Effect of dowel length on the retention of 2 different prefabricated posts.

OBJECTIVE: To compare in vitro the retentive values of stainless steel, parallel-sided posts to quartz-fiber, tapered posts for 2 different dowel lengths (5 and 10 mm). METHOD AND MATERIALS: Both post systems were cemented with a dual-cure adhesive resin cement. Single-rooted extracted human teeth (n = 40) were decoronated and randomly divided into 4 groups of 10 samples each. Posts of 5 and 10 mm in length were luted with the resin cement. Each sample was placed on a universal testing machine, and using a push-out method, a vertical load was applied at a crosshead speed of 2 mm/min. The amount of force required to dislodge the post was recorded. The effect of post type and length was evaluated using a 2-way analysis of variance. RESULTS: A statistically significant main effect was found for post length (P <.001), with the 10-mm posts of both post systems requiring greater force to dislodge than the 5-mm posts. There was no interaction between post length and post type (P >.05). CONCLUSION: It is concluded from this study that there is no statistical difference in retention between quartz-fiber, tapered posts and stainless steel, parallel-sided posts when they are cemented with the same resin cement (P >.05). The study also concludes that adequate retentive values are achieved with both post systems at the shorter, 5-mm post length.

Interdisciplinary approach to endodontic therapy for uncooperative children in a dental school environment.

The aim of this study was to describe an interdisciplinary approach for endodontic therapy of behavior-challenging children and to report the efficacy of sedation techniques for these procedures. Sedation records of thirty-two patients who received root canal treatment were reviewed. Age at treatment in months, gender, year of treatment, tooth type, status of root maturation (open or closed apex), etiological factor(s), sedation protocol, and outcome were the variables analyzed. The collected information was entered into a computerized flowchart and the data analyzed using descriptive statistics. Midazolam in combination with meperidine or hydroxyzine were the most common protocols used (46 percent and 40 percent of the cases, respectively). Only two (6 percent) treatments were aborted due to uncontrolled behavior during sedation. We conclude that cooperation between pediatric dentists and endodontists is fundamental to achieving success when providing root canal treatment for uncooperative child patients.

Impact of a biological barrier in pulpectomies of primary molars.

PURPOSE: The purpose of this in vitro study was to determine whether placement of a resorbable collagen barrier at the apical one third of the root canal could prevent extrusion of pulpectomy filling material. METHODS: Twenty-five extracted primary mandibular second molars, with at least two thirds of root length remaining, were used. The apical third of each root was covered with utility wax, and teeth were embedded in acrylic. Carious tooth structure was removed, crowns were reduced to a flat surface, and canals were accessed and preflared. Working lengths were established by reducing file lengths 2 mm short of the anatomic apex. Cleaning and shaping was performed using hand and rotary files, and canals were irrigated with sodium hypochlorite and dried with paper points. CollaCote was randomly packed into 1 of 2 prepared canals, and obturation was performed with Vitapex. Postoperative radiographs were independently evaluated for the presence of overfilling, and data were statistically analyzed using chi-square analysis. RESULTS: Overfilling was observed in 16% (4/25) of the CollaCote treated canals and in 42% (10/24) of canals when no barriers were used (P = .047). CONCLUSION: The application of CollaCote at the apical one third of the canals did not completely prevent, but did significantly decrease, the risk for overfilling in primary molars.

Endodontic treatment of a Patient with Huntington's disease.

Huntington's disease is a lethal autosomal dominant disorder that affects men and women equally. The prevalence of Huntington's disease in North America is 5 to 10 per 100000 people. It is characterized by regular personality changes, dementia, and choreiform (dance-like) movements. Literature concerning dental treatment of patients who have been diagnosed with this type of disease is scarce. Continuous ingestion of medications to control the symptoms of this disease leads to xerostomia, which, maximized by unrestrained movements, often leads to progressive tooth decay, irreversible pulpitis, and tooth loss. Maintenance of teeth in patients with this type of disease is desirable and challenging. Like any patient, a comprehensive treatment plan needs to be developed with equal emphasis on restoration and home care. This case report illustrates how a morphologically difficult endodontic procedure can be successfully administered in a patient diagnosed with HD. Overall case success was attributed to a dental team approach and short-duration appointments to limit patient stress.

Personal video monitor as an accessory to dental operating microscopes.

OBJECTIVE: The aim of this study was to perform a qualitative assessment of the personal video monitor (PVM) as an accessory to the dental operating microscope (DOM). METHOD AND MATERIALS: The PVM was attached to a color video monitor, which was already attached to a DOM through a beam splitter. One faculty clinician performed a complete oral examination on a patient wearing a binocular inclinable lens adapted to the DOM under different magnifications, while a second faculty watched the procedure simultaneously using a PVM. After completing the examination, the operators exchanged the viewing devices and repeated the procedure. RESULTS: When compared to a standard binocular lens attached to the DOM, the second operator using the PVM had an unencumbered view of his surroundings and was able to make head movements freely. However, when comparing the resolution of the standard binocular lens to the PVM, the binocular lens provided a sharper picture with better illumination, especially when using higher magnification. Statistical analysis was not incorporated, as the goal of this experiment was to qualify rather than quantify the established PVM resolution, in this initial analysis. CONCLUSION: The authors concluded that the PVM attached to the video camera and the DOM allowed a second operator to watch the procedure, and it could be used as an important teaching tool. Another application is that the patient may wear the PVM while the procedure is in progress. However, the resolution in the PVM needs to be significantly improved in order to achieve an adequate level of efficiency in four-handed microdentistry.

Periradicular radiographic assessment in diabetic and control individuals.

OBJECTIVE: The purpose of this study was to investigate the prevalence of radiographic periradicular radiolucencies in endodontically treated and untreated teeth in patients with and without diabetes. STUDY DESIGN: The records of 30 subjects with diabetes and 23 control subjects attending the Endodontic Graduate Clinic at the University of Florida, Gainesville, were reviewed. The number of teeth with root canal treatments with and without periradicular radiolucencies and the number of teeth without endodontic treatment but with periradicular lesions were recorded. RESULTS: There were no main effects of sex, diabetes diagnosis, or age (the covariate) on the 3 outcomes of interest- nonsurgical endodontic treatment (NSE) with lesions, NSE without lesions, and no NSE with lesions. However, there were significant interactions between sex and diabetes diagnosis for both of the endodontic outcomes, NSE with lesions (F = 4.292; P <.05) and NSE without lesions (F = 4.241; P <.05). This meant that men with type 2 diabetes who had endodontic treatments were more likely to have residual lesions after treatment. CONCLUSION: Type 2 diabetes is associated with an increased risk of ill response by the periradicular tissues to odontogenic pathogens.

Cyclosporin-induced gingival overgrowth in a child treated with CO2 laser surgery: a case report.

A case of a 10 year-old boy with gingival overgrowth due to cyclosporin therapy after heart transplantation is described. Different treatment approaches are discussed and the surgical effect of CO2 laser is illustrated. The critical role of routine professional cleaning and good oral health maintenance for the healthy status of the gingival tissue is also emphasized in this paper. Replacement of cyclosporin by tacrolimus, another immunosuppressive agent associated with minimal to none gingival overgrowth, might be considered in cases with reported recurrences.

Comparison of the apical seal obtained by a dual-cure resin based cement or an epoxy resin sealer with or without the use of an acidic primer.

This study compared the apical leakage of roots obturated with gutta-percha using either a dual-cure resin based cement (Panavia F) or an epoxy-resin sealer (Thermaseal plus) with or without the application of an acidic primer (ED Primer). Eighty-six single rooted canine teeth were decoronated, cleaned, and shaped by using hand and rotary instruments, randomly divided into four groups, and obturated as follows: group A (n = 20): ED Primer applied followed by thermoplastized obturation with gutta-percha and Thermaseal Plus sealer; group B (n = 20): thermoplastized obturation with gutta-percha and Thermaseal Plus; group C (n = 20): ED primer applied followed by thermoplastized obturation with gutta-percha and Panavia F; group D (n = 20): thermoplastized obturation with gutta-percha and Panavia F. Both a negative control (n = 3; entire root coated with wax) and a positive control (n = 3; obturated with only a fitted master cone) were included in the study. Groups A, B, C, D, and the controls were immersed in molten sticky wax, leaving the apical 2-mm exposed, and quickly chilled. All teeth were immersed in 1% methylene blue dye solution for 10 days, rinsed, and sectioned longitudinally. Apical dye penetration was measured stereomicroscopically at 10-fold magnification. The analysis of variance and Duncan Multiple Range were used for result analysis. The specimens obturated with gutta-percha and an epoxy-resin sealer (with or without an acidic primer) demonstrated significantly less linear dye penetration than specimens obturated with gutta-percha and the dual-cure, resin-based cement (with or without an acidic primer).