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1.
J Contemp Dent Pract ; 21(2): 211-214, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381830

RESUMO

AIM: The aim of the present study was to present a case of maxillary aspergillosis with unusual clinical presentation and imaging findings. BACKGROUND: The range of lesions and conditions that affect the maxillary sinus is wide and vast. This necessitates a dynamic multidisciplinary approach for proper diagnosis and effective management. CASE DESCRIPTION: We present an unusual case of maxillary aspergillosis that mimicked apical periodontitis and was most consistent with lymphoma from the diagnostic imaging perspective. Histopathology, however, established the correct diagnosis; appropriate management commenced promptly. CONCLUSION: It is imperative that maxillary aspergillosis be diagnosed and managed properly and promptly to improve prognosis. Advanced imaging is required, but it plays an adjunct role to histopathology. Long-term follow-up is also necessary to ensure complete resolution of the infection. CLINICAL SIGNIFICANCE: Correlating clinical and imaging findings is a crucial step and any inconsistencies should be resolved promptly so as not to delay adequate management. Histopathology often serves to dispute any inconsistencies and allows the establishment of a proper diagnosis.


Assuntos
Aspergilose , Sinusite Maxilar , Periodontite Periapical , Humanos , Maxila , Seio Maxilar
2.
Stomatologiia (Mosk) ; 99(2): 7-10, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32441068

RESUMO

The purpose of the study was to evaluate the degree of purification of the deltoid root canal branching during endodontic treatment of teeth. Morphological assessment of dentine of 14 extracted incisors and premolars in patients aged from 24 up to 56 years with the diagnosis chronic apical periodontitis was conducted in two experimental groups: main (1 group, 7 teeth) and control (2 group, 7 teeth). In the 2 group conventional root canal treatment was carried out with processing of 3% solution of sodium hypochlorite and final sealing with gutta-percha pins by lateral condensation. In the 1 group root canals were additionally irrigated by 3% sodium hypochlorite solution by means of the RinsEndo device. Based on the study results we recommend using the hydrodynamic method of irrigation of root canals with 3% sodium hypochlorite solution in endodontic treatment of patients with chronic apical periodontitis.


Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Dentina , Humanos , Pessoa de Meia-Idade , Irrigantes do Canal Radicular , Obturação do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio
3.
Rev. Asoc. Odontol. Argent ; 108(1): 19-24, ene.-abr. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1096713

RESUMO

Objetivo: Presentar la terapia regenerativa como una al- ternativa para la resolución de un caso de traumatismo denta- rio en un diente permanente incompletamente desarrollado. Caso clínico: Se realizó el tratamiento de un incisivo central superior con mortificación pulpar y periodontitis api- cal aguda subsecuente a trauma dental en un paciente de 8 años de edad. Se aplicó el protocolo de regeneración pulpar recomendado por la Asociación Americana de Endodoncia. Se estimuló la formación de un coágulo en el interior del con- ducto a partir de los tejidos periapicales, previa desinfección con la pasta triple antibiótica, y finalmente se colocó mineral trióxido agregado coronal a este. Se obtuvo así una matriz es- teril que permitió el crecimiento de nuevo tejido y se realiza- ron controles periódicos durante 4 años. Se constató silencio clínico. Radiográficamente, se observó la formación de tejido sobre las paredes del conducto y el cierre apical. Conclusión: La terapia regenerativa como alternativa de tratamiento, en este caso, permitió la disminución de la luz del conducto por el depósito de tejidos calcificados y el cierre del foramen apical, mejorando el pronóstico de la pieza dentaria (AU)


Aim: To present pulp regeneration therapy as an alter- native to resolve dental trauma in immature permanent teeth. Clinical case: We report a clinical case of an immature central superior incisor with pulp mortification and acute api- cal periodontitis subsequent to dental trauma, in an 8 year old patient. The pulp Regeneration protocol recommended by the American Endodontics Association was applied. We stimulated a clot formation inside the duct from periapical tissues and after disinfection with a mixture of three antibi- otics mineral trioxide aggregated was finally place coronal to the clot. Thus a sterile matrix was obtained that allowed new tissue's growth. Periodic check-up visits were carried out over a 4 years period. Clinical silence was observed. Tissue formation on duct walls and apical closure were radiograph- ically detected (AU) Conclusion: Regenerative therapy is an alternative for the treatment of immature permanent teeth, in ths clinical case it allowed the reduction of the width of the duct by the opposition of hard tissues and the closure of the apical fora- men improving the forecast of these teeth.


Assuntos
Regeneração , Dentição Permanente , Incisivo/lesões , Periodontite Periapical , Argentina , Materiais Restauradores do Canal Radicular/uso terapêutico , Cicatrização/fisiologia , Traumatismos Dentários/complicações , Necrose da Polpa Dentária , Ápice Dentário/crescimento & desenvolvimento , Unidade Hospitalar de Odontologia
4.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(2): 205-210, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32314896

RESUMO

Primary tooth root canal therapy is a treatment performed on primary teeth diagnosed with pulpitis or periapical periodontitis. This procedure requires perfect instrumentation, disinfection, and filling of root canals to eliminate infection, control inflammation, relieve pain, prevent pathological effects on inherited permanent tooth, and prolong primary tooth preservation. This paper reviews the research history on primary tooth root canal treatment and summarizes the progress on primary tooth root canal treatment, including anatomical morphology, root canal preparation, root canal disinfection, root canal filling, and application of antibiotics.


Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Humanos , Obturação do Canal Radicular , Preparo de Canal Radicular , Tratamento do Canal Radicular , Dente Decíduo
5.
Stomatologiia (Mosk) ; 99(1): 33-37, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32125299

RESUMO

In the course of the present study four endodontic treatment schemes were tested and the most effective scheme was determined through the use of calcium hydroxide-based paste being applied three times at an interval of 7-14 days with the subsequent long-term temporary obturation using calcium hydroxide with iodoform, ultrasonic activation of sodium hypochlorite in the root canal, hydrodynamic irrigation and a diode laser. During the entire treatment period, the most effective scheme has revealed a reduction in defect size by 2,57±0,17 (p>0,0001) as well as a 1,84 degree (p>0,0001) decrease in PAI score. Based on optical density data, it was concluded that the application of calcium hydroxide with iodoform in the treatment scheme leads to an 2,2-4,2% improvement in bone tissue regeneration in the periapical zone. The greatest and complete inhibition of microorganisms was determined in patients of the first and third experimental groups in which a diode laser was used. The use of a diode laser in endodontic dental treatment with periapical destruction, enhances antibacterial activity and contributes to the complete inhibition of pathogenic microflora in the root canals.


Assuntos
Periodontite Periapical , Hidróxido de Cálcio , Humanos , Irrigantes do Canal Radicular , Tratamento do Canal Radicular , Hipoclorito de Sódio
6.
Med Oral Patol Oral Cir Bucal ; 25(3): e383-e387, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32134898

RESUMO

BACKGROUND: Aim Previous reports have been analyzed the prevalence/association of apical periodontitis (AP) with systemic diseases. The present study aims to analyze the prevalence of healthy/diseased periapex and endodontic treatments in patients with Multiple Myeloma (MM) and compare the results with those of control subjects. MATERIAL AND METHODS: Methodology Panoramic radiographs of 50 individuals with MM were evaluated and compared with 50 controls that were sex and age matched exactly with the diseased group. Radiographic analysis was performed by 2 two experienced endodontists under standardized conditions. The periapical status (presence or not of AP) was assessed using the periapical index (PAI). Data included systemic health, technical quality of root fillings, total number of teeth, quality of restoration, and periapical status. Statistical evaluation of differences between groups included used chi-squared tests and Fisher's exact tests. RESULTS: The prevalence of root canal-treated teeth was 10.11% in the MM group and 12.05% in the control group (p=0.90). The average root canal-treated teeth in the test group was 2,34 and 2.48 in the control group, where the difference was statistically significant (p=0.05). AP in 1 or more teeth was found in 86 % and in 78% of the patients in the MM and the control groups, respectively. When analyzed by subject, there was no statistically significant difference in the prevalence of AP (p>0.72). Similarly there was also no statistically significant difference in the prevalence of PA (p=0.85), when analyzed by tooth, AP was found in 63.2% and 62.9% in MM and control groups. CONCLUSIONS: The presence of AP and endodontic treatment was not significantly different in individuals with MM compared with control subjects. Future studies are needed to elucidate and confirm the association between MM and AP.


Assuntos
Mieloma Múltiplo , Periodontite Periapical , Humanos , Prevalência , Radiografia Panorâmica , Tratamento do Canal Radicular
7.
Braz Dent J ; 31(1): 37-43, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159704

RESUMO

The objective of this in vivo study was to assess the effect of the root canal irrigation by negative and positive apical pressure on the expression of molecules that are an indicative of cell differentiation with mineralizing phenotype in teeth of dogs with incomplete rhizogenesis and induced periapical lesion. A total of 30 teeth (60 roots) were distributed into 3 groups (n=20): EndoVac®, Conventional and Control. After 90 days, the routine histotechnical procedures were performed and the sections were submitted to immunohistochemical technique for the staining of osteopontin (OPN), alkaline phosphatase (ALP) and the RUNX2 transcription factor in the apical and periapical regions of the roots. A semi-quantitative analysis of the positive immunostaining was performed and the intensity of the expression was classified in absent (0), mild (1), moderate (2), or intense (3). Scores data were statistically analyzed by the Kruskal-Wallis non-parametric test and Dunn post-test, and the significance level was set at 5%. RUNX2 immunostaining revealed that in the negative pressure group there was a significantly stronger (p<0.05) immunostaining in comparison to the control group. Regarding the OPN expression, it was not possible to detect a statistically significant difference between the groups (p>0.05). After analyzing ALP immunostaining, a statistically significant difference was observed between the groups (p<0.05), and the negative pressure group showed a markedly stronger mark immunostaining than the control group. The results of the present in vivo study allowed concluding that negative apical pressure irrigation presents mineralizing potential in immature teeth with apical periodontitis.


Assuntos
Periodontite Periapical , Dente , Animais , Cães , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Tratamento do Canal Radicular
8.
Stomatologiia (Mosk) ; 99(1): 38-42, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32125300

RESUMO

AIM: To evaluate the effectiveness of the innovative concept of dental medical technologies in patients with resected (amputated) roots of teeth with and without periodontal diseases. MATERIAL AND METHODS: Of the 516 examined patients with periapical destructive foci of infection of various genesis, 4 clinical groups of 24 people were randomly formed: (1) with a diagnosis of apical periodontitis of incisors, canines or premolars with individual milled transdental implants made of zirconium dioxide; (2) patients with a similar diagnosis and concomitant periodontitis of moderate severity with the same implants; (3) patients with periapical destructive process of molars without periodontitis with the same implants. Control group (4) included patients with similar diagnoses with resection of the root apex without implantation. Patients of the study groups were operated in accordance with the developed clinical protocols, including the manufacture and installation of individual transdental implants with fixation in the postoperative period, developed within the framework of tooth-preserving technologies of immobilizing structures. RESULTS: The reinforcement of teeth with resected roots with transdental implants together with immobilization of these teeth in the postoperative period restores the biomechanical characteristics of the tooth 2.7 times more effectively. However, there is a slight change in the mobility of the operated teeth in an earlier period (after 3 months), which is associated with the resorption of the bone-replacing agent used to fill the intraoperative defect and with the defective formation of bone tissue. The values of peritelomeric 6 months after the operation differ from the control by 1.4 units only.


Assuntos
Implantes Dentários , Periodontite Periapical , Periodontite , Humanos , Dente
9.
Int Endod J ; 53(6): 742-753, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32034789

RESUMO

AIM: To evaluate the antimicrobial effectiveness of Ca(OH)2 paste combined with Ibuprofen or Ciprofloxacin in infected root canals of teeth with asymptomatic apical periodontitis. METHODOLOGY: Forty-five patients were randomly divided into three groups using a web programme according to the medication selected: Ca(OH)2 : 1 g Ca(OH)2 powder with 1 mL propylene glycol, Ca(OH)2  + Ibuprofen: 50 mg of Ibuprofen was added into 950 mg Ca(OH)2 powder and mixed with 1 mL propylene glycol, Ca(OH)2  + Ciprofloxacin: 50 mg of Ciprofloxacin was added into 950 mg Ca(OH)2 powder and mixed with 1 mL propylene glycol. Root canal bacteriological samples were collected before root canal treatment (S1) and after chemo-mechanical procedures (S2). After root canal preparation, the intracanal medicaments were placed into the root canals to a level approximately 1 mm short of the working length using K-files and access cavities were filled temporarily. The participants were scheduled for a second visit 7 days later when the medication was removed mechanically, and after irrigation of the root canals, the final samples (S3) were collected. Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the numbers of total bacteria, Enterococcus faecalis and Streptococcus species. For intragroup analysis, a Friedman test was used to compare reduction of counts of total bacteria, Streptococci and E. faecalis amongst the three samples (S1, S2 and S3). The chi-square test was used to compare the number of root canals positive for bacteria in S1, S2 and S3 amongst the groups. RESULTS: Intragroup analysis revealed a significant reduction in the number of intracanal bacterial cells from S1 to S2 and from S2 to S3 in all medication groups (P < 0.01). Although there was no significant difference amongst the groups when comparing quantitative S1 or S2 data, there were significantly lower bacterial counts in the Ca(OH)2  + Ciprofloxacin group (0.49 × 102 ) than the pure Ca(OH)2 (1.25 × 102 ) and Ca(OH)2  + Ibuprofen groups (0.76 × 102 ) at S3. The percentage reduction from S1 to S3 and from S2 to S3 was significantly greater in the Ca(OH)2 + Ciprofloxacin than the pure Ca(OH)2 and Ca(OH)2 + Ibuprofen groups (P < 0.05). In the Ca(OH)2  + Ciprofloxacin group, there were significantly fewer positive cases (8/15) than the pure Ca(OH)2 (13/15) and Ca(OH)2  + Ibuprofen (13/15) groups (P < 0.05). CONCLUSION: The addition of Ciprofloxacin to Ca(OH)2 provided further antibacterial effectiveness when used as an intracanal medicament in vivo during root canal treatment.


Assuntos
Antibacterianos , Hidróxido de Cálcio , Ibuprofeno , Periodontite Periapical , Clorexidina , Ciprofloxacino , Cavidade Pulpar , Humanos , Irrigantes do Canal Radicular , Preparo de Canal Radicular
10.
Int Endod J ; 53(6): 812-823, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32053244

RESUMO

AIM: First, to determine the feasibility of using the low-density lipoprotein receptor knockout (LDLR KO) mouse model to study apical periodontitis (AP). Secondly, to investigate the causal relationship between AP and atherosclerosis. It was hypothesized that it would be feasible to induce AP and atherosclerosis in LDLR KO mice and find a difference in atherosclerosis between AP and Sham groups. METHODOLOGY: Using a published methodology, AP was induced in LDLR KO mice by exposing the dental pulp of the four first molars (Tx). Shams received only anaesthesia. Mice were fed a high fat, Western-type diet (WTD), to induce atherosclerosis. At 16 weeks, mice were euthanized and aortas collected to measure atherosclerosis lesion burden (oil red O staining). Periapical lesions were validated using micro-CT and histology. Systemic inflammation was measured using a cytokine array. RESULTS: Both groups developed a similar degree of atherosclerosis (mean lesion area 7.46 ± 0.44% in the Tx group compared with 7.65 ± 0.46%, in the Sham group, P = 0.77), and a similar degree of inflammation. Periapical lesions (PALs) in all four molars were only identified in a small subset of Tx mice. CONCLUSIONS: A novel mouse model, which combines AP and CVD, was created. This model allows investigation of the relationship between the two diseases, whilst avoiding other potential common confounders. Although no difference in the degree of atherosclerosis was found between the groups, more studies in which the number of periapical lesions, changes in systemic inflammation and the degree of atherosclerosis are correlated are necessary to ultimately determine the impact of AP on CVD.


Assuntos
Aterosclerose , Periodontite Periapical , Animais , Citocinas , Modelos Animais de Doenças , Inflamação , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout
11.
PLoS One ; 15(2): e0227347, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32012166

RESUMO

This trial assessed post-operative pain and healing of apical periodontitis following endodontic therapy with a reciprocating system compared to a crown-down technique with hand files and lateral compaction filling. One-hundred and twenty nonvital anterior teeth with apical periodontitis were randomly treated using either a reciprocating single file followed by matching-taper single-cone filling or a hand file and lateral compaction filling. Postoperative pain was assessed during the 7 days after the treatment, using a visual analogue scale and a verbal rating scale. Apical healing was assessed using the periapical index score after a 12-month follow-up. The hypothesis tested was that both protocols were equivalent and present similar effectiveness in healing periapical lesions. Data were analyzed through two one-sided tests, t-tests, as well as Mann-Whitney and Chi-squared tests (α = 0.05). Logistic regression was used to investigate the association of clinical and demographic factors with the success of treatment. Regardless of the assessment time, no difference in incidence (38%-43% at first 24h), intensity of postoperative pain, and incidence of flare-up (≈ 3%) was observed between the two endodontic protocols. Both protocols resulted in a similar healing rate of apical periodontitis. After 12 months, the success rate ranged from 73% to 78% and the difference between the treatments fell within the pre-established equivalence margin (-0.1; -0.41 to 0.2). Endodontic treatment combining a reciprocating single file with matching-taper single cone showed similar clinical effectiveness to the treatment using hand-file instrumentation and the lateral compaction filling.


Assuntos
Periodontite Periapical/cirurgia , Endodontia Regenerativa/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Adulto , Feminino , Humanos , Masculino , Medição da Dor/métodos , Dor Pós-Operatória/patologia , Periodontite Periapical/patologia , Tratamento do Canal Radicular/métodos , Dente/fisiopatologia , Dente/cirurgia , Cicatrização
12.
J Clin Pediatr Dent ; 44(1): 15-19, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995420

RESUMO

Regenerative endodontic therapy (RET) provides a novel treatment modality for the immature teeth with pulp necrosis. The aim of this case series was to evaluate RET of immature permanent teeth using platelet rich fibrin (PRF) at 36-month follow-up periods. In the present case series, three immature maxillary incisors diagnosed with pulp necrosis and apical periodontitis were treated with RET. The root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and medicated with triple antibiotic paste(TAP). At the second visit, TAP was removed and root canals were conditioned with 17% EDTA. PRF was used as a scaffold. MTA was placed over PRF and the teeth were restored with composite resin. Periapical radiographs and cone beam computerized tomography(CBCT) were used to evaluate the healing. At the end of the 36-month follow-up periods, there was no response to pulp sensibility tests with cold and electric pulp tester, but all teeth showed decreased periapical lesions or evidence of healing.


Assuntos
Periodontite Periapical , Fibrina Rica em Plaquetas , Necrose da Polpa Dentária , Humanos , Incisivo , Endodontia Regenerativa , Tratamento do Canal Radicular
13.
Swiss Dent J ; 130(1): 31­35, 2020 Jan 13.
Artigo em Alemão | MEDLINE | ID: mdl-31904205

RESUMO

Inflammation-related pathologies such as apical periodontitis or radicular cysts are frequent lesions of the jawbones. Typically, a radiolucency is present that is not always distinguishable from other pathologies. A surgical approach would allow for tissue harvesting with further histopathologic processing. However, in the present case report of a cystic and large tunnelling lesion in the anterior maxilla, a conservative treatment with diagnostic needle aspiration and subsequent root-canal therapy was chosen. The long-term follow-up (eight years) including cone-beam computed tomography demonstrates a complete healing of the former bone defect with reestablishment of the vestibular and palatal cortices as well as absence of pain and other clinical symptoms.


Assuntos
Periodontite Periapical , Cisto Radicular , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila , Tratamento do Canal Radicular
14.
J Endod ; 46(3): 397-403, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31983459

RESUMO

INTRODUCTION: This retrospective study aimed to assess the radiologic characteristics of the possible associations between mucosal thickening of the maxillary sinuses (MSs) and periodontal and anatomic conditions of healthy and diseased maxillary teeth. METHODS: The periapical health of the maxillary molars in cone-beam computed tomographic (CBCT) images from 50 patients (mean age = 40.60±14.59 years) was evaluated using the CBCT-periapical index. Anatomic associations between maxillary molars and the inferior wall of the MSs and periodontal bone loss and its relation to MS pathology were assessed. The possible effects of these conditions on mucosal thickening of MSs were analyzed. Kruskal-Wallis, Mann-Whitney U, chi-square, and logistic regression (for relative risk) tests were used for statistical analysis. RESULTS: CBCT-periapical index 4 was the most frequently encountered apical periodontitis (AP) lesion. The risk for pathologic changes in the MSs was significantly higher in the presence of AP (P < .001). This risk was 62.364 times greater than that in areas of MSs adjacent to healthy teeth of the same patient (95% confidence interval, 7.968-488.14). Thicker MS mucosae were detected when the molar roots with AP were closer to the MSs (P < .004). No statistically significant difference was found between periodontal status and MS pathology. CONCLUSIONS: The findings of this study showed that MSs were affected by the endodontic health of adjacent molar teeth. Dental and medical practitioners should take into consideration the possible odontogenic causes while examining pathologic changes in the MS.


Assuntos
Seio Maxilar , Dente Molar , Periodontite Periapical , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Periodontite Periapical/diagnóstico por imagem , Estudos Retrospectivos
15.
Postgrad Med ; 132(2): 156-161, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31933403

RESUMO

Objective: A relationship between dentists and medical doctors should be encouraged to reduce cardiovascular risk in cardiac patients with dental infection. The aim of this study was to evaluate the attitudes of cardiologists and cardiovascular surgeons (cardiac specialists) toward managing endodontic infections and oral health in patients with cardiovascular diseases (CVDs).Methods: A survey of 16 questions assessing knowledge of endodontic infection, dental examination, timing of endodontic treatment, and antibiotic prophylaxis was sent to cardiac specialists in Turkey. The participants' responses were compared by means of the chi-square test (p ≤ 0.05).Results: Responses were received from 444 (44.71%) participants. Of all participants, 91.4% agreed that endodontic infections are important diseases that should be treated. Cardiac patients were referred to a dentist by 66.6% of the cardiologists and 80.3% of the cardiovascular surgeons (p = 0.002). Almost all participants (97.3%) believed that the heart health of cardiac patients with endodontic infections could be negatively affected by this infection.Conclusion: Although there is not yet any conclusive evidence on whether the presence of an endodontic infection may have an impact on CVDs, this study showed that most cardiac specialists attached importance to endodontic infections.


Assuntos
Atitude do Pessoal de Saúde , Cardiologistas/psicologia , Doenças Cardiovasculares/epidemiologia , Saúde Bucal , Periodontite Periapical/epidemiologia , Adulto , Idoso , Antibioticoprofilaxia/métodos , Feminino , Humanos , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Periodontite Periapical/tratamento farmacológico , Cirurgiões , Turquia
16.
BMC Oral Health ; 20(1): 23, 2020 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-31996198

RESUMO

BACKGROUND: This study, by using a variable-controlled survey model, sought to compare clinical decisions made by dentists with different clinical backgrounds in South Korea regarding teeth with apical periodontitis and to identify factors that influenced decision-making. METHODS: A questionnaire with 36 questions about identical patient information, clinical signs, and symptoms was filled out by participants. Each question referred to a radiograph that had been manipulated using computer software in order to control tooth-related factors. Participants were instructed to record their demographic information and choose the ideal treatment option related to each radiograph. Simple and multivariable logistic regression analyses (p < .05) were used to investigate factors related to the decision to extract the tooth. We divided factors into dentist-related factors (gender, years of experience, and professional registration) and tooth-related factors (tooth position, coronal status, root canal filling status, and size of the periapical radiolucency). Dentists were categorized into three groups, based on professional registration: general dental practitioners (GDPs), endodontists, and other specialists. Simple logistic regression analysis (p < .05) was used to evaluate the tooth-related factors influencing extraction, depending on the dentists' specialty. RESULTS: Participants mostly preferred saving the teeth over extraction. This preference was highest among the endodontists, followed by other specialists and GDPs. Extractions were significantly preferred for molars, teeth with previous root canal fillings, and those with apical lesions greater than 5 mm. CONCLUSIONS: This study suggests that dentists' decision-making regarding teeth with apical periodontitis was associated with their work experience and specialty and influenced by tooth position, root canal filling status, and size of the apical lesion. CLINICAL RELEVANCE: This survey revealed that clinical decision-making related to teeth with apical periodontitis was affected by dentists' specialty and work experience and by tooth-related factors, such as tooth position, root canal filling status, and size of the apical lesion.


Assuntos
Tomada de Decisão Clínica/métodos , Odontólogos/psicologia , Periodontite Periapical , Padrões de Prática Odontológica/estatística & dados numéricos , Tratamento do Canal Radicular , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite Periapical/diagnóstico , Periodontite Periapical/terapia , República da Coreia , Inquéritos e Questionários
17.
Int Endod J ; 53(3): 298-307, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31587317

RESUMO

AIM: To evaluate the effect of intraorifice barriers and bases on the healing of apical periodontitis following root canal treatment in mandibular molars. METHODOLOGY: A total of 120 permanent mandibular molars with necrotic pulps and periapical radiolucencies (PAI score ≥ 3) were recruited. Root canal treatment was performed in all teeth using a standard protocol, following which they were randomly allocated to one of the three treatment groups: intraorifice barrier group: coronal 3-mm gutta-percha was removed and replaced with glass-ionomer cement (GIC) barrier. The floor of the pulp chamber was then sealed with 2-mm-thick GIC base followed by final composite resin restoration; base group: received 2-mm-thick GIC base before placement of composite resin restoration; and control group: had pulp chamber entirely filled with composite resin only. Follow-up was done at 3, 6, 9 and 12 months. Combination of clinical and radiographic parameters were used to assess treatment outcome. The data were analysed using Kruskal-Wallis, chi-square and Wilcoxon signed-rank tests and logistic regression analysis. RESULTS: At the end of 12 months, the base group had the most favourable healing (97.1%), whilst the control group had the least favourable healing (83.8%). The intraorifice barrier group had healing of 92.1%. However, there was no significant difference in healing between groups at the end of the follow-up period (P > 0.05). Additional subgroup analysis revealed a nonsignificant effect of periodontal status and root filling level on periapical healing. CONCLUSION: The use of an additional barrier under permanent restorations did not significantly improve the outcome of primary root canal treatment in posterior teeth after 12 months. However, its influence in the long term requires further evaluation.


Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Necrose da Polpa Dentária , Guta-Percha , Humanos , Tratamento do Canal Radicular
18.
Int Endod J ; 53(3): 354-365, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31581318

RESUMO

AIM: To evaluate the specific role of ICAM-1 in host responses against endodontic infection. METHODS: Apical periodontitis was experimentally induced in the mandibular first molars of ICAM-1 knockout and wild-type (WT) mice by pulp exposure to the oral environment. At 7, 21 and 42 days following pulp infection, the animals were euthanized and the jaws were prepared for analysis under conventional and fluorescence microscopy (histopathologic and morphometric analysis), immunohistochemistry (polymorphonuclear leucocytes), enzyme histochemistry (osteoclasts and cementoclasts) and RT-PCR (IL-1 α, TNF-α, INF-γ, IL-10, RANK, RANKL and OPG). A generalized linear model with GLIMMIX procedure with Satterthwaite approximation method of degrees of freedom, Tukey-Kramer, pseudo-ranking nonparametric, Bonferroni-Holm multiple testing adjustment, analysis of variance (ANOVA) and the Tukey's multiple comparisons tests were used to evaluate the statistical differences between the groups using SAS 9.4 and the GraphPad Prism 5.0 software (α = 0.05). RESULTS: Compared to WT mice, ICAM-1 knockout mice had significantly greater bone resorption (P < 0.05), reduced recruitment of neutrophils to periapical inflammatory tissues (P < 0.05) and an increased number of fibroblasts (P < 0.05) at all experimental periods. The osteoclast number was significantly higher in ICAM-1 KO than that of WT animals at all times (P < 0.05), while there was no significant difference between the groups regarding cementoclasts. At day 21, the level of IL-1α, RANK, RANKL and IL-10 had increased significantly in tissues from ICAM-1 KO versus WT mice (P < 0.05), while no significant difference was observed in TNF-α and OPG levels (P > 0.05). Tissue levels of INF-γ were significantly lower in ICAM-1 KO than those in WT mice (P < 0.05). CONCLUSION: ICAM-1 deficiency impaired the host response against endodontic infection, resulting in increased tissue destruction.


Assuntos
Molécula 1 de Adesão Intercelular , Periodontite Periapical , Animais , Camundongos , Camundongos Knockout , Osteoclastos , Fator de Necrose Tumoral alfa
19.
Clin Oral Investig ; 24(1): 133-140, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31041576

RESUMO

OBJECTIVES: To investigate signs of infection and infection-related complications of apical periodontitis (AP) in patients who underwent chemotherapy for lymphoma. MATERIALS AND METHODS: Data were collected retrospectively from the dental and medical records of patients receiving chemotherapy for lymphoma. Based on the findings from a dental evaluation made in conjunction with chemotherapy, the patients were divided into two groups, patients with or without teeth with AP. RESULTS: Eighty-six of the 213 patients had one or more teeth with AP and received no planned dental treatment for this condition, while 127 patients had no AP-affected teeth. During chemotherapy, seven patients (8%) developed local symptoms related to teeth with AP, while no patients in the control group developed symptoms of AP. No significant differences were found with respect to the administration of antibiotics related to dental infection or hospital admission events due to fever or infection, between the group with AP and the group without AP. CONCLUSIONS: AP is a common finding and exacerbation seems more common in patients diagnosed with chronic AP than in patients without chronic AP. The presence of chronic AP in patients treated with chemotherapy for lymphoma is not linked to additional medical complications that require hospital admission owing to fever/infection. CLINICAL RELEVANCE: Knowledge regarding infection-related complications of AP in patients with lymphoma treated with chemotherapy will guide clinical decision-making by identifying those patients who warrant treatment. This will allow dental interventions to be postponed until completion of chemotherapy, without serious medical complications. The results of this study serve as a basis for larger prospective studies.


Assuntos
Antineoplásicos/uso terapêutico , Linfoma/tratamento farmacológico , Periodontite Periapical , Protocolos de Quimioterapia Combinada Antineoplásica , Bleomicina , Dacarbazina , Doxorrubicina , Feminino , Doença de Hodgkin , Humanos , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Tratamento do Canal Radicular , Vimblastina
20.
Inflamm Bowel Dis ; 26(2): 280-282, 2020 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-31247090

RESUMO

Focal infection theory posits that periodontal pathobionts play a causal role in initiating or exacerbating diseases. Periodontal disease is a common inflammatory, multifactorial disease of the periodontal tissues. The main factor for inflammation is mature dental plaque with the presence of pathogens in the microbial biofilm. Disturbances of the systemic and/or mucosal immune system, antibiotic treatments, immunosuppressants, and biologic therapies all increase the chance of infections and inflammatory processes (ie, apical periodontitis). The pathogenesis of Crohn's disease and ulcerative colitis, the 2 main forms of inflammatory bowel disease (IBD), is still unclear, but both autoimmune and immune-mediated phenomena are involved. It is a global disease with a prevalence of 0.3% and an incidence of 280-320 per 100,000 people in North America. According to the literature, there is a negative association between poor oral health and risk of IBD, and this protective effect increases with the severity of poor dental hygiene. On the other hand, existing IBD seems to be associated with an increased risk of periodontal disease and worse oral health compared with other diseases. The nature of these associations is unclear, but it is unquestionable that all have an effect on the others. Additional studies are needed to confirm if there is a causal relationship between dental status and IBD. Apical periodontitis in patients affected by Crohn's disease or ulcerative colitis needs to be considered carefully, and it is important to treat the disease.


Assuntos
Colite Ulcerativa , Doenças Inflamatórias Intestinais , Periodontite Periapical , Estudos de Casos e Controles , Humanos , América do Norte , Prevalência
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