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Query: UMLS:C0031099 (periodontitis)
12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because of the patient's age and the width of the apical foramen, conventional or surgical root canal fillings are frequently not indicated for the treatment of chronic apical periodontitis in teeth whose roots have not yet fully grown. Therefore resorbable paste fillings are applied either to induce deposition of apical hard substance or to bridge the time until root canal filling is possible. In a comparative clinical and radiological study in 171 young patients, Walkhoff's iodoform paste and calcium hydroxide were examined with regard to their inductive effect on the formation of an apical hard substance barrier.
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PMID:[Therapy of chronic apical periodontitis in traumatically injuring front teeth with ongoing root growth]. 26 65

In essence, endodontics as a clinical discipline is concerned with the prevention and treatment of pulpal and periapical infection. In recent research the infective process has been investigated as well as the mechanisms by which the pulp and periodontium deal with microbial insults. With regard to the pulp, findings on the hemodynamics of pulpitis suggest that the inflammatory response in this tissue is much less influenced by the special anatomic environment of the tooth than was previously believed. Pulpal diseases are being underdiagnosed, mostly because of inadequate examination methods. Laser Doppler flowmetry which gives a vascular rather than a nervous response may gain importance in pulpal diagnostics in the future. It is established that apical periodontitis with bone resorption cannot develop in the absence of bacteria in the root canal system. Root canal infection is characterized by a wide variety of combinations of relatively few anaerobic bacteria, and bacterial synergism plays an important role in maintaining the infection. Microbial invasion of an apical granuloma may take place. Non-oral and environmental organisms like Pseudomonas aeruginosa are frequently isolated from treatment-resistant cases. Success of endodontic treatment depends on the reduction or elimination of the infecting bacteria. This may predictably be obtained after a thorough chemo-mechanical instrumentation and disinfection of the root canal with calcium hydroxide. The standardized technique which entails the preparation of a cylindrical apical box with removal of significant amounts of dentin near the root apex predictably gives a clean canal. This technique has provided excellent clinical and radiographic results in well documented follow-up studies.
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PMID:Recent development in endodontic research. 155 4

An apical dentine sampling technique was applied in order to monitor the bacteriology of the pulp canal and radicular dentine before and during treatment of teeth with chronic apical periodontitis. Twenty-three teeth with a radiographic diagnosis of apical periodontitis were studied. They were subjected to a standardized two-appointment treatment regimen of extensive apical reaming in the absence of antimicrobial agents and 1-week dressing with calcium hydroxide. Bacteriological samples were taken from the root canal at the start, and apical dentine samples at the end, of each sitting. Provision was made to allow growth of anaerobic bacteria. All root canals but one showed growth at the start of treatment. Dentine samples were positive in 14 of the 23 teeth at the end of the first appointment. Eight of the 23 canals had detectable growth from the canal at the start of the second appointment, but in sufficient numbers for quantification in only one root canal. The subsequent dentine samples were otherwise negative at the second appointment. There was a tendency for teeth causing symptoms to harbour more bacteria than symptomless teeth.
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PMID:Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study. 191 83

The purpose of the study was to compare the effect of three intracanal medicaments on the incidence of post-instrumentation flare-ups. All teeth were instrumented to a predetermined minimum size using a 0.5% solution of sodium hypochlorite as the irrigant. Formocresol, Ledermix, and calcium hydroxide were placed in strict sequence irrespective of the presence or absence of symptoms or radiographic signs of apical periodontitis. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed the patient was instructed to call the office immediately and was considered to have had a flare-up. Twelve flare-ups occurred in teeth with radiographic signs of apical periodontitis; none in teeth without periapical radiolucencies. Six of the twelve flare-ups occurred in retreatment cases and the other six occurred in teeth without previous endodontic treatment. No significant difference was found in the flare-up rate among the three intracanal medicaments.
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PMID:Relationship of intracanal medicaments to endodontic flare-ups. 213 14

The effects of different intracanal medicaments and zinc oxide-eugenol based root canal sealers on an experimentally induced apical periodontitis were studied histologically in mesial roots of lower molars of Wistar rats. After root canal instrumentation each canal was filled either with an intracanal medicament twice for 3 days each time or with a sealer for 21 days. The intracanal medicament chlorophenol caused periapical tissue damage. P-chloroxylenol-camphor lead to periapical improvement as did 5% sodium-hypochlorite. 12% sodium-hypochlorite gave tissue damage. After intracanal medication with an aqueous suspension of calcium hydroxide periapical repair was clearly visible. A combination of a corticoid and an antibiotic appeared to induce damage of the periapical tissues. The root canal sealers Endomethasone and N2 essentially impaired periapical repair. The results were acceptable for Aptal-Zink-Harz root canal fillings after 21 days as well as after 56 days.
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PMID:Reaction of inflamed periapical tissue to intracanal medicaments and root canal sealers. 784 66

Gram-negative organisms incorporate hydroxy fatty acids into the lipid A moiety of lipopolysaccharide (LPS), and in the case of some members of the family Enterobacteriaceae, hydroxy fatty acids are incorporated exclusively into lipid A. However, a limited number of Bacteroides species have been shown to incorporate several classes of 3-hydroxy fatty acids, particularly 3-hydroxy iC17:0, into constitutive lipids as well as LPS. The present study examined the distribution of hydroxy fatty acids in two periodontal pathogens, Prevotella intermedia and Porphyromonas gingivalis, by employing a phospholipid extraction procedure (E. G. Bligh and W. J. Dyer, Can. J. Biochem. Physiol. 37:911-917, 1959) which partitioned constitutive lipids into the organic solvent phase and LPS into the aqueous phase. The distribution of hydroxy fatty acids within organic solvent and aqueous extracts of these bacterial species was then compared with the distribution in subgingival plaque samples isolated from either gingivitis or severe periodontitis sites as well as the distribution in gingival tissue samples. The organic solvent and aqueous extracts were hydrolyzed under strong alkaline conditions, and the free fatty acids were treated to form pentafluorobenzyl-ester, trimethylsilyl-ether derivatives. Hydroxy fatty acid levels were quantified by using gas chromatography-negative-ion chemical ionization-mass spectrometry. By using this approach, the mean values of the 3-hydroxy iC17:0 recovered within organic solvent extracts of P. gingivalis strains ranged from 56 to 63% of total 3-hydroxy iC17:0. Substantially less 3-hydroxy iC17:0 (< 5%) was recovered in organic solvent extracts of P. intermedia. By comparison, 75% of the 3-hydroxy iC17:0 in periodontitis subgingival plaque samples was recovered in organic solvent extracts, while only 43% of the 3-hydroxy iC17:0 in gingivitis plaque samples from the same patients was recovered in organic solvent extracts. However, 3-hydroxy iC17:0 was recovered essentially only in organic solvent extracts of both healthy or mildly inflamed and periodontitis gingival tissue samples. The preferential recovery of 3-hydroxy iC17:0 in tissue lipids indicates that gingival tissues do not harbor significant levels of subgingival plaque organisms which contain 3-hydroxy iC17:0. Furthermore, these results indicate that LPS from these organisms is not prevalent in gingival tissues. Finally, these results indicate either selective penetration of certain bacterial lipids into gingival tissues or that 3-hydroxy iC17:0 is metabolically transferred from bacterial lipids into gingival tissue lipids.
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PMID:Distribution of 3-hydroxy iC17:0 in subgingival plaque and gingival tissue samples: relationship to adult periodontitis. 806 90

In addition to the successful replantation of avulsed permanent teeth, the replantation of primary anterior teeth may also be indicated. The decision is based on age and stage of tooth development, development of dentition, storage of the avulsed tooth and the way it is transported to the treatment site, the appropriate in vitro treatment of the tooth before reinsertion, and the willingness of the child to cooperate. A method involving retrograde filling of the primary tooth root with calcium hydroxide after resecting the root apex has proved successful. Other commercially available root filling materials and pins are not indicated. Calcium hydroxide allows the tooth to heal in place without reaction and prevents the development of apical periodontitis. As regards any surgical intervention, the attending dentist in this case has to weigh the benefits against the risks.
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PMID:Replantation of avulsed primary anterior teeth: treatment and limitations. 932 80

A clinical study using non-vital maxillary central incisors exhibiting acute apical periodontitis was carried out to evaluate the incidence of post-operative pain after biomechanical preparation and dressing with a calcium-hydroxide paste or a corticosteroid-antibiotic solution. Sixty teeth from 48 patients were prepared and dressed on the first visit and re-evaluated clinically 7 days later. No difference was observed in the incidence of post-operative pain between the two groups.
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PMID:Acute apical periodontitis: incidence of post-operative pain using two different root canal dressings. 982 37

Teeth with induced chronic periradicular periodontitis in dogs were root canal treated. After the biomechanical preparation, using K files and 5.25% sodium hypochlorite as the irrigant solution, all root canals were dressed with an antibacterial dressing based on calcium hydroxide, which was left in place for 7 days. After this time, the root canals were obturated with lateral condensation of cold gutta-percha with either a calcium hydroxide root canal filling material (Sealapex) or a zinc oxide-eugenol sealer (Fill Canal). After 270 days, histopathological analysis showed better apical and periapical repair in the teeth obturated with Sealapex (P < 0.05).
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PMID:Effect of different root canal sealers on periapical repair of teeth with chronic periradicular periodontitis. 986 33

This study was performed to evaluate radiographic healing of teeth with apical periodontitis, treated in one visit or in two visits (a) with or (b) without calcium hydroxide as an intracanal disinfecting medicament. The patients were assigned one of the three treatment groups by the throwing of a die. The Periapical Index (PAI) Scoring Method was used to compare differences in periapical status from the beginning of treatment to a 52-wk follow-up evaluation. Overall, the periapical status of the treated teeth improved significantly after 52 wk (p < 0.0001). A PAI score of 1 or 2 was considered as representing a "good" periapical status while 3, 4, or 5 was a "bad" status. When base line PAI scores were controlled for, the calcium hydroxide group showed the most improvement in PAI score (3, 4, or 5 to 1 or 2), followed by the one-step group (74% vs. 64%). The teeth that were left empty between visits had clearly inferior healing results. Power statistics were conducted to determine the numbers required for significant differences between the groups, and it was shown that large experimental groups on the order of hundreds of patients would be required to show significant differences.
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PMID:Endodontic treatment of teeth with apical periodontitis: single vs. multivisit treatment. 1053 Feb 59


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