Histologic Features of External Cervical Resorption Affecting Impacted Maxillary Canines: A Report of 2 Cases.

Reports on the histopathologic features of external cervical resorption (ECR) in unerupted teeth are scarce. This article reports on 2 maxillary impacted canines from different patients that showed ECR lesions and were surgically removed and histologically evaluated. Case 1 showed symptoms associated with oral communication of the dental follicle and pulpal exposure.

Biomechanical perspectives on dentine cracks and fractures: Implications in their clinical management.

Objectives: The present review discussed the biomechanical properties of cracks and fractures in crown and root dentine and attempted to explain why cracked teeth and vertical root fractures are so frequent despite the existence of multiple crack toughening mechanisms in dentine. The implications of this knowledge were used to justify how these defects are managed clinically.

Data, Sources And Study Selection: Literature search was conducted on PubMed, Web of Science, and Scopus for a narrative review on fracture mechanics of crown and root dentine as well as the clinical management of cracked teeth and teeth with vertical root fracture.

Outcome of Direct Pulp Capping Using Calcium Hydroxide: A Long-term Retrospective Study.

Introduction: This retrospective study evaluated the long-term outcome of direct pulp capping in mature teeth using specific case selection and treatment procedures.

Methods: Teeth with pulp exposure due to advanced caries and clinical diagnosis of reversible pulpitis were treated by direct pulp capping. Treatments were conducted over a period of 15 years by a single operator.

Surgical management of a lateral lesion refractory to root canal retreatment caused by an extraradicular calculus. A case report.

This article describes the management of a root canal-treated maxillary central incisor displaying a radiographic lateral radiolucency and a sinus tract that persisted irrespective of root canal retreatment following high standards. Endodontic microsurgery was indicated and curettage of the pathologic tissue revealed a calculus-like material attached to the outer root surface around the exit of a large lateral canal. A non-conventional approach was chosen: No root-end resection was conducted.

Unusual Lesion Caused by Food Displacement Into the Oral Mucosa, Mimicking a Sinus Tract.

This article reports an unusual case of foreign body lesion on the oral mucosa. A 61-year-old man, with no previous traumatic episode, presented with a small swelling resembling a sinus tract on the mucosa in the anterior mandible, adjacent to the left central and lateral incisors. Because of a discrete drainage of serous/purulent exudate, the clinician initially suspected endodontic involvement; however, the adjacent teeth were caries-free, responded positively to pulp tests, and the periapical tissues were radiographically normal.

Bacterial Invasion of Pulp Blood Vessels in Teeth with Symptomatic Irreversible Pulpitis.

Introduction: This study described the degenerative changes and infection patterns of the pulp tissue associated with symptomatic irreversible pulpitis.

Methods: The material consisted of 32 extracted teeth with untreated deep caries that were clinically and histologically diagnosed with irreversible pulpitis and were part of the histopathologic collection of 1 of the authors. The controls consisted of intact teeth with normal uninflamed pulps and teeth with reversible pulpitis.

Pulp Response to Periodontal Disease: Novel Observations Help Clarify the Processes of Tissue Breakdown and Infection.

Introduction: This study evaluated the pulp response to periodontal disease of increasing severity.

Methods: The material comprised human teeth affected by moderate (n = 16) to severe (n = 48) periodontal disease and no clinically identified caries lesions. Specimens were obtained by extraction and were processed for histopathologic and histobacteriologic methods.

Mineral trioxide aggregate apexification: a 20-year case review.

Apexification strategies in traumatised non-vital immature permanent teeth can promote root-end closure and continued root development. However, traumatic injuries may compromise the integrity of generative cells of the apical papilla responsible for root maturation. This report describes the long-term treatment outcome of mineral trioxide aggregate (MTA) apexification managed with late-term surgical intervention.

Pulp and dentine responses to selective caries excavation: A histological and histobacteriological human study.

Objective: The present study investigated the histobacteriological condition of human carious dentine, and the histological response of dental pulps after selective caries excavation to firm dentine and cavity restoration with adhesive procedures.

Methods: Twelve vital teeth with medium/deep occlusal caries from 12 patients were scheduled for extraction. The patients gave consent to have caries removed selectively and the cavity restored with adhesive procedures prior to extraction.

Unusual Location of Dens Invaginatus Causing a Difficult-to-Diagnose Pulpal Involvement.

This article reports on an unusual case of dens invaginatus in a maxillary third molar that was causing severe symptoms of irreversible pulpitis. This malformation was not clinically or radiographically identified, and the occurrence of referred pain made the early identification of the responsible tooth difficult. Determination of the tooth that was the source of symptoms was only possible after an observation period and fast aggravation of the pathologic process to cause pulp necrosis and extreme tenderness to percussion.

Bacteriologic status of non-cavitated proximal enamel caries lesions. A histologic and histobacteriologic study.

Objectives: This histologic and histobacteriologic study evaluated non-cavitated interproximal white spot lesions in human teeth for the 1) presence and morphology of bacterial aggregations at the enamel-dentinal junction (EDJ), and 2) reactions in the subjacent pulp tissue.

Methods: The material comprised 16 third molars diagnosed with early interproximal caries lesions obtained consecutively in a single clinical practice. Four third molars with clinically intact proximal surfaces served as controls.

"True" Versus "Bay" Apical Cysts: Clinical, Radiographic, Histopathologic, and Histobacteriologic Features.

Introduction: This study compared the main clinical, radiographic, and histologic features of true and bay apical cysts.

Methods: The study material comprised 95 biopsy specimens of apical periodontitis lesions obtained attached to the root tip of both untreated and root canal-treated teeth. Clinical and radiographic data were recorded.

An Unusual Case of a Large Periapical Cyst Mimicking a Nasopalatine Duct Cyst.

This article reports on the management of a large median symmetrical lesion of the anterior palate, which was clinically and radiographically diagnosed as an infected nasopalatine duct cyst. However, histopathology demonstrated it to be a radicular cyst of endodontic origin.

Cleaning, Shaping, and Disinfecting Abilities of 2 Instrument Systems as Evaluated by a Correlative Micro-computed Tomographic and Histobacteriologic Approach.

Introduction: This study assessed the cleaning, shaping, and disinfection abilities of 2 instrumentation systems in molar root canals using a novel correlative analytical approach.

Methods: The root canals from extracted mandibular and maxillary molars with apical periodontitis were pair matched according to anatomic similarities as determined by micro-computed tomographic analysis and prepared with either XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (n = 16) or Reciproc Blue (VDW, Munich, Germany) (n = 16) instruments and 2.5% sodium hypochlorite irrigation.

An Immunofluorescence Study to Analyze Wound Healing Outcomes of Regenerative Endodontics in an Immature Premolar with Chronic Apical Abscess.

Introduction: Limited studies have examined tissue formation via immunofluorescence in regenerative endodontic procedures (REPs) performed on infected human teeth. This report investigated the immunofluorescent histologic outcomes of REPs in which repeated canal disinfection was required.

Methods: An 11-year-old girl presented with a fractured dens evaginatus (#29) with a sinus tract.

Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology.

The American Association of Endodontists (AAE) Consensus Conference Recommended Diagnostic Terminology states that mature permanent teeth clinically diagnosed with irreversible pulpitis are treated with pulpectomy and root canal filling because inflamed vital pulp is not capable of healing. Histological studies have demonstrated that clinically diagnosed irreversible pulpitis does not involve the entire pulp. A recent International Endodontic Journal Editorial suggested clinical diagnosis of pulp disease should be reassessed because of the poor correlation between clinical symptoms and pulp sensibility testing and the actual histological status of the pulp.

Histologic Response of Human Pulp and Periapical Tissues to Tricalcium Silicate-based Materials: A Series of Successfully Treated Cases.

Pulpal/periapical responses of human teeth that are treated successfully with tricalcium silicate-based materials are extremely difficult to obtain because of the typical unavailability of these teeth for histologic examination. The present case series reports histologic and histobacteriologic findings of 3 human teeth that had undergone pulpotomy, orthograde retreatment, and apicoectomy/root-end filling using tricalcium silicate-based endodontic materials. The teeth were extracted after 34 days, 7 weeks, and 20 months, respectively, because of unusual circumstances.

Atypically grown large periradicular cyst affecting adjacent teeth and leading to confounding diagnosis of non-endodontic pathology.

This article reports a case of a large osteolytic lesion in the mandible, mostly associated with the apices of the premolars, and suspected as having a non-endodontic origin because the 2 premolars responded positively to the cold sensibility test. The distal border of the lesion reached the mesial root of the first molar, which also had a small lesion in its distal aspect. Cone-beam computed tomography revealed that the large lesion communicated with the small molar lesion.

Vital pulp therapy: histopathology and histobacteriology-based guidelines to treat teeth with deep caries and pulp exposure.

Objectives: Vital pulp therapy (VPT) encompasses distinct treatment modalities for deep caries that approximate the pulp chamber in vital teeth. Confusion exists in the literature in terms of the indication and rationale for each VPT approach. The objectives of the present study are to elucidate the indications for VPT and to present a set of histopathology and histobacteriology-based guidelines for VPT in teeth with deep caries.

Histological evaluation of hard tissue formation after direct pulp capping with a fast-setting mineral trioxide aggregate (RetroMTA) in humans.

Objectives: To histologically evaluate the morphology of the newly formed mineralized tissue and of the adjacent cells, in intact human teeth subjected to mechanical pulp exposure and capping with a fast-setting mineral trioxide aggregate (RetroMTA).

Materials And Methods: Seven caries-free third molars from three adults were subjected to pulp exposure, direct capping with RetroMTA, and restoration with a composite resin. Seven months later, the teeth were clinically and radiographically evaluated, extracted, and subjected to histological processing and evaluation.

Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies.

Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals.

Management and Histobacteriological Findings of Mucosal Fenestration: A Report of 2 Cases.

This article describes 2 unusual cases of mucosal fenestration associated with necrotic infected teeth, resulting in exposure of the root apex to the oral cavity. Both cases consisted of maxillary incisors with pulp necrosis and radiographic/tomographic evidence of apical periodontitis. Clinically, the root apex was exposed to the oral cavity through a fenestration in both bone and mucosa and covered with bacterial plaque and calculus.

Large Bacterial Floc Causing an Independent Extraradicular Infection and Posttreatment Apical Periodontitis: A Case Report.

This article describes a case of large persistent posttreatment apical periodontitis associated with 2 maxillary incisors, which was successfully managed by periradicular surgery. Histobacteriologic analysis revealed that the lesion was a granuloma that contained in its body a very large actinomycoticlike colony surrounded by accumulations of polymorphonuclear leukocytes and showing no direct communication with the root canal systems from both teeth. One incisor had no evidence of persistent intraradicular infection, whereas the other exhibited some residual dentinal tubule infection in the apical canal, which may have not significantly contributed to persistent inflammation given the organization and agglomeration of inflammatory cells around the large extraradicular bacterial colony.

Changes in the radicular pulp-dentine complex in healthy intact teeth and in response to deep caries or restorations: A histological and histobacteriological study.

Introduction: The present study reported the histological events that occurred in the radicular pulp of human mature teeth in the presence of medium/deep untreated caries lesions, and those teeth with restorations or direct pulp capping, with particular emphasis on the morphology of the canal wall dentine and the odontoblast layer.

Methods: Sixty-two teeth with medium/deep caries lesions, extensive restorations or after application of a direct pulp capping procedure were obtained from 57 subjects. Fourteen intact mature teeth served as controls.