Evolving Aspects of Endodontic Treatment an Introduction to the Issue

Total Page:16

File Type:pdf, Size:1020Kb

Evolving Aspects of Endodontic Treatment an Introduction to the Issue April 2018 Bacteria and the Root Canal System Cone Beam CT and Endodontic Treatment Prospects of Regrowing Pulps JournaCALIFORNIA DENTAL ASSOCIATION EVOLVING ASPECTS OF ENDODONTIC TREATMENTLEIF K. BAKLAND, DDS “I was convinced from my first order. The savings are very impressive!” —Dr. R in San Luis Obispo County, CA More shoppers. More savings for everyone. Join CDA members who are enjoying less overhead and more control. They’re sharing in big group purchasing benefits by shopping the TDSC Marketplace. See 20% average savings,* plus free shipping, on 25,000 dental supplies from authorized vendors. Shop, save and share today at tdsc.com. The Dentists Service *Price comparisons are made to the manufacturer’s list price. Actual savings on the TDSC Marketplace Company will vary on a product-by-product basis. April 2018 CDA JOURNAL, VOL 46, Nº4 DEPARTMENTS 209 The Editor/The TDSC Marketplace and You 213 Letter to the Editor 215 Impressions 269 RM Matters/Spring Cleaning Isn’t Limited to the Offi ce: Update Patient Records To Mitigate Risks 273 Regulatory Compliance/Managing Emergency Patients 278 Tech Trends 215 FEATURES 221 Evolving Aspects of Endodontic Treatment An introduction to the issue. Leif K. Bakland, DDS 227 Can We Eliminate Microorganisms From the Root Canal System? This article discusses the current status of irrigation effectiveness and progress. Markus Haapasalo, DDS, PhD 237 Can Use of Cone Beam Computed Tomography Have an Effect on Endodontic Treatment? This paper reviews the most updated guidelines for use of CBCT to illustrate the effects this has on clinical endodontic practice. Robert S. Roda, DDS, MS 249 Can We Regrow Pulps? This manuscript discusses techniques for managing teeth that will allow continued root development in young patients. Paul V. Abbott, BDS, MDS 260 Implant Dentistry and Endodontics: Can There Be a Mutually Beneficial Relationship? This article reports on the value of dental implants when indicated and the coexistence of endodontics and implant dentistry. Tory Silvestrin, DDS, MSD, and Charles J. Goodacre, DDS, MSD APRIL 2018 207 CDA JOURNAL, VOL 46, Nº4 Volume 46, Number 4 JournaCALIFORNIA DENTAL ASSOCIATION April 2018 CDA Classifieds. Free postings. published by the Editorial Production Manuscript California Kerry K. Carney, DDS, CDE Val B. Mina Submissions EDITOR-IN-CHIEF SENIOR GRAPHIC DESIGNER Priceless results. Dental Association www.editorialmanager. 1201 K St., 14th Floor [email protected] com/jcaldentassoc Sacramento, CA 95814 Randi Taylor SENIOR GRAPHIC DESIGNER 800.232.7645 Ruchi K. Sahota, DDS, CDE ASSOCIATE EDITOR cda.org Letters to the Editor Upcoming Topics www.editorialmanager. Brian K. Shue, DDS, CDE May/General Topics com/jcaldentassoc CDA Offi cers ASSOCIATE EDITOR Natasha A. Lee, DDS June/Millennial Dentists PRESIDENT Gayle Mathe, RDH July/Student Research Subscriptions SENIOR EDITOR [email protected] Subscriptions are available only to active members of R. Del Brunner, DDS Leif K. Bakland, DDS Advertising the Association. The PRESIDENT-ELECT GUEST EDITOR Sue Gardner subscription rate is $18 and [email protected] ADVERTISING SALES is included in membership Andrea LaMattina, CDE [email protected] dues. Nonmembers can PUBLICATIONS MANAGER Richard J. Nagy, DDS 916.554.4952 view the publication online VICE PRESIDENT at cda.org/journal. [email protected] Kristi Parker Johnson EDITORIAL SPECIALIST Permission and Manage your subscription Judee Tippett-Whyte, DDS Reprints online: go to cda.org, log in SECRETARY Blake Ellington Andrea LaMattina, CDE and update any changes to TECH TRENDS EDITOR [email protected] PUBLICATIONS MANAGER your mailing information. [email protected] Email questions or other Steven J. Kend, DDS Jack F. Conley, DDS 916.554.5950 changes to membership@ TREASURER EDITOR EMERITUS cda.org. [email protected] CDA classifiedsclassifieds workwork harder to Robert E. Horseman, DDS HUMORIST EMERITUS bbringring you resuresults.lts. SeSellinglling a practice Craig S. Yarborough, DDS, MBA or a piece ooff equipment? Now you SPEAKER OF THE HOUSE [email protected] can include photos to help buyers Stay Connected cda.org/journal Clelan G. Ehrler, DDS see the potential. IMMEDIATE PAST PRESIDENT [email protected] And if you’re hiring, candidates Management Journal of the California Dental Association (ISSN 1043–2256) is published monthly by the anywhere can apply right from California Dental Association, 1201 K St., 14th Floor, Sacramento, CA 95814, 916.554.5950. Peter A. DuBois Periodicals postage paid at Sacramento, Calif. Postmaster: Send address changes to Journal the site. Looking for a job? You can EXECUTIVE DIRECTOR of the California Dental Association, P.O. Box 13749, Sacramento, CA 95853. post that, too. And the best part— Jennifer George The California Dental Association holds the copyright for all articles and artwork published it’s free to all CDA members. CHIEF MARKETING OFFICER herein. The Journal of the California Dental Association is published under the supervision of CDA’s editorial staff . Neither the editorial staff , the editor, nor the association are responsible for Carrie E. Gordon any expression of opinion or statement of fact, all of which are published solely on the authority All of these features are designed to CHIEF STRATEGY OFFICER of the author whose name is indicated. The association reserves the right to illustrate, reduce, help you get the results you need, revise or reject any manuscript submitted. Articles are considered for publication on condition Alicia Malaby that they are contributed solely to the Journal. faster than ever. Check it out for COMMUNICATIONS DIRECTOR Copyright 2018 by the California Dental Association. All rights reserved. yourself at cda.org/classifieds. 208 APRIL 2018 Editor CDA JOURNAL, VOL 46, Nº4 The TDSC Marketplace and You Kerry K. Carney, DDS, CDE hen I was a child, we would order our shoes from the For the Marketplace to succeed and support Sears, Roebuck and our members, CDA members need to support Company catalog. I the Marketplace by using it to buy supplies. Wcan remember my mother tracing around my foot to record my footprint on a piece of paper that she would then send to the mail- order company. After some weeks, the box would arrive with my new penny loafers. It The Dentists Service Company is The staff member who does the ordering was easy and convenient. We did not have striving to recreate that experience for will have to change the way she or he has to drive into a big city to purchase shoes. our CDA members when we order dental ordered for years. This can be diffi cult. Sears and Roebuck began as a watch supplies through the TDSC Marketplace. There are issues of friendship, trust, loyalty, and jewelry mail-order company in 1893. The Marketplace was established to provide ease and familiarity. They may have had Rural areas at that time offered a limited CDA members with the same advantage the same dental supply representative for variety of items at prices that varied that large group practices enjoy in securing years. It can feel like a betrayal of a friend. according to the vendor’s inclination. favorable pricing. The price-negotiating Also, in some offi ces the dental supply rep The mail-order company expanded and power of CDA’s 27,000 members can does the inventory and restocking, thereby became successful because it offered a wide translate into reductions in overhead and saving the staff member the physical effort. selection of products at set, listed prices. In overall cost of providing patient care. But though this cooperation on the part 1906, Sears went public and was the fi rst For the Marketplace to succeed and of the rep may seem like it is free, we all major retail IPO in American fi nancial support our members, CDA members know the cost is part of the calculus that history. In the three decades between 1925 need to support the Marketplace by determines the supply prices. Sometimes and 1955, Sears expanded into brick-and- using it to buy supplies. This sounds the supply ordering may be the job of a staff mortar stores and the sales from those easy. The pricing is very good and the member who does not feel comfortable stores eventually exceeded the mail-order shipping is free. If they do not have the with the computer. This can make it revenue. In 1993, Sears discontinued its item you are looking for, they will try to hard to switch over to the online site. catalog. The company continued to expand source it for you so it will be available Therefore, it may be necessary to assign and its profi ts peaked at $1.5 billion in in the future. They are eager for your the job to another more computer-savvy 2006. However, just four years later, their feedback and will adapt to your needs and member of the offi ce team. Sometimes profi ts plummeted to virtually nothing. suggestions. It is easy to reach a human the hard job of changing gets in the way. The irony here is that in 1994, just to speak to for customer support and they In my offi ce, I was very excited about one year after Sears discontinued its strive for excellence in every customer the Marketplace. I introduced my staff catalog business, Jeff Bezos incorporated interaction. But I want to advise you of to it and said, “This is where we want to the company that would eventually one hurdle that you must overcome. place our orders.” I checked in a few days be known as Amazon. The mail-order When I talk with colleagues about later and asked, “Did you order this from business that had been abandoned by Sears the Marketplace, they “get it” right away. TDSC?” The answer was no. I explained was reinvented and became the online They understand how it can help their again that we wanted to support TDSC immediate-gratifi cation machine and the practices and they want to support an and place our orders there.
Recommended publications
  • Management of Anterior Spacing with Peg Lateral by Interdisciplinary Approach : a Case Report
    Case Report Management of Anterior Spacing with Peg Lateral by Interdisciplinary Approach : A Case Report Dr Sanjay Prasad Gupta Assistant Professor & Consultant Orthodontist, Department of Orthodontics, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu Correspondence: Dr Sanjay Prasad Gupta; Email: [email protected] ABSTRACT Anterior spacing is a common esthetic problem of patient during dental consultation. The most common etiology include tooth size and arch length discrepancy. Maxillary lateral incisors vary in form more than any other tooth in the mouth except the third molars. Microdontia is a condition where the teeth are smaller than the normal size. Microdontia of maxillary lateral incisor is called as “peg lateral”, that exhibit converging mesial and distal surfaces of crown forming a cone like shape. A carefully documented diagnosis and treatment plan are essential if the clinician is to apply the most effective approach to address the patient’s needs. A patient sometimes requires a multidisciplinary approach to correct the esthetics and to improve the occlusion. This case report describes the management of an adult female patient with a proclined upper anterior teeth, upper anterior spacing, deep bite and peg shaped upper right lateral incisor tooth through orthodontic and restorative treatment approach. Key words: Anterior spacing, Peg lateral, Esthetic, Interdisciplinary approach INTRODUCTION Peg shaped lateral incisors occur in approximately 2% to 5% of the general population, and women show a Maxillary lateral incisors vary in form more than any slightly higher frequency than men. Usually they are found other tooth in the mouth except the third molars. If the equally on the right and left, uni or bilaterally, however variation is too great, it is considered a developmental some studies have shown their bilateral occurrence anomaly.1 Developmental alterations which are most slightly higher than the unilateral occurrence.
    [Show full text]
  • Dental Anomalies: Foundational Articles and Consensus Recommendations, 2021
    Dental Anomalies: Foundational Articles and Consensus Recommendations, 2021 Adekoya-Sofowora CA. Natal and neonatal teeth: a review. Niger Postgrad Med J 2008;15:38-41 Al-Ani AH, Antoun JS, Thomson WM, Merriman TR, Farella M. Hypodontia: An Update on Its Etiology, Classification, and Clinical Management. Biomed Res Int. 2017:9378325. doi.org/10.1155/2017/9378325. Anthonappa RP, King NM, Rabie AB. Aetiology of supernumerary teeth: A literature review. Eur Arch Paediatr Dent. 2013;14:279-88. Dashash, M. Yeung CA, Jamous I, Blinkhorn A. Interventions for the restorative care of amelogenesis imperfecta in children and adolescents. Cochrane Database Syst Rev 2013;6:CD007157. Gallacher A, Ali R, Bhakta S. Dens invaginatus: diagnosis and management strategies. Br Dent J 2016;221:383-7. Gill DS, Barker CS. The multidisciplinary management of hypodontia: a team approach. Br Dent J 2015;218:143-9. Khalaf K, Miskelly J, Voge E, Macfarlane TV. Prevalence of hypodontia and associated factors: a systematic review and meta-analysis. J Orthod. 2014; 41:299-316. Lammi L. Arte S, Somer M, Javinen H, et al. Mutations in AXIN2 cause familial tooth agenesis and predispose to colorectal cancer. Am. J. Hum. Genet. 2004, 74:1043–1050. Marvin ML, Mazzoni S, Herron CM, Edwards S, et al. AXIN2-associated autosomal dominant ectodermal dysplasia and neoplastic syndrome. Am J Med Genet A. 2011,155 898–902. Seow WK. Developmental defects of enamel and dentine: Challenges for basic science research and clinical management. Aust Dent J 2014;59:143-54. Shields ED, Bixler D, El-Kafrawy AM. A proposed classification for heritable human dentine defects with a description of a new entity.
    [Show full text]
  • Supernumerary Premolars Associated with Dens Evaginatus: Report of 2 Cases
    C LINICAL P RACTICE Supernumerary Premolars Associated with Dens Evaginatus: Report of 2 Cases • Shiu-yin Cho, BDS, MDS • Abstract Dens evaginatus is a dental anomaly found predominantly in people of Mongoloid origin. Dentists practising in Western countries should also be aware of this condition because of the increasing migration of people from Asia. Supernumerary premolars are uncommon but may be found incidentally during radiographic examination of teeth with dens evaginatus. This article reports 2 cases of concomitant occurrence of supernumerary premolars and dens evaginatus. The presence of a supernumerary premolar in 1 quadrant is an indication for radiographic examination of all other premolar regions. MeSH Key Words: bicuspid/anomalies; tooth abnormalities/diagnosis; tooth, supernumerary/diagnosis © J Can Dent Assoc 2005; 71(6):390–93 This article has been peer reviewed. upernumerary teeth are teeth in excess of the number opment.1,14 Environmental factors, however, may also play a found in the normal series.1 The prevalence of super- part. The association of supernumerary premolars with dens S numerary teeth in the permanent dentition of the evaginatus has been reported only infrequently.10 This article white population is about 2% to 3%, and about 90% of all reports 2 cases of concomitant occurrence of supernumerary supernumerary teeth occur in the premaxilla.2–5 premolars and dens evaginatus. Supernumerary premolars have been reported to represent 3% to 9% of all supernumerary teeth, and their prevalence Case Reports ranges from 0.29% to 0.64%.4–7 Case 1 Dens evaginatus is a developmental anomaly that mani- A 12-year-old Chinese girl attended the author’s clinic fests as a tubercle emerging from the surface of the affected for a regular checkup.
    [Show full text]
  • Dens Evaginatus: a Problem-Based Approach
    Hindawi Publishing Corporation Case Reports in Dentistry Volume 2015, Article ID 393209, 4 pages http://dx.doi.org/10.1155/2015/393209 Case Report Dens Evaginatus: A Problem-Based Approach A. Ayer,1 M. Vikram,1 and P. Suwal2 1 Department of Conservative Dentistry & Endodontics, B.P. Koirala Institute of Health Sciences, Dharan 56700, Nepal 2Department of Prosthodontics, B.P. Koirala Institute of Health Sciences, Dharan 56700, Nepal Correspondence should be addressed to A. Ayer; [email protected] Received 24 August 2015; Revised 25 November 2015; Accepted 26 November 2015 Academic Editor: Yousef S. Khader Copyright © 2015 A. Ayer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by the presence of tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth. Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case report is about the presentation of dens evaginatus in mandibular premolars bilaterally; among them tooth 44 was associated with chronic apical periodontitis. Fractured tubercle of three premolars was sealed with composite resin. Root canal treatment was performed with tooth 44. Routine endodontic treatment did not result in remission of infection. Therefore, culture and sensitivity tests were performed to identify the cause and modify treatment plan accordingly. Triple antibiotic paste was used as an intracanal medicament to disinfect the root canal that resulted in remission of infection.
    [Show full text]
  • Dens Evaginatus and Dens Invaginatus in Maxillary Lateral Incisor: Report of Two Cases
    10.5005/jp-journals-10026-1037 ParasCASE Mull REPORT Gehlot et al Concurrent Occurrence of Developmental Anomalies— Dens Evaginatus and Dens Invaginatus in Maxillary Lateral Incisor: Report of Two Cases Paras Mull Gehlot, Vinutha Manjunath, MK Manjunath ABSTRACT • Type II (Semitalon): An additional cusp of a millimeter or Developmental anomalies affecting tooth morphology are common more but extending less than half the distance from the in the literature. Dens evaginatus (DE) occurring in anterior tooth, CEJ to the incisal edge. termed ‘talon cusp’ is a relatively rare developmental anomaly. It • Type III (Trace talon): Enlarged or prominent cingula and presents as an additional cusp that project predominantly from their variations, i.e. conical, bifid or tubercle-like. the lingual surface of primary or permanent anterior teeth. Dens invaginatus (DI) is a developmental anomaly resulting from infolding Histologically, it is composed of normal enamel and dentin of the tooth crown or root before calcification has occurred. and it may or may not contain pulpal tissue.2 Clinically DE Concurrent occurrence of DE and DI within the same tooth is 4 rare. The present article reports two cases with concurrent can pose esthetic and functional problems to the patient. occurrence of DE and DI in permanent maxillary lateral incisor. In Dens invaginatus (DI) is a developmental anomaly due to case 1 the DE and DI are associated with nonvital tooth and in a deepening or invagination of the enamel organ into the case 2 the DE and DI are associated with a vital tooth. The dental papilla prior to calcification of the dental tissues.5 management aspects are discussed.
    [Show full text]
  • Journal Spring 2009.Indd
    EDITORIAL JOURNAL OF THE THE FUTURE IS NOW MASSACHUSETTS DENTAL SOCIETY E ARE LIVING IN EXPONENTIAL TIMES. THE TOP 10 IN-DEMAND JOBS IN 2010 DID NOT EXIST Win 2004. EDITOR • One out of eight couples in the United States last year met online. David B. Becker, DMD • There are more than 200 million registered users on MySpace. ASSISTANT EDITOR • There are 31 billion searches on Google each month; there were 2.7 billion in 2006. Arthur I. Schwartz, DMD • The fi rst commercial text message was sent in December 1992. Today the number of text messages sent and received daily exceeds the total population of the planet. EDITOR EMERITUS • The amount of new technical information is doubling every two years. This Norman Becker, DDS means that for students starting a four-year technical degree, half of what they MANAGING EDITOR OF learn in their fi rst year of study will be outdated by their third year of study. PUBLICATIONS AND WEB SITE • A fi ber-optic cable has been developed that pushes 14 trillion bits per second Melissa Carman down a single strand of fi ber. That is the equivalent of 2,660 CDs or 210 million MANAGER, GRAPHIC DESIGN phone calls every second. This capacity is currently tripling every six months Jeanne M. Burdette and is expected to do so for the next 20 years. • Predictions are that by 2049, a $1,000 computer will exceed the computational GRAPHIC DESIGNER capabilities of the entire human species. Shelley Padgett Even the source of the information cited above—a slideshow video presentation on YouTube entitled “Did You Know?” (originally created by Colorado high school Editorial Board teacher Karl Fisch and updated by Iowa State University professor Scott McLeod, JD, PhD)—attests to this phenomenal growth in technology.
    [Show full text]
  • Dens Evaginatus of Anterior Teeth (Talon Cusp): Report of Five Cases
    Restorative Dentistry Dens evaginatus of anterior teeth (talon cusp): Report of five cases Juan J. Segura-Egea, DDS, MD, PhD1/Alicia Jiménez-Rubio, DDS, MD, PhD2/ José V. Ríos-Santos, DDS, MD, PhD3/Eugenio Velasco-Ortega, DDS, MD, PhD3 The talon cusp, or Dens evaginatus of anterior teeth, is a relatively rare dental developmental anomaly characterized by the presence of an accessory cusplike structure projecting from the cingulum area or ce- mentoenamel junction. This occurs in either maxillary or mandibular anterior teeth in both the primary and permanent dentition. This article reports five cases of talon cusp, two of them bilateral, affecting perma- nent maxillary central and lateral incisors and canines that caused clinical problems related to caries or occlusal interferences. (Quintessence Int 2003;34:xxx–xxx) Key words: dens evaginatus, dental anomalies, occlusal interference, talon cusp ens evaginatus is a developmental anomaly char- volved (67%), followed by the central incisors (24%) Dacterized by the presence of an extra cusp, occur- and canines (9%).7,8 ring more frequently in mandibular premolars.1 In ca- Family histories of cases reported previously re- nines and incisors, Dens evaginatus originates usually vealed that sometimes talon cusp affected patients who in the palatal cingulus as a tubercle projecting from had consanguineous parents.6,9 Moreover, there are sev- the palatal surface; however, the anomaly also has af- eral dates [Au: What is meant by “dates?” Reports?] fected the labial surface of the tooth.2,3 Mitchell4 first in the literature that support the hereditary character of described this dental anomaly as a “process of horn- talon cusp: the anomaly has been described affecting like shape, curving from the base downward to the two siblings,10,11 two sets of female twins,12 and two cutting edge” on the lingual surface of an maxillary family members,9 and the prevalence of talon cusp is central incisor of a female patient.
    [Show full text]
  • QUICK ORAL HEALTH FACTS ABOUT the YOUNG Dr Ng Jing Jing, Dr Wong Mun Loke
    ORAL health IN PRIMARY CARE UNIT NO. 2 QUICK ORAL HEALTH FACTS ABOUT THE YOUNG Dr Ng Jing Jing, Dr Wong Mun Loke ABSTRACT Table 1. Eruption sequence of Primary Dentition This article sheds light on the sequence of teeth eruption Primary Upper Teeth Primary Lower Teeth in the young and teething problems; highlights the importance and functions of the primary dentition and Central Incisors: 8-13 months Central Incisors: 6-10 months provides a quick overview of common developmental Lateral Incisors: 8-13 months Lateral Incisors: 10-16 months dental anomalies and other dental conditions in Canines: 16-23 months Canines: 16-23 months children. First Molars: 16-23 months First Molars: 13-19 months Second Molars: 25-33 months Second Molars: 23-31 months SFP2011; 37(1) Supplement : 10-13 Table 2. Eruption sequence of Adult Dentition Adult Upper Teeth Adult Lower Teeth INTRODUCTION Central Incisors: 7-8 years Central Incisors: 6-7 years The early years are always full of exciting moments as we observe Lateral Incisors: 8-9 years Lateral Incisors: 7-8 years our children grow and develop. One of the most noticeable Canines: 11-12 years Canines: 9-10 years aspects of their growth and development is the eruption of First Premolars: 10-11 years First Premolars: 10-11 years teeth. The first sign of a tooth in the mouth never fails to Second Premolars: 11-12 years Second Premolars: 11-12 years attract the attention of the parent and child. For the parent, it First Molars: 6-7 years First Molars: 6-7 years marks an important developmental milestone of the child but Second Molars: 12-13 years Second Molars: 11-13 years for the child, it can be a source of irritation brought on by the Third Molars: 18-25 years Third Molars: 18-25 years whole process of teething.
    [Show full text]
  • CASE REPORT Multiple Dens Evaginatus
    CASE REPORT Multiple dens evaginatus: diagnosis, management, and complications: case report Elsa A. Echeverri, DDSMing M. Wang, DDS, MS CarmenChavaria, DDSD. Lance Taylor, DDS Abstract Dens evaginatus is a disturbance in tooth formation that appears clinically as an accessory occlusal tuberculated cusp composedof enamel and dentin, usually enclosing pulp tissue. The tubercle often fractures or is worn away, with subsequent pulp exposureleading to pulpal inflammation, necrosis, and periapical inflammation. Whenthis happensto an immaturetooth, diagnosis maybe complicatedby the similarity in radiographicappearance of the periapical lesion and the dental follicle. The managementof such teeth maybe complicated because of their immaturity. A case report of multiple abradeddens evaginatus with pulp necrosis is presentedthat illustrates 1) the difficulty of diagnosingotherwise apparentlyhealthy teeth associatedwith periapical lesions and sinus tracts, and 2) their managementand treatment complications including recurrent infections and root fractures. (Pediatr Dent 16:314-17, 1994) Literature review obvious etiology for a pulpitis such as caries or trauma. Dens evaginatus is an anomalous tooth develop- Immature root development in a young patient makes ment arising during morphodifferentiation. It is caused managing the affected teeth a problem. by abnormal proliferation of the inner enamel epithe- Case report 1 lium into the stellate reticulum of the enamel organ Pasthistory with a core of dentin surrounding a narrow extension 2 A 11-year-old Hispanic boy was referred to the Uni- of the pulp tissue projecting into the tubercle. It is also versity of Texas -- Houston, Health Science Center, referred to as tuberculated cusp, accessory tubercle, Dental Branch, Pediatric Dentistry Emergency Clinic occlusal tuberculated premolar, Leong’s premolar, by a pediatrician in November1990.
    [Show full text]
  • Dens Evaginatus in Hemophilic Patient. a Case Report
    Int. J. Morphol., 28(2):375-378, 2010. Dens evaginatus in Hemophilic Patient. A Case Report Dens Evaginatus en un Paciente Hemofílico. Reporte de un Caso Eduardo Borie E.; Gonzalo Oporto V. & Daniel Aracena R. BORIE, E. E.; OPORTO, V. G. & ARACENA, R. D. Dens evaginatus in hemophilic patient. A case report. Int. J. Morphol., 28(2):375- 378, 2010. SUMMARY: Tooth development occurs through the interaction between oral tissues during embryogenesis. Alteration through odontogenesis may cause tooth morphological alterations, one of these could be Dens evaginatus. This anatomical variation could be originated from an abnormal proliferation and folding of a portion of the inner enamel epithelium and subjacent ectomesenchymal cells of the dental papilla into the stellate reticulum of the enamel organ during the bell stage of tooth formation. Dens evaginatus is defined as a tubercle, or supplemental solid elevation on some portion of the crown surface. Inadequate clinical management of these teeth may result in a pulpal exposure and possible loss of vitality of the tooth. The research wants to report a case of Dens evaginatus in a permanent mandibular premolar requiring endodontic treatment. A 13-year old male patient attended the Dental Service of a local Hospital, reporting pain the lower left side of the jaw. He reported to be in medical treatment for hemophilia. During an intra oral examination, the left side in the mandible exhibited a multitubercular appearance of left premolars which suggest. Patient shows a sinus tract related to tooth 3, 4, which was sore to palpation and percussion. In radiographic analysis a radio-opacity appeared in the tubercle area of the tooth.
    [Show full text]
  • A Novel Presentation of a Molariform Supplemental Tooth with Dens Evaginatus Concrescent with a Maxillary Premolar
    Journal of Dentistry and Oral Hygiene Vol. 3(1), pp.1-5, January 2010 Available online at http://www.academicjournals.org/JDOH ISSN 2141-2472 ©2011 Academic Journals Case Report A novel presentation of a molariform supplemental tooth with dens evaginatus concrescent with a maxillary premolar Pramod Jain1, Rajeev Kumar Garg2*, Pooja Narain3 and Anjali Kapoor1 1Department of Periodontology and Implant Dentistry, Government Dental College and Hospital, Jaipur Rajasthan, India. 2Dental Surgery Clinic, Jaipur Rajasthan, India. 3Department of Oral Pathology and Microbiology, Jaipur Dental College and Hospital, Jaipur Rajasthan, India. Accepted 20 December, 2010 Concrescence can occur between two adjacent normal teeth or it can also happen between a normal and a supernumerary tooth. Dens evaginatus are uncommon and usually arise from the occlusal surfaces of mandibular premolars or the palatal surfaces of the maxillary incisors. Evaginatus odontomes have rarely been seen associated with supernumerary teeth. We describe a very rare combination of supplemental tooth with dens evaginatus concrescent with a maxillary first premolar in an otherwise healthy 13 years old boy with a chief complaint of discomfort in maxillary left quadrant. Recognition of these conditions and early diagnosis are important to avoid complications. Key words: Concrescence, dens evaginatus, evaginatus odontome, molariform supernumerary tooth. INTRODUCTION Concrescence is an uncommon developmental twinning arising from concrescence may lead to legal issues. anomaly in which juxtaposed teeth are united in the Supernumerary teeth are teeth in excess of the number cementum but not in the dentin. The incidence of found in the normal series. The prevalence of concrescent teeth is reported to be highest in the supernumerary teeth in the permanent dentition is about posterior maxilla (Echeverri et al., 1994) complicating 2 to 3%, and about 90% of all supernumerary teeth occur exodontia and influencing endodontic, orthodontic, in the premaxilla.
    [Show full text]
  • A Guide to the Endodontic Literature Success & Failure
    A Guide to the Endodontic Literature Success & Failure: Authors Description European Soc. Definition of Success: Clinical symptoms originating from an endodontically-induced apical periodontitis should neither persist nor develop after RCT Endodontology (1994 IEJ): and the contours of the PDL space around the root should radiographically be normal. AAE Quality Assurance Objectives of NSRCT (= nonsurgical root canal treatment) Guidelines · Prevent adverse signs or symptoms · Remove RC contents · Create radiographic appearance of well obturated RC system · Promote healing and repair of periradicular tissues · Prevent further breakdown of periradicular tissues The Mantra: · Apical periodontitis (=AP; = periapical radiolucency =PARL) is caused primarily by bacteria in RC systems (Sundqvist 1976; Kakehashi 1965; Moller 1981) · If bacteria in canal systems are reduced to levels that are not detected by culturing, then high success rates are observed (Bystrom 1987; Sjogren 1997) · Best documented results for canal disinfection are chemomechanical debridement with Ca(OH)2 for at least 1week (Sjogren 1991) · Mechanical instrumentation alone (C&S) reduces bacteria by 100-1,000 fold. But only 20-43% of cases show complete elimination (Bystrom 1981; Bystrom & Sundqvist 1985) · Do C&S and add 0.5% NaOCl produces complete disinfection in 40-60% of cases (Bystrom 1983) · Do C&S with 0.5% NaOCl and add one week Ca(OH)2: get complete disinfection in 90-100% of cases (Bystrom 1985; Sjogren 1991). Problems with the Mantra · Koch’s postulates cannot be applied
    [Show full text]