Acutely infected teeth: to extract or not to extract?

Abstract: Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics.

Newly forming bone graft: a novel surgical approach to the treatment of denuded roots

Many techniques have been proposed for root coverage. However, none of them presents predictable results in deep and wide recessions. OBJECTIVES: The aim of this case series report is to describe an alternative technique for root coverage at sites showing deep recessions and attachment loss >4 mm at buccal sites. MATERIAL AND METHODS: Four patients presenting deep recession defects at buccal sites (>4 mm) were treated by the newly forming bone graft technique, which consists in the creation of an alveolar socket at edentulous ridge and transferring of granulation tissue present in this socket to the recession defect after 21 days. Clinical periodontal parameters, including recession depth (RD), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI) and keratinized gingiva width (KGW) were evaluated by a single examiner immediately before surgery and at 1, 3, 6 and 9 months postoperatively. RESULTS: All cases showed reduction in RD and PD, along with CAL gain, although no increase in KGW could be observed. These findings suggest that the technique could favor periodontal regeneration along with root coverage, especially in areas showing deep recessions and attachment loss.

The importance of apical patency and cleaning of the apical foramen on root canal preparation

O limite apical de trabalho sempre constituiu um tema de muita controvérsia. Apesar dos vários trabalhos que já foram publicados sobre o assunto, ainda não existe uma definição sobre ele. A recente discussão sobre patência apical e limpeza do forame e a incorporação desses procedimentos ao tratamento endodôntico parece ter gerado uma polêmica maior ainda. É possível que essa polêmica tenha a sua causa maior na ausência de interrelação do conhecimento que se tem sobre o coto pulpar e tecidos periapicais e a realidade dos fatos da clínica. Através de uma discussão sobre os principais aspectos desse tema, este artigo pretende apresentar uma nova concepção a respeito da importância da patência apical e limpeza do forame no preparo do canal.

TRATAMIENTO DE CONDUCTOS EN DIENTES TEMPORARIOS

El presente trabajo de investigación, se refiere al tratamiento de conductos en dientes temporarios, pulpares, los cuales se presentan con mucha frecuencia en la clínica de odontopediatria de la facultad de odontología constituyendo por tanto un tema de mucha importancia. Fue desarrolado viendo la necesidad de conservación primordial de los dientes en la cavidad bucal en los niños. Evitándo de este modo las malposiciones dentarias y maloclusión futuras de los dientes permanentes, por que de este modo se contribuye a la: Estética, masticación y fonación; impidiendo los efectos negativos, psicológicos, asociados con la perdida prematura de los dientes anteriores. El tratamiento de conductos radiculares en dientes temporarios se realizoprevio conocimiento de la anatomia dentaria de los dientes temporarios por ser fundamental para el exito de la endodoncia, este tratamiento es el último recurso para evitar la exodoncia, prematura