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Dentin-Pulp Complex Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Amaury Pozos-Guillén, Héctor Flores
In the last two decades, advances in biomaterials and clinical research have made different modalities of treatment to treat the dentin-pulp complex possible, allowing manipulation of reactionary and reparative dentinogenesis. The resolution of infection and the disease process remains the primary goal of any endodontic therapy. A repaired tissue that promotes the resolution of disease and re-establishment of some or all of the original tissue functions should be a desirable goal. The goal of regenerative endodontics is the use of biologic-based procedures to arrest the disease process, preventing its recurrence while favoring the repair or replacement of damaged structures of the dentin-pulp complex.
Effects of Stress on Physiological Conditions in the Oral Cavity
Published in Eli Ilana, Oral Psychophysiology, 2020
Subjects in two of the studies were dental patients undergoing nonsurgical endodontic therapy.14,27 The stressor was the patient’s fear of the upcoming endodontic therapy. Prior to treatment, each subject completed a dental-anxiety questionnaire and supplied a sample of unstimulated pooled saliva. During treatment, patients were instructed to perform different relaxation procedures (e.g., hypnosis, meditation). Another saliva sample and a second dental anxiety questionnaire were obtained after the session was completed. Positive correlations were found between the questionnaire-assessed evaluation of stress and relaxation and the salivary results. The stress-related salivary changes were increased opacity, increased protein, reduced volume, reduced a amylase, and reduced pH. These results were also found when separate salivary gland secretions were used28 and when the technique of relaxation was performed by a patient well trained in deep relaxation through meditation.31
Hyaline Bodies in the Walls of Odontogenic Cysts
Published in Roger M. Browne, Investigative Pathology of the Odontogenic Cysts, 2019
Classically hyaline bodies and rings associated with a foreign body reaction have been described in edentulous portions of the alveolus, especially in the molar mandibular region of full lower denture wearers36,39,40,42–47 within periapical lesions and odontogenic cyst walls,25,37–41 in association with retained roots,46,47 impacted lower third molars with a history of pericoronitis39,47 and as a complication of periodontal surgery.42 There have been no studies of the incidence of this lesion in odontogenic cysts. Published data indicates that 33 of the 164 cases reported have been within the connective tissue walls of odontogenic cysts. Of these, 27 were present in dental cysts,25,38,40 3 in dentigerous cysts25,37,40 and 3 in odontogenic keratocysts.40 Three further lesions have been described in nasopalatine cysts42,47 and two in cysts of unknown origin.40 The site distribution of the reported lesions and their association with the presence of dentures, extraction sockets, gross caries, and teeth subjected to endodontic therapy which have been subjected to prolonged open drainage has been used to support the view that the lesion is the result of trauma and subsequent implantation of indigestible food particles (e.g., cellulose from vegetables) in areas prone to food stagnation. Thus most reported studies have concentrated on attempts to differentiate between possible exogenous (food) and endogenous origins of the hyaline rings.
The pharmacological management of dental pain
Published in Expert Opinion on Pharmacotherapy, 2020
Joseph V. Pergolizzi, Peter Magnusson, Jo Ann LeQuang, Christopher Gharibo, Giustino Varrassi
Dental pulp is a connective tissue in which nerves, blood vessels, and lymphatics reside. Most dental pain involves insult to the pulp which may be traumatic, infectious, or due to inflammation. Damage to earlier dental work can also cause the pulp to become inflamed and painful [67]. In many cases, such dental pain can be temporarily relieved with a nonopioid analgesic, an opioid analgesic, or a combination product, but the underlying cause of the pain must be addressed with endodontic therapy or extraction of the offending tooth. Topical treatments can relieve pain temporarily, such as a topical anesthetic gel (20% benzocaine or 5% lidocaine). Topical pain relievers for oral pain must be regarded as temporary solutions aimed at facilitating examination and assessment in emergency situations [66]. A topical bactericidal intraoral solution (such as Ora-5) may be helpful although the use of antibiotics should be limited to only those cases where they are clearly indicated [68]. Benzocaine, such as 20% gel, can be effective and is well tolerated by patients with toothache [69,70]. See Table 2.
The influence of kinematics of engine-driven nickel-titanium instruments on root canal shape assessed by micro-computed tomography: a systematic review
Published in Acta Odontologica Scandinavica, 2019
Sandro Junio de Oliveira Tavares, Estéfano Borgo Sarmento, Ludmila da Silva Guimarães, Lívia Azeredo Alves Antunes, Leonardo Santos Antunes, Cinthya Cristina Gomes
Most of the difficulties occurring during endodontic therapy are the result of anatomical complexity, making it imperative to widen the canal, while maintaining the original anatomy to minimize damage to the dental structure [3]. A safe mechanical preparation technique is needed to enlarge root canals, including those that are curved, to minimize the risk of deviation [4]. Nickel-titanium (NiTi) instruments were introduced into the market to allow an efficient, fast and safe mechanical preparation, while maintaining the original canal shape [5]. With a lower modulus of elasticity, these instruments have greater flexibility compared to stainless steel instruments [6]. This gives them a characteristic of super elasticity, allowing a ‘memory effect’. That is so these instruments, having great resistance, can return to their original form after they have been altered [7].
Profile of intrusive luxation and healing complications in deciduous and permanent teeth – a retrospective study
Published in Acta Odontologica Scandinavica, 2018
Thais Rodrigues Campos Soares, Luciana Pereira Silva, Sabrina Loren de Almeida Salazar, Ronir Raggio Luiz, Patrícia de Andrade Risso, Lucianne Cople Maia
Conservative management was characterized by attempting to maintain the tooth in the oral cavity, while the radical aimed at extraction [8]. In deciduous teeth, many authors recommend minimal invasive therapy using monitoring or endodontic therapy [8,14,15]. However, extraction may be performed in cases where there is risk presented to the permanent tooth germ or an inability of the patient to cooperate due to his/her young age [7]. In permanent teeth, endodontic therapy is indicated when necrosis or inflammatory root resorption is present [1], and varies according to root development [11,16]. When endodontic therapy is unsuccessful, or not possible, extraction is recommended, which increases the need for rehabilitation and treatment costs [1].