Medication-Related Osteonecrosis of the Jaw (MRONJ) Mistaken for Acute Apical Abscess.

The objective of this case study is to report on the diagnosis and treatment of medication-related osteonecrosis of the jaw (MRONJ), which was originally misdiagnosed and mistreated as endodontic disease. A patient was referred for worsening odontalgia despite root canal therapy on tooth No. 19 and a course of oral antibiotics.

Evidence-Based Pain Management: Dispelling Disinformation in Dentistry.

According to the American Dental Association Principles of Ethics and Code of Professional Conduct, dental professionals hold a special position of trust and privilege within society, and thus are bound to adhere to the highest standards of conduct. This code of ethics defines key tenets, including veracity, patient autonomy, beneficence, nonmaleficence, and justice. Maintaining these ethical principles goes beyond the competent delivery of operative care and requires up-to-date, evidence-based knowledge and practices on the part of clinicians.

Incidental CBCT Findings: The Importance of Reading the Whole Image.

The use of cone-beam computed tomography (CBCT) imaging often elicits changes in both diagnostics and treatment plans when incorporated into endodontic workups. In endodontic practice, CBCT scans enable detection of periapical pathology before it is apparent on traditional 2-dimensional intraoral radiographs. The visualization provided by CBCT scans can help clinicians confirm suspected diagnoses, including but not limited to periapical pathology, traumatic tooth displacement, and vertical root fracture.

Saving Cracked Teeth: The Current State of Evidence.

Treatment planning for cracked teeth can be quite challenging for clinicians, as various outcomes-related clinical parameters must be considered. Historically, extraction was recommended for cracked teeth with radicular extensions due to their poor prognosis. Recent literature, however, suggests that these teeth may be saved with careful case selection and appropriate treatment.

Vital Pulp Therapy: Managing Deep Caries in the Permanent Dentition.

The adoption of vital pulp therapy (VPT) is a significant advancement in preserving the longevity of vital mature pulp. VPT represents a potential alternative approach to nonsurgical root canal therapy in which compromised pulp is treated such that it maintains its vitality and function. With the introduction of novel bioceramic materials, including calcium silicate cements and mineral trioxide aggregate, the prognosis for VPT in mature permanent teeth has greatly increased, and as a result, adaptation of VPT in these teeth has garnered considerable support.

Diagnosis and Management of Maxillary Sinusitis of Endodontic Origin.

The anatomic proximity of maxillary posterior teeth to the maxillary sinus provides a natural conduit for the spread of dental pathology into the maxillary sinus. This diffusion results in the development of sinus disease attributable to endodontic pathology, and is termed "maxillary sinusitis of endodontic origin" (MSEO). Ultimately, suspicion of odontogenic causes of sinus disease should come as a relief to the provider and patient alike as the conditions are very treatable by noninvasive means with high expected success.

Outcomes-Based Treatment Planning in Endodontics: Applying the Latest Evidence.

A comprehensive understanding of the factors that influence treatment outcomes is crucial in endodontic diagnosis and treatment planning. Having knowledge that takes into account dental and patient-related conditions when choosing procedures can help clinicians maximize the prognosis of natural teeth and reduce postoperative complications. That being said, the landscape of outcome studies in endodontics is continually evolving, presenting a challenge for many clinicians trying to stay current with the latest literature.

Cementoblastoma Mimicking Pathology of Endodontic Origin: A Case Report.

Interdisciplinary care in the management of complex pathology is critical to ensure patients receive predictable, evidence-based treatment. The authors report the unique case of a healthy 38-year-old female patient who presented to a private endodontics practice with a radiopaque lesion associated with the root of tooth No. 20.

Managing Endodontic Complications: The Pathophysiology and Treatment of Flare-ups.

At its core, endodontics is a specialty centered on saving patients' teeth. Nonsurgical root canal therapy and nonsurgical retreatment, arguably the "bread and butter" of endodontics, not only facilitate the preservation of the natural dentition, but in many cases, alleviate pain. Most patients arrive for endodontic treatment expecting symptom relief.

Pain Management and Endodontics: Rapidly Evolving Science Benefits Patient Care.

Pain management and endodontics represent two separate but very much interrelated disciplines. Advances in both fields have resulted in significant improvements in the predictable and comfortable delivery of patient care. From the utilization of cone-beam computed tomography (CBCT) imaging, the use of biomaterials, and enhanced irrigation in endodontics, to greater understanding of pain physiology and treatment, providers and patients alike are benefiting from rapidly evolving science.

The Diagnostic Dilemma of Unseparated Fractures.

Unseparated fractures in teeth without a history of prior endodontic treatment represent a common presentation in clinical practice. Historic heterogeneity in diagnostic terminology and treatment recommendations have produced considerable uncertainty among clinicians regarding how to best treat these teeth. That said, a current review of the literature can provide clinicians with an evidence-grounded framework for managing unseparated fractures.

The Use of Selective Anesthesia in Endodontic Diagnosis.

Foundational to the diagnosis of endodontic disease is the ability for clinicians to replicate a patient's pain via clinical testing. Patients experiencing degenerative pulp diseases, like an acutely symptomatic irreversible pulpitis,may present with poorly localized pain that cannot be clinically replicated. Selective anesthesia techniques can aid clinicians in the accurate diagnosis of these patients' symptoms.

Cracked teeth: Distribution and survival at 6 months, 1 year and 2 years after treatment.

Background/purpose: The unpredictable condition of cracked teeth warrants further investigation and clinical experiences. The purpose of this study was to collect and record data on demographics, clinical characteristics, different treatment modalities and survival of cracked teeth at 6-month, 1-year and 2-year recalls.

Methods: 77 cracked teeth from 65 patients were included.

Endosseous implants versus nonsurgical root canal therapy: a systematic review of the literature.

For this article, the authors identified and reviewed the current literature, addressing two treatment options for endodontically involved teeth: root canal therapy and restoration versus extraction and the placement of a dental implant. The literature was evaluated as a basis for making treatment decisions. PubMed was queried for all studies that compared nonsurgical root canal therapy (NSRCT) and restoration with the extraction of teeth and placement of a dental implant.

Periodontal disease among adult, new-immigrant, Chinese Americans in Boston with and without diabetes -- a brief communication.

Objectives: We compared the periodontal disease levels in a population of low socioeconomic status (SES), urban, adult, Chinese American immigrants with and without type 2 diabetes.

Methods: Dental records of 51 diabetic adults were compared with 102 nondiabetic controls from South Cove Community Health Center, Boston, MA, cross-matched by age and gender.

Results: Our results showed that the proportion of sites with bone loss greater than 5 mm in the mesial areas of teeth was significantly correlated with higher glycosylated hemoglobin (HbA1c) (r = 0.

Validation of self-reported periodontal disease: a systematic review.

Self-report is an efficient and accepted means of assessing many population characteristics, risk factors, and diseases, but has rarely been used for periodontal disease (chronic periodontitis). The availability of valid self-reported measures of periodontal disease would facilitate epidemiologic studies on a much larger scale, allow for integration of new studies of periodontal disease within large ongoing studies, and facilitate lower-cost population surveillance of periodontitis. Several studies have been conducted to validate self-reported measures for periodontal disease, but results have been inconsistent.

Transport of di(2-ethylhexyl)phthalate (DEHP) applied with sewage sludge to undisturbed and repacked soil columns.

Municipal sewage sludge is often used on arable soils as a source of nitrogen and phosphorus, but it also contains organic contaminants that may be leached to the ground water. Di(2-ethylhexyl)phthalate (DEHP) is a priority pollutant that is present in sewage sludge in ubiquitous amounts. Column experiments were performed on undisturbed soil cores (20-cm depth x 20-cm diameter) with three different soil types: a sand, a loamy sand, and a sandy loam soil.