bluuebunny/crossref_metadata_2025 huggingface dataset:
How do patients perceive the benefit of reconstructive dentistry with regard to oral health‐related quality of life and patient satisfaction? A systematic review
Authors: Thomason J. Mark , Heydecke Guido , Feine Jocelyne S. , Ellis Janice S.
Published: June 2007

Background: Reconstructive dentistry encompasses an enormous range of treatment modalities from the restoration of single teeth to the reconstruction of the whole dentoalveolar complex in edentulous patients. Some treatment modalities have been assessed in terms of quality‐of‐life (QoL) outcomes and satisfaction

Objectives: The aim of the present investigation was to search and review studies published between 1996 and 2006 in which the impact of the treatment was measured in terms of QoL outcome, ideally, oral health‐related quality of life (OHRQoL). Patient satisfaction was also accepted as an outcome.

Materials and methods: The primary search engine used was NICB PubMed based on MeSH headings. Hand searching of the cited references in the included papers identified a number of additional studies. The primary focus of the search was to link treatment to QoL outcomes.

Results: The majority of included studies involved the treatment of edentulous patients, particularly the mandible. The preponderance of the studies comparing conventional dentures (CDs) and implant‐supported overdentures (IODs) were randomized‐controlled trials (N=18). There was compelling evidence that patients were more satisfied with IODs than CDs. There was strong evidence that OHRQoL can be significantly improved using IODs. Evidence suggesting that one retention system is superior to another needs further clarification. Although high satisfaction ratings have been reported for maxillary implant prostheses, the overall ratings given to the maxillary implant prostheses were not significantly greater than for CDs.

There was only sparce information regarding QoL or satisfaction outcomes for the majority of other forms of reconstructive dentistry.

Conclusion: Apart from the restoration of the edentulous mandible with IODs or CD, where there is an accumulating body of evidence on the effect of treatment choice, there are many procedures for which there are little or no such data at all. As yet, the entire range of reconstructive treatment has witnessed insufficient investigations relating treatment to its effect on QoL or satisfaction. This is an area that needs to be expanded as a way of quantifying the effect of treatment choices.
A systematic review of the survival and complication rates of all‐ceramic and metal–ceramic reconstructions after an observation period of at least 3 years. Part I: single crowns
Authors: Pjetursson Bjarni E. , Sailer Irena , Zwahlen Marcel , Hämmerle Christoph H. F.
Published: June 2007

Objectives: The objective of this systematic review was to assess the 5‐year survival rates of all‐ceramic single crowns and to compare it with the survival rates of metal–ceramic crowns and to describe the incidence of biological and technical complications.

Methods: An electronic Medline and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all‐ceramic and metal–ceramic crowns with a mean follow‐up time of at least 3 years. Patients had to have been examined clinically at the follow‐up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Annual failure rates were analyzed using standard and random‐effects Poisson regression models to obtain summary estimates of survival proportions.

Results: The search provided 3473 titles and 177 abstracts. Full‐text analysis was performed for 86 articles, resulting in 34 studies that met the inclusion criteria. In meta‐analysis, the 5‐year survival of all‐ceramic crowns was estimated at 93.3% (95% confidence interval (CI): 91.1%–95%) and 95.6% (95% CI: 92.4%–97.5%) for metal–ceramic crowns.

All‐ceramic crowns were also analyzed according to the material utilized. Densely sintered alumina (Procera®technique) crowns showed the highest 5‐year survival rate of 96.4%, followed by reinforced glass–ceramic crowns (Empress®technique) and InCeram‐crowns with survival rates of 95.4% and 94.5%, respectively. A significantly lower survival rate of 87.5% was calculated for glass–ceramic crowns after 5 years.

All‐ceramic crowns were also grouped and analyzed regarding the position in the mouth. All four types of all‐ceramic crowns showed lower survival rates when seated on posterior teeth. Moreover, for glass–ceramic crowns (84.4%) and InCeram‐crowns (90.4%), this difference reached statistical significance (P=0.009, P=0.028).

Conclusion: Based on the present systematic review, all‐ceramic crowns, when used for anterior teeth, showed survival rates at 5 years comparable to those seen for metal–ceramic crowns.

When used for posterior teeth, the survival rates at 5 years of densely sintered alumina crowns (94.9%) and reinforced glass–ceramic crowns (93.7%) were similar to those obtained for metal–ceramic crowns. Furthermore, lower survival rates of 90.4% and 84.4% can be expected for InCeram crowns and glass–ceramic crowns when utilized for premolars and molars.
Is there a superiority of multimodal as opposed to simple therapy in patients with temporomandibular disorders? A qualitative systematic review of the literature
Authors: Türp Jens C. , Jokstad Asbjørn , Motschall Edith , Schindler Hans J. , Windecker‐Gétaz Isabelle , Ettlin Dominik A.
Published: June 2007

Background: Pain is the most common motivation for patients with temporomandibular disorders (TMDs) to seek care. Therapeutic options range from patient education to joint surgery.

Objectives: To conduct a systematic review of articles reporting on simple and multimodal management strategies in TMD patients. ‘Simple therapy’ was defined as care provided by a dentist, without using technical dental interventions, whereas ‘multimodal’ refers to at least two different modalities. We followed the null hypothesis of no difference between these two approaches.

Material and methods: A systematic search was carried out in the following databases: Ovid® Medline (1966–2006), Cochrane Library (Issue 3/2006), and Science Citation Index (1945–2006). Subsequently, the reference lists of the identified articles were searched to find additional pertinent publications. We divided the study reports according to the main presenting symptom: (1) disc displacement without reduction, with pain; (2) TMD pain, without major psychological symptoms; and (3) TMD pain, with major psychological symptoms.

Results: Eleven articles representing nine different clinical studies were identified. (1) In the disc displacement group with pain, multimodal therapy was not superior to explanation and advice. (2) A combination of occlusal appliance and biofeedback‐assisted relaxation/stress management was not significantly superior to either of these therapies after 6 months. Furthermore, brief information alone or combined with relaxation training or occlusal appliance, respectively, were equally efficacious at the 6‐month follow‐up. There was no superiority of multimodal therapy including splints as compared with simple care. A slightly better outcome was reported for a combination of education and home physical therapy regimen than for patient education alone. (3) In temporomandibular pain patients with major psychological disturbances, patients benefited more from a combined therapeutic approach compared with simple care.

Conclusion: Current research suggests that individuals without major psychological symptoms do not require more than simple therapy. In contrast, patients with major psychological involvement need multimodal, interdisciplinary therapeutic strategies. The clinician's acceptance of the importance of psychological factors in TMD pain forms the platform for convincingly educating patients about the need for multimodal management.
The genetics of generalized vitiligo and associated autoimmune diseases
Authors: Spritz Richard A.
Published: June 2007

Vitiligo is an acquired disorder in which patches of depigmented skin and often overlying hair, and mucous membranes, are the result of progressive autoimmune loss of melanocytes from the involved areas. Considered the most common pigmentary disorder, vitiligo involves complex interaction of environmental and genetic factors that ultimately contribute to melanocyte destruction, resulting in the characteristic depigmented lesions. In the past few years, studies of the genetic epidemiology of vitiligo have led to the recognition that generalized vitiligo is part of a broader autoimmune disease diathesis. Attempts to identify genes involved in susceptibility to generalized vitiligo have involved gene expression studies, genetic association studies of candidate genes, and genome‐wide linkage analyses to discover new genes. These studies have begun to yield results that shed light on the mechanisms of vitiligo pathogenesis. It is anticipated that the discovery of biological pathways of vitiligo pathogenesis will provide novel targets for future approaches to the treatment and prevention of vitiligo and its associated autoimmune diseases.
Pulpal ischemia in man: effects on detection threshold, A‐delta neural response and sharp dental pain
Authors: Ahlquist M. , Franzén O.
Published: June 2007

Abstract— Preferential blocks of peripheral nerves have shown that myelinated nerves are more susceptible to local compression and less resistent to asphyxia than unmyelinated fibers. Since two groups of functionally different nociceptors exist in the dental pulp, it is of theoretical and clinical interest to determine the influence of ischemia on the sensitivity of human dental pulp, using standard means for testing tooth vitality and at the same time investigating the intensity coding in one pathway of the afferent trigeminal system. Adrenaline was used to study the differential effect of adrenaline‐induced ischemia on intradental A‐delta nerve activity (INA) and the concomitant sharp pain, as well as on the detection threshold for monopolar electrical stimulation. Cold (ethyl chloride) and heat (heated gutta‐percha) stimulation was applied to the tooth surface. In accordance with the hydrodynamic theory of dentin sensitivity the rapid fluid flow induced in the dentinal tubuli by these thermal stimuli is an adequate stimulus for selectively activating the A‐delta nerves in healthy pulps. Consistency plots of the magnitude of the perceptual experience of sharp pain against the neural population response in linear coordinates yielded a high product‐moment correlation, implying linearity for the intensity coding relationship. In contrast to the significant reduction of INA and its perceptual correlate of sharp pain after adrenaline administration, the electrical detection threshold remained constant during the full test period, suggesting that electrical threshold measurements have their limitations as a diagnostic tool or criterion for assessing the sensitivity of the dental pulp. The absence of A‐delta activity was parallelled by no sensation of sharp pain. These findings suggested that the integrated neural A‐delta activity constituted the underlying peripheral neurophysiological mechanism of the sensory intensity of sharp dental pain.
Detection of interleukin‐6 in human dental pulp and periapical lesions
Authors: Barkhordar R. A. , Hayashi C. , Hussain M. Z.
Published: June 2007

Abstract— Pulpal and periapical diseases are characterized by inflammation. The cytokine IL‐6 is a major mediator of the host response to tissue injury and infection. This study examined the level of interleukin‐6 (IL‐6) in six inflamed human pulps and six human periapical lesions of endodontic origin using ELISA. Pulp samples from eight clinically impacted teeth were used as controls. The periapical samples exhibited significant levels of IL‐6 (mean= 78.1 ± 9 pg/mg protein) as did inflamed pulpal tissues (mean= 36±3.9 pg/mg protein) compared to healthy pulp (mean= 0.01±0.02 pg/mg protein). These data indicated that IL‐6 was produced and released locally in the inflamed pulpal and periapical lesions.
Tissue response to an epoxy resin‐based root canal sealer
Authors: Leonardo M. R. , da Silva L. A. B. , Almeida W. A. , Utrilla L. S.
Published: June 2007

Abstract— Thc objective of the present study was to evaluate two different types of root canal sealers: AH Plus (an epoxy resin‐based sealer) and Fill Canal (a zinc oxide‐eugenol based sealer). A total of 34 root canals with vital pulp from dogs' premolars were used. After instrumentation, the root canals were filled with gutta‐percha and AH Plus or gutta‐percha and Fill Canal sealers using a classical technique of lateral condensation. After histological processing, the sections were stained with hematosylincosin or Mallory's trichrome stain. Inflammatory cells or areas of necrosis were not associated with AH Plus. Hard tissue formation apically to the material was observed in 14 specimens. The Fill Canal sealer presented an inflammatory response of moderate intensity in the periapical region, mainly adjacent to the material.
Traumatic injuries of the teeth in connection with general anaesthesia and the effect of use of mouthguards
Authors: Skeie A. , Schwartz O.
Published: June 2007

Abstract— The aim of the present study was to describe the frequency of dental injuries over a 10‐year period, where a mouthguard was used in approximately 10% of intubation cases or endoscopying. The types of injury are presented and the use of different types of mouthguard is discussed. Among 120 086 procedures involving anaesthesia carried out in thc period 1983–1992 at Bispebjerg Hospital, Copenhagen, 75 cases of dental trauma occurred. The incidence of dental traumatic injuries was 0.06′%. Although eight patients had used mouthguards they were registered with traumatic injuries to the teeth in connection with general anaesthesia. Of the patients, 58% were women and 42% men, with a mean age of 61 years. Seventy‐eight percent of the injuries were located in the maxilla and 91% of these involved the ineisor area of the maxilla. Forty‐one percent were classified as lateral luxations or mobile teeth, 47% were classified as fractured teeth, 10% tooth avulsions and the remaining 2% were classified as concussions. Because of the low frequency of traumatic dental injuries in connection with general anaesthesia and the non‐significant effect of the use of mouthguards, routine use of mouthguards is not recommended. Only when a patient is to have an endoscopy done under general anaesthesia, and the surgeon or anaesthesiologist foresees problems (restricted mouth opening, extensive fixed prosthetics, extensive loss of marginal bone) is use of an individually made mouthguard indicated.
Antimicrobial effect of six endodontic sealers: an in vitro evaluation
Authors: Kaplan A. E. , Picca M. , Gonzalez M. I. , Macchi R. L. , Molgatini S. L.
Published: June 2007

Abstract— The aim of this study was to determine the in vitro antimicrobial effect of six endodontic sealers after 2, 20 and 40 days.

The sealers studied were Apexit, Endion, AH26, AH‐Plus, Procosol and Ketac Endo. The microorganisms used were Candida albicans, Stnphylococcus aureus, Streptococcus mutans and Actinomyces israelii. Petri dishes were filled with sterile agar and 0.1‐ml wells were prepared and filled with the sealers. The agar plates were stored for 24 h at 37°C. The samples were then removed, immersed in 4.5 ml of culture medium and divided into three groups. The samples in group 1 were stored for 2 days at 37°C whereas the samples of groups 2 and 3 were stored at 4°C for 20 and 40 days respectively. The samples were then removed and discarded, and 0.1 ml of the culture medium was seeded on the agar plates in order to perform colony forming unit counts. Apexit, Endion and AH‐Plus produced slight inhibition on Streptococcus mutans at 20 days and on Actinomyces israelii at every time interval. No effect was found on Candida albicans and Staphylococcus aureus. Ketac Endo only produced an antimicrobial effect on Actinomyces israelii at 2 and 40 days. AH26 and Procosol showed antimicrobial effect at 40 days on Candida albicans, at 20 and 40 days on Streptococcus mutans and Staphylococcus aureus, and an effective inhibition on Actinomyces israelii at every time interval. Statistical analysis revealed both sealers and microorganisms to be significant factors affecting results in groups 2 and 3. In conclusion, the sealers evaluated in this study showed different inhibitory effects depending on time span. Overall, sealers containing eugenol and formaldehyde proved to be most effective against the microorganisms at the time intervals studied.
Number of roots and canals in maxillary first premolars: study of an Andalusian population
Authors: Chaparro A. J. , Segura J. J. , Guerrero E. , Jimenez‐Rubio A. , Murillo C. , Feito J. J.
Published: June 2007

Abstract— A study of 150 extracted maxillary first premolars from citizens of Seville, Andalusia, southern Spain, revealed 60 teeth with one root (40.0%), 85 teeth with two roots (56.7%) and five teeth with three roots (3.3%). The distribution of root canal shapes in the sample showed that all teeth with two or three roots had type I root canals (each canal had one apical foramen). Conversely, most of the single‐rooted maxillary first premolars had root canal shape type II (two canals converging in the same apical foramen). Only 1.3% of the teeth had a unique orifice in the pulp chamber and only one root canal. These results emphasized the importance of good knowledge of the root canal morphology and the need for a careful radiographic examination as part of competent root canal therapy of maxillary first premolars.
Post‐operative symptoms and healing after endodontic treatment of infected teeth using pulsed Nd: YAG laser
Authors: Koba K. , Kimura Y. , Matsumoto K. , Watanabe H. , Shinoki T. , Kojy R. , Ito M.
Published: June 2007

Abstract— Forty‐four teeth in 38 patients, diagnosed with chronic apical periodontitis, were endodontically treated. Root canals were shaped using a step‐back technique with 5% NaOCl and 3% H2O2 as irrigants. In half of the teeth the canal terminus was irradiated with pulsed Nd:YAG laser (1 W, 15 pps, 1 s). All canals were then obturated with laterally condensed gutta‐percha points and sealer, and final radiographs were obtained. Occurrence of spontaneous pain was recorded 1 day after treatment. Percussion pain was recorded after 1 week, and then at 3 and 6 months after treatment. Radiographic follow‐up was performed at 3 and 6 months. Percussion pain was significantly less (P>0.05) in the laser‐treated group than in the control group, both 1 week and 3 months after treatment. Other differences between the groups were not significant. These results suggested that the clinical application of pulsed Nd: YAG laser might be advantageous for the treatment of infected root canals.
Biomechanics of endodontic endosseous implants—a comparative photoelastic evaluation
Authors: Asundi A. , Kishen A
Published: June 2007

Abstract— Dental biomechanics is an interdisciplinary study wherein engineering principles are used for the better understanding of clinical dentistry. The present biomechanical study was done to understand the mechanism by which an endodontic implant transmits occlusal forces to the surrounding bone. In this experimental study, photoelastic techniques were utilized to compare stress distribution patterns in the supporting bone of an intact tooth, a tooth with supporting bone loss, and a tooth stabilized using an endodontic endosseous implant. It was concluded that there were distinct variations in the biomechanics underlying various dental clinical conditions. Further, the implant did not appear to improve the stress distribution.
Complex treatment of dens invaginatus type III in maxillary lateral incisor
Authors: Fröner I. C. , Rocha L. F. da Costa , da Costa W. F. , Barros V. M. da Rocha , Morello D.
Published: June 2007

Abstract— The complex anatomy and diagnosis of dens invaginatus make endodontic treatment of such teeth difficult. This case describes combined nonsurgical and surgical treatment of a maxillary lateral incisor with a normally shaped canal and a dens invaginatus type III with a lateroradicular lesion. The root canal was treated conventionally with gutta‐percha and a zinc oxide‐eugenol sealer. The root was surgically exposed and the canal of the dens invaginatus was cleaned, instrumented and obturated with gutta‐percha and a zinc oxide‐eugenol sealer. At follow‐up 3 years 6 months later, the tooth was asymptomatic and radiographically showed repair of the lesion in the region of the dens invaginatus.
Drying and rewetting anterior crown fragments prior to bonding
Authors: Farik B. , Munksgaard E. C. , Andreasen J. O. , Kreiborg S.
Published: June 2007

Abstract— Fractured anterior teeth can be restored by adhesive bonding of the fragment to the remaining tooth structure. This in vitro study describes the effect on fracture strength of fragments dried and rewetted for various periods of time prior to bonding. Seventy central incisors from sheep were fractured. The resulting incisal crown fragments were then stored in air at room temperature at ambient humidity (70± 16%) for 5 s, 30 min, 1 h, 3 h, 6 h, 12 h, or 24 h. The apical parts of the fractured teeth were stored in water. After storage in air each fragment was then bonded to the matching apical tooth structure with a bonding agent and a low‐viscosity composite resin. After water storage for 2 days, mean fracture strength was measured. Another group of teeth comprising 40 sheep central incisors was fractured and the fragments were stored in air at room temperature for 24 h as above. The fragments were then immersed in water for 10 min, 1 h, 1 day, or 7 days, prior to bonding and measurement as described above. Statistical analysis revealed that the fracture strength of the fragment‐bonded teeth was unaffected by air storage of the fragment for up to 1 h prior to bonding, after which additional drying resulted in decreased fracture strength. Fragments dried for 24 h in air and rewetted by immersion in water for at least 1 day were fragment‐bonded without loss of fracture strength.
Evaluation of the ability of thermal and electrical tests to register pulp vitality
Authors: Peterson K. , Söderström C. , Kiani‐Anaraki M. , Lévy G.
Published: June 2007

Abstract— The aim of the present study was to evaluate the ability of thermal and electrical tests to register pulp vitality. Sensitivity, specificity, negative predictive value and positive predictive value were calculated by comparing the test results with a “gold standard”. The thermal tests studied were a cold test (ethyl chloride) and a heat test (hot gutta‐percha). For the electrical test, the Analytic Technology Pulp Tester® was used. The examined teeth were 59 teeth with unknown pulpal status in need of endodontic treatment and 16 intact teeth, all with radiographically normal periapical bone structures. In total 46 teeth with vital pulps and 29 teeth with necrotic pulps were tested. This gave a disease prevalence of 39%. The gold standard was established by direct pulp inspection of the 59 teeth in need of endodontic treatment. In the 16 intact teeth the pulp was judged as vital. The number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) test results was calculated for each method as compared to the gold standard. Based on this, the sensitivity, specificity, positive predictive value and negative predictive value were calculated for each method. The sensitivity was 0.83 for the cold test, 0.86 for the heat test and 0.72 for the electrical test. The specificity was 0.93 for the cold test, 0.41 for the heat test and 0.93 for the electrical test. The positive predictive value was 0.89 for the cold test, 0.48 for the heat test and 0.88 for the electrical test, and the negative predictive value was 0.90 for the cold test, 0.83 for the heat test and 0.84 for the electrical test. This indicated that the probability of a non‐sensitive reaction representing a necrotic pulp was 89% with the cold test, 48% with the heat test and 88% with the electrical test. It also indicated that the probability of a sensitive reaction representing a vital pulp was 90% with the cold test, 83% with the heat test and 84% with the electrical test.
Treatment of root perforation by intentional reimplantation: a case report
Authors: Poi W. R. , Sonoda C. K. , Salineira S. L. , Martin S. C.
Published: June 2007

Abstract— Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. In this paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8‐year follow‐up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforatiotdinstrument retrieval.
Management of an avulsed primary incisor
Authors: Weiger R. , Heuchert T.
Published: June 2007

Abstract— The case describes the management of an avulsed maxillary central primary incisor of a 3 1/2‐year‐old girl. The tooth was retained in the oral cavity for 30 min. After replantation it was splinted for 17 days. At day 11 the root canal was completely instrumented and obturated with a calcium hydroxide paste. The l‐year follow‐up documented no pathologic clinical or radiographic findings. One and a half years after the trauma the tooth was extracted since a fistula and extensive external inflammatory resorption had developed. The permanent successor erupted along with its neighboring central incisor without any complications 6 months later. Conventional approaches for treating avulsed permanent teeth could also be applied to avulsed primary incisors to preserve them for a certain period without the additional risk of damaging their developing permanent successors.
The antimicrobial effect of calcium hydroxide in root canals pretreated with 5% iodine potassium iodide
Authors: Molander A. , Reit C. , Dahlén G.
Published: June 2007

Abstract— Calcium hydroxide (CH) is often used as a routine interappointment dressing during the endodontic treatment of teeth with apical periodontitis. However, it fails to consistently produce sterile root canals. The present study was set up to find out whether an antimicrobial strategy including the use of CH could be made more effective if: 1) canals were pretreated with 5% iodine potassium iodide (IPI), and 2) the dressing period was extended up to 2 months. Fifty human teeth, with radiographically verified apical periodontitis, were microbiologically sampled. After chemomechanical preparation the canals were pretreated with IPI for 3–7 days. Teeth where microorganisms persisted were then treated with CH for 2 months. Following instrumentation and dressing with IPI, 43 bacterial strains were recovered in 22 of the teeth. Samples obtained after the CH dressing period disclosed growth of 13 facultative and two strict anaerobic strains in 10 teeth. Enterococcus faecalis was identified in two specimens. In conclusion, the present study gave no evidence for an increased antimicrobial effect of CH if it was left for longer periods in the root canal. Although pretreatment with IPI from a quantitative point of view did not seem to add antimicrobial power, it might reduce the frequency of persisting strains of E. faecalis.
Muco‐gingival and periodontal health recovery following reimplantation of teeth
Authors: Schatz J.P. , Dubrez B. , Roehrich N.
Published: June 2007

Abstract— Reimplantation of avulsed permanent teeth following traumatic injuries is a widely accepted therapeutic measure; however, though periodontal healing is considered to be the major determinant of long‐term survival of reimplanted teeth, the mucogingival reaction to reimplantation has never been assessed. In the present study, hygiene level and gingival inflammation of 13 reimplanted teeth were assessed according to the plaque index (PI) and the gingival index (GI) around both reimplanted and control teeth. The periodontal condition was evaluated by measuring probing depth and probing attachment level at the same location. The clinical parameters of the reimplanted teeth were compared with those of contralateral teeth with the help of the non‐parametric Wilcoxon signed ranks test. There were no statistically significant difrerences in PI and GI scores at any points of measurements around both reimplanted and control teeth; neither did probing depths and probing attachment levels differ between reimplanted and contralateral teeth. The results of the present study indicated that the muco‐gingival reaction following traumatic avulsion did not affect the long‐term prognosis of the reimplanted teeth.
Influence of several factors on the success or failure of removal of fractured instruments from the root canal
Authors: Hülsmann M. , Schinkel I.
Published: June 2007

Hulsmann M, Schinkel I. Influence of several factors on the success or failure of removal of fractured instruments from the root canal. Endod Dent Traumatol 1999; 15: 252–258. © Munksgaard, 1999.

Abstract — The influence of several factors on the success rate of removal procedures of fractured endodontic instruments was evaluated postoperatively. In 105 teeth with 113 fragments removal attempts were undertaken using a wide range of techniques and instruments. All cases were analyzed with special regard to the following factors: type of tooth and root canal, site of fragment in relation to root canal curvature, length of fragment, and type of fractured instrument. Success of treatment was defined as removal or complete bypassing of the fragment. Of 82 instruments in molars (maxillary: 32, mandibular: 50), 56 were removed or bypassed (max.: 26, mand.: 30). Of 16 fragments in premolars (max.: 12, mand.: 4), 8 could be removed or bypassed (max.: 6, mand.: 2). Of 14 fragments in canines and incisors (max.: 7, mand.: 7), 13 could be removed completely (max.: 6, mand.: 7). When the fragment was localized before the curvature 2 of 18 cases failed, when localized inside the curvature 13 of 31 cases failed and when localized beyond the curvature 15 of 33 cases failed. Anatomical factors favorable for removal were: straight canals, incisors and canines, localization before the curvature, length of fragment more than 5 mm, localization in the coronal or mesial third of the root canal, reamer or lentulo spirales. In molars removal procedures were most successful in the palatal canals of maxillary molars.
Ultrasonic root‐end preparation with smooth and diamond‐coated tips
Authors: Zuolo M. L. , Perin F. R. , Ferreira M. O. F. , de Faria F. P.
Published: June 2007

Zuolo ML, Perin FR, Ferreira MOF, Faria FP. Ultrasonic root‐end preparation with smooth and diamond‐coated tips. Endod Dent Traumatol 1999; 15: 265–268. © Munksgaard, 1999.

Abstract — The purpose of this study was to compare the effects of smooth and diamond‐coated ultrasonic retrotips on the external and internal surfaces of root‐end preparations with the aid of a scanning electron microscope (SEM). Forty‐four mesial roots of human mandibular molars were selected. The canals were cleaned, shaped and obturated using gutta‐percha and sealer. The apical portions were resected at a 45°‐angle bevel exposing both mesial canals and the isthmus area. The roots were then divided into two groups according to the type of root‐end preparation: Group A —performed with smooth retrotips (S) and Group B — performed with diamond‐coated retrotips (DC). The specimens were coded and prepared for SEM evaluation. Observations of the external surface preparation showed that the S and DC retrotips produced very well‐centered cavities involving both canals and isthmus area with minimal deviations and no perforative defects. When the internal surface of the root‐end preparations was evaluated, it was evident that the use of S retrotips resulted in clean canal walls with little superficial debris and smear layer. Internal canal surfaces done with DC retrotips were irregular showing patent grooves, in contrast with the more uniform, regular and smoother surfaces when S retrotips were employed.
Inflammatory and replacement resorption in reimplanted permanent incisor teeth: a study of the characteristics of 84 teeth
Authors: Kinirons M. J. , Boyd D. H. , Gregg T. A.
Published: June 2007

Kinirons MJ, Boyd DH, Gregg TA. Inflammatory and replacement resorption in reimplanted permanent incisor teeth: a study of the profiles of 84 teeth. Endod Dent Traumatol 1999; 15: 269–272. © Munksgaard, 1999.

Abstract — Avulsion is a serious injury which can cause damage to some or all of the dental and surrounding tissues. This study examined the profiles of teeth showing inflammatory resorption, in terms of time prior to reimplantation, contamination, pulp extirpation time and period of splinting and compared them to teeth without resorption. There were a total of 71 children in the present study (mean age 9.8 years, range 6–16 years) with a total of 84 reimplanted teeth. Inflammatory resorption was present in 22 teeth. There was a significant relationship between the presence of inflammatory resorption and the time the teeth were dry prior to reimplantation, with a lesser effect for total delay time. There were slightly later pulp extirpation times for teeth with inflammatory resorption, with median delays of 16 and 11 days respectively and increased inflammatory resorption in teeth extirpated at 20 days or later. Replacement resorption was present in 40 teeth. There was a significantly longer splinting time in teeth with replacement resorption and more resorption in teeth splinted for longer than 10 days. It was concluded that pulp extirpation time was not critical unless the delay exceeded 20 days and that splinting time should not exceed 10 days.
Non‐vital immature permanent incisors: factors that may infIuence treatment outcome
Authors: Finucane D. , Kinirons M. J.
Published: June 2007

Finucane D, Kinirons MJ. Non‐vital immature permanent incisors: factors that may influence treatment outcome. Endod Dent Traumatol 1999; 15: 273–277. © Munksgaard, 1999.

Abstract — This study examines the treatment of non‐vital immature permanent incisors using the calcium hydroxide apexification tecnique. The objectives of the present study were to determine the speed and location of bamer formation and those factors discernible at presentation and during treatment which may be related to it. Forty‐four non‐vital immature incisors undergoing calcium hydroxide apexification were reviewed in detail. All cases were reviewed every 8–12 weeks for up to 18 months, or until apexification occurred. Details of the time and nature of the injuries and treatment were recorded. The degree of apical development prior to treatment was assessed, and barrier formation, location and time were noted. Mean time to barrier formation was 34.2 weeks (range 13–67 weeks). The strongest predictor of rapid barrier formation was the rate of change of calcium hydroxide and a barrier also formed more rapidly in cases with narrower initial apical width. There was evidence of displacement and a higher mean time for barrier formation in half of the cases. The presence of an abscess was the weakest predictor of rapid barrier formation and the effect was not significant (P=0.280). The barrier was located at the apex in 28 cases (63.6%) and the distance from the barrier to the apex for the remaining 16 (36.4%) varied from 1 mm to 5 mm. The number of placements of calcium hydroxide varied from 1 to 4 with a mean of 1.9, and there was a higher mean number of calcium hydroxide placements in the cases where the barrier was located at the apex.
The diagnostic accuracy of microbiologic root canal sampling and the influence of antimicrobial dressings
Authors: Reit C. , Molander A. , Dahlén G.
Published: June 2007

Reit C, Molander A, Dahlén G. The diagnostic accuracy of microbiologic root canal sampling and the influence of antimicrobial dressings. Endod Dent Traumatol 1999; 15: 278–283.© Munksgaard, 1999.

Abstract — The routine approach to endodontic treatment of teeth with apical periodontitis often involves an interappointment dressing with calcium hydroxide. However, investigations have demonstrated a negative influence of calcium hydroxide on the accuracy of microbiological root canal sampling (MRS). The aim of the present study was to investigate whether the use of a fluid dressing like 5% iodine potassium iodide (IPI) would increase the accuracy of MRS. Following instrumentation of 50 teeth with radiographically verified apical periodontitis the root canals received IPI as an intra‐canal dressing. One week after closure canals were sampled, “test sample” (TS), and then left filled with sampling fluid and temporarily sealed. Seven days later a “gold standard” (GS) sample was obtained. Bacteria were recovered in 22 teeth (44%) in TS as well as in GS. Fifteen teeth (30%) were positive for growth in both samples. Using the detection level “very sparse growth” of microbes the sensitivity and specificity of MRS reached 68% and 75%, respectively. In an earlier study, following the same experimental protocol, but with calcium hydroxide as intracanal dressing, the corresponding values were 33% and 81%. In 25% of these cases bacteria persisted in the canals. As compared to calcium hydroxide, the use of IPI resulted in improved test accuracy, but loss of antibacterial capacity. Conclusively, intracanal dressings seem to vary in their influence on the microbiologic test performance as well as in their antibacterial efficacy. In a clinical situation the choice of interappointment dressing should include consideration of these potentially conflicting properties.
A comparison of laser Doppler flowmetry with other methods of assessing the vitality of traumatised anterior teeth
Authors: Evans D. , Reid J. , Strang R. , Stirrup D.
Published: June 2007

Evans D, ReidJ, Strang R, Stirrups D. A comparison of laser Doppler flowmetry with other methods of assessing the vitality of traumatised anterior teeth. Endod Dent Traumatol 1999; 15: 284–290. © Munksgaard, 1999.

Abstract — Laser Doppler flowmetry is a non‐invasive electro‐optical technique which allows the semi‐quantitative recording of pulpal blood flow. This study aimed to determine the reliability (measured as the sensitivity and specificity) of laser Doppler flowmetry as a method of assessing the vitality of traumatised anterior teeth, and to compare it with standard pulpal diagnostic tests. Recordings of pulpal blood flow were taken from 67 non‐vital anterior teeth (55 patients), where the pulpal status was confirmed by pulpectomy. For comparison, recordings were also taken from 84 vital anterior teeth (84 patients). Analysis of the recordings allowed diagnostic criteria to be developed which gave the technique a sensitivity and specificity of 1.0 for this sample. None of the other standard pulpal diagnostic methods tested was as reliable. This was usually due to low sensitivities, which ranged between 0.92 for sensibility testing with ethyl chloride down to 0.36 for periapical radio‐lucency and 0.16 for a history of pain. Laser Doppler flowmetry was found to be a reliable method of assessing the pulpal status of traumatised anterior teeth, although it is technique‐sensitive and time‐consuming to use.
Mental nerve paresthesia associated with an amalgam filling: a case report
Authors: Hilú R. E. , Zmener O.
Published: June 2007

Hilú RE, Zmener O. Mental nerve paresthesia associated with an amalgam filling: a case report. Endod Dent Traumatol 1999; 15: 291–293.© Munksgaard, 1999.

Abstract — We present a case report in which a mental nerve paresthesia occurred in connection with an amalgam filling placed in direct contact with the pulp of a mandibular first molar. The main evidence for amalgam being the dominant etiological factor was the positive epicutaneous patch testing response to the components of the amalgam alloy, and the total remission of symptoms without further clinical complications after removal of the amalgam filling and subsequent endodontic therapy.
Malformation in the primary and permanent dentitions following trauma prior to tooth eruption: a case report
Authors: Cole B. , Welbury R.
Published: June 2007

Cole B, Welbury R. Malformation in the primary and permanent dentitions following trauma prior to tooth eruption: a case report. Endod Dent Traumatol 1999; 15: 294–296. © Munksgaard, 1999.

Abstract — Dento‐facial injuries that occur prior to the eruption of teeth in the primary dentition are rare, but can result in damage to the primary dentition. We report a rare case where an injury to the anterior maxilla and mandible of an infant prior to primary tooth eruption resulted in hypoplasia, displacement and impaction of the primary dentition and damage to a developing permanent tooth.
In vitro viability, mitogenicity and clonogenic capacity of periodontal ligament cells after storage in six different media
Authors: Ashkenazi M. , Sarnat H. , Keila S.
Published: June 2007

Abstract— The choice of storage medium for preserving traumatic‐ally avulsed teeth is important for the success of future replantation. The objectives of this study were to evaluate the effectiveness of six different media: culture medium, α minimal essential medium (αMEM), milk, Hank's balanced salt solution (HBSS), ViaSpan and conditioned medium (CM) to preserve cultured periodontal ligament fibroblasts (PDLF). Periodontal ligament fibroblasts were obtained from explants of human healthy extracted teeth. Plates with confluent PDLF were soaked in the various media for 2, 8 and 24 h at 4°C. A control group was incubated with culture medium at 37°C. After incubation, cell viability was determined by trypan blue exclusion test. Viable cells were then analyzed for mitogenic (with thymidine) and clonogenic capacity (by culturing one cell/well). Storage of PDLF up to 24 h decreased their vitality by only 2%‐14%. Vitality of the PDLF after 2, 8 and 24 h was highest when stored in milk or HBSS (91%‐97%) and lowest when stored in ViaSpan or CM (82%‐93%). PDLF stored for 2–8 h in various media had a mitogenic capacity comparable to the control. However, increasing the storage period to 24 h decreased the mitogenicity of the cells by 3%‐39%. The highest mitogenicity was found in PDLF stored in milk or HBSS and the lowest in CM or ViaSpan. The clonogenic capacity of the cells dropped by 38%‐71% after 24 h and was the best indicator of the deteriorating effect of long storage. Milk and HBSS were the most effective in preserving the clonogenic capacity. Nevertheless, reduction in the viability, mitogenicity or clonogenic capacity was statistically significant in nearly all the tested media only after 24 h of incubation. In conclusion, HBSS and milk were the most effective media for preserving the viability, mitogenicity and clonogenic capacity after storage for up to 24 h at 4°C.
Experimental comparative study of various mouthguards
Authors: Hoffmann J. , Alfter G. , Rudolph N. K. , GÖZ G.
Published: June 2007

Abstract— The aim of this study was to evaluate the mechanical and physical properties of several standard size commercially available mouthguards. For the purpose of objective testing, a special study model, which the various gum shield devices could be fitted onto, was developed to record tooth deflection caused by impact forces induced by a pendulum ram impact testing machine. The data measured on teeth provided with various gum shield devices were correlated with those of unprotected teeth; this enabled the individual cushioning effects of the respective devices and their specific force conduction to be evaluated. Using mouthguards considerably diminishes the deflection of the teeth subjected to stress in comparison with the row of unprotected teeth. In addition, force is transmitted to the adjacent teeth all the way to the distal regions of the row of teeth. The individual cushioning effects are directly correlated to the thickness of the material; the force distribution is determined by the rigidity of the gum shield device. The devices examined showed considerable differences with regard to force distribution and dimensioning. The study showed that this was due to the thickness of the materials, the manufacturing process and the composition of the materials of the devices examined. In comparison to laboratory‐produced devices of similar material thickness, the devices that were designed to be fitted by the user achieved significantly poorer results as regards both cushioning properties and dissipation of exerted forces.
Effect of chelating agents on the molecular composition and extent of decalcification at cervical, middle and apical root dentin locations
Authors: Verdelis K. , Ellades G. , Ovllr T. , Margelos J.
Published: June 2007

Abstract— The aim of this study was to investigate the interaction of two chelating agents used in endodontic treatment with dentin from different root locations. Standardized cervical, middle and apical root dentin specimens were prepared and subjected to treatment with 15% neutral EDTA and RCPrep. Following rinsing with water, dentin surfaces were studied by reflected light optical microscopy and micro‐MIR FTIR spectroscopy, while the wash‐off extracts were analyzed by atomic absorption spectrometry (AAS) to determine the content of calcium and phosphorus. Neutral EDTA removed the smear layer and opened tubules while RCPrep did not. FTIR measurements showed higher decalcification of dentin surfaces after neutral EDTA treatment although its effect was reduced at apical regions. AAS measurements of calcium and phosphorus confirmed the higher dentin dissolution potential of EDTA at cervical and middle root dentin locations. The results of the present study implied different reaction modes for the two chelating agents tested which might affect the efficiency of the chemo‐mechanical preparation when these agents are used.
Detection and measurement of endodontic root perforations using a newly designed apex‐locating handpiece
Authors: Zmener O. , Grimberg F. , Banegas G. , Chiacchio L.
Published: June 2007

Abstract— Access openings and lateral root perforations were prepared in 40 single‐rooted extracted teeth. The distance to the perforations was measured visually and then with the Tri Auto ZX. The electronic device was used first in its apex‐locating function and then in conjunction with its automatic reverse mechanism. On average, the electronically measured length was slightly shorter than the visually measured length (P<0.05). When the automatic reverse mechanism was used, the values registered were either consistent with or slightly different (±0.5 mm) from the electronically measured length (P<0.05). The results of this study revealed that the Tri Auto ZX detected and measured endodontic root perforations within a range of clinically acceptable variations.