Concept of predictable disinfection in endodontics.

Factors influencing the appropriate time to obturate a tooth are the patient's signs and symptoms, pulp and periradicular status, degree of difficulty, and patient management. The current consensus is that one-step treatment procedures are acceptable in cases where the patient exhibits a vital pulp. The removal of normal or inflamed pulp tissue and performance of the procedure under aseptic conditions should result in a successful outcome because of the absence of bacterial contamination. Obturation at the initial visit also precludes the contamination as a result of leakage during the period between the patient's visits. When patients present with acute symptoms caused by pulp necrosis and acute periradicular abscess, the obturation is generally delayed until the patient is asymptomatic. The interappointment antimicrobial dressing is indicated before the definitive obturation (Ref. 15).

Adenocarcinoma of the esophagus presenting as orbital cellulitis.

A 56-year-old man was seen with signs and symptoms consistent with orbital cellulitis. Computed tomographic scan showed a localized bony defect in the sphenoid wing, on which a biopsy was performed through a lateral orbitotomy. Pathologic examination of the surgical specimen revealed mucinous adenocarcinoma, and metastatic workup revealed an extensive lower esophageal malignant neoplasm. Arch Ophthalmol. 2000;118:986-988