1/10. Dentinal dysplasia type I: report of a case.A case of dentinal dysplasia type I is presented. This rare hereditary disturbance of dentine is characterized by short-rooted teeth with sharp conical apical constrictions, aberrant growth of dentine in the pulp chamber leading to reduced pulp space in permanent teeth and total pulpal obliteration in the primary dentition. Clinical, radiographic and histopathological material from a 7-year-old boy, showing the typical features of this disorder in which teeth are prematurely lost through periapical abscesses, cysts or spontaneous exfoliation, is described. A review of the theories of pathogenesis of this condition is included. Management of patients with dentinal dysplasia is difficult and a discussion of the shortcomings of various treatment strategies, including conventional endodontic therapy, periapical curettage and retrograde root filling, and a preventive regimen, are discussed. In this case, despite diagnosis being made at an early age and the provision of regular dental care, the patient is now losing teeth because of spontaneous abscess formation.- - - - - - - - - - ranking = 1keywords = periapical (Clic here for more details about this article) |
2/10. Symmetrical pulp obliteration in mandibular first molars.Pulp obliteration is an extremely rare morphological type of pulp calcification, with calcified material completely occupying the pulp chamber and root canal spaces. The etiology of pulp obliteration may be trauma or systemic diseases such as secondary hyperparathyroidism. Pulp obliteration may also be seen in dental anomalies such as dentinogenesis imperfecta and dentinal dysplasia. In cases of pulp obliteration with periapical disease, the preferred treatment is surgery, while calcified canals without symptoms or periapical lesions are best left untreated.- - - - - - - - - - ranking = 1keywords = periapical (Clic here for more details about this article) |
3/10. dentin dysplasia type I: report of atypical cases in the permanent and mixed dentitions.dentin dysplasia type I is a rare hereditary disturbance of dentin formation characterized clinically by nearly normal appearing crowns and severe hypermobility of teeth. Radiographic analysis shows obliteration of all pulp chambers, short, blunted, and malformed roots, and periapical radiolucencies of noncarious teeth. This paper presents 2 cases demonstrating both classic and atypical features of type I dentin dysplasia in the mixed and permanent dentitions. The clinical, radiographic, and histopathologicfindings of this condition and treatment are described.- - - - - - - - - - ranking = 0.5keywords = periapical (Clic here for more details about this article) |
4/10. Combined endodontic and surgical treatment of a three-rooted maxillary first premolar.A case is reported in which endodontic treatment of a maxillary first premolar was complicated by the fact that the tooth had three roots. One of the roots was completely calcified and therefore could not be negotiated with endodontic files. There was a large periapical lesion associated with the tooth and this was surgically removed. During the surgical procedure a retrograde cavity was prepared on the calcified root using ultrasonic instruments and this was filled using Super EBA cement. Twelve months later the tooth was asymptomatic and the periapical tissues had completely healed.- - - - - - - - - - ranking = 1keywords = periapical (Clic here for more details about this article) |
5/10. Criteria for management of calcific metamorphosis: review with a case report.Calcific metamorphosis is seen commonly in the dental pulp after traumatic tooth injuries and is characterized by deposition of hard tissue within the root canal space. Opinion differs among practitioners as to whether to treat these cases upon early detection of calcific metamorphosis or to observe them until symptoms or radiographic signs of pulpal necrosis are detected. In this article, the clinical, radiographic, and histopathologic appearance of calcific metamorphosis is described; a review of the literature is presented to address these issues in an attempt to establish sound rationale for treatment. Approximately 3.8% to 24% of traumatized teeth develop varying degrees of calcific metamorphosis. Studies indicate that of these, approximately 1% to 16% will develop pulpal necrosis. Most of the literature does not support endodontic intervention unless periradicular pathoses is detected or the involved tooth becomes syptomatic. It may be advisable to manage cases demonstrating calcific metamorphosis through observation and periodic examination. A report of a case where in non-surgical endodontic intervention was successfully carried out a patient suffering from calcific metamorphosis with periapical pathoses is also presented.- - - - - - - - - - ranking = 0.5keywords = periapical (Clic here for more details about this article) |
6/10. Multiple pulp stones and shortened roots of unknown etiology.An unusual case of generalised pulpal calcifications (pulp stones) with normal clinical crowns is reported in a 13-year-old boy. Radiographic examination revealed pulp stones in the single rooted and premolar teeth, situated at the midroot level, with the roots bulging around them. The apical portion of the roots, periodontal ligament space, and surrounding bone had a normal radiographic appearance, apart from the upper premolars, and no periapical pathology was discernible. The upper premolars exhibited considerably shortened roots. No medical, dental, or family history was found to be contributory. Reviewing the literature revealed similar cases, but with differing diagnoses including dentine dysplasia (DD) or idiopathic cases. This report suggests either a variation of DD or possibly a new nonsyndromic dentine defect, and highlights the difficulties in establishing a definitive diagnosis by traditional methods. The recent discovery that mutation of the bicistronic dentine sialophosphoprotein gene (DSPP) is involved in DD may provide solutions to this problem.- - - - - - - - - - ranking = 0.5keywords = periapical (Clic here for more details about this article) |
7/10. Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin.AIM: To report the repair of an extensive periapical lesion of endodontic origin, following nonsurgical treatment. SUMMARY: Clinical and radiographic examination revealed an extensive periapical lesion related to tooth 22, extending from the distal surface of tooth 21 to the mesial surface of 26. The patient reported a previous history of dental trauma involving this quadrant and had been under orthodontic treatment for a year. Intraoral examination revealed an asymptomatic bony hard swelling, mainly confined to the palate. During root canal exploration irregular walls associated with 3 mm of apical calcification were noted. After apical patency was obtained 1 mL of bloody serous exudate was drained. Intracanal aspiration provided a further 2 mL of yellow serous exudate. Following biomechanical preparation, a dressing of calcium hydroxide with anaesthetic solution was applied and replaced four times over a period of 12 months. The clinical-pathological picture demonstrated resolution of the lesion during this period of time. The 14-month clinical and radiographic examinations revealed normal bony contour and a significant resolution of the maxillary radiolucency. KEY learning POINTS: Periapical lesions of endodontic origin may develop asymptomatically and become large. Proper biomechanical preparation followed by calcium hydroxide medication renewed periodically represents a nonsurgical approach to resolve extensive inflammatory periapical lesions.- - - - - - - - - - ranking = 3.5keywords = periapical (Clic here for more details about this article) |
8/10. Dentinal dysplasia, Type I. Report of a case with endodontic therapy.The first reported case of endodontic therapy in dentinal dysplasia, Type I, is described. The first histologic diagnosis of periapical granuloma instead of periapical cyst in dentinal dysplasia, Type I, is also reported.- - - - - - - - - - ranking = 1keywords = periapical (Clic here for more details about this article) |
9/10. Spectrum of dentin dysplasia in a family: case report and literature review.The dentin dysplasias (DD), which may be classified as type 1 (DD1) or type 2 (DD2), form a group of rare, inherited dentin abnormalities that are clinically distinct from dentinogenesis imperfecta. Studies of affected families may help to distinguish different types of DD and provide further insight into their etiology and clinical management. This report describes a family that showed characteristic dental features of DD1, including clinically normal crowns in both primary and permanent dentitions, and mobile teeth that may be associated with premature exfoliation. Radiographic features included calcification of the pulp with crescent-shaped, radiolucent pulp remnants, short, tapering, taurodontic roots, and many periapical pathoses that may be cysts or granulomas. A spectrum of dentin dysplasia was noted within the family. Strategies to prevent pulp and periapical infections and early exfoliation of the teeth include meticulous oral hygiene and effective caries-preventive measures.- - - - - - - - - - ranking = 1keywords = periapical (Clic here for more details about this article) |
10/10. Dentinal dysplasia type I: review of the literature and report of a family.A family is reported with dentinal dysplasia type I affecting both dentitions. Presenting features included unusual mobility of the teeth, followed by early exfoliation; normal clinical shape of the crowns of the teeth, but with an amber color without any sign of attrition or abnormal loss of enamel. Radiographic findings showed pulp-chamber and root-canal obliteration, poor root formation, radiolucent linear appearance of the pulp chamber parallel to the cementoenamel junction and frequent periapical radiolucencies. Histological studies have reported large masses of calcified tubular dentin, atypical osteodentin, and also true denticle.- - - - - - - - - - ranking = 0.5keywords = periapical (Clic here for more details about this article) |
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