Treatment Planning
M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson in Restorative Techniques in Paediatric Dentistry, 2021
Existing restorations should be examined with care for recurrent caries and for the type and integrity of the restorations. In particular, glass ionomer cements and composite resin restorations should be examined most critically, since their success rates in primary teeth are poor and they often need replacement. An example of a poor quality glass ionomer restoration in a primary molar that has failed is shown in Figure 1.5. Too often, an attempt is made to restore a large cavity in a primary tooth with a material that will not hold for very long. Leakage around the margins or breakdown of the margins leads to failure of the restoration. In many cases the cavity was originally quite deep, and irreversible pulpal necrosis occurs when the tooth dies and an abscess ensues. This is the situation illustrated in Figure 1.5.
Major Orofacial Infection
Thomas T. Yoshikawa, Shobita Rajagopalan in Antibiotic Therapy for Geriatric Patients, 2005
Dental caries presents as a yellowish, dark brown, or black discoloration on the outer surface of the teeth due to demineralization and staining of the calcified tooth structure. In the elderly, interproximal and root caries are more common than those found on the occlusal or biting surfaces of the posterior teeth, which is more commonly seen in younger age groups. Acidogenic and aciduric bacteria colonizes in a biofilm on tooth surfaces as a result of inadequate oral hygiene measures. Arrested caries may occur in response to decreased microbial activity and remineralization with inorganic ions from saliva (4). Upon reaching the tooth's pulp tissues, dental caries usually causes the patient to report the accompanying pain as a toothache. The pain is associated with the inflammatory responses of the pulp (pulpitis) to the invading organisms and their toxins in the severely confined space of the tooth's inner core. The progressive swelling engorges the pulp, constricts the blood supply of the tooth, and causes pulpal necrosis. If the nonvital and infected pulp tissues are not removed by root canal treatment or extraction of the tooth, the suppurative infection will progress into the alveolar bone and subsequently into adjacent anatomical spaces producing additional pain, swelling, fever, chills, and bacteremia.
Dentin-Pulp Complex Regeneration
Vincenzo Guarino, Marco Antonio Alvarez-Pérez in Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Publications related to regenerative endodontics have increased significantly in the last decade. In an electronic search in PubMed, with appropriate MeSh terms including ‘regenerative endodontics’, 259 studies of potential relevance were identified (18 April 2019). The first case reports of ‘revascularization’ were reported in 2001 and 2004. Successful clinical outcomes in teeth with pulp necrosis were reported without the conventional obturation of the root canal with gutta-percha or bioceramic materials. These studies defined the direction of the investigation in this topic. From these statistics, it becomes immediately clear that these two conditions remain a significant public health problem and require better strategies for disease prevention and clinical management (Iwaya et al. 2001; Banchs and Trope 2004).
Analysis of oral microbiota in non-vital teeth and clinically intact external surface from patients with severe periodontitis using Nanopore sequencing: a case study
Published in Journal of Oral Microbiology, 2023
Alessio Buonavoglia, Francesco Pellegrini, Gianvito Lanave, Georgia Diakoudi, Maria Stella Lucente, Fausto Zamparini, Michele Camero, Maria Giovanna Gandolfi, Vito Martella, Carlo Prati
In our study, all the teeth but the control case presented bacteria on the root surface and in the root canal system, demonstrating the possibility of bacteria to spread directly from the periodontal pocket to the root canal system, despite the apical foramen was not reached by periodontal lesion. It is well known that periodontal diseases may determine the exposure of other anatomical communications, over the apical segment, between periodontal tissues and the root canal system, with possible invasion of the root canal system from periodontal bacteria and/or their toxic metabolic products [18]. ‘Retrograde’ pulpitis is an inflammatory pulpal condition caused by response to bacterial invasion and toxic products entering through anatomical communications that became exposed to the oral fluids. Total pulp necrosis is determined when the blood supply to all root canals is interrupted by periodontal disease that involves apical root segment determining a vascular damage and subsequent hypoxia [1].
Nanofibers as drug-delivery systems for infection control in dentistry
Published in Expert Opinion on Drug Delivery, 2020
Maurício G. C. Sousa, Mariana R. Maximiano, Rosiane A. Costa, Taia M. B. Rezende, Octávio L. Franco
As previously mentioned, a large variety of microorganisms are responsible for the infection of the dental pulp tissue and consequently contribute to pulp necrosis [76]. Some studies have sought to understand the differences between the microbiota present in pulp infections caused by dental caries and dental trauma [77]. The most often found species in cases of dental trauma, so far, were Actinomyces naeslundii, Porphyromonas endodontalis, Parvimonas micra, Fusobacterium nucleatum, Porhiromonas gingivalis, Tannerella forshytia, Filifactor alocis and Treponema denticola [64]. Other species such as Enterococcus faecalis have also been studied, mainly as a base microorganism for understanding how antimicrobial pastes would act on the root canal system, since this microorganism is related to cases of persistent infection and endodontic failure [78].
A retrospective study of traumatic dental injuries in primary dentition: treatment outcomes of splinting
Published in Acta Odontologica Scandinavica, 2018
Won Chang Cho, Ok Hyung Nam, Mi Sun Kim, Hyo-Seol Lee, Sung Chul Choi
TDIs in the primary dentition can cause clinical complications, including colour changes, pulp necrosis, pulp canal obliteration and external or internal root resorption [1]. Clinical success and failure were identified based on literature reports [10,14]. According to Flores [12], discoloration may not be associated with pulp necrosis. Thus, unless associated infection is present, root canal treatment is not recommended in discoloured teeth. Also, the frequency of secondary pulp necrosis among teeth with pulp canal obliteration is low [1,10,15,16]. Thus, in this analysis, discoloration and pulp canal obliteration were considered as examples of clinical success. Clinical failure included pulp necrosis, pathological root resorption, pathological loss of teeth and pathological bone resorption.
Related Knowledge Centers
- Dental Abscess
- Dental Trauma
- Endodontics
- Necrosis
- Periapical Cyst
- Periapical Periodontitis
- Pulpitis
- Tooth Decay
- Pulp
- Dental Pulp Test