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Pulp Vitality (pulp + vitality)
Selected AbstractsInfluence of the type of dental trauma on the pulp vitality and the time elapsed until treatment: a study in patients aged 0,3 yearsDENTAL TRAUMATOLOGY, Issue 3 2004Daniela Maria Carvalho Pugliesi Abstract ,,,The purpose of the present study was to determine the influence of the type of trauma on the pulp vitality and the time elapsed until seeking dental care in children aged 0,3 years seen at the Baby Clinic of the Araçatuba Dental School, UNESP. A total of 1813 records were analyzed. Two hundred and three patients, corresponding to 302 traumatized teeth, were assessed clinically and radiographically. Hard-tissue injuries were the most frequent (52%), with a predominance of enamel crown fractures (41.4%), followed by concussions (12.6%) and intrusions (11.6%). Clinical and radiographic examination revealed that 72% of the traumatized teeth maintained pulp vitality. In the case of supporting-tissue lesions, 51.1% of the patients sought care within 1,15 days after injury, while in the case of hard-tissue injuries, 52.7% sought care only after 16 days. The results showed that supporting-tissue injuries had a significant influence on the faster seeking of dental care. [source] Apexogenesis after initial root canal treatment of an immature maxillary incisor , a case reportINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2010S. R. Kvinnsland Abstract Aim, To present a case where a traumatized, immature tooth still showed capacity for continued root development and apexogenesis after root canal treatment was initiated based on an inaccurate pulpal diagnosis. Summary, Traumatic dental injuries may result in endodontic complications. Treatment strategies for traumatized, immature teeth should aim at preserving pulp vitality to ensure further root development and tooth maturation. A 9-year-old boy, who had suffered a concussion injury to the maxillary anterior teeth, was referred after endodontic treatment was initiated in tooth 21 one week earlier. The tooth had incomplete root length, thin dentinal walls and a wide open apex. The pulp chamber had been accessed, and the pulp canal instrumented to size 100. According to the referral, bleeding from the root made it difficult to fill the root canal with calcium hydroxide. No radiographic signs of apical breakdown were recorded. Based on radiographic and clinical findings, a conservative treatment approach was followed to allow continued root development. Follow-up with radiographic examination every 3rd month was performed for 15 months. Continued root formation with apical closure was recorded. In the cervical area, a hard tissue barrier developed, which was sealed with white mineral trioxide aggregate (MTA). Bonded composite was used to seal the access cavity. At the final 2 years follow-up, the tooth showed further root development and was free from symptoms. Key learning points, ,,Endodontic treatment of immature teeth may result in a poor long-term prognosis. ,,The pulp of immature teeth has a significant repair potential as long as infection is prevented. ,,Treatment strategies of traumatized, immature permanent teeth should aim at preserving pulp vitality to secure further root development and tooth maturation. ,,Radiographic interpretation of the periapical area of immature teeth may be confused by the un-mineralized radiolucent zone surrounding the dental papilla. [source] Laser Doppler flowmetry in endodontics: a reviewINTERNATIONAL ENDODONTIC JOURNAL, Issue 6 2009H. Jafarzadeh Abstract Vascular supply is the most accurate marker of pulp vitality. Tests for assessing vascular supply that rely on the passage of light through a tooth have been considered as possible methods for detecting pulp vitality. Laser Doppler flowmetry (LDF), which is a noninvasive, objective, painless, semi-quantitative method, has been shown to be reliable for measuring pulpal blood flow. The relevant literature on LDF in the context of endodontics up to March 2008 was reviewed using PubMed and MEDLINE database searches. This search identified papers published between June 1983 and March 2008. Laser light is transmitted to the pulp by means of a fibre optic probe. Scattered light from moving red blood cells will be frequency-shifted whilst that from the static tissue remains unshifted. The reflected light, composed of Doppler-shifted and unshifted light, is returned by afferent fibres and a signal is produced. This technique has been successfully employed for estimating pulpal vitality in adults and children, differential diagnosis of apical radiolucencies (on the basis of pulp vitality), examining the reactions to pharmacological agents or electrical and thermal stimulation, and monitoring of pulpal responses to orthodontic procedures and traumatic injuries. Assessments may be highly susceptible to environmental and technique-related factors. Nonpulpal signals, principally from periodontal blood flow, may contaminate the signal. Because this test produces no noxious stimuli, apprehensive or distressed patients accept it more readily than current methods of pulp vitality assessment. A review of the literature and a discussion of the application of this system in endodontics are presented. [source] Determination of pulp vitality in vivo with pulse oximetryINTERNATIONAL ENDODONTIC JOURNAL, Issue 9 2008E. Calil Abstract Aim, To evaluate the use of pulse oximetry as a test for pulp vitality, by comparing in the same patient, the levels of oxygen saturation of the index finger and of the maxillary central incisor and canine teeth without clinically detectable pulp inflammation. Methodology, Seventeen male and female patients aged between 26 and 38 years participated and a total of 32 maxillary central incisor and 32 canine teeth were analysed. Selection criteria required the teeth to have healthy crowns, or with restorations no more than 2 mm in diameter and no clinical and radiographical signs or symptoms of pulp or periapical inflammatory changes. The negative control group consisted of 10 root filled teeth. Measurements were first taken from the index finger of patients. Their teeth were then subjected to a thermal test with refrigerant gas and then to a vitality test with pulse oximetry. Data were analysed by Pearson's and paired t- tests. Results, There were no significant statistical correlations between blood oxygen levels in the index finger and in the teeth of the patient (P > 0.05). There was a statistically significant difference in the oxygen levels between the two tooth groups studied and the index finger (P , 0.002). Mean oxygen values in the index finger of patients were 95% (SD = 1.6), oxygen values in the maxillary central incisor were 91.29% (SD = 2.61) and mean oxygen values in maxillary canine were 90.69% (SD = 2.71). Conclusion, The method determined consistently the level of blood oxygen saturation of the pulp in maxillary central incisor and canine teeth and can therefore be used for pulp vitality testing. Further studies are required to assess the effectiveness and validity of pulse oximetry in determining pulp vitality in traumatized teeth. [source] Assessment of pulp vitality: a reviewINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 1 2009VELAYUTHAM GOPIKRISHNA Background., One of the greatest diagnostic challenges in clinical practice is the accurate assessment of pulp status. This may be further complicated in paediatric dentistry where the practitioner is faced with a developing dentition, traumatized teeth, or young children who have a limited ability to recall a pain history for the tooth in question. A variety of pulp testing approaches exist, and there may be confusion as to their validity or appropriateness in different clinical situations. Aim., The aim of this paper is to provide the clinician with a comprehensive review of current pulp testing methods. A key objective is to highlight the difference between sensitivity testing and vitality testing. A biological basis for pulp testing is also provided to allow greater insight into the interpretation of pulp testing results. The rationale for, and methods of, assessing pulpal blood flow are described. [source] A Prospective Ten-Year Clinical Trial of Porcelain VeneersJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 2 2006Article first published online: 25 APR 200 abstract Objective:, The purpose of this prospective clinical study was to evaluate the performance of porcelain veneers after 5 and 10 years of clinical service. Materials and Methods:, A single experienced clinician placed 87 porcelain veneers in 25 patients in 1990 and 1991. The teeth included maxillary central incisors to first premolars. As described in the 5-year report of this study, preparations included a chamfer margin, 0.3 to 0.7 mm labial enamel reduction, and incisal edge coverage. A single laboratory technician fabricated the veneers using feldspathic porcelain on refractory dies. Internal surfaces were etched with 5% hydrofluoric acid and silanated. Teeth were isolated with a rubber dam prior to veneer placement. All veneers were bonded with a light-activated resin cement. Patients were recalled at 5 to 6 years and at 10 years after initial veneer placement. Two evaluators examined each veneer for retention, fractures, color match, surface roughness, marginal adaptation, leakage, recurrent caries, pulp vitality, and patient satisfaction. Marginal adaptation was assessed further using scanning electron microscopy to examine epoxy replicas. Results:, Five years after placement, all 87 veneers remained in place and had "perfect" color match and surface smoothness. Four veneers had fractures, but only one of those required repair. Ninety-nine percent of the veneers had clinically acceptable marginal adaptation, although just 14% of the veneers had "perfect" marginal adaptation at all margins. One had clinically unacceptable staining from leakage. Recurrent caries was present at the proximal margin of two veneers. At the 10-year evaluation, which had a 93% recall rate, color match and surface roughness remained optimal. Thirteen of 22 patients were very satisfied with the esthetic result, whereas 7 complained of minor esthetic problems. The fracture rate increased substantially, to 34% at the 10-year recall. However, only 11% of the fractures were clinically unacceptable. None of the veneers had debonded, but the percentage of veneers with "perfect" marginal adaptation had declined to only 4%. Leakage was now evident around two-thirds of the veneers, and eight restorations had recurrent caries. Conclusion:, Porcelain veneers are a reliable and effective means for conservative esthetic treatment of anterior teeth in the long term. After 10 years of clinical service, esthetic results remained good, patient satisfaction was high, and the retention rate was excellent. The number of irreparable fractures was low. Appropriate preparation design, occlusion, and use of adhesive materials contribute to the ultimate outcome. [source] | ||||||||||