Treatment of severely decayed anterior primary teeth with short-post technique (Mushroom Restorations) under general anesthesia.

AIMS: The aim of this study was to evaluation the treatment success of the short post technique (mushroom restoration) using a composite resin in severely decayed primary anterior teeth after 6, 12, and 18 months after treatment. METHODS: Eighteen children aged 3-5 years with severely decayed primary maxillary anterior teeth (60 anterior maxillary primary teeth in total) were included. Patients were treated under general anesthesia (GA). After pulpectomy, a "mushroom shape" was formed in the root canals for the purpose of retention, and the root canals were filled with zinc oxide-eugenol (ZOE), and the teeth were restored with composite resin. The status of treatment was evaluated clinically and radiographically for periapical radiolucency, pathological root resorption, marginal fracture, and loss of restoration for each treated tooth. All findings were recorded. RESULTS: As a result of the evaluation criteria, the success rates at 6, 12 and 18 months were 86%, 80%, and 71%, respectively. None of the teeth showed apical radiolucency or pathological root resorption at the end of the 18th month period. CONCLUSION: The short-post (mushroom restorations) technique is a clinically acceptable alternative method for restoration of severely decayed primary teeth. This study supports the feasibility of treatment with this technique for pediatric patients treated under GA.

The use of a single-step regenerative approach for the treatment of a replanted mandibular central incisor with severe resorption.

AIM: To report the clinical and radiographic treatment outcome of an immature replanted mandibular incisor with severe inflammatory external root resorption following a single-step regenerative approach. SUMMARY: A 7-year-old female patient was referred 1 week following an extrusion injury to her mandibular central incisor (tooth 31). There was a history of a 6 months previous avulsion injury to the same tooth, which had been replanted after 20 min of extra-oral time. On clinical examination, all teeth were asymptomatic and there was an arch wire splint placed on the mandibular incisors. Radiographic examination revealed severe inflammatory external root resorption of tooth 31. A diagnosis of necrotic pulp and asymptomatic apical periodontitis was made. Under local anaesthesia and rubber dam isolation, an access cavity was prepared. The canal was irrigated using 6% NaOCl solution delivered through the EndoVac negative pressure irrigation system (Endo Vac, Axis/SybronEndo, Coppell, TX, USA). A 17% EDTA solution was used for 5 min followed by a final rinse of sterile water. The periapical tissues were probed using a K-file, and bleeding was induced. A blood clot was allowed to form filling the entire canal. A thick plug of MTA was placed in direct contact with the blood clot. The tooth was restored with composite resin. All procedures were performed in a single visit. The splint was removed 2 weeks later. Recall examination after 24 months revealed healthy soft tissues with normal periodontal probing and mobility. The 24 months radiographic evaluation revealed healing of the severe inflammatory external root resorption and continuous root development/dentine wall thickening of the apical third. No signs of ankylosis or significant discoloration was present.

Associations between smoking and tooth loss according to the reason for tooth loss: the Buffalo OsteoPerio Study.

BACKGROUND: Smoking is associated with tooth loss. However, smoking's relationship to the specific reason for tooth loss in postmenopausal women is unknown. METHODS: Postmenopausal women (n = 1,106) who joined a Women's Health Initiative ancillary study (The Buffalo OsteoPerio Study) underwent oral examinations for assessment of the number of missing teeth, and they reported the reasons for tooth loss. The authors obtained information about smoking status via a self-administered questionnaire. The authors calculated odds ratios (ORs) and 95 percent confidence intervals (CIs) by means of logistic regression to assess smoking's association with overall tooth loss, as well as with tooth loss due to periodontal disease (PD) and with tooth loss due to caries. RESULTS: After adjusting for age, education, income, body mass index, history of diabetes diagnosis, calcium supplement use and dental visit frequency, the authors found that heavy smokers (≥ 26 pack-years) were significantly more likely to report having experienced tooth loss compared with never smokers (OR = 1.82; 95 percent CI, 1.10-3.00). Smoking status, packs smoked per day, years of smoking, pack-years and years since quitting smoking were significantly associated with tooth loss due to PD. For pack-years, the association for heavy smokers compared with that for never smokers was OR = 6.83 (95 percent CI, 3.40 -13.72). The study results showed no significant associations between smoking and tooth loss due to caries. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Smoking may be a major factor in tooth loss due to PD. However, smoking appears to be a less important factor in tooth loss due to caries. Further study is needed to explore the etiologies by which smoking is associated with different types of tooth loss. Dentists should counsel their patients about the impact of smoking on oral health, including the risk of experiencing tooth loss due to PD.

Revisión de una fractura radicular con tratamiento atípico durante 23 años / Review of root fracture with atypical treatment for 23 years

Presentamos el caso de un incisivo central superior derecho, con fractura del tercio medio radicular, que fue tratado de forma atípica y se revisó durante 23 años de evolución. La fractura del tercio medio, conminuta en su área central, se produjo por un traumatismo contuso, acudiendo el paciente de urgencia por dolor agudo y movilidad del cliente. Con el diagnóstico de pulpitis aguda y fractura radicular media con subluxación, se decidió tratarlo en toda su longitud después de su ferulización. Practicado el tratamiento se dejó hidróxido de calcio en el conducto y a las dos semanas, con un diente asintomático desde el primer día, se selló definitivamente con hidróxido de calcio en suero fisiológico y gutapercha en condensación lateral. Tres meses después se retiró la ferulización y el diente esta asintomático, funcional y con una movilidad semejante a la de los incisivos vecinos. Radiológicamente, el área de fractura presento distintos aspectos diagnósticos a lo largo de 23 años de seguimiento. Actualmente, el incisivo sigue asintomático, firme, funcional y con un remodelado de su contorno bien definido (AU)

We are herewith presenting a case based on a maxillary right superior central incisor, which suffered a middle third fracture of the root. This fracture has been atypically treated and has been checked up throughout 23 years. The middle third fracture, which is comminuted in its central area, was caused by a contusion trauma. The patient came with urgency due to tooth mobility as well as an acute pain. After being diagnosed acute pulpitis and mid radicular fracture with subluxation, it was agreed to treat it throughout the whole process after its ferulization. Once treated, calcium hydroxide was left in the canal and two weeks after, with an asymptomatic tooth since the first day, it was sealed with calcium hydroxide with physiological saline solution and lateral condensation with gutta-percha. Three months after, ferulization was removed and the incisor was asymptomatic, functional and with mobility similar to the neighboring incisive. Radiograph examinations proved that the fracture presented different diagnosis throughout its 23 years. Nowadays, this incisor keeps being asymptomatic, firm and functional with a well done reshape (AU)

Traditional tooth bud gouging in a Ugandan family: a report involving three sisters.

It has been reported in the literature that some rural populations of Sub-Saharan and Eastern Africa and other isolated areas around the world, practise gouging or enucleation of primary tooth buds to cure childhood illnesses. The unerupted primary canine tooth bud is believed to be the cause of febrile illness, diarrhoea, and vomiting; prevalent in infants in these areas of the world. Tooth bud gouging has implications for the developing dentition, and is a potential risk to the health and life of the child. Reported prevalence ranges from 22%-90%. From the information in this case report, the practise of tooth bud gouging is no longer confined to rural areas and may well be performed by communities that have emigrated to the UK. The three sisters described, now resident in the UK, suffered tooth gouging in a city clinic in Uganda. The damage caused to the primary and permanent dentition is described and treatment planning and options are suggested for each case to restore structure and function. Appropriate provision of healthcare and education could avoid the potential long-term damage to the health of the child and their developing dentition by the practise of tooth bud gouging, whether it occurs in the developing or developed world.

[A comparative analysis of the efficacy of different types of filling materials in the surgical elimination of tooth perforations (experimental morphological research)]. / Sravnitel'nyi analiz éffektivnosti plombirovochnykh materialov razlichnykh tipov pri khirurgicheskom ustranenii perforatsii zubov (éksperimental'no-morfologicheskoe issledovanie).

Based on the experimental morphological findings, the authors compare the efficiency of tooth perforation repair in experimental animals by surgical method using Dyract compomer, Base Line glass ionomeric cement, and Ostim-100 osteoplastic material. The data indicate a high efficiency of this method. Base Line material is preferable for filling the perforation in dental wall, as it reliably performed the isolating function under experimental conditions.