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Clinical Case Reports Jan 2023This study aims to highlight the possibility of an effective endodontic surgical surgery when nonsurgical treatment of the right maxillary anterior teeth has failed. One...
This study aims to highlight the possibility of an effective endodontic surgical surgery when nonsurgical treatment of the right maxillary anterior teeth has failed. One year after the apicoectomy, the periapical lesion has completely healed, new bone has formed, and the patient is symptom-free.
PubMed: 36698516
DOI: 10.1002/ccr3.6884 -
International Journal of Surgery Case... 2016Glandular odontogenic cyst is a rare and recently recognized type of developmental odontogenic cyst. Being odontogenic in origin, because of the pluripotentiality of the...
INTRODUCTION
Glandular odontogenic cyst is a rare and recently recognized type of developmental odontogenic cyst. Being odontogenic in origin, because of the pluripotentiality of the odontogenic epithelium it can show glandular or salivary features.
PRESENTATION OF A CASE
A 46 year old female patient was referred to the Oral and Maxillofacial Surgery department with chief complaint of painless swelling in the right anterior region of maxilla, radiographically associated with teeth 12, 13. Mucosa over the swelling was slightly bluish in colour and no associated palatal swelling was seen. No incidence of trauma was reported and involved teeth were not mobile.
DISCUSSION
Although we have many differential diagnoses, our working diagnosis was a periapical cyst, so conventional treatment of root canal treatment, cyst enucleation, and apicoectomy was planned.
CONCLUSION
Here we present a case which was initially misdiagnosed and mismanaged but on subsequent histopathologic examination revealed the final diagnosis.
PubMed: 27093689
DOI: 10.1016/j.ijscr.2016.02.018 -
Clinical Oral Investigations Jun 2021To assess survival rates and frequency of complications for immature and mature autotransplanted teeth after at least 1 year in function.
OBJECTIVES
To assess survival rates and frequency of complications for immature and mature autotransplanted teeth after at least 1 year in function.
MATERIALS AND METHODS
All consecutive patients who had undergone tooth autotransplantation between 2000 and 2018 were invited to a clinical and radiographic follow-up examination. First, survival rates were calculated on the basis of a phone inquiry. A clinical follow-up examination allowed for the calculation of the success rate, i.e., absence of any potentially adverse clinical and radiographic findings of the autotransplanted teeth. Moreover, the effect of demographic, dental, and surgical variables on survival/success was analyzed statistically.
RESULTS
Thirty-eight teeth in 35 patients were transplanted during the study period. Three teeth in 3 patients were excluded due to missing records. All other patients were successfully contacted and interviewed by phone. Out of these 35 transplants, 32 were still in function, and 3 had been extracted, yielding a 91.4% survival probability after a median follow-up of 3.4 years. Of the 32 teeth qualifying for the success analysis, 20 (62.5%) showed absence of potentially adverse findings, while 3 (9.4%) required root canal treatment (RCT). Out of the 9 mature, root-end resected transplants, 4 exhibited ongoing pulp canal obliteration, all with a single root canal. Postoperative and potentially adverse findings or failures were found more frequently in the group of mature transplants (55.6%) than immature transplants (30.4%) and for molars (72.7%) than premolars (17.6%) or canines (25%). None of the potential predictors had a statistically significant effect on survival or success.
CONCLUSION
Autotransplanted teeth yielded a satisfying midterm survival rate regardless of their stage of development. An additional, extraoral root-end resection of mature transplants may lead to rates of revascularization and postoperative pulp canal obliteration higher than the data reported on unmodified mature transplants.
CLINICAL RELEVANCE
Extraoral root-end resection of mature teeth shows promising outcomes for transplants especially with a single root canal and uncomplicated root morphology.
Topics: Apicoectomy; Bicuspid; Follow-Up Studies; Humans; Retrospective Studies; Transplantation, Autologous; Treatment Outcome
PubMed: 33263141
DOI: 10.1007/s00784-020-03673-y -
Acta Stomatologica Croatica Sep 2017To determine the percentage of persistant apical lesions positive for bacterial nucleic acids, to detect microorganisms difficult to cultivate in persistant apical...
OBJECTIVES
To determine the percentage of persistant apical lesions positive for bacterial nucleic acids, to detect microorganisms difficult to cultivate in persistant apical lesions by PCR and relate them to endodontic failure, clinical symptoms and diabetes mellitus.
MATERIALS AND METHODS
The samples of persistent apical lesions were collected during apicoectomy. Bacterial ubiquitous primer 16S rRNA was used to detect 16S ribosomal RNA in 36 samples. A species-specific PCR was performed with primers targeted to the bacterial 16S rRNA genes of , , and .
RESULTS
Six samples (16.67%) were positive for bacterial ribosomal RNA. was detected in three samples. and were detected in one sample each. The prevalence of infection of such lesions with , and is low.
CONSLUSION
The study we conducted gave insufficient data about extraradicular infection and its connection with diabetes mellitus and clinical symptoms.
CONCLUSIONS
Apical lesions persisting after endodontic treatment could harbor microorganisms other than and species.
PubMed: 29225362
DOI: 10.15644/asc51/3/5 -
Dental Materials Journal 2011This study evaluated apical periodontal healing after root-end sealing using 4-META/MMA-TBB resin (SB), and root-end filling using reinforced zinc oxide eugenol cement... (Comparative Study)
Comparative Study
This study evaluated apical periodontal healing after root-end sealing using 4-META/MMA-TBB resin (SB), and root-end filling using reinforced zinc oxide eugenol cement (EBA) or mineral trioxide aggregate (MTA) when root canal infection persisted. Apical periodontitis was induced in mandibular premolars of beagles by contaminating the root canals with dental plaque. After 1 month, in the SB group, SB was applied to the resected surface following apicoectomy. In the EBA and MTA groups, a root-end cavity was prepared and filled with EBA or MTA. In the control group, the root-end was not filled. Fourteen weeks after surgery, histological and radiographic analyses in a beagle model were performed. The bone defect area in the SB, EBA and MTA groups was significantly smaller than that in the control group. The result indicated that root-end sealing using SB and root-end filling using EBA or MTA are significantly better than control.
Topics: Aluminum Compounds; Alveolar Process; Animals; Apicoectomy; Bicuspid; Boron Compounds; Calcium Compounds; Dental Cements; Dental Cementum; Dental Plaque; Dental Pulp Cavity; Dentin; Dogs; Drug Combinations; Female; Methacrylates; Methylmethacrylates; Oxides; Periapical Periodontitis; Periapical Tissue; Radiography; Random Allocation; Resin Cements; Retrograde Obturation; Root Canal Preparation; Silicates; Wound Healing; Zinc Oxide-Eugenol Cement
PubMed: 21778612
DOI: 10.4012/dmj.2010-158 -
International Journal of Oral Science May 2018The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance...
The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging (MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted (T2wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation (T1w/T1wFS), and contrast-enhanced fat-saturated T1-weighted (T1wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results (6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient (ICC), Cohen's kappa (κ), Mann-Whitney U-test and Fisher's exact test. Lesion identification and consecutive structured image analysis was possible on T2wFS and T1wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter (intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness (intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria (intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas: (1) outer margin of lesion, (2) texture of "peripheral rim" in T1wFS+C, (3) texture of "lesion center" in T2wFS, (4) surrounding tissue involvement in T2wFS, (5) surrounding tissue involvement in T1wFS+C and (6) maximum "peripheral rim" thickness (all: P < 0.05). In conclusion, this pilot study indicates that radiation-free dental MRI enables a reliable differentiation between periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.
Topics: Contrast Media; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Periapical Granuloma; Pilot Projects; Radicular Cyst; Reproducibility of Results; Sensitivity and Specificity
PubMed: 29777107
DOI: 10.1038/s41368-018-0017-y -
International Journal of Environmental... Oct 2020Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study...
Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists' preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants ( = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations ( ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists' privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment-decision-correlated factors are recommended for correct treatment planning.
Topics: Adult; Attitude of Health Personnel; Clinical Decision-Making; Cross-Sectional Studies; Dentists; Female; Focus Groups; Germany; Humans; Male; Middle Aged; Periapical Periodontitis; Practice Patterns, Dentists'; Root Canal Therapy; Surveys and Questionnaires
PubMed: 33066223
DOI: 10.3390/ijerph17207447 -
Journal of the Formosan Medical... Jun 2019Apical surgery is an option for management of endodontically-treated tooth with persistent periapical lesions or symptom and sign. The objective of this study was to...
BACKGROUND/PURPOSE
Apical surgery is an option for management of endodontically-treated tooth with persistent periapical lesions or symptom and sign. The objective of this study was to investigate the correlation between the demography, preoperative, postoperative factors and healed rate of apical surgery.
METHODS
Subjects were retrospectively collected from patients who received apical surgery/apicoectomy at the Endodontic Department, National Taiwan University Hospital from January 2013 to June 2015. The standard apical surgery procedures were performed. The demography, preoperative clinical and radiographic examination data as well as postoperative variables were collected. The outcome assessment was carried out after surgery. Statistical analysis was performed by chi square test to evaluate the potential outcome predictors.
RESULTS
Total 187 patients and 234 teeth receiving apical surgery were included. 53 male and 134 female patients were collected. The age was ranged between 17 and 89 years old and the mean age was 43.64 years old. Better healed rate with significant differences were observed in female patient (p < 0.05), age ≤60 years old (p < 0.01), preoperative root canal filling material >2 mm short of apex (p < 0.01), lesion size from ≤2 mm to ≤12 mm (p < 0.05) and follow-up period ≧12 months (p < 0.01) groups.
CONCLUSION
Gender, age, preoperative root canal filling material extent, lesion size and follow-up period may affect the outcome of apical surgery. Tooth type, post, prosthesis, and lesion area showed no marked effect on apical healing. These results provide more detailed information for the clinical practitioners to make treatment plans and are important for clinical endodontic practices.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Apicoectomy; Child; Female; Humans; Male; Middle Aged; Radiography, Dental; Retrospective Studies; Root Canal Filling Materials; Taiwan; Tooth Apex; Tooth, Nonvital; Treatment Outcome; Young Adult
PubMed: 30454858
DOI: 10.1016/j.jfma.2018.10.019 -
Journal of Clinical Medicine Dec 2022Tooth germ autotransplantation of open apices of the teeth exhibits high pulpal healing rates, whereas that of mature permanent teeth normally causes irreversible pulpal...
Tooth germ autotransplantation of open apices of the teeth exhibits high pulpal healing rates, whereas that of mature permanent teeth normally causes irreversible pulpal necrosis. Extraoral root-end resection (EORER) during transplantation may promote pulpal revascularization (PRV) in transplanted mature teeth and reduce endodontic treatment requirement. This study compared the primary outcomes of survival rates, PRV, and root resorption and determined relevant confounders in autotransplanted mature and immature teeth. The medical charts of consecutive patients who underwent tooth autotransplantation between January 2017 and March 2021 were evaluated. Teeth with a documented follow-up of at least 1 year were included. During the study period, 59 teeth were transplanted in 44 patients. Overall, 2 teeth were excluded owing to missing data; 57 teeth were analyzed, including 25 mature teeth additionally treated with EORER. After a mean follow-up of 21.2 ± 16.1 months, no significant differences in primary outcomes were detected. Fifty-five teeth remained in situ (96.5%), and radiological signs of root resorption were detected in 9/57 teeth (15.8%). PRV was positive in 54/57 teeth (94.7%). Surgical duration and PRV failure were significantly associated with high incidences of root resorption. Mature teeth autotransplantation with EORER yielded similar results to immature teeth autotransplantation and is a feasible treatment option. Long surgery and failed revascularization increased root resorption rates. More factors should be evaluated in larger trials with longer observation periods.
PubMed: 36498773
DOI: 10.3390/jcm11237199 -
Cureus Nov 2023Background Endodontic microsurgery (apicectomy) can be considered in cases of persistent infection that is resistant to conventional root canal treatment. The aim of...
Background Endodontic microsurgery (apicectomy) can be considered in cases of persistent infection that is resistant to conventional root canal treatment. The aim of this study was to evaluate the quality and readability of the available online information regarding the apicectomy procedure in Arabic. Methods Online search on the three most commonly used websites (Google, Yahoo, and Bing) using one keyword. The first 100 websites from each search were analyzed for quality and readability using DISCERN instrument scores, the Journal of the American Medical Association (JAMA) benchmarks, the Health On the Net (HON) seal, Flesch Reading Ease Scores (FRES), Flesch-Kincaid Grade Level (FKGL), and the Simplified Measure of Gobbledygook (SMOG) Index. Results Searching using the Arabic translation for "root end resection surgery" revealed 349,900 websites. Following the inclusion criteria, 31 websites were selected and evaluated in this study. The selected websites belonged to either non-profit organizations or commercial websites. The quality of most of the selected websites received a moderate score (83.9%) using the DISCERN tool. None of the selected websites obtained the HON seal. Quality evaluation using the JAMA benchmarks revealed that currency was the most achieved item (45.2%), followed by authorship (22.6%). Evaluation of the readability of the selected websites using the FRES, FKGL, and SMOG showed that the included websites were considered readable. Conclusion Although the included websites were readable, the quality of the websites was moderate. There is an urgent need to create more trustworthy and readable websites explaining the different endodontic treatments.
PubMed: 37942129
DOI: 10.7759/cureus.48333