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Free Full Text ArticleRetrospective clinical and radiologic evaluation of nonsurgical endodontic tr...
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Retrospective clinical and radiologic evaluation of nonsurgical endodontic treatment in human immunodeficiency virus (HIV) infection.

J Contemp Dent Pract. 2006 Feb 15;7(1):1-8

Authors: Suchina JA, Levine D, Flaitz CM, Nichols CM, Hicks MJ

PURPOSE: This retrospective study evaluated the clinical and radiographic status of nonsurgical endodontic treatment (ET) of anterior and posterior teeth in HIV-seropositive patients. METHODS: ET was analyzed in 26 anterior and 34 posterior teeth from 54 consecutive HIV patients (gender ratio 3 Male : 1 Female, mean age 40.2 years, mean CD4 240, CD4<500 in 88%, 12 with AIDS) over a six year period with a minimum of six months follow-up. ET was evaluated as successful, questionable, or failure based upon clinical factors (palpation, mobility, sinus tract, percussion, function, infection/swelling, occlusion, symptoms) and radiographic factors (periodontal ligament space, rarefaction, lamina dura, root resorption, obturation) during post-treatment examinations with a mean follow up of 26 months. RESULTS: Clinical evaluation at follow up found ET outcome was successful in 88%, questionable in 10% (tenderness with percussion, mobility, widened ligament), and a failure in 2% (developed lesion after ET). Periapical lesions were present in 37% of cases (mean lesion size 6.2 mm). Following ET, mean lesion size (1.8 mm) had decreased by 71%. Obturation was evaluated as optimal or acceptable in 68%. Radiographic evaluation was considered successful in 80%, no change in 15%, and a failure in 5%. CONCLUSIONS: Despite obturation deficiencies and the immunocompromised state of the patients, endodontic therapy has a relatively high degree of success in the majority of HIV/AIDS patients. HIV infection and AIDS should not be considered as a contraindication to endodontic therapy in this patient population.

PMID: 16491142 [PubMed - indexed for MEDLINE]

Free Full Text ArticleResolution of furcation bone loss after non-surgical root canal treatment: ap...
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Resolution of furcation bone loss after non-surgical root canal treatment: application of a peptidase-detection kit for treatment of type I endoperiodontal lesion.

J Oral Sci. 2005 Sep;47(3):143-7

Authors: Yoneda M, Motooka N, Naito T, Maeda K, Hirofuji T

Here, we report the management of a type I endoperiodontal lesion with furcation bone loss. A 59-year-old female attended our hospital with the chief complaint of mobility of tooth 46 and recurrent gingival swelling around the tooth. She previously received dental treatment from two dentists, but her condition did not improve. The tooth manifested the symptoms of typical periodontitis, such as gingival swelling, tooth mobility, pus discharge from the periodontal pocket and furcation bone loss. The tooth had no caries and the pulp reacted to an electric pulp test. Careful examination of the gingiva revealed traces of dental fistula. X-ray examination via a gutta percha inserted into the fistula revealed that furcation bone loss was associated with the periapical lesion. We diagnosed a type I endoperiodontal lesion, and applied Periocheck, a detection kit for peptidase-producing bacteria, to check for decreases in bacteria in the furcation and root canals. Soon after non-surgical root canal treatment, the condition of tooth 46 improved without periodontal treatment. After confirming a negative score with Periocheck, the root canal was filled. After 3 months, the furcation bone loss was on the way to recovery. These results indicate that proper diagnosis and confirmation of a decrease in root canal bacteria are important for treating endoperiodontal lesions.

PMID: 16313093 [PubMed - indexed for MEDLINE]

Free Full Text ArticleThe clinical significance and management of apical accessory canals in maxill...
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The clinical significance and management of apical accessory canals in maxillary central incisors.

J Am Dent Assoc. 2005 Mar;136(3):331-5; quiz 379-81

Authors: Iqbal MK, Gartenberg J, Kratchman SI, Karabucak B, Bui B

BACKGROUND: The maxillary central incisor is considered to be the least difficult subject for a clinical endodontic experience. However, the internal anatomy of maxillary central incisors can present a number of variations, including multiple accessory canals. CASE DESCRIPTION: This article highlights the clinical significance and management of accessory canals located in the apical one-third of maxillary central incisors. The authors present two case reports in which failure to detect the accessory canals led to root canal failure and subsequent surgical intervention. Another two case reports present the serendipitous discovery and nonsurgical management of accessory canals during the initial treatment of maxillary incisors. CONCLUSIONS AND CLINICAL IMPLICATIONS: It is important for the clinician to be able to detect the signs suggesting the presence of accessory canals in maxillary central incisors. Failure to do so may lead to a less-than-optimal endodontic treatment outcome.

PMID: 15819346 [PubMed - indexed for MEDLINE]

Free Full Text ArticleCase challenge. Chronic maxillary inflammation.
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Case challenge. Chronic maxillary inflammation.

J Contemp Dent Pract. 2000 Feb 15;1(2):100-5

Authors: Omnell KA, Rohlin M

A 30-year old male was referred by a dental practitioner to the Department of Oral Radiology at the University of Lund, Sweden, for a radiological evaluation of chronic symptoms of inflammation on the right side of the maxilla. According to the patient, at age 12 he had surgery to remove a non-erupted maxillary right second premolar. Postoperatively, a draining sinus tract appeared on the buccal aspect of the alveolar process. Thirteen years later, at age 25, surgery was again performed and the sinus tract reappeared. Intermittent discharge of exudate from the sinus tract occurred since the second surgery. Clinical and radiological examinations were conducted prior to a third surgery. The clinical examination revealed pus draining from the tract located on the buccal aspect of the alveolar process between the right maxillary first molar and first premolar. The radiological examination included periapical radiographs of the right maxillary first premolar and canine, a panoramic radiograph, and frontal tomograms of the maxillary right premolar area.

PMID: 12167893 [PubMed - indexed for MEDLINE]

Free Full Text ArticleAlopecia areata of dental origin.
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Alopecia areata of dental origin.

Med Oral. 2002 Jul-Oct;7(4):303-8

Authors: Gil Montoya JA, Cutando Soriano A, Jimenez Prat J

The association of alopecia areata and infectious foci of dental origin is relatively common, and may be explained by the autoimmune nature of the disorder. We describe a case of alopecia areata with no apparent cause and that was effectively resolved by eliminating a focalized dental infection via endodontic treatment. The presence of common immune mediators in the pathogenesis of both alopecia areata and dental infection could account for the dental origin of the hair loss. In this sense, patients with localized alopecia should be subjected to careful exploration of the oral cavity in search of possible dental infections.

PMID: 12134132 [PubMed - indexed for MEDLINE]

Free Full Text ArticleDiagnosis and treatment of cutaneous facial sinus tracts of dental origin.
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Diagnosis and treatment of cutaneous facial sinus tracts of dental origin.

J Am Dent Assoc. 1999 Jun;130(6):832-6

Authors: Johnson BR, Remeikis NA, Van Cura JE

BACKGROUND: Cutaneous draining sinus tracts of dental origin often are a diagnostic challenge. A delay in correctly diagnosing these types of lesions can result in ineffective and inappropriate treatment. CASE DESCRIPTION: The authors present five cases of facial lesions that were initially misdiagnosed as lesions of nonodontogenic origin. The correct diagnosis in each case was cutaneous sinus tract secondary to pulpal necrosis and suppurative apical periodontitis. All facial sinus tracts resolved after the patients received nonsurgical root canal therapy. CLINICAL IMPLICATIONS: As patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, possible dental etiology may be overlooked. Early correct diagnosis and treatment of these lesions can help prevent unnecessary and ineffective antibiotic therapy or surgical treatment.

PMID: 10377641 [PubMed - indexed for MEDLINE]

Free Full Text ArticleTooth root abscess and fistula in the squirrel monkey (Saimiri sciureus).
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Tooth root abscess and fistula in the squirrel monkey (Saimiri sciureus).

Can Vet J. 1974 Jun;15(6):171-2

Authors: Olfert ED

PMID: 4211071 [PubMed - indexed for MEDLINE]

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