1/8. Reversible and irreversible painful pulpitides: diagnosis and treatment.The foregoing clinical evidence indicates that when pain is severe, or when mild to moderate pain is present with a previous history of pain in the aching tooth, with or without periapical radiolucency, the tooth is in the IRPP category. Treatment dictates endodontic therapy or extraction. On the other hand, when clinical evidence indicates that the pain is mild or moderate with no previous history of pain, normal pulp vitality, and there is no positive percussion sign, the pulp is in the RPP category. Treatment dictates indirect or direct pulp capping in teeth with or without periapical radiolucency. The success rate favours teeth with no periapical radiolucency, 98%; in teeth with periapical radiolucency the success rate is less favorable, 43%. Efforts should be made to maintain pulp vitality. Endodontic therapy can always be done, if in time the pulp develops necrosis.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/8. Endodontic and periodontal treatments of a geminated mandibular first premolar.AIM: To describe a rare case of gemination involving a mandibular first premolar. SUMMARY: The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/8. The pulpectomy in primary teeth.BACKGROUND: The pulpectomy is an underutilized treatment modality for severely infected primary teeth. CASE DESCRIPTION: The author presents two pulpectomy cases that were filled with Vitapex. CLINICAL IMPLICATIONS: Vitapex is an excellent filling material for primary tooth pulpectomies. Its clinical characteristics and ease of use may make the pulpectomy procedure a more-attractive alternative to extraction.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/8. Chondroid metaplasia in inflamed pulp tissue: a case report.OBJECTIVE: The aim of the present report is to report an unusual case of chondroid metaplasia of the dental pulp. STUDY DESIGN: A white 45-year-old female patient appeared with signs and symptoms of an irreversible pulpitis on an upper left decayed third molar. After extraction, the tooth was fixed, demineralized, and processed for light microscopy. RESULTS: Pulp tissue was replaced at one of the pulp horns by a colliquative necrosis surrounded by neutrophil leucocytes and congested blood vessels. Serial sections demonstrated a complete opening of the decayed tooth to the oral environment, and an area of chondroid metaplasia of the pulp was evident. Chondroid tissue was surrounded by a dense concentration of chronic inflammation cells. CONCLUSIONS: According to the best knowledge of the authors, this is possibly the first report of an occurrence of chondroid metaplasia in the dental pulp. This metaplasia could be the result of an attempt at tissue repair by the pulp tissue injured by the carious lesion. The pathologic changes in the dental pulp could have activated some of the mechanisms that have been described in other tissues, producing the formation of chondroid tissue. Pulp tissue may adapt to changed environmental stimuli by a deviation from normal cell differentiation.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/8. Inflammatory resorption caused by an adjacent necrotic tooth.A case history is presented with a large periapical lesion and a perforating resorption defect on a cuspid. Endodontic therapy was performed, presuming that the necrotic cuspid caused the inflammatory response. No radiographic healing was evident 18 months after endodontic therapy. Considerable healing was demonstrated 6 months later, following the extraction of an adjacent tooth with prior root canal therapy. It was concluded that the failing root canal therapy of the extracted tooth was the primary factor leading to the inflammatory lesion, the resorptive perforation of the adjacent tooth, and its pulpal necrosis. It has not been reported prior that inflammatory resorption can result from the pulpal necrosis of an adjacent tooth.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/8. Odontogenic sinus tracts.Odontogenic sinus tracts are the most common cause of a chronically draining, fixed, nodulocystic papule of the face and neck. Injury or disease of a tooth may result in a periapical abscess that subsequently dissects along the path of least resistance and erupts through the skin. If recognized early, the sinus tract usually resolves after appropriate endodontic therapy or extraction.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/8. Garre's osteomyelitis of the mandible resolved by endodontic treatment.A case of Garre's osteomyelitis of the mandible is presented. The occlusal radiographs are good examples of the redundant cortical layering of the bone (onion skinning) that is classically found with this phenomenon. The cause of this case was a necrotic pulp in a carious molar with a periapical radiolucent area. We believe this is the first reported case in which an odontogenic source of infection (carious tooth) was treated not by extraction but by endodontic therapy. During the year after the root canal filling, the periapical radiolucent area filled in with new bone and the bony expansion of the mandible was completely resolved.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/8. Treatment of extraoral sinus tracts from traumatized teeth with apical periodontitis.When a draining lesion is encountered on the skin of the face, an endodontic origin should always be considered in differential diagnosis. Non-surgical endodontic therapy, sometimes complimented by surgery, or extraction are the choices for the treatment of these cases. Three cases of extraoral sinus tract on the chin caused by necrotic pulp of traumatized lower anterior teeth are presented. A paste consisting of calcium hydroxide and barium sulfate powder mixed with glycerin was used. Usage of calcium hydroxide paste was advocated for rapid and successful treatment of extraoral lesions communicating with necrotic teeth.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |