1/51. Elective mutism: effect of dental treatment with N2/O2-inhalation sedation: review and report of case. Elective mutism in children is characterized by a marked, emotionally determined selectivity in speaking, such that the child demonstrates his or her language competence in some situations but fails to speak in other situations. An eight-year-old boy with elective mutism had to undergo restorative dental treatment. It was chosen to use relative analgesia to perform this treatment. The sedation with oxygen and nitrous oxide resulted in complete symptom remission as long as the sedation lasted. ( info) |
2/51. Endodontic management of a mandibular third molar fused with a fourth molar. CASE REPORT: Developmental anomalies in permanent molars frequently require surgical intervention. A case of a mandibular third molar fused with a fourth molar which was successfully treated with conservative endodontic therapy is reported. ( info) |
3/51. Mandibular and maxillary furcation tunnel preparations--literature review and a case report. AIM: The objective of this literature review and subsequent case report is to discuss and illustrate the tunnel preparation procedure as a treatment alternative for furcation-involved molars. review OF THE literature: Furcation tunnel preparation, i.e., the creation of access for plaque control between periodontally diseased roots, has not been discussed in the literature as comprehensively as root resective therapy, though success rates appear to fall within the same range. A short root trunk and a wide furcation entrance diameter are prerequisites for the indication of the tunnel preparation procedure. Although accessory canals in the furcation area are frequent findings on extracted teeth, endodontic complications have not been reported to be major complications after tunnel preparation. Caries developed at tunneled teeth even under proper maintenance, but did not necessarily lead to the loss of an affected tooth. CASE REPORT: In the case presented to illustrate the indication for the tunnel preparation procedure, periodontal disease was almost entirely restricted to the furcation sites of molar teeth. Affected teeth were either extracted or left intact and subjected to tunneling procedures. Periodontal health could be established and maintained at both single and double tunnels over a period of 2 years of periodontal supportive therapy. ( info) |
4/51. 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. ( info) |
5/51. Treatment of dens invaginatus in supernumerary teeth. The endodontic treatment and aesthetic restoration of a case of Oehlers Type I dens invaginatus in supernumerary teeth is presented. ( info) |
6/51. Prophylactic treatment of dens evaginatus using mineral trioxide aggregate. Two case reports with dens evaginatus are presented. Each patient had one tooth affected. There was a prominent tubercle on the occlusal surface of the mandibular second premolar. Under local anesthesia and rubber dam isolation a partial pulpotomy was conducted and mineral trioxide aggregate was placed. After 6 months the teeth were removed as part of planned orthodontic treatment. Histological examination of these teeth showed an apparent continuous dentin bridge formation in both teeth, and the pulps were free of inflammation. These cases show that mineral trioxide aggregate can be used as an alternative to existing materials in the proplylactic treatment of dens evaginatus. ( info) |
7/51. Pseudo-dental pain and sensitivity to percussion. Two case reports examine a little-known cause of dental pain and sensitivity to percussion. Contrary to the traditional assumption that pain and sensitivity to percussion almost always are diagnostic of pulpal inflammation and/or necrosis, these symptoms actually may be referred to the sensitive tooth from trigger points in the masticatory muscles. Therefore, myofascial pain syndrome must be ruled out in patients who have dental pain and display sensitivity to percussion. ( info) |
8/51. Root-canal treatment of a trifid crown premolar. AIM: To describe successful root-canal treatment of a permanent maxillary first premolar with unusual anatomy. SUMMARY: A diagnosis of irreversible pulpitis of a geminated first premolar was made. Clinical and radiographic examination revealed a tooth with a trifid crown that joined to give the appearance of a single root at the cementoenamel junction. Root-canal treatment involved three separate access openings and treating four canals, three of which joined to exit through a common foramen. KEY learning POINTS: Symptomatic teeth with morphological aberrations can be saved by root-canal treatment.Careful clinical and radiographic evaluation are essential, as treatment must be modified to address the unusual complexities of the root-canal system(s). ( info) |
9/51. Chronic pigmented purpura associated with odontogenic infection. Five patients with chronic pigmented purpura associated with odontogenic infection are described. Four patients had Schamberg's disease, and one had itching purpura. These patients were resistant to topical corticosteroid treatment, but appearance of purpuric spots ceased after treatment for periodontitis, pulpitis, or both. No circulating immune complexes were detected, and neither immunoglobulin nor complement was deposited in the papillary vessels of the skin. Odontogenic infection might be one of the precipitating factors for chronic pigmented purpura. ( info) |
10/51. 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. ( info) |