1/5. 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) |
2/5. 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) |
3/5. Endodontic implications of bisphosphonate-associated osteonecrosis of the jaws: a report of three cases.Bisphosphonates are commonly used in medicine to maintain bone density in patients with certain nonneoplastic diseases or cancers. A serious adverse effect of bisphosphonates that has substantial dental significance is osteonecrosis that appears to uniquely affect the mandible and maxilla without occurring in other bones of the skeleton. patients with bisphosphonate associated osteonecrosis of the jaws may present with pain and exposed necrotic bone. This has substantial clinical implications because surgical procedures (including extractions or endodontic surgical procedures) are contraindicated in the jaws of these patients and the presenting pain may mimic pain of odontogenic origin. This report describes three patients with bisphosphonate associated osteonecrosis and emphasizes the endodontic implications of managing these patients.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/5. Treatment and maintenance of a dentate patient with 'radiation caries'.patients with xerostomia are presenting dental practitioners with challenges in caries control, long-term restoration and prosthodontic difficulties. In many cases, extraction may be the best option, but for younger, dentate patients, this may be inappropriate. This paper describes the management of a young partially dentate patient with severe xerostomia following irradiation of the salivary glands. Preventive and restorative management are discussed, together with treatment and healing of peri-radicular pathology.The case report demonstrates that long-term stabilization and management of caries and peri-radicular lesions are possible over a seven-year period for a patient with severe radiation caries. CLINICAL RELEVANCE: Many dental patients present with some degree of xerostomia due to age, side-effects of anti-hypertensive and psychotropic drugs and also as a side-effect of radiotherapy. General dental practitioners are ideally placed to monitor and provide early intervention for this highly caries-susceptible group of patients. With good patient motivation and professional support, tooth loss is not inevitable and this case report suggests strategies and demonstrates the clinical stages in the management of severe caries due to xerostomia.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/5. 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) |