UMKC Spreadsheet Random Part 3 Flashcards
Non-healing endo Samples from failing NS RCT, found microorganisms in 71%, fungi in 7%,
Waltimo, Haapasalo, 1997
3 Visit Endo supported 83% one step, 71% two steps (all had PAR)
Weiger, 2000
PAR vs. No PAR 96% w/o PAR, 86% w/PAR (10% difference)
Sjogren (1990)
DB and P root of Mx 1M 100% - 1 canal
Vertucci, 1984
Bacteria needed for PAR Human:32 traumatized teeth; PAR only when bacteria present in RCS, Sterile necrotic pulp = no PAR; pain increased with # of bacterial species
Sundqvist, 1976
Getting thermafills out System B at 225 degrees to insert to 10-15 mm for 6-8 sc. Then weave files and pull. Careful - melting point of plastic carrier = 300 degrees C
Wolcott, Himel, Hicks, 1999
Getting thermafills out Retreating theramafills, bypass with Hedstrom and pull
Wilcox, 1993
Pathogenesis 2 things necessary for resorption: 1) loss of protective layer (pre-cementum, pre-dentin); 2) inflammation
Trope, 1998
Predictors of post-op pain Best predictors of post op pain is pre-op pain or swelling
Walton, Fouad, 1992
Anachoresis - refuted Famous monkey study - no bacteria found in apical granuloma, inflammatory lesion prevents spread of bacteria confining them to RCS
Walton, 1992
Pathogenesis Reviews
Torabinejad, Kettering
Remove smear layer? Smear layer removal reduced the leakage of bacteria through the RCS
Walton, 2003 (Remove)
RETX own case? Re-treating one’s own failures, unlikely to debride new areas because instrumentation would only enlarge in same direction as first preparation
Wilcox, 1991
Remove smear layer? Smear layer removed best with 17% EDTA followed by 5.25% NaOCl
Yamada, 1983
Coronal Seal 3 days exposure to saliva, extensive coronal leakage to a tracer dye through apparently intact root fillings
Swanson, 1987
Lack of correlation of clinical testing and Histology Poor correlation of clinical testing result and actual histology of pulp
Seltzer, Bender, 1963
Referred Pain Acute pain can be referred to ipsilateral opposite arch (Md left to Mx left)
Sharav, 1984
Hollow Tube Theory Disputed Hollow Tube Theory - sterile empy polyethylene tubes healed in rat connective tissue
Torneck, 1966
Why do some PARs not heal? Review
Simon
Md 1M 64% - 3 canals, 29% - 4 canals
Skidmore, 1971
Flare-ups Flareup Incidence = 3%; pre-op pain is best predictor
Walton, 1992
Immune components involved Demonstrated neuropeptides in the pulp (Substance P, CGRP, NKA, NPY & VIP)
Stashenko, 1999
Compact Gutta-percha as it cools As gutta-percha cools and solidifies, shrinkage of 1-2% occurs, so compact as it cools during obturation
Wong, 1981
Strange morphology Of unusual or aberrant morphologies, 60% of time it was seen bilaterally
Sabala, 1994
Methods Described Walking bleach, Na perborate walking bleach
Spasser, 1961
Minimizing resorption Recommended placing a 2 mm base at CEJ to preclude resorption from internal bleaching, 10% of cases - cementum and enamel don’t meet
Rotstein, 1991
Access when cutting access, remember that pulp chamber is in center of crown, classic access is too far mesially
Wilcox, Walton, 1989
Tooth survival data Outcomes of 4744 teeth over 5 yrs after RETX in Delta Dental plans; 89% of teeth retained 5 yrs after RETX
Salehrabi, Rotstein, 2010
Canal configuration Type I = 1; Type II - 2 into 1; Type III - 2 separate; Type IV - 1 into 2
Weine
Preflaring canals Preflaring canals reduced rates of separation of .04 rotary files in crown-down technique
Roland, 2002
Bacteria in PAR? Large PAR = more bacterial species present; Small PAR = fewer species present; Average = 5.4 strains/canal
Sundqvist, 1992
Predictors of post-op pain Best predictors of post op pain is pre-op pain and anxiety, others include: female, allergies, no or small PAR, RETX, or age of 40-59
Torabinejad, 1988
Post space Less leakage when post space prepared at time of obturation compared to one week after obturation
Solano, 2005
Membrane needed? Through and through lesion - 88% success with GTR, 57% without it
Taschieri, Del Fabbro, 2008
Types Types of resorption: transient inflammatory (surface), progressive inflammatory, internal, external (progressive, cervical, and replacement)
Tronstad, 1988
Where to stop obturation? Best results when fill to apical constriction which ranges from 0.5-2 mm short of radiographic apex
Ricucci, 1998
Post space Argues that post space preparation weakens tooth
Trope, 1998
Culturing Used Virginia Polytechnic Institute Anaerobic Laboratory method to culture anaerobic bacteria in necrotic RCS
Wittgow, 1975
Techniques Balanced Force Technique - Crown-down to establish radicular access, CW, then CCW with apical force, CW to remove, don’t go >35 on curved canals
Roane, Sabala, 1985
Pulpotomy Demonstrated that you should remove blood clot after partial pulpotomy procedure, since it reduces healing. With no clot, got 76% healing rate.
Schroder, 1971
Anachoresis - supported Anachoresis as possible way for bacteria to enter pulp, 2 requirements: bacteria, inflammation
Robinson, Boling, 1941
Are EALs safe? EALs and EPTs safe in 27 patients (cardiac pacemakers)
Wilson, Baumgartner, 2006
Sargenti Paste formaldehyde containing N2 formulation produces extensive tissue necrosis, won’t be resorbed so surgery may be needed to remove
Spangberg, 1974
C-shaped canals 1988 2.7%, 1998 7.6% C shaped in Mand 2nd M. Asians more
Weine
Ca(OH)4 Ca(OH)2 inactivates LPS in vitro
Trope, Barthel, 1997
Strangulation theory Disproved strangulation theory, cat study that showed localized increase in pressure with no strangulation
Tonder, 1983
PCR Popularized use of polymerase chain reaction in endodontics
Siqueira, 2005
Endotoxin Symptomatic teeth and those with PAR have increased LPS than asymptomatic teeth
Schein, Schilder, 1975
Fracture categories 5 categories of tooth fractures: craze lines, cruspal fx, cracked tooth, split tooth, VRF
Rivera, 2003 (AAE Coll for Exc)
Obturation fill 94% = Short 2 mm
Sjogren (1990)
Extrusion Apical worm, if RCS flood with irrigant, extrusion will always occur
Vande Visse, Brilliant, 1975
Flap considerations recommended PBI (papilla base incision) for surgery to preclude gingival recession
Velvart, 2002, 2004
RETX 81% healed; 93% functional (with perforation - 42% healed)
Toronto (Friedman)
Size vs. taper GT 20 and 40 files were tested with 0.06/0.08/0.10 tapers; size 40 was found to better clean the canals, no diff among tapers within the size groups
Usman, Baumgartner, 2004
Goal of Shaping Tapered prep permits better debridement of apical preparation, reduces over-instrumentation of foramen and improves ability to obturate
Walton, 1976
Caution with US retroprep First report of US and Cracks, Cracks may be due to impact of US tip against dentin and heat formation
Saunders, Gutmann, 1994
Coronal Seal Coronal microleakage is important cause of RCT failure
Saunders, Saunders, 1994
Remove smear layer? Smear layer produced during RCt may inhibit bacterial colonization of root canals
Walton, 1994 (Don’t remove)
Calcification If cannot bypass calcification, then C&S & obturate to level of calcification and place on recall for potential surgery
Schindler, 1988
Calcified canals Even when no canal appears on radiograph, there will usually be a clinical canal at least the size of a #10 file.
Walton 1990
Pacemaker cautions? EALs and EPTs safe in 27 patients
Wilson, Baumgartner, 2006
Surfactants, heat, and concentration Optimizing conc, temp, flow, and surface tension can improve the tissue-dissolving effectiveness of hypochlorite 50-fold
Stojicic, Haapasalo, 2010
Membrane needed? GTR may be beneficial for treatment of large PA lesions (> 10 mm),through and through lesion, or endo/perio lesion
Tsesis, 2011
Strange morphology Den evaginatus (prevalence 1-2%): composed of enamel, dentin, and pulpal extension; usually premolars, mostly in Mongoloid people
Senia, Regezi 1974
Size vs. taper White dentinal shavings don’t indicate fully debrided canal
Walton, 1976
MTA Review of MTA and all aspects of it
Torabinejad, Parirokh, 2013
Regendo SCAP cells viable following necrosis
Sonoyama & Huang, 2008
Irrigation methods Showed limitations of NaOCl to reach apical 3 mm of RCS
Senia, 1971
Apexification 91-94% healing with MTA (can do it in one visit)
Witherspoon
3rd S RCT showed that success rate of 2nd surgery performed on same tooth is 92.9% (Modern technique)
Song, 2011
PAR formation primary bone-resorbing cytokine in human PAR = IL-1 beta; bacterial induced IL-1 beta and prostaglandins are destructive
Want, Stashenko, 1993
Outcomes assessment Using scope, US and Super EBA: 94 cases w/ success of 96%; 85% granuloma, 15% cyst
Rubenstein, Kim, 1999
2 Visit Endo supported 74% two steps, 64% one step
Trope, 1990
Direct Pulp Cap <50% (caries exposure - consider IP)
Tronstad
Cells of pulp Cells of pulp: odontoblasts, fibroblasts, undifferentiated mesenchymal cells, macrophages, lymphocytes, dendritic cells
Ten Cate
Inject slowly Inject slowly (1-2 mL/min) to get better spread of LA and therefore better hemostasis
Roberts, Sowray, 1987
Pulp microcirculation Resin replica of microcirculation
Takahashi, Kim, 1982
Gutta-percha GP exists in beta-semicrystalline state, undergoes change to alpha phase upon heating (47 degrees C), compactable not compressable
Schilder, 1974
NiTi Description of heat treated NiTi and its improved properties
Shen, 2013
Landmark Articles Cleaning (irrigate) and Shape (mechanical) to facilitate placement of root canal filling
Schilder, 1967
PAR formation Rat model: Th1 pro-inflammatory in expansion phase of PARL, Th2 more dominant after lesion equilibrium has been established
Stashenko, 1999
Focal Infection Theory No clear evidence that bacteria from RC can cause disease in remote sites of body
Siqueira, 2002
Going long GP activates C3 complement; may explain why over-extension with GP may induce bone resorption in some patients
Serene, Vesely
In the case-control study, overall healing rates were 91.8% for cases with a fractured instrument and 94.5% for matched controls (p > 0.05, Fisher?s exact test). Healing in both groups was lower in teeth with a preoperative periapical radiolucency (86.7% versus 92.9%, p > 0.05).
Spili, 2005
Hollow Tube Theory Hollow tube theory - body cannot tolerate an underfilled canal
Rickert, Dixon, 1931
MTA MTA very biocompatible, Cementum grows over MTA retrofill with Sharpy’s fibers
Torabinejad, 1995
Correlation with Pain Cellular composition of PA granuloma had no relation to symptoms, treatment, morphology or duration
Stern, 1981
How to avoid file separation Preflarring canals reduced rates of separation of .04 rotary files in crown-down technique
Roland, 2002
Minimizing resorption Recommended sealing orifices with 2 mm of Cavit prior to walking bleach
Smith, Cunningham, 1992
Electronic apex locator Reported that PDL and oral mucosa have a constant electrical resistance of ~6.5 kOhms
Suzuki, 1942
Cyst formation Breakdown theory of cysts (cyst development) - osmotic pressure buildup causes expansion due to Starling’s law
Toller, 1967
Methods of vitality testing Thermal tests with cold does not damage pulp (extracted ortho teeth)
Rickoff, Trowbridge 1988
VRF causes NiTi spreaders better since less force and more distributed than SS and can penetrate deeper
Schmidt, 2000
Optimal obturation length Systematic Review, teeth obturated 0-1 mm from radiographic apex had best success, obturation past apex had worst success
Schaeffer, Walton, 2005
Correlation with Pain No correlation between symptoms/diagnosis and histology
Seltzer & Bender, 1963
Concerns with Hemostatic agents Calcium sulfate as hemostatic agent packed in crypt
Scarano, 2012
VRF detection VRF not visible on radiograph unless it’s in direct plane as x-ray beam which doesn’t happen often
Rud, Omnell, 1970
Avulsion Systemic tetracycline showed decreased rates for inflammatory resorption after avulsion
Sae-Lim, Trope, 1998
Calcification All sections of all roots demonstrated a canal histologically, although some regions had no canal visible radiographically.
Walton, 1990
Flare-ups 8.4% was the average
Tsesis, 2008 (review)
Regendo Calcium hydroxide less toxic to SCAP than TAP and DAP
Ruparel, 2012
Strangulation theory Disproved strangulation theory
Van Hassel
RETX vs. S RCT NS RETX prior to S RCT gives higher success than S RCT alone
Taschieri, 2010
Why Chloroform? Best solvent for GP is chloroform
Tamse, 1986
Temporaries Need 3.5 mm of Cavit to prevent leakage
Webber, 1978
Flare-ups Causes of flareups - overinstrumentation, overmedication, extruded debris, incomplete pulp removal, over-irrigation, hyperocclusion, root fracture
Seltzer, Naidorf, 1985
US retroprep First to describe US use for root resection
Richman, 1957
Outcomes assessment 5 yr follow up of 181 teeth w/S RCT; 85% healing w/US and super-EBA vs. 68% healing with rotary handpiece and amalgam
Testori, 1999
Cyst formation Immunlogic theory (cyst development) - continued immune rxn to antigens (bacteria from RCS), which causes proliferation of epithelium
Torabinejad, 1983
Effect of file separation on prognosis 19% higher incidence of failure with separated instruments
Strindberg, 1956
Necrosis with calcification? Only 8.5% of teeth with canal obliteration after trauma develop necrosis, so prophylactic NS RCT not indicated
Robertson, Andreasen, 1996
Electronic apex locator Root ZX is 96% accurate within +/- 0.5 mm of apical foramen
Shabahang, 1996
Md 1P 70% - 1 canal, 25% - 2 canals
Vertucci, 1984
Effect of Endo on tooth Endo treated teeth aren’t more brittle
Sedgley, Messer, 1992
MTA Described clinical indications and techniques for using MTA, pulp caps, apical barrier, root perfs, root end fillings
Torabinejad, Chivian, 1998
Leave tooth open? If leave tooth open, more likely to be contaminated with enterics bacteria (E. faecalis)
Siren, 1997
Cognitive Dissonance Cognitive dissonance in endodontics (Sometimes NS RCT fail)
Seltzer, Bender, 1965
Epi. contraindications Vasoconstrictors contraindicated if: taking tricyclic antidepressants, non-selective beta blockers (propranolol), halothane, cocaine
Yagiella, 1999
S RCT 97% healed in 3-12 mo.; 92% in 5-7 yr
Rubinstein, Kim
Apexification 91-94% healing with MTA
Witherspoon
Outcomes assessment Complete Healing, Incomplete healing (scar tissue), uncertain healing, unsatisfactory healing
Rud, Andreasen 1972
Spaces of infection Facial spaces of infection: canine, mental, masticator, lateral pharyngeal, sublingual, submental, submandibular
Spilka, 1966
Concerns with Hemostatic agents Bone wax interferes with healing, so it’s contraindicated
Witherspoon, Gutmann, 1996
Always prep isthmus Assume isthmus is present whenever MB root of Mx 1M is resected
Weller, Kim, 1995
Apical barriers Dentinal chips showed little periradicular inflammation in monkeys
Tronstad, 1978
What apical size? Canal worked to size #35 showed adequate irrigation in apical third
Salzgeber, Brilliant, 1977
Focal Infection Theory Bacteremias only develop if instrumentation beyond apex, then only last for 10 minutes
Seltzer & Bender
Leakage Studies Problem with leakage studies: reliability questionables, variables in tracer penetration, relation between invitro and in vivo results
Wu, Wesselink, 1993
Formocresol pulpotomies Introduced formocresol pulpotomies
Sweet, 1930
Classifications Perio/Endo classifications: primary endo; primary endo w/secondary perio; primary perio; primary perio w/secondary endo; true combined lesions
Simon, Glick, Frank 1972
Instrumentation errors Coined terms: Canal zip, elbow; argued against reaming (before NiTi); Terms introduced by Garcia & Gutierrez
Weine, Kelly, Lio, 1975
Direct Pulp Cap <50% (caries exposure - consider IP)
Tronstad
Tooth survival data Outcomes of 1,462,936 teeth from 1,126,288 PTs assessed over 8 yrs in Delta Dental plans; 97% of teeth were retained after 8 yrs; sig diff among teeth with crowns
Salehrabi, Rotstein, 2004
Value of radiographs Radiographs are valuable in determining extra roots or strange canal configurations, look for eccentricallyl located RCS to suspect extra canal
Slowey, 1974
Remove smear layer? Syst Rev: Smear layer removal improves fluid-tight seal of RCS whereas others factors such as obturation technique or type of sealer do not produce sig diffs
Shavravan, 2007
Referred Pain With increased severity and duration of pain, patient loses ability to locate painful tooth
Van Hassel, Harrington, 1969
Type of post Glass fiber post is best (don’t use a stiff one) and can strengthen thin walled root
Salameh, 2007
What apical size? All of these guys like large apical sizes contrary to Bucannan who likes small (#25) sizes
Roane, Trope, Barnett
E. faecalis 4% NaOCl is effective at killing E. faecalis in vitro infected RCS
Siqueira, 2002
Cyst or Granuloma? Can’t distinguish between cyst or granuloma on CBCT
Rosenberg, 2010
Techniques Step back flaring
Walton, 1976
Techniques Passive step-back technique - patency with small K file, coronal flare GG, confirm WL, rework GG, prepare apical stop then step back to blend
Torabinejad, 1994
NaOCl Solvent action of NaOCl
Senia, Marshall, Rosen
Where to stop obturation? Filling canals short have better success
Strindberg, 1956
Prognosis 20% of cracked teeth with RP and were restored with crowns developed IP or necrosis and required endo tx
Rivera and Krell, 2007
Mediators involved IL-1 (500x more potent than TNF), TNF alpha/beta all stimulate bone resorption
Stashenko, 1990
Post needed Anterior teeth don’t require post and crown. But premolars and molars require cuspal protection
Sorensen, Martinoff, 1984
Flare-ups Incidence of flare-ups independent of IC med; Flare-up rate of 2.6%
Trope, 1990
Immune components involved Immunological reactions
Torabinejad, Kettering, Bakland
Flap considerations Mean of 0.42 mm recession at buccal sites of intrasulcular incised flaps
Von Arx, 2008
Arachidonic acid pathway COX 2 - prostacyclins (dilation, inhibits platelet aggretation), COX 1 - thromboxane (constriction, platelet aggregation)
Torabinejad, 1995
Reducing bacterial levels If bacteria in RCS reduced to levels not detected by culturing, then success rates are 26% higher (94% success vs. 68% success)
Sjogren, Sundqvist 1997
Thin film thickness Thin film of sealer is ideal
Weiner, Schilder, 1971
Methods of vitality testing Laser doppler detected vital vs. necrotic vs. empty pulp chamber, & Case report of Laser Doppler preventing NS RCT on healthy tooth secondary to trauma
Trope, 1997
Perforation repair Review of surgical repair
Regan, Witherspoon, 2005
Archaea in endo Members of the archaea domain may have a role as human pathogens, found in necrotic untreated teeth with apical periodontitis
Vianna, 2006
Post-treatment disease Teeth with AP: Extraradicular biofilm 6% prevalence, intraradicular biofilm 77% prevalence (Larger lesion = more likely to have biofilm)
Ricucci, Siqueira, 2010
Going long Small GP pieces are extremely inflammatory
Sjogren, 1995
Don’t trust radiograph Found apical foramen 0.72 mm short of radiographic apex and width of CDJ = 0.19 mm
Stein, Corcoran, 1990
PAR prevention B-cells likely responsible for preventing spread of PA Abscess
Stashenko, 2000
Regendo EDTA irrigation releases growth factors from dentin, which could stimulate DPSC’s
Roberts-Clark, Smith 2000
Antibiotics for pain relief? Prophylactic Abx had no effect on post-op pain levels
Walton, Chiapinelli, 1993
DPC on carious exposure Carious exposures have <50% success with direct pulp caps. Carious exposures should be considered irreversible pulpitis.
Tronstad, Mjor, 1972
Luxated teeth Trauma to primary teeth may affect permanent teeth
Torneck, 1982
Steroids effective? No. IC Steroids; intracanal ketorolac better than than placebo for reducing post-endo pain. Steroids did not make a difference
Rogers, 1999
Leave tooth open? Reasons to not leave teeth open: bacterial contamination, contamination with food debris or blockage of canals, unnecessary follow-up appts to close tooth
Seltzer, Naidorf, 1984
Cyst formation Cavitation breakdown theory (cyst development) - growth or epi. cells removes central cells from nutrition, innermost cells die
Ten Cate, 1972
Coronal Seal Quality of coronal restoration equally important as root filling at determination of apical health
Tronstad, 2000
PDL Not detrimental to the health of PDL and is type of IO injection
Walton,
Time with NaOCl Need at least 30 Minutes: Rat tissue in direct contact with 3% NaOCl for 30 min greatly reduced volume of tissue
The, 1979
NiTi 1st description of NiTi as an endo file. 2-3x more flexible than SS, lower modulus of elasticity (Nitinol is a term that came for the Navy, just like IRM)
Walia, Brantley, Gerstein, 1988
Flare-ups 3% incidence of flareups; prospective RCT found no benefits to prophylactic antibiotics for reducing flareups
Walton, Fouad, 1993
Response of EPT to necrotic teeth 72 % necrotic teeth correctly identified by EPT with negative resposne
Seltzer, Bender, et al 1963
NS RCT success? Success criteria
Strindberg, 1956
File separation Clockwise rotation has greater chance of separation than a counterclockwise rotation
Roane, Sabala, 1994
Electronic apex locator CLASSIC; applied Suzuki’s idea to develop an apex locator
Sunada, 1962
Gutta-percha GP activates C3 complement; may explain why over-extension with GP may induce bone resorption in some patients
Serene, Vesely
Concerns with Hemostatic agents Epi-soaked CollaCote does not cause systemic issues
Vy, Baumgartner, 2004
Treatment Dog study - tx of external resorption: 12 wk of Ca(OH)2 more effective than short term (1 wk)
Trope
NS RCT success? 86% healed; 95% functional
Toronto (Friedman)
Correlation with Pain Examined 142 teeth with pain; no correlation between histology and clinical symptoms
Tyldesley, Mumford, 1970
S RCT 74% healed; 91% functional
Toronto (Friedman)
Looking for zebras Found pulp necrosis due to neoplasm that disrupted blood flow. Think of this when pt has history of cancer, and pulp necrosis has no etiology
Todd, Langeland, 1987
Cyst formation Epithelial proliferation theory (cyst development) - epithelial cells proliferate to line abscess cavity
Seltzer, Summers, 1974
Sargenti Paste no RD needed, RCT length somewhere near apex, objective is chemical (not C&S), try to keep N2 in canals, but “well tolerated” by PA tissues
Sargenti
Pain relief? Prophylactic Abx had no effect on post-op pain levels
Walton, Chiapinelli, 1993
History of various methods Disputed Luks claim that gutta-percha is compressible
Schilder, 1974
Flare-ups RETX has significantly more flare-ups
Torabinejad, 1988
PAR in Vital Teeth? In rats, PAR visualized prior to pulp necrosis
Yamasaki, 1994
Adjust occlusion? Adjust occlusion helps relieve pain (especially those with percussion sensitivity)
Rosenberg, 1998
Ferrule effect 1 mm of ferrule needed to increase Fx resistance
Sorenson, 1990
Leave tooth open? Leaving teeth open can lead to foreign body reaction of material forced in PA tissue, called “oral pulse granulomas”
Simon, 1982
3rd surgery? showed that success rate of 2nd surgery performed on same tooth is 92.9% (Modern technique)
Song, 2011
Accessory canals Filled lateral canals mix of sealer, smear layer and bacteria, not necessarilly cleaned and filled
Ricucci, 2010
Primary anaerobic endo bacteria Porphyromonas endodontalis, P. gingivalis, Actinomyces israeli, Propionobacterium acnes, Fusobacterium nucleatum, Wolinella necta,
Siqueira, 1996
System-B temperature? System B at 300 degrees never raised external root surface temperature by more than 10 degrees
Sweatman, Baumgartner, 2001
Pathogenesis Widely accepted that PAR is inflammatory response to prevent dissemination of bacteria from infected RCS into bone
Stashenko, 1990
US retroprep US tips gave superior results compared to rotary handpiece for retropreps
Steiman, 1995
Trust the Patient? With increased severity and duration of pain, patient loses ability to locate painful tooth
Van Hassel, Harrington, 1969
Cat link with cervical resorption? Showed association between feline Herpes virus and invasive cervical root resorption
Von Arx, 2009
Perforation repair MTA useful for furcal perforation repair; No difference if covered by wet or dry cotton pellet (moisture derived from furcal tissue
Sluyk, Hartwell, 1998
PAR in Vital Teeth? PA inflammatory cell infiltration, increased osteoclast numbers and bone destruction seen well in advance of total pulpal necrosis
Stashenko, 1995
Where to stop obturation? Necrotic teeth w/o PAR = 96% success; Necrotic w/PAR = 86%; Best success w/PAR is to obturate within 0-2 mm of radiographic apex
Sjogren, 1990
Gutta-percha Small GP pieces are extremely inflammatory (larger pieces not as inflammatory)
Sjogren, 1995
Landmark Articles Filling root canals in 3 dimensions, objective is to seal complex RCS to ensure health
Schilder, 1967
MB root of Mx 1M 50% - 2 canals
Weine, 1969
Disinfect Gutta-percha Gutta-percha can be disinfected by submerging in NaOCl 5.25% for 1 min.
Senia, 1975
Need for IC Med? Best documented results for canal disinfection = chemomechanical debridement with Ca(OH)2 for 1 wk (1 wk disinfection = 2, 3, 4 weeks)
Sjogren, 1991
Pain to percussion Pain on biting suggests PDL inflammation that is due to either necrotic pulp or irreversibly inflamed pulp
Seltzer, Bender, 1985
PAR formation bone resorbing activity is due to immune cells secreting cytokines in response to LPS, including: IL-1beta, TNF-alpha, PGE2 (tooth can be vital and have PAR)
Stashenko, 1999
Where to stop obturation? Overfill decreased success and = persistant inflammation; underfill had no influence
Seltzer, Bender, 1963, 1967
