1/13. guided tissue regeneration in the management of severe periodontal-endodontic lesions.Diagnosis of combined periodontal-endodontic lesions can prove difficult and frustrating. They are often characterised by extensive loss of periodontal attachment and alveolar bone, and their successful management depends on careful clinical evaluation, accurate diagnosis, and a structured approach to treatment planning for both the periodontic and endodontic components. Recent advances in regenerative periodontics have led to improved management of periodontal-endodontic lesions. This paper reviews the management of such lesions in light of these recent advances and illustrates this through reports of two patients who had severe periodontal involvement.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/13. The diagnosis of referred orofacial dental pain.Every patient's description of the location of pain must be treated with caution. In order to arrive at a diagnosis of pain a logical method should be employed. This consists of the history and clinical examination including pulp tests and radiographs. Where the patient complains of pain on hot or cold, an attempt should be made to reproduce the patient's pain to check on the accuracy of its description and to aid in localisation. patients frequently refer pain to previously endodontically-treated teeth. These may not be the cause of the problem. In order to facilitate the process of diagnosis the following hypothesis has been advanced. A tooth can only be the source of pain if there are objective signs associated with that tooth. Lack of response to pulp tests constitutes such a sign, provided the tooth has not previously been endodontically treated. If, however, such treatment has taken place, (regardless of whether this was well or poorly executed), a further objective sign other than lack of vitality is required before such a tooth can be implicated as the source of pain. The guidelines suggested are illustrated by means of clinical examples.- - - - - - - - - - ranking = 0.0049579774375715keywords = process (Clic here for more details about this article) |
3/13. Management of periodontitis associated with endodontically involved teeth: a case series.The pulp and the periodontal attachment are the two components that enable a tooth to function in the oral cavity. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The function of the tooth is severely compromised when either one of these is involved in the disease process. Treatment of disease conditions involving both of these structures can be challenging and frequently requires combining both endodontic and periodontal treatment procedures. This article presents cases of periodontitis associated with endodontic lesions managed by both endodontic and periodontal therapy.- - - - - - - - - - ranking = 1.0049579774376keywords = alveolar, process (Clic here for more details about this article) |
4/13. Origin, diagnosis, and treatment of the dental manifestations of vitamin d-resistant rickets: review of the literature and report of case.Previous discussions center on early diagnosis, initial treatment, and follow-up therapy for the patient with vitamin d-resistant rickets. Both the medical and dental aspects of treatment for these patients has a long-range effect on the normal developmental patterns. Although treatment is begun at an early age, some rachitic skeletal effects such as minor bowing of the legs and bossing of the skull will invariably be noticed. In patients with controlled rickets the alveolar processes undergo normal development, with apparent normal dental eruption. The poor development and calcification of the alveolus seen in the untreated patient leads to loss of the lamina dura and periodontal ligament of the teeth. patients with resistant rickets possess a functional dentition, although not without inherent defects. Various degrees of fracture and attrition of enamel can be seen, and hypoplasia of dentin is nearly a universal result. Defects extending to the dentinoenamel junction have been shown in repeated cases. Cementum, because of its close relationship with dentin calcification, also appears abnormal. Pulp tissue may undergo abberations of physiology in resistant rickets, although further work in this respect is needed. With respect to the possible dental pathoses seen in this disease, the dental history of the patient with resistant rickets discussed in this report showed that several of the deciduous teeth, possibly the mandibular left second premolar and right first molar, and definitely the maxillary right second premolar and canine and the mandibular left canine had all undergone pulpal degeneration of apparently unknown causation. In the maxillary right second premolar and the mandibular left canine, enamel fractures were clinically and radiographically apparent. However, the maxillary right canine originally had an acute abscess with no defects other than normal, minimal wear facets. No causative factor for its necrosis could be found. Overt enamel fractures in the maxillary right second premolar and the mandibular left canine may have led to microexposures of the pulp with subsequent bacterial pulpal contamination. suppuration present in several of the pulps when first entered during endodontic treatment, as well as chronic fistulas in several areas, support the conclusion that contamination by some means does indeed occur.- - - - - - - - - - ranking = 1.0049579774376keywords = alveolar, process (Clic here for more details about this article) |
5/13. Acute pulpal-alveolar cellulitis syndrome. V. Apical closure of immature teeth by infection control: the importance of an endodontic seal with therapeutic factors. Part 2.During orthodontic treatment to promote eruption of maxillary and mandibular second bicuspids, a young male patient had a severe endodontic cellulitis of a mandibular bicuspid. Apexogenesis and resolution of the periapical lesion was achieved by infection control with nonspecific intracanal medication without calcium hydroxide, as stated by Das. A mild periodontal cellulitis occurred shortly thereafter and rapidly resolved. A second endodontic cellulitis, after apexogenesis without an endodontic seal, occurred shortly after completion of orthodontic treatment. This also quickly resolved, and the canal was effectively sealed. This case indicates the importance of an effective endodontic seal shortly after apexogenesis is induced by infection control. This report and others on the subject indicate that apexogenesis of nonvital permanent immature teeth by infection control is a predictable endodontic treatment procedure.- - - - - - - - - - ranking = 4keywords = alveolar (Clic here for more details about this article) |
6/13. Polymer implantation in periodontic endodontic lesions. Two case reports.A polymethylmethacrylate polymer was used in an attempt to fill periodontal osseous defects. Healing was within normal limits, probing depth and mobility were decreased, and there were no adverse post-operative sequelae. Although there were periapical radio-lucencies that appeared to be endodontic in origin, endodontic therapy did not result in osseous defect fill. The non-resorbable, radiopaque polymer particles appeared to become incorporated within the radiodense tissue of the osseous defects. The alveolar bone within the defects was seen to increase in radiopacity, consistent with osteogenesis.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
7/13. Acute pulpal-alveolar cellulitis syndrome V. Apical closure of immature teeth by infection control: case report and a possible microbial-immunologic etiology. Part 1.Das with Matusow and Goodall previously noted the rapid clinical apexogenesis of nonvital immature permanent teeth that are involved with an acute endodontic cellulitis. This apexogenesis was achieved by control of infection and by nonspecific intracanal medication without the use of calcium hydroxide. The case report confirms the clinical observations. The experimental canine endodontic cellulitis in a cebus primate was induced as an immunologic pulp infection with a facultative streptococcus species. The noted epithelial proliferation and organization into lacelike strands and bilaminar loops, similar to Hertwig's epithelial root sheath in root development, appear to be immunologic and genetic in origin, with an acceleration of the root maturation process.- - - - - - - - - - ranking = 4.0049579774376keywords = alveolar, process (Clic here for more details about this article) |
8/13. paresthesia of the inferior alveolar nerve caused by periodontal-endodontic pathosis.paresthesia, one of the more common complaints involving sensory disturbances, can be attributed to various causes. A case is reported in which paresthesia of the right lower buccal gingiva and lip occurred as a result of combined endodontic-periodontal pathosis associated with the right mandibular first molar.- - - - - - - - - - ranking = 4keywords = alveolar (Clic here for more details about this article) |
9/13. Clinical considerations in the diagnosis and treatment of intra-alveolar root fractures.Clinical and radiographic data collected from the 14 cases of intra-alveolar root-fractures, with follow-ups of one to 25 years, complement the findings of other investigators in that the prognosis of the endodontium is extremely favorable. A survey of reports indicate that 75% to 80% of the pulps in intra-alveolar root fractures recover with no need of any endodontic therapy. Furthermore, pulpal pain is seldom encountered. Although the electric pulp tester is considered an important diagnostic tool, it does have limitations. The significance of the negative response is questionable, especially in young, undeveloped teeth with open apexes. The failure to respond to the tester may be attributed to a high electrical impedance. As nociceptor nerve fibers are last to develop, failure to respond to the tester in young teeth may give a false signal of pulp necrosis. Traumatized vital teeth often give an initial negative response, as does a tooth with rapid dentin deposition. Fracture detection can be increased by taking X rays from more than one angle. Radiolucent areas occur in the region of the root fracture more readily than in the periapical region, in a ratio of 7 to 1. Variations in angulations can give false impressions of complete dentinal union and complete or incomplete calcification of the pulpal space and an illusion of a comminuted fracture. The latter seldom occur in intra-alveolar root fractures. Furthermore, the apparent obliteration of the canal and pulp chamber, as seen on the radiograph, does not imply total obliteration with calcific tissue. The root canals are most often patent and negotiable.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 7keywords = alveolar (Clic here for more details about this article) |
10/13. Acute pulpal-alveolar cellulitis syndrome. III. Endodontic therapeutic factors and the resolution of a candida albicans infection.An acute pulpal-alveolar cellulitis, involving a drug-resistant candida albicans, was resolved successfully with endodontic treatment in 6 days. Effective debridement, irrigation, and intracanal medication were significant factors in obtaining a negative culture at completion of treatment. The case illustrates that clinical procedures and judgment can be major factors in the resolution of serious infection, where antibiotic therapy is not feasible. External heat compresses should be avoided in pulpal-alveolar cellulitis cases. Hot intraoral saline rinses are recommended to promote tooth drainage and the formation of fluctuant mucosal swellings. External cold compresses may help reduce facial swelling and provide relief from discomfort.- - - - - - - - - - ranking = 6keywords = alveolar (Clic here for more details about this article) |
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