The efficacy of two ultrasonic units in shaping curved canals in teeth were compared. Twenty teeth were instrumented using the Cavi-Endo unit at a power setting 1 using the technique recommended by the manufacturer. Another group of 20 teeth received similar treatment but were instrumented with the Enac unit. The time taken to instrument each canal was recorded. The pre- and post-instrumented radiographs of the teeth of x 10 magnification were taken using a microfocal technique. The radiographs were subjected to a subtraction technique to result in composite images of the pre- and post-instrumented shapes. The canal shape and the incidence of elbows were evaluated using various measurements taken from the radiographs. The manner the dentine was removed was similar in both groups. All canals exhibited unequal removal along the canal with more dentine being removed at the coronal end. The Enac group exhibited a higher incidence of elbows which occurred further apically than those in the Cavi-Endo group. There was no significant difference between groups in the following: time of instrumentation, amount of apical and coronal canal enlargement, apical deviation and change in width at the elbow. These findings were no different from those of another study using simulated canals.
A method of treating an apical root fracture with accompanying resorption at the junction of the fracture fragments using glass-cermet cement is described. Endodontically, the material had previously been used for repair of lateral resorptive root defects and retrograde root fillings. Complete bone regeneration was observed three years post-operatively following treatment of the root fracture in the conventional manner. The various advantages of glass-cermet cement as a root filling material used in the technique described are discussed.
A case report showing the eruption of the left maxillary and mandibular permanent cuspids in a six-year-old boy, is presented. In addition, the dental age of all the permanent cuspids as seen by the eruption and tooth development suggested that the cuspids are comparable to those seen in a 13 to 14 year-old-boy. A search of the literature has not revealed any such reports.
Teeth are the most durable structures in the human body. The pattern of their development has been used as a credible technique of age determination of unidentified bodies. Dental age estimation is by comparison of the dental status of an individual with published dental surveys. The third molars are the last teeth to erupt and are regarded as the most variable in the dentition. Nevertheless, radiographs depicting their growth have been used to determine the chronological age. A case for actual need for age estimation using a developing third molar is presented here.
The root canal walls of twenty -five deciduous molar teeth with exposed and necrotic pulps were examined using thescanning electronmicroscope. Immediately after extraction, all teeth were fixed in Kamosky's solution. The coronal portion of the tooth was sectioned at about 2mm above the enamel cemental junction.The mesial and distal roots were separat~d and either split in the mesio-distal or bucco-lingual direction. All specimens were prepared for SEM. Obsevations showed that all roots were infected with organisms consisting of cocciand short rods. Some of the coccihad penetrated the dentine layer. However, the distribution of organisms is. not uniform throughout thecanals. Bacterialinvasion ismostinthecoronal region and reduces towards the apical region: Accompanying bacterial invasion is root canal walls deterioration. The odontoblastic processes are the first to deteriorate followed by the predentine layer.
One hundred and ninety-eight single-rooted teeth from individuals aged 21-90 yr of Caucasian, Malay, Chinese Malay and Indian Malay origin were studied. Single or serial longitudinal sections of extracted teeth were cut following dye imbibition of patent dentinal tubules. The extent of sclerosis of apical dentinal tubules was assessed and correlated with the age of the individual. Correlation with age was higher in the Caucasian than the Malay races and within the Malaysian racial groups correlation with age was highest in the Malays and lowest in the Chinese. It is concluded that factors other than age may be important in the formation of sclerotic apical dentine in teeth of different racial origin. The effect of racial origin should be considered when using sclerosis as a means of age determination in forensic cases.
The palatal root of the first permanent molar is the most commonly deflected root into the maxillary sinus during extraction. A rational approach to the surgical removal of a root from the antrum is important. Some surgeons prefer the alveolar approach while others prefer the Caldwell-Luc operation. A case is presented where the palatal root tip of the left upper first molar was removed from the maxillary sinus by the Caldwell-Luc approach with simultaneous closure of the oro-antral fistula resulting from dental extraction. A fibreoptic light probe was used. The advantages and disadvantages as well as how to avoid the common complications of this surgical technique are discussed. A good result was achieved with successful removal of the root and no loss of sensibility of the teeth and/or gum for this case.
Surgery done around gingival margin may eventually result in loss of attachment and recession of the gingiva. Root hypersensitivity is another possible complication when coupled with overzealous tooth brushing by the patients. This paper presents an alternative method to remove a lesion located at the lateral cervical third of a root. Its advantage is that the gingival margin is kept intact.
The composite reinforcement technique has been used clinically to salvage damaged root-filled teeth compromised by caries, trauma, developmental abnormalities, internal resorption and iatrogenic causes. This clinical case report describes the use of the technique to reattach a fractured fragment in a compromised endodontically treated root besides reinforcing it for continued function in the mouth. Factors of clinical importance related to this additional application; including reattachment of tooth fragments, post crown retention, coronal microleakage and fracture resistance and strength, are also briefly discussed.
Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent) and a corticosteroid-antibiotic paste (Ledermix) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.
Phosphophoryn, a higWyphosphorylated protein, is the most abundant protein among the non-collagenous protein of dentine. The staining of phosphophoryn can be done by using the silver colloid staining. In this paper, the staining effect of the silver colloid stain on both non-sclerotic and sclerotic dentine was investigated. Eight teeth from donors aged 14, 17, 22, 34, 55, 57, 60 and 65 were used for this experiment. The younger teeth were used to demonstrate normal root dentine while the older age teeth were used to demonstrate sclerotic root dentine at the apical region of the root. There was no staining of the normal root dentine as compared to sclerotic dentine when the silver colloid staining was used.
The ultrastructure of the odontoblast reflects the certain phases that the cell undergoes in their lifecycle. Ultrastructure studies of the odontoblasts have often been carried out using young teeth. In this study, teeth from an older individual have been used to study the odontoblasts from the crown and root area. The odontoblasts from the crown area retain their columnar shape while odontoblasts from the root area appeared to be flattened. The organelles present in the odontoblasts either from the crown or root area was observed to be reduced.
The cross-sectional canal morphology and minimum widths of buccal and lingual canal walls were studied in 20 mandibular molars with C-shaped roots and canal orifices. The roots were mounted in clear resin blocks and sectioned transversely at 1-mm intervals. A total of 154 cross-sections were evaluated with an image analyzer. Twelve different longitudinal canal configurations were identified. The most prevalent were types 1-2 and 1-2-1 with each type occurring in four roots. Evaluation of the cross-sectional morphology showed that the configurations were complete "C" (27%), incomplete C (64%), and non-C (9%). The mean value for the minimum width of the lingual canal wall was 0.58 +/- 0.21 mm and the buccal wall was 0.96 +/- 0.26 mm. This suggests that there is a higher risk of root perforation at the thinner lingual walls of C-shaped canals during shaping and post canal preparation procedures. Both buccal and lingual canal walls were frequently narrower at mesial locations.
The treatment of haematological malignancy is multimodal and involves chemotherapy, radiotherapy and/or bone marrow transplants. With the advancement in cancer therapy, there is an increase in the survival of many children with childhood haematological malignancy. In addition, the late effect of the oncology treatment to the orofacial and dental development becomes significant in terms of the potential clinical impact that may affect the quality of life of the survivor. The severity of the long-term effects is dependent on the age of the child at initiation of treatment and whether chemotherapy is combined with radiation or not. The dental treatment may become more complex if the patient requires advanced restorative dental care and the roots malformation may complicate orthodontic treatment. Therefore these patients may require a scheduled careful preventive programme, long-term follow up, with prophylactic treatment and intervention at appropriate time to minimize the consequences of the disease and the given therapy.
The objectives of this study were to measure the Furcation Entrance Dimensions of first and second permanent molars in Malaysian samples and to compare the Furcation Entrance Dimensions with the blade widths of periodontal Gracey’s curette used for root surface instrumentation. A total of 199 extracted permanent teeth were measured, which comprised of 51 mandibular first molars, 51 mandibular second molars, 45 maxillary first molars and 52 maxillary second molars. Furcation Entrance Dimension was measured using calibrated test gauges. Results showed 51.91% of Furcation Entrance Dimension was