78 research outputs found
Evolving New Strategies for Periodontal, Endodontic, and Alveolar Bone Regeneration
No full textThis chapter describes evolving experimental approaches that are geared toward periodontal/bone regeneration. Currently, the pinnacle of regenerative periodontal treatment is the use of bone substitutes combined with barrier membranes, which already demonstrates how far we have progressed from the old resective approaches that dominated the field. Thus, the focus of the clinical repertoire shifted from a purely surgical to biologically oriented treatment of the detrimental effects of periodontal disease and bone defects that may prevent future implant placement. The continuous presence of bacteria at the tooth-epithelium or implant-epithelium junction results in a progressive inflammatory process, which leads to the destruction of the gingival connective tissue and subsequently of the alveolar bone, periodontal ligament (PDL), and cementum on the root surface. This process, when left undisturbed, will lead eventually to the loss of the involved tooth or implant. Not only is this loss of periodontal support detrimental to the stability and function of the tooth or implant, it also hampers the restoration of the diseased area with implants following the removal of the ailing tooth/implant. Therefore, the clinical art of periodontology has been paying a tremendous amount of attention to periodontal regeneration
Medicolegal consideration in endodontics:general and surgical aspects
No full textPatient injuries in relation to medical treatment and in particular conventional or surgical endodontics might under certain circumstances trigger a wish for economical compensation. In many parts of the world, the patient would have to take the practitioner into a civil court to get compensation. However, in a number of countries, there is a legislation which deals with injuries in relation to medical treatment and compensation. Medicolegal considerations in relation to endodontic treatment are in a few countries particularly detailed. Endodontic complaints and insurance cases are relatively frequently occurring. A subcategorization of endodontic complaints shows that the suboptimal root filling represents a potential risk for complaints. Endodonticsurgery as an area of claim per se seems lesser involved than conventional endodontics. Statistics about endodontic claims may indicate where risk management and educational efforts can be most effectively directed to improve the standard of care. “Lessons to learn” are presented only in cases where the “complained tooth” has been treated with the use of endodontic surgery.</p
Medico-legal aspects of altered sensation following endodontic treatment : a retrospective case series
No full textObjective: The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication. Study design: A comprehensive search of an Israeli professional liability insurance database was conducted to retrospectively identify and analyze cases of persistent altered sensation following endodontic treatment. Results: Sixteen claims of persistent altered sensation following endodontic treatments were identified and analyzed. The typical profile of a claim was a female patient who underwent an endodontic treatment at a second mandibular molar, which was associated with overfilling. A significant correlation between the tooth location and the suggested cause of nerve injury was found. None of the claims were reported by the practitioners, and all cases were identified as a result of the patient's demand for financial compensation, either directly or by legal actions. Conclusions: When a nerve injury is diagnosed, the treating practitioner should be encouraged to seek medical and legal assistance so as to prevent permanent damage and to enable a better medico-legal response
Endoscopic minimally invasive management of a periradicular lesion invading the maxillary sinus
No full textA referred patient presented with a lesion of endodontic origin located at the apex of tooth #27. The tooth had been endodontically treated and re-treated. A periapical radiograph revealed a close relationship between the lesion and the maxillary sinus. A cone-beam computed tomography scan confirmed that the lesion had invaded the sinus cavity. The treatment plan consisted of periapical surgery using an endoscope as a magnification device. Due to a sinus membrane perforation, a new sinus membrane repair technique was performed. Twelve months after surgery, a cone-beam computed tomography scan revealed successful healing of the lesion. The continuous preservation of the sinus physiology was also observed. The use of an endoscope as a magnification device and a tailored technique for sinus membrane management allowed us to achieve a successful treatment outcome in the case of an endodontic lesion invading the maxillary sinus
A new surgical technique for preservation of endodontically treated teeth with coronally located vertical root fractures: a prospective case series
No full textOBJECTIVE:
The purpose of this study was to present a new surgical preservation technique for teeth with incomplete vertical root fracture.
STUDY DESIGN:
Seventeen patients with 1 endodontically treated maxillary anterior tooth in which an incomplete vertical root fracture involving only the buccal side was suspected underwent a flap elevation procedure to visualize the pattern of bone loss and assess the type of root fracture. If the preoperative diagnosis was confirmed, a groove following the fracture line was prepared using retro-tips driven by an ultrasonic device and sealed with mineral trioxide aggregate after filling of the bone defect with calcium sulfate.
RESULTS:
A total of 10 vertical root fracture repair procedures were performed. At 12 months' follow-up, all cases showed clinical and radiographic success. After 33 months, 7 patients were available for a follow-up: 5 cases remained successful, and 2 teeth (lateral incisors) failed.
CONCLUSIONS:
The present surgical approach for preservation of teeth with incomplete vertical root fracture demonstrated satisfactory results regarding clinical outcome
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