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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 -
Diagnostics (Basel, Switzerland) May 2023Pleuroparenchymal Fibroelastosis (PPFE) is a rare disease that consists of elastofibrosis that involves the pleura and subpleural lung parenchyma; it is an unusual...
Pleuroparenchymal Fibroelastosis (PPFE) is a rare disease that consists of elastofibrosis that involves the pleura and subpleural lung parenchyma; it is an unusual pulmonary disease with unique clinical, radiological and pathological characteristics. According to recent studies, PPFE may not be a definite disease but a form of chronic lung injury. The aim of this retrospective study is to determine the incidence and to evaluate the distribution, severity and progression of this radiological entity on high-resolution CT (HRCT) exams of the chest, performed in routine clinical practice. In total, 1514 HRCT exams performed in the period January 2016-June 2018 were analyzed. For each exam, the presence of PPFE was evaluated and a quantitative score was assigned (from 0 to 7 points, based on the maximum depth of fibrotic involvement of the parenchyma). When available, two exams with a time interval of at least 6 months were compared for each patient in order to evaluate progression (defined as the increase in the disease score). Patients were divided into different groups according to exposure and their associated diseases. Statistical analysis was performed by using the Wilcoxon test and Kruskal-Wallis test. PPFE was detected in 174 out of 1514 patients (11.6%), with a mean score of 6.1 ± 3.9 (range 1-14). In 106 out of 174 patients (60.9%), a previous CT scan was available and an evolution of PPFE was detected in 19 of these (11.5%). Among these 19 patients with worsening PPFE, 4 had isolated PPFE that was associated with chronic exposure or connective tissue disorders, and the other 15 had an associated lung disease and/or a chronic exposure. In this group, it was found that the ventral segments of the upper lobes, fissures and apical segments of the lower lobes had a greater statistically significant involvement in the progression of the disease compared to the non-progressive group. In 16 of 174 patients (9.2%, 7 of which belonged to the radiological progression group) a biopsy through video-assisted thoracoscopic surgery or apicoectomy confirmed PPFE. PPFE-like lesions are not uncommon on HRCT exams in routine clinical practice, and are frequently found in patients with different forms of chronic lung injury. Further studies are necessary to explain why the disease progresses in some cases, while in most, it remains stationary over time.
PubMed: 37175018
DOI: 10.3390/diagnostics13091627 -
BMC Oral Health Feb 2020The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs.
BACKGROUND
The present study compares the apical microleakage of three different root-end filling materials in which the retrograde cavity is prepared by two different burs.
METHODS
Eighty extracted single rooted maxillary and mandibular premolars were taken. Root canal treatment was completed. Apical 3 mm of all the teeth were resected with diamond disk. The tooth were divided into four groups with two subgroups for each group containing 10 tooth (N = 10) as: Group IA (Negative Control and IB (Positive Control); Group IIA and IIB: Prepared with round carbide bur and round diamond bur respectively, filled with GIC; Group IIIA and IIIB: Prepared with round carbide bur and round diamond bur respectively, filled with MTA; Group IVA and IVB: Prepared with round carbide bur and round diamond bur, filled with Biodentine. After applying two coats of nail varnish leaving apical 3 mm (except for negative control group) all teeth were immersed in 2% methylene blue for 3 days and again in 65% nitric acid for next 3 days for extraction of dye. The obtained solution was then transferred to eppendorf tube and centrifuged in microcentrifuges at 14,000 revolution per minutes (RPM) for 5 min. Optical density or absorbance of the supernatant solution was measured with UV spectrophotometer at 550 nm.
RESULTS
The absorbance of the supernatant solution after dye extraction is decreasing in the order of positive control> GIC > MTA > Biodentine> negative control group. The significant difference was observed between GIC and MTA (p = 0.0001) and GIC and Biodentine (p = 0.0001) with two different burs but statistically non-significant difference was observed between MTA and Biodentine with Carbide bur (p = 0.127) and Diamond bur (p = 0.496) respectively.
CONCLUSIONS
Within the limitations of the present study, it can be concluded that Biodentine and MTA showed less microleakage as compared to GIC. There is no significant difference between mean microleakage of MTA and Biodentine. However, the mean OD of the Biodentine was least of all evaluated materials. Preparation of the root-end using round carbide bur as well as round diamond burs showed comparable microleakage for all three filling materials.
Topics: Aluminum Compounds; Apicoectomy; Calcium Compounds; Dental Cements; Dental Leakage; Drug Combinations; Humans; Oxides; Pemetrexed; Root Canal Filling Materials; Silicates; Tooth Apex; Treatment Outcome
PubMed: 32013975
DOI: 10.1186/s12903-020-1025-9 -
International Journal of Dentistry 2020Root perforation is a common endodontic accident. Its management depends mainly on root canal disinfection and sealing the perforation area by preventing any...
Root perforation is a common endodontic accident. Its management depends mainly on root canal disinfection and sealing the perforation area by preventing any communication with the periodontium to prevent recontamination. A patient was referred to treat root perforation due to a previous treatment of tooth #22. The diagnosis was symptomatic periapical periodontitis, and the treatment plan was to retreat the root canal of #22 and make a surgical intervention (apicoectomy) associated with antimicrobial photodynamic therapy as a complementary technique. Five mineral oxides (5MO) cement was used as a root-end filling material. The procedures were performed in two sessions and controlled in two visits (after 30 days and 12 months). A bone neoformation was observed at the periapical area of tooth #22. 5MO bioceramic cement was effective in inducing the repair of the periapical lesion and had the ability to seal the exposed periapical area of the tooth. Its success depended mainly on root canal and surgical site disinfection.
PubMed: 33376491
DOI: 10.1155/2020/6677588 -
Iranian Endodontic Journal 2021The aim of this manuscript is to describe and discuss the advantages and obstacles of using a guided implant system adapted for endodontic microsurgery in the execution...
The aim of this manuscript is to describe and discuss the advantages and obstacles of using a guided implant system adapted for endodontic microsurgery in the execution of a case with indication of multiple endodontic microsurgery intervention in a single appointment. Cone-beam computed tomography (CBCT) scans were aligned and processed with the planning software, complementing the Straumann® guided instruments. The drill handles of the system employed directed milling cutters and guided drills based on the sleeve-in-sleeve concept used in the osteotomy and apical resection of teeth #13, #14, #23 and #24. The root-ends were retro-prepared and sealed with putty bioceramic sealer. The patient was completely asymptomatic at the 12 months follow up visit and CBCT revealed complete tissue healing of the involved teeth. The protocol demonstrated to be reliable and reproducible. Its applicability can be extended to other anatomical complex scenarios. The reproducibility of the technique would encourage the maintenance of teeth in patients with indication to multiple endodontic surgery and permitted the conclusion of this case with precision and comfort to both patient and operator.
PubMed: 36704394
DOI: 10.22037/iej.v16i3.30842 -
PloS One 2022Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding...
BACKGROUND
Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding to IPL increasingly deepened, IPL classification based on different elements was proposed although there still lacks an overall classification system. This study, aiming to systematically integrate the available data published in the literature on IPL associated with histopathology, proposed a comprehensive classification framework and treatment decision tree for IPL.
METHODS AND FINDINGS
English articles on the topic of "implant periapical lesion", "retrograde peri-implantitis" and "apical peri-implantitis" were searched on PubMed, Embase and Web of Science from 1992 to 2021, and citation retrieval was performed for critical articles. Definite histopathology and radiology of IPL are indispensable criteria for including the article in the literature. The protocol was registered in PROSPERO (CRD42022378001). A total of 509 papers identified, 28 studies were included in this review. In only one retrospective study, 37 of 39 IPL were reported to be at the inflammatory or abscess stage. 27 cases (37 implants) were reported, including acute non-suppurative (1/37, developed to chronic granuloma), chronic granuloma (5/37), acute suppurated (2/37), chronic suppurated-fistulized (6/37), implant periapical cyst (21/37), poor bone healing (2/37), foreign body reaction (1/37). Antibiotics alone did not appear to be effective, and the consequence of surgical debridement required cautious interpretation because of the heterogeneity of lesion course and operation. Implant apicoectomy and marsupialization were predictable approaches in some cases.
CONCLUSIONS
The diversiform nature of IPL in the case reports confirms the need for such histopathological classification, which may enhance the comparison and management of different category.
Topics: Humans; Peri-Implantitis; Retrospective Studies; Radicular Cyst; Suppuration; Granuloma; Decision Trees; Dental Implants
PubMed: 36548276
DOI: 10.1371/journal.pone.0277387 -
International Journal of Paediatric... Sep 2022Previously published epidemiological outcome studies of nonsurgical root canal therapy (NSRCT) in the United States utilize data only from a single, private dental...
BACKGROUND
Previously published epidemiological outcome studies of nonsurgical root canal therapy (NSRCT) in the United States utilize data only from a single, private dental insurer for adult populations.
AIM
This study aimed to investigate the outcomes of initial NSRCT, performed on permanent teeth, in a publicly insured paediatric population.
DESIGN
New York State Medicaid administrative claims were used to follow 77 741 endodontic procedures in 51 545 patients aged 6-18, from the time of initial NSRCT until the occurrence of an untoward event (retreatment, apicoectomy, and extraction). The initial treatment and untoward events were identified by Current Dental Terminology codes. The Kaplan-Meier survival estimates were calculated at 1, 3, and 5 years. Hazard ratios for time to permanent restoration and restoration type were calculated using the Cox proportional hazards model.
RESULTS
The median follow-up time was 44 months [range: 12-158 months]. Procedural, NSRCT, survival was 98% at 1 year, 93% at 3 years, and 88% at 5 years. Extraction was the most common untoward event. Teeth permanently restored with cuspal coverage had the most favorable treatment outcomes.
CONCLUSIONS
Overall, 89% of teeth were retained and remained functional over a minimum follow-up time of 5 years. These results elucidate the expected outcomes of NSRCT in permanent teeth for paediatric patients with public-payer dental benefits.
Topics: Adult; Child; Humans; Medicaid; Retreatment; Root Canal Therapy; Treatment Outcome
PubMed: 35000244
DOI: 10.1111/ipd.12953 -
Journal of Endodontics Jul 2019The aim was to assess the association of inducible costimulator (ICOS) and ICOS ligand with bone destruction in apical periodontitis (AP).
INTRODUCTION
The aim was to assess the association of inducible costimulator (ICOS) and ICOS ligand with bone destruction in apical periodontitis (AP).
METHODS
Specimens from patients presenting with AP were obtained during apicoectomy and subjected to histopathologic analysis and molecular assessment of ICOS/ICOS ligand. In addition, the experimental AP was induced by exposing the pulp of first mandibular molars of rats. Histologic and radiographic examinations were performed to validate the periapical lesions. The immunolocalization and messenger RNA expression of ICOS/ICOS ligand were evaluated by immunofluorescence staining and quantitative real-time polymerase chain reaction. The osteoclastic activities in periapical lesions, including the lesion size and the expression of tartrate-resistant acid phosphatase and the receptor activator of nuclear factor kappa B ligand, were recorded and followed by correlation analysis with ICOS/ICOS ligand expression.
RESULTS
In excisional specimens from AP patients, a significantly increased expression of ICOS/ICOS ligand was found compared with the healthy control. In the experimental AP samples, the expression of ICOS/ICOS ligand, tartrate-resistant acid phosphatase, and receptor activator of nuclear factor kappa B ligand was significantly elevated in inflamed periapical tissues (AP group) when compared with the healthy control. The number of ICOS/ICOS ligand cells was highly correlated with the periapical lesion size (r = 0.892, P < .01 and r = 0.930, P < .01, respectively).
CONCLUSIONS
The increased expression of ICOS/ICOS ligand in periapical lesions was associated with the inflammatory infiltration and alveolar bone destruction of AP.
Topics: Alveolar Bone Loss; Animals; Humans; Inducible T-Cell Co-Stimulator Protein; Inflammation; Ligands; Osteoclasts; Periapical Periodontitis; Periapical Tissue; Proteins; Rats; Tartrate-Resistant Acid Phosphatase
PubMed: 31153660
DOI: 10.1016/j.joen.2019.03.018 -
European Journal of Dentistry Feb 2023In this case report, we describe the treatment of a patient referred to our clinic with a hopeless tooth 21 with an attached pontic. The aim of this case report was to,...
In this case report, we describe the treatment of a patient referred to our clinic with a hopeless tooth 21 with an attached pontic. The aim of this case report was to, first, describe the advantages and disadvantages of gaining soft tissue with a self-inflating soft tissue expander before performing a bone augmentation procedure in implant dentistry in the esthetic zone. Second, we describe how an amalgam tattoo, caused by a previously performed apicoectomy that made the extension of the raised flap to cover the augmented site esthetically undesirable, was removed. Two silicone enveloped Osmed hydrogel self-inflating soft tissue expanders were placed submucosally on the right- and left-hand side of the amalgam tattoo. One of these two perforated the overlaying mucosa after 24 days. Both tissue expanders were removed, the amalgam tattoo was excided, the site augmented, and an implant with a crown and a pontic was placed.
PubMed: 36195209
DOI: 10.1055/s-0042-1749156 -
Dental Press Journal of Orthodontics 2018Tooth dilacerations are dental anomalies characterized by an abrupt deviation in the longitudinal axis of a tooth. They may occur either in the crown, between the crown...
INTRODUCTION
Tooth dilacerations are dental anomalies characterized by an abrupt deviation in the longitudinal axis of a tooth. They may occur either in the crown, between the crown and root, or in the root. Although not so common, impacted maxillary incisors exhibiting root dilaceration pose a diagnostic and treatment challenge to the clinician.
DESCRIPTION
This case report describes the management of a horizontally impacted and dilacerated maxillary central incisor in a 12-year-old girl. Cone-beam computed tomographic scans were used to accurately localize the position of the dilacerated tooth, and to assess the extent of root formation and degree of dilaceration present in the root. Treatment included surgical exposure and orthodontic traction, followed by root canal treatment and apicoectomy.
RESULTS
Through a meticulously planned interdisciplinary approach, the impacted dilacerated central incisor was properly aligned and demonstrated good stability after the long-term follow-up.
CONCLUSION
Taking into consideration the concerns and expectations of the patient, communicative feedback between the oral surgeon, orthodontist and endodontist helped achieving successful esthetic, structural and functional outcome in the present case.
Topics: Apicoectomy; Child; Cone-Beam Computed Tomography; Female; Humans; Incisor; Interdisciplinary Communication; Maxilla; Orthodontic Appliances, Fixed; Patient Care Planning; Patient Care Team; Root Canal Therapy; Tooth, Impacted
PubMed: 30088564
DOI: 10.1590/2177-6709.23.3.037-046.oar