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.

Histobacteriologic Conditions of the Apical Root Canal System and Periapical Tissues in Teeth Associated with Sinus Tracts.

Introduction: This histobacteriologic study described the pattern of intraradicular and extraradicular infections in teeth with sinus tracts and chronic apical abscesses.

Methods: The material comprised biopsy specimens from 24 (8 untreated and 16 treated) roots of teeth associated with apical periodontitis and a sinus tract. Specimens were obtained by periradicular surgery or extraction and were processed for histobacteriologic and histopathologic methods.

Complicated untreated apical periodontitis causing paraesthesia: A case report.

The purpose of this article was to report a case of untreated apical periodontitis resulting in severe late complications. A patient with an asymptomatic crowned root canal-treated mandibular molar revealing a radiographic substandard endodontic treatment and a slight periapical radiolucency was made aware of the treatment options and opted for no treatment. The lesion slightly increased in size after 6 years, but the tooth remained asymptomatic and endodontic retreatment was again refused.

Pulp and apical tissue response to deep caries in immature teeth: A histologic and histobacteriologic study.

Unlabelled: Descriptions of the pathologic changes in the pulp and associated apical structures of human immature teeth in response to deep caries are lacking in the literature.

Objectives: This article describes the histologic events associated with the radicular pulp and the apical tissues of human immature teeth following pulp inflammation and necrosis.

Methods: Twelve immature teeth with destructive caries lesions were obtained from 8 patients.

Apically Extruded Sealers: Fate and Influence on Treatment Outcome.

Introduction: This retrospective study evaluated cases of unintentional overfillings for the fate of the extruded sealers and their influence on treatment outcome.

Methods: One hundred five teeth treated by a single operator and exhibiting overfillings in the postobturation radiograph were included in the study. Seventy-five teeth exhibited apical periodontitis lesions at the time of treatment.

The cracked tooth: histopathologic and histobacteriologic aspects.

Introduction: The diagnosis and treatment planning of cracked teeth depend on the understanding of how cracks affect the surrounding tissues. This study evaluated the dentin and pulp conditions in teeth affected by cracks and attrition.

Methods: Specimens under investigation included 12 cracked posterior teeth and 8 teeth with severe attrition.

Correlation between clinical and histologic pulp diagnoses.

Introduction: Clinicians routinely face conditions in which they have to decide whether the dental pulp can be saved or not. This study evaluated how reliable the clinical diagnosis of normal pulp/reversible pulpitis (savable pulp) or irreversible pulpitis (nonsavable pulp) is when compared with the histologic diagnosis.

Methods: The study material consisted of 95 teeth collected consecutively in a general practice over a 5-year period and extracted for reasons not related to this study.

Repair of extensive apical root resorption associated with apical periodontitis: radiographic and histologic observations after 25 years.

Introduction: Root resorption is a frequent finding in teeth with apical periodontitis. In cases of severe apical periodontitis, root resorption may involve not only cementum but also dentin. Resorbed tooth structures can only be repaired with cementum because stem cells in the periradicular tissues are not capable of differentiating into odontoblasts.

Is hard tissue formation in the dental pulp after the death of the primary odontoblasts a regenerative or a reparative process?

Objectives: Conceptually, two types of tertiary dentine may be produced in response to caries and environmental irritations: "reactionary dentine" that is secreted by existing primary odontoblasts and "reparative dentine", formed after the death of the odontoblasts by proliferation and differentiation of progenitor cells into odontoblast-like cells. Because histologic evidence for tubular dentine generated by newly differentiated odontoblast-like cells is lacking in human teeth, the present study examined pulpal cellular changes associated with caries/restorations, in the presence or absence of pulpal exposures.

Methods: Ninety-six extracted human teeth were histologically processed and serial sectioned for light microscopy: 65 contained untreated enamel/dentine caries; 20 were heavily restored and 11 had carious exposures managed by direct pulp-capping.

Prevalence of ciliated epithelium in apical periodontitis lesions.

Introduction: This article reports on the morphologic features and the frequency of ciliated epithelium in apical cysts and discusses its origin.

Methods: The study material consisted of 167 human apical periodontitis lesions obtained consecutively from patients presenting for treatment during a period of 12 years in a dental practice operated by one of the authors. All of the lesions were obtained still attached to the root apices of teeth with untreated (93 lesions) or treated canals (74 lesions).

Histologic and histobacteriologic observations of failed revascularization/revitalization therapy: a case report.

Introduction: Mechanical debridement plays an important role in eliminating intracanal bacteria, such as biofilm on the canal walls and bacteria in the dentinal tubules. Mechanical debridement is not recommended for root canal disinfection in revascularization/revitalization therapy. Here we report a failed revascularization/revitalization case, which could be due to inadequate root canal disinfection without mechanical removal of biofilm and bacteria in dentinal tubules.

Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization.

Introduction: Histologic studies of teeth from animal models of revascularization/revitalization are available; however, specimens from human studies are lacking. The nature of tissues formed in the canal of human revascularized/revitalized teeth was not well established.

Methods: An immature mandibular premolar with infected necrotic pulp and a chronic apical abscess was treated with revascularization/revitalization procedures.

Exuberant Biofilm infection in a lateral canal as the cause of short-term endodontic treatment failure: report of a case.

Introduction: This article describes a case in which signs and symptoms persisted in spite of the endodontic treatment following high standards to characterize a short-term failure.

Methods: After several appointments of root canal treatment in an attempt to resolve persistent symptoms, including 106 days of calcium hydroxide intracanal medication, periradicular surgery was performed, and the root apex and the lesion were subjected to histologic and histobacteriologic analyses.

Results: The lesion was diagnosed as a cyst, and the main root canal was free of bacteria and debris.

One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study.

Introduction: This study analyzed the in vivo microbiological status of the root canal systems of mesial roots of mandibular molars with primary apical periodontitis after 1- or 2-visit endodontic treatment.

Methods: Mesial root canals were instrumented by using either a combination of K3 and LightSpeed instruments (mesiobuccal canals) or the ProTaper system (mesiolingual canals), with 5% NaOCl irrigation. Patency files were used.