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Chandak M, Chaudhari P, Jidewar N, Sarangi S, Ikhar A, Dass A, Suryawanshi T. Successful Management of a Tooth With an Endodontic-Periodontal Lesion Using a Bone Graft. Cureus 2024; 16:e58828. [PMID: 38800164 PMCID: PMC11116750 DOI: 10.7759/cureus.58828] [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: 11/20/2023] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
As periodontal and endodontic tissues have a close association, they come into close touch and have a lot of possible places for communication. In a clinical setting, this correlation promotes infection spread and results in the typical endo-perio lesion appearance. Because the two tissues are in close touch with one another, managing such lesions can be difficult. The success of treatment depends on a thorough examination and careful planning, with the sole focus on repair and regeneration. In these situations, bone graft materials with such characteristics have demonstrated encouraging outcomes. The treatment outcome along with a follow-up for a case of an endo-perio lesion with furcation involvement is shown in the accompanying case report. In treating such instances, a multidisciplinary approach is necessary, emphasizing regeneration.
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Affiliation(s)
- Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Payal Chaudhari
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Namrata Jidewar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swayangprabha Sarangi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anuja Ikhar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhilasha Dass
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejas Suryawanshi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Influence of the timing of periodontal intervention on periapical/periodontal repair in endodontic-periodontal lesions: a systematic review. Clin Oral Investig 2023; 27:933-942. [PMID: 36585525 DOI: 10.1007/s00784-022-04849-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION This study is aimed at answering the following question: "Does the timing of periodontal intervention influence the periapical/periodontal repair in endodontic-periodontal lesions?". MATERIAL AND METHODS Six electronic databases were systematically searched for studies published up to April 2022, without restriction of language or year of publication, following the PIOS strategy: (P) adult patients with a diagnosis of endodontic-periodontal lesions, (I) endodontic and periodontal treatment, (O) periapical and periodontal healing, and (S) clinical studies. Risk of bias assessment was performed with the revised Cochrane risk of bias tools for randomized trials (RoB 2) and non-randomized interventions (ROBINS-I). The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS Three studies (one prospective, one retrospective, and one randomized clinical trial) were included in the present review. Non-randomized studies had a critical and serious risk of bias. The randomized clinical trial had some concerns risk of bias. Non-randomized studies reported that the endodontic intervention should be performed previous to the periodontal intervention. Randomized clinical trial reported improvements when endodontic and periodontal interventions were performed simultaneously. GRADE analysis showed a very low quality of evidence for both randomized and nonrandomized studies. CONCLUSIONS Based on the evidence from the included studies, although it is suggested that the endodontic treatment should be performed prior to periodontal treatment, it is not possible to assure the best treatment sequence for endodontic-periodontal lesions. CLINICAL RELEVANCE Evidences suggests that although the endodontic intervention should be the first therapy of choice, it was not possible to specify the best time to perform the periodontal intervention.
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Jahreis M, Soliman S, Schubert A, Connert T, Schlagenhauf U, Krastl G, Krug R. Outcome of non‐surgical root canal treatment related to periodontitis and chronic disease medication among adults in age group of 60 years or more. Gerodontology 2019; 36:267-275. [DOI: 10.1111/ger.12407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/28/2019] [Accepted: 03/29/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Martin Jahreis
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Sebastian Soliman
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Alexander Schubert
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine University of Basel Basel Switzerland
| | - Ullrich Schlagenhauf
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
| | - Ralf Krug
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
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Tewari S, Sharma G, Tewari S, Mittal S, Bansal S. Effect of immediate periodontal surgical treatment on periodontal healing in combined endodontic-periodontal lesions with communication-A randomized clinical trial. J Oral Biol Craniofac Res 2018; 8:105-112. [PMID: 29892531 PMCID: PMC5993466 DOI: 10.1016/j.jobcr.2018.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/12/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Management of combined endodontic-periodontal lesions needs more clinical investigations. The aim of this prospective randomized clinical trial was to evaluate the effect oftime interval between the non-surgical endodontic treatment (ET) and open flap debridement (OFD) on periodontal healing in combined endodontic periodontal lesions with apical communication. METHODS Forty patients were randomly allocated to two treatment protocols. Group 1(immediate periodontal surgery): OFD was performed at 21 days of initiation of ET and SRP, and Group 2(delayed periodontal surgery): OFD was performed after 3 months of initiation of ET and SRP. The primary parameters included probing pocket depth (PPD), relative attachment level (RAL) and bleeding on probing (BOP) and tooth mobility (TM). RESULTS Significantly more reduction in PPD, TM and gain in RAL was observed in Group 1 at 3 months of OFD. (P < 0.05) Whereas at 6 months follow up of OFD (6 and 9 months of ET in Group1 and Group 2, respectively), intergroup analysis showed statistically comparable reduction in BOP (%), PPD, TM and gain in RAL (P > 0.05) in both the groups. CONCLUSION Immediate periodontal surgery may not affect the outcome of the treatment of combined endo-perio lesions with apical communication.
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Affiliation(s)
- Shikha Tewari
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Geetanjali Sharma
- Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Sanjay Tewari
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shweta Mittal
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Jin Y, Chen B, Ni YH, Yan FH. [Time lapse between endodontic and periodontal treatments of combined periodontal-endodontic lesion: a systematic review]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:167-173. [PMID: 29779278 PMCID: PMC7030345 DOI: 10.7518/hxkq.2018.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/21/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study aims to evaluate the time lapse between the endodontic and periodontal treatments of the combined periodontal-endodontic lesion to guide the clinical treatment. METHODS A systemic literature search was performed in articles published from 1980 to March 2017 using the electronic databases, including PubMed, EMbase, Cochrane, Web of Science, CNKI, CBM, and Wanfang Databases. RESULTS After screening, two randomized controlled trials, two prospective case series studies, and eight case reports were ultimately included. All clinical studies and case reports were treated with root canal therapy and periodontal nonsurgical or periodontal surgical treatment, with root canal therapy as the initial treatment step. Changes in the periodontal probing depth and attachment loss were reported in all clinical studies and case reports. CONCLUSIONS An observational period between the endodontic and periodontal nonsurgical treatments may not be required. However, given that the quality of several included studies was limited, and the number of randomized controlled trials was small, a large number of randomized controlled trials are needed to verify this result.
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Affiliation(s)
- Yue Jin
- Dept. of Periodontology, Nanjing Stomatological Hospital, The Affiliated Stomatological Hospital of Medical School of Nanjing University, Nanjing 210008, China
| | - Bin Chen
- Dept. of Periodontology, Nanjing Stomatological Hospital, The Affiliated Stomatological Hospital of Medical School of Nanjing University, Nanjing 210008, China
| | - Yan-Hong Ni
- Dept. of Periodontology, Nanjing Stomatological Hospital, The Affiliated Stomatological Hospital of Medical School of Nanjing University, Nanjing 210008, China
| | - Fu-Hua Yan
- Dept. of Periodontology, Nanjing Stomatological Hospital, The Affiliated Stomatological Hospital of Medical School of Nanjing University, Nanjing 210008, China
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Neves VC, Toledo BE, Camargo GA, Souza AA, Zuza EP. Determination of the Influence of Chronic Periodontitis on Pulp Sensibility by Means of Electric and Thermal Cold Testing. J Endod 2017; 43:1802-1805. [DOI: 10.1016/j.joen.2017.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 07/05/2017] [Accepted: 07/09/2017] [Indexed: 10/18/2022]
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Rotstein I. Interaction between endodontics and periodontics. Periodontol 2000 2017; 74:11-39. [DOI: 10.1111/prd.12188] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 02/06/2023]
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Gupta S, Tewari S, Tewari S, Mittal S. Effect of Time Lapse between Endodontic and Periodontal Therapies on the Healing of Concurrent Endodontic-Periodontal Lesions without Communication: A Prospective Randomized Clinical Trial. J Endod 2015; 41:785-90. [PMID: 25817213 DOI: 10.1016/j.joen.2015.02.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 02/06/2015] [Accepted: 02/08/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this prospective randomized clinical trial was to evaluate the effect of a time lapse between endodontic treatment and nonsurgical periodontal treatment on periodontal healing of concurrent endodontic-periodontal lesions without communication. METHODS Thirty-one patients were randomly divided into 2 groups: group 1: endodontic treatment and scaling and root planning (SRP) were performed simultaneously and group 2: SRP was performed 3 months after endodontic treatment. Both groups were followed for 3 and 6 months after SRP. Primary outcome variables were the probing depth, clinical attachment level, and periapical index score. RESULTS Both the groups showed a significant improvement in all the clinical parameters evaluated after the completion of endodontic and periodontal treatment (P < .05). No statistically significant difference in improvement was observed between the 2 groups at 3 and 6 months after SRP (P > .05). Periodontal healing responses were comparable in the 2 groups, with no apparent detriment resulting from simultaneous treatment. Improvements in periodontal parameters that were achieved in 6 months in group 2 were achieved only in 3 months in group 1 (P > .05). CONCLUSIONS Nonsurgical periodontal treatment may be performed simultaneously with endodontic treatment in the management of concurrent endodontic-periodontal lesions without communication, and an observation period after endodontic treatment may not be required.
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Affiliation(s)
- Shilpi Gupta
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Sanjay Tewari
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
| | - Shikha Tewari
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shweta Mittal
- Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Kambale S, Aspalli N, Munavalli A, Ajgaonkar N, Babannavar R. A sequential approach in treatment of endo-perio lesion a case report. J Clin Diagn Res 2014; 8:ZD22-4. [PMID: 25302276 DOI: 10.7860/jcdr/2014/9927.4692] [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: 05/08/2014] [Accepted: 06/17/2014] [Indexed: 11/24/2022]
Abstract
Endo-perio lesions primarily occur by way of the intimate anatomic and vascular connections between the pulp and the periodontium. Endodontic-periodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult. An untreated primary endodontic lesion may become secondarily involved with periodontal breakdown, which clinically present unusual signs and symptoms. This may delay the diagnosis and hence the correct treatment. This case report describes diagnosis and treatment protocol for an endo-perio lesion of primary endodontic with secondary periodontal involvement.
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Affiliation(s)
- Sharanappa Kambale
- Senior Lecturer, Department of Conservative Dentistry & Endodontics, Vasantdada Patil Dental College and Hospital Kavalapur , Sangli, Maharashtra India
| | - Nagaveni Aspalli
- Reader, Department of Conservative Dentistry & Endodontics, AME'S Dental College , Raichur, Karnataka, India
| | - Anil Munavalli
- Reader, Department of Conservative Dentistry & Endodontics, Vasantdada Patil Dental College and Hospital Kavalapur , Sangli, Maharashtra India
| | - Nishant Ajgaonkar
- Postgraduate Student, Department of Conservative Dentistry & Endodontics, Vasantdada Patil Dental College and Hospital Kavalapur , Sangli, Maharashtra India
| | - Roopa Babannavar
- Senior Lecturer, Department of Conservative Dentistry & Endodontics, Jodhpur Dental College General Hospital , Jodhpur, Rajasthan, India
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Raheja J, Tewari S, Tewari S, Duhan J. Evaluation of efficacy of chlorhexidine intracanal medicament on the periodontal healing of concomitant endodontic-periodontal lesions without communication: an interventional study. J Periodontol 2014; 85:1019-26. [PMID: 24835418 DOI: 10.1902/jop.2014.130430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Treatment of concomitant endodontic-periodontal lesions remains a challenge in clinical practice and requires effective endodontic and regenerative periodontal therapy. Among other factors, cross seeding and recolonization of flora may affect the outcome of periodontal therapy. Intracanal medicaments have been shown to exert antimicrobial activity on the external root surface, and local delivery of antimicrobials has been suggested to be a complementary approach in the management of periodontitis. Therefore, the objective of this study is to determine the influence of chlorhexidine (CHX) intracanal medicament on the clinical outcomes of therapy. METHODS Thirty-one patients were divided into two treatment groups: 1) open flap debridement (OFD) in endodontically treated teeth (control); and 2) OFD in endodontically treated teeth with CHX placed in the coronal space (test). The clinical variables evaluated were probing depth (PD), clinical attachment level (CAL), and percentage of sites with PD ≥5 mm. Reevaluation was performed at 3 and 6 months post-surgery. RESULTS Both treatments resulted in improvement in all the clinical variables evaluated. Postoperative measurements from test and control groups showed reductions in mean PD of 2.22 ± 1.27 and 0.91 ± 0.81 mm, mean CAL gains of 2.16 ± 1.12 and 0.60 ± 0.93 mm, and 43.33% ± 31.37% and 17.71% ± 14.23% reduction in sites with PD ≥5 mm. Significantly more PD reduction, CAL gain, and percentage reduction in sites with PD ≥5 mm were observed in the test group at 6 months (P <0.05). CONCLUSION CHX may be used as an effective intracanal medicament for promoting periodontal healing in concomitant endodontic-periodontal lesions.
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Affiliation(s)
- Jyoti Raheja
- Department of Conservative Dentistry & Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Li H, Guan R, Sun J, Hou B. Bacteria community study of combined periodontal-endodontic lesions using denaturing gradient gel electrophoresis and sequencing analysis. J Periodontol 2014; 85:1442-9. [PMID: 24579762 DOI: 10.1902/jop.2014.130572] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The entire microbial population and predominant microflora of root canals (RCs) and adjacent periodontal pockets (PPs) from teeth with combined periodontal-endodontic lesions were determined and compared. METHODS Pooled RC and PP samples were collected from the molars of 20 patients diagnosed with combined periodontal-endodontic lesions. DNA was extracted for polymerase chain reaction-based denaturing gradient gel electrophoresis (PCR-DGGE), cloning, and sequence analysis. A coefficient of similarity (Cs) was used to determine the similarity of the bacterial profiles from RCs and PPs. RESULTS Significantly fewer bands were produced by PCR-DGGE from RCs (5.9 ± 1.7) than from PPs (8.0 ± 1.8) (P <0.001). The average Cs of the RC and PP samples was 93.81% ± 10.26%. Overall, 60 genera/species were identified by sequencing. Of these, the predominant genera in RCs were Porphyromonas sp. (13.9%), Filifactor sp. (12.5%), and Parvimonas sp. (11.1%), similar to the genera obtained from PP samples. In total, 43 genera/species were common to the RC and PP samples. The most prevalent bacteria in both the RC and PP samples were (in descending order) Filifactor alocis, Parvimonas micra, Porphyromonas gingivalis, and Tannerella forsythia. CONCLUSIONS The high similarity in the sets of organisms present in both RC and PP samples in this study suggests that the pocket could be a source of RC infection. The data also demonstrate that combined periodontal-endodontic lesions consist of a diverse and complex microbial community.
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Affiliation(s)
- Hong Li
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
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Zuza EP, Carrareto ALV, Lia RCC, Pires JR, de Toledo BEC. Histopathological features of dental pulp in teeth with different levels of chronic periodontitis severity. ISRN DENTISTRY 2012; 2012:271350. [PMID: 22577568 PMCID: PMC3346691 DOI: 10.5402/2012/271350] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 02/10/2012] [Indexed: 11/29/2022]
Abstract
Purpose. To evaluate the histopathological condition of the pulp in teeth with different levels of chronic periodontitis in humans. Methods. Twenty-five single-root nondecayed teeth were divided into three groups as follows: group 1, clinical attachment level (CAL) 3 to 4 mm and alveolar bone loss (BL) from 4 to 6 mm without reaching the tooth apex; group 2, CAL ≥ 5 mm and BL > 6 mm without reaching the tooth apex; group 3, CAL ≥ 5 mm and BL > 6 mm up to the tooth apex. Histological analyses were accomplished after laboratorial processing. Results. The mean of CAL was 3.2 ± 0.7 mm in group 1, 7.6 ± 2.0 mm in group 2, and 12.1 ± 2.8 mm in group 3, while for BL it was 4.8 ± 0.9 mm, 7.6 ± 2.2 mm, and 11.9 ± 2.1 mm, respectively. Histopathological data in the pulpal chambers were similar among the three groups showing normal aspects, and, the radicular pulps showed variable levels of reactive dentin, fibrosis, dystrophic mineralizations, atrophy, and mononuclear inflammatory infiltrate. Conclusions. Gradual progression of the chronic periodontitis led to changes in the histopathological aspects of the radicular pulp with progressive involvement.
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Affiliation(s)
- Elizangela Partata Zuza
- Department of Master of Dental Science, School of Dentistry, Educational Foundation of Barretos (UNIFEB), Avenida Roberto Frade Monte, 389, 14783-226 Barretos, SP, Brazil
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Bruno KF, de Alencar AHG, Estrela C, Batista ADC, Pimenta FC. Microbiological and microscopic analysis of the pulp of non-vital traumatized teeth with intact crowns. J Appl Oral Sci 2010; 17:508-14. [PMID: 19936534 PMCID: PMC4327682 DOI: 10.1590/s1678-77572009000500028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 11/09/2008] [Indexed: 11/22/2022] Open
Abstract
Objective: This study evaluated the presence of microorganisms and analyzed microscopically the pulp of 20 traumatized human teeth with intact crowns and clinical diagnosis of pulp necrosis, based on the association of at least three of the clinical criteria: crown discoloration, negative response to thermal and electric pulp vitality tests, positive response to vertical and horizontal percussion, pain on palpation or mobility. Material and Methods: Microbiological collection was performed from the root canals to evaluate the presence of microorganisms. The pulp samples were stained with hematoxylin and eosin (H.E.) for histological evaluation of possible morphological alterations. Results: Analysis of results was performed by statistical tests (linear regression test and diagnostic analysis) and subjective analysis of the sections stained with H.E. and revealed that only 15% of the sample did not exhibit microbial development. The time elapsed between dental trauma and onset of endodontic intervention ranged from 15 days to 31 months; the percussion test presented high sensitivity (80%) for detection of microorganisms in the root canal of traumatized teeth; 3 teeth (15%) did not present pulp tissue, being characterized as complete autolysis; analysis of pulp samples was performed on the other 17 cases, among which 3 (15%) exhibited partial necrosis without possibility of repair and 14 presented complete necrosis; none of the clinical criteria employed for the diagnosis of pulp necrosis in traumatized teeth was pathognomonic. Conclusions: The present results allowed the following conclusions: with regard to microbiological findings, 85% of teeth presented microorganisms in the root canal, despite the presence of an intact crown. Concerning the microscopic findings, 100% of traumatized teeth presented pulp necrosis; the pulp vitality tests based on pulp response to heat, cold and vertical percussion were the most reliable to diagnose pulp necrosis in traumatized teeth.
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ROTSTEIN ILAN, SIMON JAMESH. The endo-perio lesion: a critical appraisal of the disease condition. ACTA ACUST UNITED AC 2006. [DOI: 10.1111/j.1601-1546.2006.00211.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Rotstein I, Simon JHS. Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontol 2000 2004; 34:165-203. [PMID: 14717862 DOI: 10.1046/j.0906-6713.2003.003431.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Ilan Rotstein
- Continuing Oral Health Professional Education, University of Southern California, School of Dentistry, Los Angeles, California, USA
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