abstracted from radiology reports, and prevalence estimates of resorption were computed for the aggregate sample and also across specific indications. RESULTS Resorption was identified in 171 patients (15.7%, 95% CI: 13.6%-17.9%) and in 249 teeth with a prevalence range of 2.6%-92.3% across specific indications. An 18.7% of the patients had 2 resorption sites whereas 8.8% had 3 or more resorption sites. The majority of affected teeth were anteriors (43.8%), followed by molars (40.6%) and premolars (14.5%). The most prevalent resorption types were external (29.3%), cervical (22.5%), infection-induced apical resorption (13.7%), internal (9.6%), and impacted tooth induced (8.8%). The majority of teeth with resorption did not have prior endodontic treatment (73.9%) and had radiographically normal periapex (69.5%). Of 249 teeth with resorption, 31% presented as incidental finding. The prevalence of incidental findings of resorption increased with age, P < .05, and was significantly lower for anterior teeth (20.2%) as compared to premolars (41.7%) and molars (36.6%), (P < .05). CONCLUSION The high proportion of incidental findings of resorption detected by CBCT suggests that resorption is not recognized/detected by conventional radiography and therefore remains underdiagnosed.
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Affiliation(s)
- Vi Dao
- UCLA School of Dentistry, Section of Endodontics, Los Angeles, California
| | - Sanjay M Mallya
- UCLA School of Dentistry, Section of Oral and Maxillofacial Radiology, Los Angeles, California
| | - Daniela Markovic
- David Geffen School of Medicine, Division of General Internal Medicine and Health Sciences Research, Los Angeles, California
| | - Sotirios Tetradis
- UCLA School of Dentistry, Section of Oral and Maxillofacial Radiology, Los Angeles, California
| | - Nadia Chugal
- UCLA School of Dentistry, Section of Endodontics, Los Angeles, California.
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Kim S, Hwang SJ, Seo MS. Effect of orthodontic treatment on the periapical radiolucency of endodontically treated teeth: a CBCT analysis. BMC Oral Health 2023; 23:289. [PMID: 37179291 PMCID: PMC10183127 DOI: 10.1186/s12903-023-02907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/22/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND This study aimed to evaluate periapical radiolucency of endodontically treated teeth before and after orthodontic treatment using cone-beam computed tomography (CBCT). METHODS Patients who underwent orthodontic treatment at Wonkwang University Daejeon Dental Hospital between January 2009 and June 2022 were included based on the following criteria: root canal treatment, and availability of CBCT images taken before and after orthodontic treatment with an interval of > 1 year between both scans. Patients with primary teeth or orthodontic tooth extractions were excluded. The size of the periapical radiolucency (SPR) of the endodontically treated tooth was evaluated using CBCT. Pre-orthodontic treatment CBCT images and the latest post-orthodontic treatment CBCT images were analyzed. The selected teeth were further categorized based on the orthodontic duration, CBCT interval, the patient sex and age, the tooth type and position (maxilla or mandible), and quality of root canal obturation. Statistical analyses were performed to evaluate changes in SPR using the paired t-test and multiple regression analysis. RESULTS In total, 115 teeth (37 anterior teeth, 22 premolars and 56 molars) from 61 patients (age, 14-54 years) were included, with 39 teeth from male patients and 76 teeth from female patients. The age was ranged between 14 and 54 years old, and mean age was 25.87 years old. The mean CBCT interval and orthodontic treatment period were 43.32 months and 36.84 months, respectively. Seventy-five teeth showed good obturation quality, 80 were not used as anchors during orthodontic treatment, and 71 were maxillary. The SPR size increased after orthodontic treatment for 56 teeth and decreased for 59 cases. The average change in SPR was -0.102 mm and the difference was not significant. Significant decrease of SPR were observed between female patients (p = 0.036) and maxillary teeth (p = 0.040). CONCLUSION Orthodontic treatment had no significant impact on the changes in the SPR in endodontically treated teeth in most categories. However, there was a significant difference among females and the maxillary teeth. In both categories, the size of radiolucency decreased significantly.
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Affiliation(s)
- Sunhong Kim
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, 77 Dunsan-Ro, Seo-Gu, 35233, Daejeon, Republic of Korea
| | - Soo-Jeong Hwang
- Department of Dentistry, Doonsan Health Promotion Center, Daejeon, Korea
| | - Min-Seock Seo
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, 77 Dunsan-Ro, Seo-Gu, 35233, Daejeon, Republic of Korea.
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Oliva Rodríguez R, Rangel Galván GY, González Amaro AM, Gutiérrez Cantú FJ, Muñoz Ruiz AI, García Corté JO, Mariel Cárdena J. Correlation between bacterial type/bacterial quantity and bone loss detected by cone beam computed tomography (CBCT) in primary endodontic infections. INVESTIGACIÓN CLÍNICA 2023. [DOI: 10.54817/ic.v64n1a01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Periapical lesions (PL) of endodontic origin are one of the most common pathological conditions that affect peri-radicular tissues. The main ob-jective of this study was to evaluate the amount and species of microorganisms isolated from necrotic pulps, establish a correlation between these and the size of periapical lesions, and how the amount and species of microorganisms decreased with non-surgical root canal treatment. Twenty-seven patients with a clinical diag-nosis of dental pulp necrosis and chronic periapical lesions were selected; a Cone Beam Computed Tomography (CBCT) and microbial samples of the root canal system were taken previous to a disinfection protocol, a post-instrumentation/disinfection protocol, and a post-medication placement. Samples were processed for colony-forming unit (CFU) counting, Gram staining technique, and bacterial identification by the API-20 Strep/API-20A system. The API system identified 21 species of microorganisms in the pre-instrumentation samples, 11 species in the post-instrumentation samples, and 11 in the post-medication samples. There was a correlation coefficient of 0.598% between the initial size of the lesion and the number of bacteria, with a coefficient of determination up to 35.7%, a correla-tion coefficient of 0.486% and a determination coefficient of 23.6% between the size of the periapical lesion and the number of CFUs. This study contributes to the knowledge of the amount and species of microorganisms isolated and identi-fied from necrotic pulps, establishes a correlation between the amount and spe-cies of microorganisms and the size of the periapical lesions, and shows how the decrease of microorganisms contributes to the healing of PL, corroborating the importance of an adequate disinfection protocol.
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Affiliation(s)
- Ricardo Oliva Rodríguez
- Programa de Postgrado en Endodoncia, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Georgina Yaretzy Rangel Galván
- Programa de Postgrado en Endodoncia, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Ana María González Amaro
- Programa de Postgrado en Endodoncia, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Francisco Javier Gutiérrez Cantú
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Abraham Israel Muñoz Ruiz
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - José Obed García Corté
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
| | - Jairo Mariel Cárdena
- Programa de Postgrado en Ciencias Dentales, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luis Potosí, SLP, México
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Prevalence and Characteristics of Root Resorption Identified in Cone-Beam Computed Tomography Scans. J Endod 2023; 49:144-154. [PMID: 36509167 DOI: 10.1016/j.joen.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Root resorption is a destructive process that compromises tooth structure and can result in tooth loss. Often it remains asymptomatic and is an incidental finding on radiographic examinations. The purpose of this study was to determine prevalence and characteristics of root resorption in patients referred for cone-beam computed tomography (CBCT) imaging for a variety of indications. METHODS The study included CBCT scans of 1086 consecutive patients referred for CBCT imaging over an 18-month period. A total of 1148 scans were acquired. Data were abstracted from radiology reports, and prevalence estimates of resorption were computed for the aggregate sample and also across specific indications. RESULTS Resorption was identified in 171 patients (15.7%, 95% CI: 13.6%-17.9%) and in 249 teeth with a prevalence range of 2.6%-92.3% across specific indications. An 18.7% of the patients had 2 resorption sites whereas 8.8% had 3 or more resorption sites. The majority of affected teeth were anteriors (43.8%), followed by molars (40.6%) and premolars (14.5%). The most prevalent resorption types were external (29.3%), cervical (22.5%), infection-induced apical resorption (13.7%), internal (9.6%), and impacted tooth induced (8.8%). The majority of teeth with resorption did not have prior endodontic treatment (73.9%) and had radiographically normal periapex (69.5%). Of 249 teeth with resorption, 31% presented as incidental finding. The prevalence of incidental findings of resorption increased with age, P < .05, and was significantly lower for anterior teeth (20.2%) as compared to premolars (41.7%) and molars (36.6%), (P < .05). CONCLUSION The high proportion of incidental findings of resorption detected by CBCT suggests that resorption is not recognized/detected by conventional radiography and therefore remains underdiagnosed.
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İnce-Yusufoğlu S, Keskin NB, Uslu G, Helvacioglu-Yigit D. Effect of EDDY and manual dynamic activation techniques on postoperative pain in non-surgical retreatment: a randomized controlled trial. BMC Oral Health 2023; 23:3. [PMID: 36597145 PMCID: PMC9809104 DOI: 10.1186/s12903-022-02702-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND During non-surgical retreatment process, the products such as dentin debris, root canal fillings, irrigation solutions, microorganisms and remaining pulp tissues can extrude to the apical area and can cause the postoperative pain and flare-up. Thus, the aim of this study was to evaluatethe effect of EDDY and manual dynamic activation (MDA) techniques on postoperative pain (PP) associated with retreatment. METHODS Ninety patients scheduled for retreatment were treated at a single visit. Non-vital mandibular premolar teeth diagnosed with asymptomatic apical periodontitis were included in this study. The patients were divided into two groups (n = 45) on the basis of the need for additional irrigation activation procedures (EDDY and MDA). The patients' post-treatment pain levels were asked to rate the intensity of their pain on a 10-point numerical rating scale (NRS) at the 12th, 24th, 48th, and 72nd h and 7 days.The data were analyzed using the chi-square and Wilcoxon signed-rank test was used for within-group comparisons and Mann Whitney U test was used to compare the groups by time period. RESULTS The difference in postoperative pain intensity between two groups was statistically significant at 12, 24, 48, and 72 h (p < 0.05). There was no significant difference at 7 days. Moreover, no statistically significant difference was found between the two groups in terms of gender and analgesic medication intake (p > 0.05). Pain intensity after the treatment was lesser in the MDA groupthanin the EDDY group at 12, 24, 48, and 72 h. CONCLUSION This study could lead us to conclude that the two activation systems can be used during endodontic retreatment with no difference at PP 7 days later. However, a comparison of the groups indicated that the EDDY resulted in significantly more PP at 12, 24, 48, and 72 h. Trial registration ClinicalTrials.gov Identifier: NCT04726670.
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Affiliation(s)
- Selen İnce-Yusufoğlu
- grid.449874.20000 0004 0454 9762Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Neslihan Büşra Keskin
- grid.449874.20000 0004 0454 9762Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Gülşah Uslu
- Private practice, Idadent Oral and Dental Health Clinic, Canakkale, Turkey
| | - Dilek Helvacioglu-Yigit
- grid.412603.20000 0004 0634 1084College of Dental Medicine, QU Health, Qatar University, P.O. Box: 2713, Doha, Qatar
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Patel S, Saberi N, Pimental T, Teng P. Present status and future directions: Root resorption. Int Endod J 2022; 55 Suppl 4:892-921. [PMID: 35229320 PMCID: PMC9790676 DOI: 10.1111/iej.13715] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/30/2022]
Abstract
Root resorption is the loss of dental hard tissue because of odontoclastic action. In permanent teeth, it is undesirable and pathological in nature. Root resorption may occur on the inner aspect of the root canal (internal root resorption) or on the outer aspect of the root (external root resorption). Regardless of its location, root resorption is irreversible, and may result in discomfort for the patient, requires management and/or, in some cases, results in the premature loss of the affected tooth. Root resorption is often challenging to accurately diagnose and manage. The aim of this narrative review is to present the relevant literature on the aetiology, pathogenesis, diagnosis and management, as well as discuss the future directions of diagnosis and management of root resorption.
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Affiliation(s)
- Shanon Patel
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK,Specialist PracticeLondonUK
| | - Navid Saberi
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| | - Tiago Pimental
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| | - Peng‐Hui Teng
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
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Ali NT, El-Boghdadi RM, Ibrahim AM, Amin SAW. Clinical and microbiological effects of ultrasonically activated irrigation versus syringe irrigation during endodontic treatment: a systematic review and meta-analysis of randomized clinical trials. Odontology 2021; 110:419-433. [PMID: 34729673 DOI: 10.1007/s10266-021-00671-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
This study aimed to systematically review clinical and microbiology-related effects of ultrasonically activated irrigation (UAI) compared to syringe irrigation (SI) during endodontic treatment. Electronic databases searching and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing UAI to SI. The RoB 2.0 Cochrane tool was used for risk-of-bias (RoB) assessment. The main outcomes were postoperative pain, treatment failure, and microbiology-related outcomes. Qualitative and quantitative analyses, wherever applicable, were performed. Risk ratios (RR) and [standardized] mean differences {[S]MD} were calculated for dichotomous and continuous outcomes, respectively. Certainty of evidence (CoE) was assessed using GRADE tool. Ten RCTs were included. UAI reduced pain incidence within the first 24 h (RR 0.50, 95% CI 0.35-0.71, 308 teeth) and microbial counts (SMDpooled - 0.40, 95% CI [- 0.78, - 0.02], I2 = 0%, 126 teeth) than SI in non-vital teeth with apical periodontitis (AP). Both groups, however, had similar effects regarding pain intensity, lipopolysaccharide amounts, and the incidence of rescue-analgesic intake, treatment failure, and microbial presence (p > 0.05). CoE ranged from low to very low. Very limited evidence suggests that UAI could reduce postoperative-pain risk within the first 24 h and microbial counts for non-vital teeth with AP compared to SI. Most meta-analyses, however, are based on very few studies, mostly low-powered, with an overall very-low-to-low CoE. Further well-designed, larger RCTs are, thus, required.
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Affiliation(s)
- Noha Tawfik Ali
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Randa Mohamed El-Boghdadi
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Ahmed Mohamed Ibrahim
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt
| | - Suzan Abdul Wanees Amin
- Department of Endodontics, Faculty of Dentistry, Cairo University, 11 ElSaraya Street, ElManyal, Cairo, 11553, Egypt.
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Machado R, Comparin D, Ignácio SA, da Silva Neto UX. Postoperative pain after endodontic treatment of necrotic teeth with large intentional foraminal enlargement. Restor Dent Endod 2021; 46:e31. [PMID: 34513637 PMCID: PMC8411006 DOI: 10.5395/rde.2021.46.e31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 01/01/2023] Open
Abstract
Objectives To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE. Trial Registration The Brazilian Clinical Trials Registry Identifier: RBR-3r967t
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Statistics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Statistics, School of Health and Bioscience, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
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Kazemipoor M, Valizadeh F, Jambarsang S. Three-dimensional pattern of inflammatory periapical lesion extension in the premolar's region: an application of K-means clustering. Curr Med Imaging 2021; 17:1151-1158. [PMID: 33632108 DOI: 10.2174/1573405617666210225090213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/01/2021] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cone-beam computed tomography (CBCT) provides better diagnosis of endodontic lesions. INTRODUCTION The present study would assess the pattern of periapical lesion extension in premolar teeth using CBCT. METHOD In this descriptive study' 330 roots in the regions of maxillary and mandibular premolars have been evaluated. Maximum periapical lesion extensions in the three orthogonal planes (axial, coronal and sagittal) were measured and recorded in millimeters. Measurements were compared based on gender' dental arch, tooth type and root. Statistical analysis was performed using repeated measure ANOVA, Bonferroni, Chi-square tests and clustering data analysis (K-means method). The significant level was set at 0.05. RESULT There were significant differences between the lesion expansions in the three dimensional planes (p-value<0.001). The highest average of lesion extension in the premolar regions of the examined population was reported in the vertical dimension (4.1± 1.3), followed by horizontal buccolingual dimension (3.4±1.1) and horizontal mesiodistal dimension (3.1±1.0) respectively. According to independent variables, in the premolar region only tooth roots showed significant differences in the lesion extension (p-value=0.002). Clustering data analysis showed that the majority of the participants categorized in a cluster with lower lesion extension. Based on clustering data analysis, the small lesions were significantly observed in the first premolar and buccal roots. CONCLUSION Since the periapical lesion extension in the buccolingual dimension, which could not be detected in the 2-D imaging techniques, was rather high in the region of premolar teeth, CBCT -as a 3-D imaging technique- is a suitable option for the precise evaluation of periapical lesion extension. Also, the majority of the lesions in this tooth area are small and located in the buccal roots.
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Affiliation(s)
- Maryam Kazemipoor
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd. Iran
| | - Fatemeh Valizadeh
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd. Iran
| | - Sara Jambarsang
- Department of Biostatistics and Epidemiology, School of Public health, Shahid Sadoughi University of Medical Sciences, Yazd. Iran
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Murthy P, Bhojraj N, Hegde U. Ultrastructural morphologic pattern in the roots of deciduous teeth in different stages of physiologic resorption. PEDIATRIC DENTAL JOURNAL 2020. [DOI: 10.1016/j.pdj.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Mostafa MEHAA, El‐Shrief YAI, Anous WIO, Hassan MW, Salamah FTA, El Boghdadi RM, El‐Bayoumi MAA, Seyam RM, Abd‐El‐Kader KG, Amin SAW. Postoperative pain following endodontic irrigation using 1.3% versus 5.25% sodium hypochlorite in mandibular molars with necrotic pulps: a randomized double‐blind clinical trial. Int Endod J 2020; 53:154-166. [DOI: 10.1111/iej.13222] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
| | - Y. A. I. El‐Shrief
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - W. I. O. Anous
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - M. W. Hassan
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - F. T. A. Salamah
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - R. M. El Boghdadi
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | | | - R. M. Seyam
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - K. G. Abd‐El‐Kader
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
| | - S. A. W. Amin
- Department of Endodontics Faculty of Dentistry Cairo University Cairo Egypt
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Rabinovich IM, Snegirev MV, Markheev CI. [Dental root resorption etiology, diagnosis and treatment]. STOMATOLOGII︠A︡ 2019; 98:109-116. [PMID: 31322606 DOI: 10.17116/stomat201998031109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The process of resorption of hard tooth tissues is associated with the activity of osteoclasts. However, the initiation of resorption can be caused by many factors acting separately or simultaneously. The paper presents the characteristics of pathological tooth resorption. The main etiological factors, pathogenesis, clinical manifestations, as well as treatment of various forms of tooth resorption are described.
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Affiliation(s)
- I M Rabinovich
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M V Snegirev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - Ch I Markheev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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13
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Li H, Luo W, Feng A, Tang ML, Kensler TB, Maldonado E, Gonzalez OA, Kessler MJ, Dechow PC, Ebersole JL, Wang Q. Odontogenic abscesses in rhesus macaques (Macaca mulatta) of Cayo Santiago. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:441-457. [PMID: 30129143 DOI: 10.1002/ajpa.23641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Odontogenic abscesses are one of the most common dental diseases causing maxillofacial skeletal lesions. They affect the individual's ability to maintain the dental structures necessary to obtain adequate nutrition for survival and reproduction. In this study, the prevalence and pattern of odontogenic abscesses in relation to age, sex, matriline, and living periods were investigated in adult rhesus macaque skeletons of the free-ranging colony on Cayo Santiago, Puerto Rico. MATERIALS AND METHODS The skulls used for this study were from the skeletons of 752 adult rhesus macaques, aged 8-31 years, and born between 1951 and 2000. They came from 66 matrilines ranging from 1 to 88 individuals. Fistulae or skeletal lesions caused by odontogenic abscesses drainage, carious lesions, tooth fractures, tooth loss, and alveolar resorption were evaluated visually. RESULTS Seventy-two specimens (9.57%) had odontogenic abscesses of varying severity. Males had a significantly higher prevalence than females. The prevalence of odontogenic abscesses in several matrilines was significantly higher than in the population as a whole. Animals born between 1950 and 1965 tended to have a higher prevalence of odontogenic abscesses than those born in later periods. DISCUSSION These results suggest that oral pathologies, such as dental and periodontal abscesses in rhesus macaques are fairly common, which may indicate familial effects interwoven with ecological and social factors. The closeness of the rhesus and human genomes allows insights to understand of the epidemiology of these diseases in the human population. Further assessment of the role played by environmental and familial factors on rhesus oral health and disease are warranted.
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Affiliation(s)
- Hong Li
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China.,Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis, Texas A&M University College of Dentistry, Dallas, Texas
| | - Wenjing Luo
- Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis, Texas A&M University College of Dentistry, Dallas, Texas
| | - Anna Feng
- Pre-Dental Scholars Program, Marquette University, Milwaukee, Wisconsin
| | - Michelle L Tang
- Department of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia
| | - Terry B Kensler
- Caribbean Primate Research Center, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Elizabeth Maldonado
- Caribbean Primate Research Center, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Octavio A Gonzalez
- Center for Oral Health Research & Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Kentucky
| | - Matthew J Kessler
- Office of Laboratory Animal Resources, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia
| | - Paul C Dechow
- Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis, Texas A&M University College of Dentistry, Dallas, Texas
| | | | - Qian Wang
- Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis, Texas A&M University College of Dentistry, Dallas, Texas
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Dalopoulou A, Economides N, Evangelidis V. Extrusion of Root Canal Sealer in Periapical Tissues - Report of Two Cases with Different Treatment Management and Literature Review. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Background: Extrusion of root canal sealers may cause damage to the surrounding anatomic structures. Clinical symptoms like pain, swelling and paresthesia or anesthesia may be present. The purpose of this presentation is to describe two cases of root canal sealer penetration into periapical tissues. A different treatment management was followed in each case.
Case reports: A 55 year-old man underwent root canal retreatment of the right mandibular first molar tooth due to a periapical lesion. Postoperative periapical radiographs revealed the presence of root canal sealer (AH26) beyond the apex in the distal root in proximity to the mandibular canal. The patient reported pain for the next 7 days. Radiographic examination after 1 year showed complete healing of the periapical area and a small absorption of the root canal sealer. A 42 year-old woman was referred complained of swelling and pain in the area of the right maxillary first incisor. Radiographic examination showed extrusion of root canal sealer in the periapical area associated with a periapical lesion. Surgical intervention was decided upon, which included removal of the sealer, apicoectomy of the tooth and retrograde filling with MTA. After 1 year, complete healing of the area was observed.
Conclusion: In conclusion, cases of root canal sealer extrusion, surgical treatment should be decided on only in association with clinical symptoms or with radiographic evidence of increasing periapical lesion.
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Affiliation(s)
- Athina Dalopoulou
- Undergraduate student, Aristotle University, Dental School, Thessaloniki, Greece
| | - Nikolaos Economides
- Associate Professor, Aristotle University, Dental School, Thessaloniki, Greece
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Tavares DP, Rodrigues JT, Dos Santos TCRB, Armada L, Pires FR. Clinical and radiological analysis of a series of periapical cysts and periapical granulomas diagnosed in a Brazilian population. J Clin Exp Dent 2017; 9:e129-e135. [PMID: 28149477 PMCID: PMC5268098 DOI: 10.4317/jced.53196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 05/22/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Periapical cysts (PC) and periapical granulomas (PG) are the two most common chronic inflammatory periapical diseases, but their clinicoradiological characteristics can vary depending on the methods employed in each study. The aim of the present work was to analyze the clinical and radiological profile of a series of PC and PG diagnosed in a Brazilian population. MATERIAL AND METHODS The files of two Oral Pathology laboratories were reviewed and all cases diagnosed as PG and PC were selected for the study. Clinical and radiological information were retrieved and data were tabulated and descriptively and comparatively analyzed. RESULTS Final sample was composed by 647 inflammatory periapical lesions, including 244 PG (38%) and 403 PC (62%). The number of women affected by PG was significantly higher than the number of women affected by PC (p=0.037). Anterior region of the maxilla was the most common affected area for both entities (39% of the cases), but the most common anatomical location of PG (anterior maxilla and posterior maxilla) was different from PC (anterior maxilla and posterior mandible) (p<0.0001). Upper lateral incisor was the most affected tooth. The mean radiological size of the PC was larger than the mean radiological size of the PG (p<0.0001) and PC showed well-defined radiological images more frequently than PG (p<0.0001). CONCLUSIONS PC were more common than PG, both showed predilection for adult females, most lesions affected predominantly the anterior maxilla and PC presented larger mean radiological diameter and well-defined images when compared with PG. Key words:Periapical granuloma, periapical cyst, radicular cyst, diagnosis, Oral Pathology.
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Affiliation(s)
| | | | | | - Luciana Armada
- DDS, MSc, PhD, Professor, Post graduation Program in Dentistry, Estácio de Sá University
| | - Fábio-Ramôa Pires
- DDS, MSc, PhD, Professor, Post graduation Program in Dentistry, Estácio de Sá University
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Kang S, Kim HC, Lee CY, Jung IY, Kim E. Scanning electron microscopic examination of resected root apices obtained from endodontic microsurgery. SCANNING 2016; 38:455-461. [PMID: 26751015 DOI: 10.1002/sca.21296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/17/2015] [Indexed: 06/05/2023]
Abstract
This study was designed to examine the morphological features of the resected root apices obtained from endodontic microsurgery using a scanning electron microscope (SEM) as well as their anatomical effect on the clinical outcome of the surgical treatment. One-hundred-six resected root apices from 91 patients/surgeries were obtained by endodontic microsurgery, and fixed immediately for storage. The resected apices were prepared for SEM to examine their morphological features, such as the number and size of the apical foramina. The patients were periodically checked up at least 1 year and the clinical outcome of the microsurgery was judged as a success or failure according to the Molven's criteria. The SEM findings and the clinical outcome of apical surgery were evaluated to see any potential correlation between them. The SEM examination revealed that 60.4% of specimens had more than two portals of exit on the resected root apices and the size of the major foramen was at least 386 micrometer and 334 micrometer from maxillary and mandibular molar, respectively. With a recall rate of 72.9%, 91.9% of the surgical cases were decided to have successful outcomes. Based on this SEM study, a relatively high frequency of multiple portals of exit was existed and the sizes of major foramina were bigger than that were reported in previous reports. The clinical outcomes of endodontic microsurgery were not correlated with the anatomical features of resected apical root apices. SCANNING 38:455-461, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sumi Kang
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Chan-Young Lee
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Il-Young Jung
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Euiseong Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
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Ookubo K, Ookubo A, Tsujimoto M, Sugimoto K, Yamada S, Hayashi Y. Scanning electron microscopy reveals severe external root resorption in the large periapical lesion. Microsc Res Tech 2016; 79:495-500. [PMID: 26957368 DOI: 10.1002/jemt.22652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 11/07/2022]
Abstract
The present study was designed to investigate the relationships between clinicopathological findings and the resorptive conditions of root apices of teeth with periodontitis. The samples included 21 root apices with large periapical radiolucent lesions. The preoperative computed tomography (CT) and intraoperative findings were correlated with the presence, extension, and the progression pattern of periapical resorption using a scanning electron microscope. The subjects' age, gender, chief complaint, type of tooth, percussion test results, size of periapical lesion using CT, and intraoperative findings were recorded. All apicoectomies were performed under an operative microscope for endodontic microsurgery. A significant large size was observed in cystic lesions compared with granulomatous lesions. The cementum surface at the periphery of the lesion was covered with globular structures (2-3 μm in diameter). Cementum resorption started as small defect formations at the surface. As the defect formation progressed, a lamellar structure appeared at the resorption area, and the size of globular structures became smaller than that of globules at the surface. Further resorption produced typical lacuna formation, which was particularly observed in fracture cases. The most morphologically severe destructive pattern of dentin resorption was observed in large cystic lesions. This study is the first report to elucidate the relationships between three clinical types of undesirable periapical lesions: (1) undertreatment, (2) periapical fracture, (3) macro-level resorption, and the microstructure of external root resorption including from small defects at the cementum surface to a significant destructive pattern inside the dentin. Microsc. Res. Tech. 79:495-500, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kensuke Ookubo
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Atsushi Ookubo
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Masaki Tsujimoto
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Kouji Sugimoto
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Shizuka Yamada
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Yoshihiko Hayashi
- Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
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18
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External root resorption during orthodontic treatment in root-filled teeth and contralateral teeth with vital pulp: A clinical study of contributing factors. Am J Orthod Dentofacial Orthop 2016; 149:84-91. [DOI: 10.1016/j.ajodo.2015.06.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 11/19/2022]
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Ricucci D, Rôças IN, Alves FRF, Loghin S, Siqueira JF. Apically Extruded Sealers: Fate and Influence on Treatment Outcome. J Endod 2015; 42:243-9. [PMID: 26725179 DOI: 10.1016/j.joen.2015.11.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/21/2015] [Accepted: 11/20/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This retrospective study evaluated cases of unintentional overfillings for the fate of the extruded sealers and their influence on treatment outcome. METHODS One hundred five teeth treated by a single operator and exhibiting overfillings in the postobturation radiograph were included in the study. Seventy-five teeth exhibited apical periodontitis lesions at the time of treatment. Sealers included Pulp Canal Sealer (Sybron Dental, Orange, CA), PCS Extended Working Time-EWT (Sybron Dental), Tubli-Seal (Sybron Endo), Endomethasone (Septodont, Saint-Maur-des-Fossés, France), AH Plus (DeTrey GmbH, Konstanz, Germany), and Apexit (Ivoclar Vivadent, Schaan, Lichtenstein). Recall radiographs were compared with immediate postobturation films for removal of the extruded material and status of the periradicular tissues. Data were grouped as 1-, 2- and >4-year recall and statistically analyzed using the chi-square and Fisher exact tests. RESULTS As for the sealers' fate, the only statistically significant differences at the 1-year recall were observed when comparing Tubli-Seal with AH Plus, Apexit, and Endomethasone (P < .05). At both the 2- and 4-year recalls, frequency of complete removal of AH Plus and Apexit was significantly lower when compared with all the other sealers (P < .05). No other significant differences were observed between groups. As for the influence on treatment outcome, there were no statistically significant differences between sealers at all follow-up periods (P > .05). Data from the >4-year recall revealed that 79% of the teeth with apical periodontitis lesions at the time of treatment had healed in comparison with 100% of the teeth with no apical periodontitis (P < .01). CONCLUSIONS Not all extruded sealers were predictably removed from the periradicular tissues. Treatment outcome was not significantly affected by the type of extruded sealer. A significantly better outcome was observed for teeth with no lesion in comparison with teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela N Rôças
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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Marceliano-Alves M, Alves FRF, Mendes DDM, Provenzano JC. Micro-Computed Tomography Analysis of the Root Canal Morphology of Palatal Roots of Maxillary First Molars. J Endod 2015; 42:280-3. [PMID: 26631299 DOI: 10.1016/j.joen.2015.10.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/22/2015] [Accepted: 10/25/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION A thorough knowledge of root canal anatomy is critical for successful root canal treatments. This study evaluated the internal anatomy of the palatal roots of maxillary first molars with micro-computed tomography (microCT). METHODS The palatal roots of extracted maxillary first molars (n = 169) were scanned with microCT to determine several anatomic parameters, including main canal classification, lateral canal occurrence and location, degree of curvature, main foramen position, apical constriction presence, diameters 1 and 2 mm from the apex and 1 mm from the foramen, minor dentin thickness in those regions, canal volume, surface area, and convexity. RESULTS All canals were classified as Vertucci type I. The cross sections were oval in 61% of the canals. Lateral canals were found in 25% of the samples. The main foramen did not coincide with the root apex in 95% of the cases. Only 8% of the canals were classified as straight. Apical constriction was identified in 38% of the roots. The minor and major canal diameters and minor dentin thickness were decreased near the apex. The minor dentin thickness 1 mm from the foramen was 0.82 mm. The palatal canals exhibited a volume of 6.91 mm(3) and surface area of 55.31 mm(2) and were rod-shaped. CONCLUSIONS The root canals of the palatal roots were classified as type I. However, some factors need to be considered during the treatment of these roots, including the frequent ocurrence of moderate/severe curvatures, oval-shaped cross-sections, and lateral canals, noncoincidence of the apical foramen with the root apex, and absence of apical constriction in most cases.
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Affiliation(s)
- Marília Marceliano-Alves
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Daniel de Melo Mendes
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Claudio Provenzano
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
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Çalışkan MK, Kaval ME, Tekin U, Ünal T. Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery. Int Endod J 2015; 49:1011-1019. [PMID: 26384024 DOI: 10.1111/iej.12554] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/12/2015] [Indexed: 02/01/2023]
Abstract
AIM To determine the histology of persistent periapical lesions associated with nonsurgical endodontic treatment failures and to compare radiographically the sizes of periapical lesions and the presence or absence of the radiopaque lamina with the histological findings. METHODOLOGY Ninety-three anterior teeth designated for apical microsurgery were included in the study. After taking standard radiographs of all cases using the parallel technique, the films were scanned and evaluated for the size of periapical radiolucent lesions and the presence or absence of radiopaque lamina by two calibrated observers. Biopsy specimens were obtained during apical microsurgery and examined under light microscopy by oral pathologists. Histological analysis established diagnoses of granuloma, cyst, abscess and scar tissue. Interobserver agreement was evaluated by the kappa test, and the relationship between histological diagnosis and lesion size was analysed by the Pearson's chi-square test. RESULTS The 93 specimens consisted of 72% periradicular granulomas; 21.5% radicular cysts, including two keratocysts; 4.3% abscesses; and 2.2% scar tissue. Cystic prevalence increased as the size of the periapical lesion increased; however, there was no correlation between the presence of a radiopaque lamina and histological diagnosis of cyst. CONCLUSIONS Neither radiographic size nor presence of an associated radiopaque line alone was sufficient to determine the type of lesion. Histological examination is required in order to reach to a definitive diagnosis.
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Affiliation(s)
- M K Çalışkan
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - M E Kaval
- Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey.
| | - U Tekin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Izmir, Turkey
| | - T Ünal
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ege University, Izmir, Turkey
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Chieruzzi M, Pagano S, De Carolis C, Eramo S, Kenny JM. Scanning Electron Microscopy Evaluation of Dental Root Resorption Associated With Granuloma. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2015; 21:1264-1270. [PMID: 26235380 DOI: 10.1017/s1431927615014713] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The inflammatory resorption of dental root apex (i.e., the process of removal of cementum and/or dentine through the activity of resorbing cells) may show different configurations and damage the apical root structure. As knowing the morphology of resorption areas of human teeth is essential for the success of endodontic treatments, we investigated the apical resorption by scanning electron microscopy, focusing on roots with granulomas. A total of 30 teeth (with penetrating carious lesions and chronic periapical lesions) were examined, the apical third of the roots were removed and analyzed to estimate periforaminal and foraminal resorption, shape and morphology of foramen resorption, centering of the periforaminal resorption area, and diameters of each apical foramen. Periforaminal resorption was present in all samples, whereas foraminal resorption was present in 92% of cases (mainly funnel shaped). Lacunae were observed in the foraminal resorption area with an average diameter of 35±14 μm. The major and minor diameters of the foramina in teeth with resorption were 443 and 313 μm, respectively (higher than in healthy teeth). This result indicates an expansion of the apical diameters caused by the pathology, which could encourage a different clinical instrumentation for these teeth.
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Affiliation(s)
- Manila Chieruzzi
- 1Civil and Environmental Engineering Department,University of Perugia,UdR INSTM,Strada di Pentima 4,05100 Terni,Italy
| | - Stefano Pagano
- 2Faculty of Medicine and Surgery,University of Perugia,S. Andrea delle Fratte,06156 Perugia,Italy
| | - Carlo De Carolis
- 2Faculty of Medicine and Surgery,University of Perugia,S. Andrea delle Fratte,06156 Perugia,Italy
| | - Stefano Eramo
- 3Department of Restorative Dentistry, Faculty of Medicine and Surgery,University of Perugia,S. Andrea delle Fratte,06156 Perugia,Italy
| | - José M Kenny
- 1Civil and Environmental Engineering Department,University of Perugia,UdR INSTM,Strada di Pentima 4,05100 Terni,Italy
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Chandler N. Electronic apex locators may be better at determining endodontic working length than radiographs and could reduce patient radiation exposure. J Evid Based Dent Pract 2015; 15:28-9. [PMID: 25666578 DOI: 10.1016/j.jebdp.2014.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Clinical efficacy of electronic apex locators: Systematic review. Martins JNR, Marques M, Mata A, Carames J.J Endod 2014;40(6):759-77. REVIEWER Nicholas Chandler, BDS, MSc, PhD, LDSRCS, MRACDS (Endo), FDSRCPS, FDSRCSEd, FFDRCSI PURPOSE/QUESTION: The authors conducted a systematic review to compare radiographic and electronic methods of determining endodontic working length. SOURCE OF FUNDING The authors reported no external funding sources. TYPE OF STUDY/DESIGN Systematic review LEVEL OF EVIDENCE Level 2: Limited-quality patient-oriented evidence STRENGTH OF THE RECOMMENDATION GRADE: Grade B: Limited-quality patient-oriented evidence.
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Affiliation(s)
- Nicholas Chandler
- Associate Professor/Specialist Endodontist, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, P.O. Box 647, Dunedin 9054, New Zealand, Tel.: +64 3 4797124; fax: +64 3 4795079.
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Spectrophotometric Determination of Irrigant Extrusion Using Passive Ultrasonic Irrigation, EndoActivator, or Syringe Irrigation. J Endod 2014; 40:1622-6. [DOI: 10.1016/j.joen.2014.03.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/15/2014] [Accepted: 03/18/2014] [Indexed: 12/20/2022]
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Estrela C, Guedes OA, Rabelo LEG, Decurcio DA, Alencar AHG, Estrela CR, Figueiredo JAPD. Detection of Apical Inflammatory Root Resorption Associated with Periapical Lesion Using Different Methods. Braz Dent J 2014; 25:404-8. [DOI: 10.1590/0103-6440201302432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 09/22/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to detect apical inflammatory root resorption (AIRR) associated with periapical lesion using cone beam computed tomography (CBCT) and scanning electronic microscopy (SEM). This clinical study evaluated AIRR in 88 root apexes, from 52 permanent teeth of 14 patients, extracted for different reasons. The patients were submitted to a clinical interview, review of dental/medical histories and clinical/imaging examinations for treatment planning. All selected teeth showed unrestorable condition because of the extensive coronal breakdown due to carious lesions, and root canal infection associated with periapical lesions. CBCT images were obtained from the patients with the aim of diagnosing the periapical diseases which showed complex or doubtful conditions. Two examiners assessed the presence or absence of AIRR. Apices were also analyzed under SEM. Chi-square test was used to compare the imaging methods for detection of AIRR. The level of statistical significance was set at 5%. AIRR associated with root canal infection and apical periodontitis was found in 61.4% of the cases studied by using SEM, and at least half of the cases by CBCT. The microscopic analysis remains as a reference standard against the imaging method to identify AIRR.
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Apical Dimension of Root Canal Clinically Assessed with and without Periapical Lesions. Int J Dent 2014; 2014:374971. [PMID: 25050122 PMCID: PMC4094701 DOI: 10.1155/2014/374971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/19/2014] [Indexed: 11/18/2022] Open
Abstract
To clinically evaluate the dimension of the more apical extent of the root canal after appropriate preflaring in the case of primary treatment and retreatment with and without the presence of periapical radiolucency, 392 single-rooted teeth with only one canal were evaluated during endodontic therapy. The canals were divided in two groups depending on the presence or absence of periapical radiolucency. After preflaring of the root canal the size of the root canal terminus (apical canal dimension) was gauged with hand-held Light Speed LS1 files inserted at the estimated working length and established with the use of an electronic apex locator. The dimension recorded in the computer database was represented by the largest instrument able to reach the electronically established working length. The differences between the treatment groups were assessed using the Mann-Whitney U test and the significance level was set at P < 0.05. Teeth with lesions had a significantly greater diameter in the apical region than teeth without lesions (P < 0.001). The dimension of the apical portion of the root canal is larger in the case of periapical radiolucency. This involves verifying this parameter in order to use the correct sized instruments and to obtain an efficient cutting action at the apical level.
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Hong JY, Yon J, Lee JS, Lee IK, Yang C, Kim MS, Choi SH, Jung UW. Effects of epigallocatechin-3-gallate on the healing of extraction sockets with a periapical lesion: A pilot study in dogs. J Biomed Mater Res B Appl Biomater 2014; 103:727-34. [PMID: 25045081 DOI: 10.1002/jbm.b.33238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 05/29/2014] [Accepted: 06/05/2014] [Indexed: 12/18/2022]
Abstract
The aim of this study was to characterize the healing process of extraction sockets with a periapical lesion following immediate graft with collagenated bovine bone mineral (CBBM) soaked with epigallocatechin-3-gallate (EGCG). Following induction of periapical lesions in premolars in five dogs, treatment of extraction sockets was divided into three groups: control (no treatment) and two test groups, CBBM with or without EGCG. 3D reconstruction and superimposition of the digital images were used to measure the dimensional changes in alveolar ridge. Histologic specimen was evaluated in all groups. The horizontal ridge widths at 4-mm level were wider in both test groups (3.3 ± 1.7 mm in CBBM; 3.0 ± 1.7 mm in CBBM+EGCG) than in the control group (1.7 ± 2.4 mm). Fibrosis and limited new bone formation were observed in the apical regions of test groups; however, the extent of fibrosis was less in the CBBM+EGCG group. Within the limitations of this study, it was conjectured that adjunctive use of EGCG with CBBM can be a candidate biomaterial in grafting of extraction socket with periapical lesion. Bone regeneration at the coronal region of the CBBM grafted socket might not be influenced by the presence of a periapical lesion.
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Affiliation(s)
- Ji-Youn Hong
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, 134-727, Republic of Korea
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Kontogiannis TG, Tosios KI, Kerezoudis NP, Krithinakis S, Christopoulos P, Sklavounou A. Periapical lesions are not always a sequelae of pulpal necrosis: a retrospective study of 1521 biopsies. Int Endod J 2014; 48:68-73. [PMID: 24579658 DOI: 10.1111/iej.12276] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/25/2014] [Indexed: 12/13/2022]
Abstract
AIM To record the incidence of lesions that were not the sequelae of pulpal necrosis (non-SPN) amongst 1521 biopsies of periapical lesions submitted with a clinical diagnosis of a sequelae of pulpal necrosis (SPN). METHODOLOGY A retrospective study of 1521 biopsy request forms of specimens submitted for histopathological examination with a clinical diagnosis 'periapical inflammation', 'periapical abscess', 'periapical granuloma' or 'periapical cyst' during an arbitrarily selected 14-year period was undertaken. Gender and age of the patient, site and maximum diameter of the lesion, symptoms, inclusion of the final diagnosis in the differential diagnosis and specialty of the clinician submitting the biopsy material were recorded in each case. The final diagnosis for each case was extracted from the pathology report, and two groups were formed, SPN and non-SPN lesions. Differences between the respective features of SPN and non-SPN cases were analysed with Yate's chi-square test and t-test (significance level P < 0.05) RESULTS: In 52 of the 1521 cases examined (3.42%), the histological diagnosis was not consistent with a SPN. In most non-SPN cases, the histopathological diagnosis was not included in the differential diagnosis. The keratocystic odontogenic tumour [odontogenic keratocyst (OKC)] was the most frequent non-SPN lesion (34.62%). Other, yet less frequent, non-SPN lesions included glandular odontogenic cysts, lateral periodontal cysts, central ossifying fibromas as well as malignancies (metastatic carcinomas and Langerhans cell histiocytosis). CONCLUSIONS Non-SPN lesions appeared in the periapical region mimicking a SPN, although rarely. Most of them were developmental cysts, in particular OKCs, but odontogenic tumours, such as ameloblastoma, or malignant lesions were also diagnosed. Histological examination of tissue harvested from periapical lesions should be performed, in particular when those lesions are large.
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Affiliation(s)
- T G Kontogiannis
- Department of Endodontics, Dental School, University of Athens, Athens, Greece
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Hacer AKSEL, Sevinc ASKERBEYLI, Cigdem CANBAZOGLU, Ahmet SERPER. Effect of needle insertion depth and apical diameter on irrigant extrusion in simulated immature permanent teeth. Braz Oral Res 2014; 28:1-6. [PMID: 25271966 DOI: 10.1590/1807-3107bor-2014.vol28.0053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 06/27/2014] [Indexed: 12/23/2022] Open
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Psimma Z, Boutsioukis C, Kastrinakis E, Vasiliadis L. Effect of Needle Insertion Depth and Root Canal Curvature on Irrigant Extrusion Ex Vivo. J Endod 2013; 39:521-4. [DOI: 10.1016/j.joen.2012.12.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/12/2012] [Accepted: 12/12/2012] [Indexed: 10/27/2022]
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Lin YP, Love RM, Friedlander LT, Shang HF, Pai MH. Expression of Toll-like receptors 2 and 4 and the OPG-RANKL-RANK system in inflammatory external root resorption and external cervical resorption. Int Endod J 2013; 46:971-81. [DOI: 10.1111/iej.12088] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 02/09/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Y. P. Lin
- Faculty of Dentistry; University of Otago; Dunedin; New Zealand
| | - R. M. Love
- Department of Oral Diagnostic and Surgical Sciences; University of Otago; Dunedin; New Zealand
| | - L. T. Friedlander
- Department of Oral Rehabilitation; University of Otago; Dunedin; New Zealand
| | - H. F. Shang
- Department of Microbiology and Immunology; Taipei Medical University; Taipei; Taiwan
| | - M. H. Pai
- Department of Medical Laboratory Science and Biotechnology; Taipei Medical University; Taipei; Taiwan
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Boutsioukis C, Psimma Z, van der Sluis LWM. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J 2013; 46:599-618. [DOI: 10.1111/iej.12038] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 11/08/2012] [Indexed: 11/29/2022]
Affiliation(s)
- C. Boutsioukis
- Physics of Fluids Group; Faculty of Science and Technology, and MESA+ Institute for Nanotechnology; University of Twente; Enschede; the Netherlands
| | - Z. Psimma
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - L. W. M. van der Sluis
- Department of Conservative Dentistry and Endodontics; Paul Sabatier University; Toulouse; France
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Giovarruscio M, Uccioli U, Malentacca A, Koller G, Foschi F, Mannocci F. A technique for placement of apical MTA plugs using modified Thermafil carriers for the filling of canals with wide apices. Int Endod J 2012; 46:88-97. [DOI: 10.1111/j.1365-2591.2012.02115.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 07/06/2012] [Indexed: 11/29/2022]
Affiliation(s)
- M. Giovarruscio
- Department of Conservative Dentistry; Dental Institute; King's College, London; London; UK
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Souza RA, Sousa YTCS, Figueiredo JAPD, Dantas JDCP, Colombo S, Pécora JD. Influence of apical foramen lateral opening and file size on cemental canal instrumentation. Braz Dent J 2012; 23:122-6. [DOI: 10.1590/s0103-64402012000200006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Since instrumentation of the apical foramen has been suggested for cleaning and disinfection of the cemental canal, selection of the file size and position of the apical foramen have challenging steps. This study analyzed the influence of apical foramen lateral opening and file size can exert on cemental canal instrumentation. Thirty-four human maxillary central incisors were divided in two groups: Group 1 (n=17), without flaring, and Group 2 (n=17), with flaring with LA Axxess burs. K-files of increasing diameters were progressively inserted into the canal until binding at the apical foramen was achieved and tips were visible and bonded with ethyl cyanoacrylate adhesive. Roots/files set were cross-sectioned 5 mm from the apex. Apices were examined by scanning electron microscopy at ×140 and digital images were captured. Data were analyzed statistically by Student’s t test and Fisher’s exact test at 5% significance level. SEM micrographs showed that 19 (56%) apical foramina emerged laterally to the root apex, whereas 15 (44%) coincided with it. Significantly more difficulty to reach the apical foramen was noted in Group 2. Results suggest that the larger the foraminal file size, the more difficult the apical foramen instrumentation may be in laterally emerged cemental canals.
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Affiliation(s)
| | | | | | | | - Suely Colombo
- Bahiana School of Medicine and Public Health, Brazil
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Souza RA, Sousa YTCS, de Figueiredo JAP, Dantas JDCP, Colombo S, Pécora JD. Relationship between files that bind at the apical foramen and foramen openings in maxillary central incisors--a SEM study. Braz Dent J 2011; 22:455-9. [PMID: 22189639 DOI: 10.1590/s0103-64402011000600003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 10/01/2011] [Indexed: 11/22/2022] Open
Abstract
Considering that instrumentation of the apical foramen has been suggested for root canal infection control, this study analyzed the relationship between the files that bind at the apical foramen and the foraminal openings in 50 maxillary central incisors. After preparation of the pulp chamber, access to the canal was obtained with #1 and 2 LA Axxess and K-files with tip cut were inserted up to the apical foramen until binding was felt. The files were fixed with methyl cyanoacrylate and the tooth-file sets were cross-sectioned 10 mm short of the apex. Scanning electron microscopic analysis was carried out and files and foraminal areas were measured using Image Tool software. Statistically significant difference (p<0.0001) was found between files and the apical foraminal areas. The mean foraminal area was 3.8 times larger than the mean file area. The results of this study suggest that it would require 4 files of greater size beyond the one that bound to the foramen in order to allow a better relationship between files and apical openings of maxillary central incisors.
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Affiliation(s)
- Ronaldo Araújo Souza
- Graduate Program, Dental School, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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Resorptive Tooth Root Lesions in the Malayan Tapir (Tapirus indicus). J Zoo Wildl Med 2011; 42:40-3. [DOI: 10.1638/2009-0247.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Case report: endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion. ACTA ACUST UNITED AC 2010; 110:e61-7. [DOI: 10.1016/j.tripleo.2010.04.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 04/06/2010] [Accepted: 04/20/2010] [Indexed: 11/23/2022]
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Waasdorp JA, Evian CI, Mandracchia M. Immediate Placement of Implants Into Infected Sites: A Systematic Review of the Literature. J Periodontol 2010; 81:801-8. [DOI: 10.1902/jop.2010.090706] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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39
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Felippe WT, Ruschel MF, Felippe GS, Pozzobon MH, Felippe MCS. SEM evaluation of the apical external root surface of teeth with chronic periapical lesion. AUST ENDOD J 2009; 35:153-7. [PMID: 19961454 DOI: 10.1111/j.1747-4477.2009.00165.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wilson Tadeu Felippe
- School of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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de Paula-Silva FWG, D'Silva NJ, da Silva LAB, Kapila YL. High matrix metalloproteinase activity is a hallmark of periapical granulomas. J Endod 2009; 35:1234-42. [PMID: 19720222 DOI: 10.1016/j.joen.2009.06.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Revised: 05/29/2009] [Accepted: 06/12/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The inability to distinguish periapical cysts from granulomas before performing root canal treatment leads to uncertainty in treatment outcomes because cysts have lower healing rates. Searching for differential expression of molecules within cysts or granulomas could provide information with regard to the identity of the lesion or suggest mechanistic differences that may form the basis for future therapeutic intervention. Thus, we investigated whether granulomas and cysts exhibit differential expression of extracellular matrix (ECM) molecules. METHODS Human periapical granulomas, periapical cysts, and healthy periodontal ligament tissues were used to investigate the differential expression of ECM molecules by microarray analysis. Because matrix metalloproteinases (MMP) showed the highest differential expression in the microarray analysis, MMPs were further examined by in situ zymography and immunohistochemistry. Data were analyzed by using one-way analysis of variance followed by the Tukey test. RESULTS We observed that cysts and granulomas differentially expressed several ECM molecules, especially those from the MMP family. Compared with cysts, granulomas exhibited higher MMP enzymatic activity in areas stained for MMP-9. These areas were composed of polymorphonuclear cells (PMNs) in contrast to cysts. Similarly, MMP-13 was expressed by a greater number of cells in granulomas compared with cysts. CONCLUSION Our findings indicate that high enzymatic MMP activity in PMNs together with MMP-9 and MMP-13 stained cells could be a molecular signature of granulomas unlike periapical cysts.
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da Silva LAB, Fernandes PM, da Silva RAB, Nelson-Filho P, Rocha LB, Rossi MA. SEM Study of Apical Morphological Alterations in Primary Teeth with Vital and Necrotic Pulps. Ultrastruct Pathol 2009; 33:183-8. [DOI: 10.3109/01913120903275642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vier-Pelisser FV, de Figueiredo JAP, Reis Só MV, Estivallet L, Eickhoff SJ. Apical resorption in teeth with periapical lesions: correlation between radiographic diagnosis and SEM examination. AUST ENDOD J 2009; 39:2-7. [PMID: 23551506 DOI: 10.1111/j.1747-4477.2009.00196.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study correlated the radiographic findings and scanning electron microscopy (SEM) images of external apical resorption (EAR) in teeth with periapical lesions. Standard radiographs were taken from 45 teeth with periapical lesions before their extraction. Using a radiographic examination, the root apex of each tooth was classified according to the EAR into the following categories: radiographic external apical resorption (REAR) absent, superficial and deep. The apical root surface was also examined with SEM. Photomicrographs of EARs were classified as periforaminal (PEAR) and foraminal (FEAR) in three degrees: 0, 1 and 2. REAR was present in 72.5% of cases, of which 20% were deep. Based upon SEM analysis, PEAR and FEAR occurred in 75.6% and 66.7% of cases respectively; 51.2% and 59% respectively, of these teeth received a score of 2. Only 15.4% of the specimens were unaffected by EAR. When teeth with periapical lesions were examined for EAR with both radiography and by SEM, there was no correlation between the findings.
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Martos J, Ferrer-Luque CM, González-Rodríguez MP, Castro LAS. Topographical evaluation of the major apical foramen in permanent human teeth. Int Endod J 2009; 42:329-34. [DOI: 10.1111/j.1365-2591.2008.01513.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nemoto E, Honda T, Kanaya S, Takada H, Shimauchi H. Expression of functional Toll-like receptors and nucleotide-binding oligomerization domain proteins in murine cementoblasts and their upregulation during cell differentiation. J Periodontal Res 2008; 43:585-93. [PMID: 18565134 DOI: 10.1111/j.1600-0765.2008.01096.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE While the primary role of cementoblasts is to synthesize the components of cementum, we have reported that immortalized murine cementoblasts (OCCM-30) express functional Toll-like receptor (TLR)-2 and -4, and these receptors are involved in the alteration of gene expression associated with cementum formation and in the upregulation of osteoclastogenesis-associated molecules, such as receptor activator of nuclear factor-kappaB (NF-kappaB) ligand. We hypothesized that cementoblasts express a wide range of pattern recognition receptors in a manner comparable to osteoblasts, which are known to express various functional TLRs and nucleotide-binding oligomerization domain (NOD) proteins. MATERIAL AND METHODS Murine cementoblasts and pre-osteoblasts were used. The gene and protein levels of TLRs/NODs were analyzed using real-time polymerase chain reaction and flow cytometry. Interleukin-6 (IL-6) and activated NF-kappaB were measured using enzyme-linked immunosorbent assay. RESULTS The expressions of TLR-1, -2, -4, -6 and -9, CD14, NOD-1 and -2 were detected in cementoblasts and were upregulated upon differentiation induced by ascorbic acid. Similar patterns were observed in the mouse MC3T3-E1 osteoblast cell line. Synthetic ligands, Pam3CSK4 (TLR-1/2 agonist), Pam2CGDPKHPKSF (TLR-2/6 agonist), lipid A (TLR4 agonist), CpG DNA (TLR-9 agonist), FK565 (NOD1 agonist) and muramyldipeptide (NOD2 agonist), effectively induced NF-kappaB activation in cementoblasts and/or ascorbic acid-treated cementoblasts. Furthermore, these ligands induced IL-6 production in a NF-kappaB-dependent manner in cementoblasts and/or ascorbic acid-treated cementoblasts. CONCLUSION These results indicate that cementoblasts possess functional TLR and NOD signaling systems and have a similar capacity to osteoblasts in responding to a wide variety of pathogens.
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Affiliation(s)
- E Nemoto
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan.
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Root Resorption Associated with Mandibular Bone Erosion in a Patient with Scleroderma. J Endod 2008; 34:102-3. [DOI: 10.1016/j.joen.2007.10.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Revised: 10/11/2007] [Accepted: 10/20/2007] [Indexed: 11/18/2022]
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Sari S, Duruturk L. Radiographic evaluation of periapical healing of permanent teeth with periapical lesions after extrusion of AH Plus sealer. ACTA ACUST UNITED AC 2007; 104:e54-9. [PMID: 17709070 DOI: 10.1016/j.tripleo.2007.03.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Revised: 02/28/2007] [Accepted: 03/19/2007] [Indexed: 11/29/2022]
Abstract
The aim of this study was to clinically and radiographically examine the effects of extrusion of AH Plus sealer on the healing of permanent teeth with apical periodontitis. A total of 87 root canals radiographically detected with apical periodontitis were included in the study. Posttreatment radiographs indicated sealer extrusion into 49 canals (Group 1) and no sealer extrusion into 38 canals (Group 2). Periapical treatment was judged as complete healing (CH), incomplete healing (IH) and no healing (NH) at the end of a 4-year follow-up period. Amounts of extraradicular sealer were recorded as "unchanged," "reduced," "almost absent," or "absent." The t test was used for the statistical analyses. In Group 1, CH was detected in 41 canals, IH in 4 canals, and NH in 4 canals. Differences between CH and both IH and NH were statistically significant (P < .001). In Group 2, CH was detected in 34 canals and NH in 4 canals. The difference between CH and NH was statistically significant (P < .001). A statistically significant difference (P < .05) between treatment groups was observed for CH at the 6-month follow-up appointment only; other than that instance, there were no statistical differences for CH or NH between the groups. In conclusion, extruded AH Plus does not prevent periapical healing, but can be a delaying factor for healing in children.
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Affiliation(s)
- Saziye Sari
- University of Ankara, Faculty of Dentistry, Department of Pedodontics, Ankara, Turkey.
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Kabak SL, Kabak YS, Anischenko SL. Light microscopic study of periapical lesions associated with asymptomatic apical periodontitis. Ann Anat 2005; 187:185-94. [PMID: 15900705 DOI: 10.1016/j.aanat.2004.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of the study has been to evaluate the degree of chronic inflammation in tissues surrounding the apex of the tooth root in patients with apical periodontitis in the remission phase. The material included 37 apical granulomas and radicular cysts obtained as a result of apiectomy, and 20 teeth which were removed together with the focus of the periapical inflammation. Routine histological techniques, as well as the immunofluorescent and immuno-chemical methods were used to examine the material. Despite the absence of clinical symptoms in 23 of 57 cases, the morphological signs of chronic inflammation were observed in the apical area of the tooth root. Morphological signs of viral invasion of epithelial and stromal cells in the radicular cyst wall were revealed in six cases. The presence of the virus of Herpes simplex I in epithelial cells (five cases) and adenoviral invasion (one case) was confirmed by immuno-fluorescent and immuno-chemical methods. Histological examination often reveals morphological signs of an active inflammatory process in the periapical tissues of patients treated during clinical remission. In our opinion, the presence of viruses in the epithelial cells of the radicular cyst may contribute to the persistence of the active stage of the inflammatory process.
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Affiliation(s)
- S L Kabak
- Belarusian State Medical University, 220116 Minsk, Republic of Belarus.
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Abstract
AIM To determine the presence of various periapical pathologies and their association with the presence and extent of internal apical inflammatory root resorption in human teeth. METHODOLOGY A total of 75 root apices from extracted teeth with periapical lesions were examined. Semi-serial sections of soft tissue lesions were stained with HE. The lesions were classified as non-cystic or cystic, and according to the degree of abscess severity: 0, 1, 2 or 3. The apices were reduced to 3 mm in length and longitudinally cut so that the internal aspect could be analyzed under scanning electron microscopy (SEM). Internal root resorption was also classified as 0, 1, 2 or 3 according to the extent of the resorbed area. Additionally, six vital teeth were used as a control. RESULTS Non-cystic lesions with severe abscesses were the most common finding (70.7%), while 20% of the lesions were cystic (4% little or no abscess; 16% severe abscesses). Non-cystic lesions with little or no abscess comprised 9.3% of the sample. Of the root canals containing periapical lesions, 48% had internal apical resorption in more than half of the area, while 25.3% of the sample had no internal resorption. Resorption degree 1 was identified in 12% of the cases, and 14.7% showed resorption degree 2. The control group displayed significantly less internal resorption than the test groups. CONCLUSIONS Most periapical lesions (86.7%), whether cystic (16.0%) or non-cystic (70.7%), showed large collections of acute inflammatory cells. Apical internal resorption was present in 74.7% of roots and was associated with periapical lesions. There was no correlation between internal apical resorption and the histological diagnosis of the lesions.
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Affiliation(s)
- F V Vier
- Post-Graduate Program of Dentistry, ULBRA, Canoas, Brazil
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