Cases reported "Dental Pulp Diseases"

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21/34. Root amputation as a predictable procedure. Report of a case.

    The diagnostic procedures required to arrive at an accurate treatment plan when one is confronted with severe periodontal and endodontic involvement in the same tooth are reviewed. A case report is presented, relating these techniques to the clinical situation. The clinical management of the "combined lesion," once the diagnosis and treatment plan have been determined, is described, with emphasis on methods which will improve the predictability of these difficult cases.
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22/34. dental care for patients receiving chemotherapy.

    Common oral complications of chemotherapy include mucositis, infections secondary to profound bone marrow aplasia, and gingival bleeding. mucositis and infections were treated with appropriate antibiotic therapy; a symptomatic tooth was extracted before chemotherapy was begun. Transfusions were performed to obtain adequate platelet levels. A regimen of ticarcillin disodium and gentamicin sulfate is recommended for antibiotic prophylaxis for selected dental procedures.
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23/34. 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)
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24/34. Endodontic involvement resulting from dental abrasion or erosion.

    A case is presented of extreme loss of tooth substance, most probably as a result of dentifrice abrasion. The lesions resulted in many instances of pulpal death and periapical pathosis. In most instances, an opening into the pulp chamber could not be demonstrated using an explorer. In two instances, an opening into the pulp chamber was present and probable. This communication with the oral cavity resulted in pulpal pathosis and an accompanying periapical lesion. In most cases of dental abrasion and erosion, or both, pulpal pathosis and periapical pathosis do not occur because of the ability of the pulp to lay down dentin as the pulp recedes. The findings in this case are not typical.
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25/34. Exploratory endodontic surgery.

    Re-treatment of complicated endodontically treated teeth requires special consideration, particularly if the patient is unable to furnish the proper past history, such as where, when, and how the tooth in question was treated. In such cases most often more than just opening the pulp chamber and root canal(s) is required for a correct diagnosis. Under such circumstances exploratory endodontic surgery may become necessary to help determine prognosis and plan treatment. Thus, the amount of damage can be estimated and the possibility of successful treatment can be better evaluated through surgical exposure and direct visual examination of the area.
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26/34. 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.
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27/34. dental anxiety: a cause for possible misdiagnosis of tooth vitality.

    fear, anxiety and anticipation of pain are prepotent emotional and cognitive mediators of pain behaviour. As pain is often used as a parameter for evaluation of tooth vitality, existing dental anxiety may occasionally lead to possible misdiagnosis. A representative case is presented in which dental anxiety led to an initial misdiagnosis of endodontic pathology.
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28/34. light and SEM observation of internal root resorption of a traumatized permanent central incisor.

    A clinical case report is presented which illustrates internal root resorption of a traumatized tooth. light and scanning electron microscope were used to further examine the defect. An explanation of the morphological structure of the resorption is discussed.
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29/34. dental pulp response to traumatic injuries--a retrospective analysis with case reports.

    The reactions of the dental pulp to traumatic injuries can be extremely varied. They range from almost immediate pulp death to long-term slow pulp canal calcification. In this study the pulpal reactions were divided into three types: pulps with a very poor prognosis that required endodontic therapy soon after the tooth was traumatized. Seventy-nine teeth were studied in this category, and all 79 teeth required endodontic therapy; pulps with a moderate prognosis that required endodontic intervention some 18 to 24 months after the traumatic episode. Forty-eight teeth were studied in this category, and 27 of them required endodontic therapy: pulps with a very good prognosis that rarely required endodontic therapy. Fifty-two teeth were studied in this category, and only 2 required endodontic therapy. The prognosis of a particular pulp depends on the degree and type of trauma.
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30/34. A combined endodontic-periodontal lesion of development origin: a case report.

    This report describes an instance in which treatment of a maxillary lateral incisor tooth failed to resolve the presenting endodontic-periodontal lesion. The predisposing aetiological factor was a longitudinal developmental groove extending from the cingulum to the apex of the tooth.
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