Chronic Disease ; Humans ; Paranasal Sinus Diseases ; etiology ; Periapical Periodontitis ; therapy

Chronic Disease ; Cone-Beam Computed Tomography ; Humans ; Periapical Abscess ; pathology ; Periapical Granuloma ; pathology ; Periapical Periodontitis ; diagnostic imaging ; pathology ; Problem Solving ; Prognosis ; Radicular Cyst ; diagnostic imaging ; pathology

The essence of pulp and periapical disease is bacterial infection. Thus, satisfactory infection control is the premise and foundation of healing, in which root canal preparation is a critical procedure. Root canal system anatomy, infection degree, physical cutting during root canal preparation, and certain cleaning measures affect the quality of infection control. Appropriate evaluation of the grades of infected root canals before treatment is necessary because different grades of root canal infection demand various disinfection schedules to facilitate tissue healing and guarantee the long-term success rate of endodontic treatment.
Dental Pulp Cavity ; Humans ; Infection Control ; Periapical Diseases ; Periapical Periodontitis ; Root Canal Irrigants ; Root Canal Preparation ; Root Canal Therapy

This is a reprospective study on the care of odontogenic infections in admission patients with geriatric diseases. The study was based on a series of 480 patients at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, From Jan. 1, 2000, to Dec. 31, 2002. The Obtained results were as follows: 1. The systemic malignant tumor was the most frequent cause of the geriatric diseases with odontogenic infectious diseases, and refractory lung disease, systemic heart disease, type II diabetes mellitus, cerebrovascular disease, bone and joint disease, senile psychologic disease were next in order of frequency. 2. Male prediction(57.5%) was existed in the odontogenic infectious patients with geriatric diseases. But, there were female prediction in senile psychologic disease, systemic heart disease and cerebrovascular disease. 3. The most common age group of the odontogenic infectious patient with geriatric disease was the sixty decade(47.9%), followed by the seventy and eighty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with geriatric disease, peak incidence was occurred as toothache(52.7%), followed by extraction wish, tooth mobility, oral bleeding, oral ulcer, fracture of restoration, gingival swelling in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(34.2%) was showed in primary endodontic treatment (pulp extirpation, occlusal reduction and canal opening drainage) and followed by scaling, incision and drainage, only drugs, pulp capping, restoration in order.
Bone Diseases ; Communicable Diseases ; Dental Pulp Capping ; Diabetes Mellitus ; Diagnosis ; Drainage ; Female ; Gangwon-do ; Heart Diseases ; Hemorrhage ; Humans ; Incidence ; Insurance, Health ; Joint Diseases ; Lung Diseases ; Male ; Oral Ulcer ; Periapical Abscess ; Periodontitis ; Pulpitis ; Tooth Mobility

This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan.1, 2000, to Dec.31,2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixtyand thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction and canal opening drainage) and followed by the incision and drainage, the medications and oral hygiene instruction, scaling, indirect pulp capping in order.
Cardiovascular Diseases ; Communicable Diseases ; Dental Pulp Capping ; Diagnosis ; Drainage ; Female ; Gangwon-do ; Hemorrhage* ; Humans ; Incidence ; Insurance, Health ; Liver Diseases ; Male ; Oral Hygiene ; Periapical Abscess ; Periodontitis ; Pulpitis ; Renal Insufficiency ; Retrospective Studies ; Toothache ; Ulcer

Prevotella intermedia has been implicated as a potent pathogen in many kinds of periodontal, pulpal and periapical diseases. However, it has been isolated from periodontally healthy adults and from edentulous children as well. The intraspecies heterogeneity of Prevotella intermedia has been demonstrated in early studies and finally Shah & Gharbia confirmed the existence of 2 DNA homology groups and proposed dividing Prevotella intermedia into 2 species, Prevotella intermedia and Prevotella nigrescens. This study was designed to examine the frequency of Prevotella intermedia and Prevotella nigrescens in diseased periodontal pockets and healthy gingival sulcus of Korean people by PCR based on 16s ribosomal DNA sequence. One hundred adults who had adult periodontitis but not taken any periodontal treatment or antibiotics during previous 6 months and 50 adults who had healthy periodontal tissue were selected for this study. The sulcular fluid was collected into VMGA by sterilized paper point and diluted to 1,000 times in anaerobic chamber. 100ml of sample was cultured in 37degrees C for 10 days. Among the bacterial colonies, BPB were selected and cultured in BHI broth and then Prevotella intermedia was identified through Gram staining and biochemical test. Identified Prevotella intermedia was cultured again and centrifuged. DNA was extracted from the pellet using several reagents. PCR was performed by previously designed primer. The results were followed. 1.BPB were isolated from 39 of 100 samples of diseased periodontal pockets(39%). 2.Prevotella intermedia was identified from 24 of 39 BPB samples. 3.Among 24 Prevotella intermedia, 21 were confirmed as Prevotella intermedia(87.5) and 2 were confirmed as Prevotella nigrescens(8.33%). 4.BPB were isolated from 9 of 50 samples of periodontally healthy patients. Among them only two were identified as Prevotella intermedia, that is, one was confirmed as Prevotella intermedia and the other was Prevotella nigrescens.
Adult* ; Anti-Bacterial Agents ; Child ; Chronic Periodontitis* ; DNA ; DNA, Ribosomal ; Humans ; Indicators and Reagents ; Periapical Diseases ; Periodontal Pocket ; Polymerase Chain Reaction ; Population Characteristics ; Prevotella intermedia* ; Prevotella nigrescens* ; Prevotella*

OBJECTIVETo assess the clinical outcome of root canal therapy (RCT) and the various factors that may influence the outcome of RCT.

METHODSA total of 695 teeth from 357 patients were retrospectively studied three years after endodontic treatment. Pre- and intra-operative information was collected from the original patient records. The post-operative sign or symptom, periapical status and coronal restoration integrity were examined 3 years after obturation. Data were subjected to bivariate and multivariate analysis.

RESULTSThe cure rate for 695 teeth was 75.1%, 96.0% of which was considered to be functional. The tooth group, pre-operative pulp and periapical status, quality of root filling and integrity of coronal restoration were revealed by means of bivariate analysis to exert a significant influence on treatment outcome. The logistic analysis indicated that the odds for cure in the teeth with pre-operative periapical radiolucency, underfilling and "open" coronal restoration were significantly lower by 2 folds, 3 folds and 1.6 folds than their counterparts, respectively.

CONCLUSIONSThe pre-operative periapical status, quality of root filling and the integrity of coronal restoration are main predictors of outcome in RCT.

Adult ; Aged ; Dental Pulp Diseases ; therapy ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Periapical Periodontitis ; therapy ; Root Canal Obturation ; Root Canal Therapy ; Treatment Outcome

OBJECTIVEThis study aimed to detect the immunoexpression of interleukin-21 (IL-21) and receptor activator. of nuclear factor KB ligand (RANKL) in periapical granulomas (PGs) and radicular cysts (RCs). The interaction of IL-21 with RANKL and its role in periapical pathogenesis were also speculated.

METHODSA total of 32 PGs and 23 RCs were selected as experimental samples. Lesion size and occurrence of tenderness were recorded. Up to 10 healthy gingival tissues were collected as normal control samples. All tissues were subjected to immunohistocheincal analysis with anti-human IL-21 and RANKL polyclonal antibodies. The correlations of IL-21 with RANKL, lesion size, and the occurrence of tenderness of the PGs and RCs were evaluated.

RESULTSIL-21-positive cells were detected in all periapical lesion tissues but not in normal tissues. In the cyst group and granuloma group, the corresponding expression levels of IL-21 were 59.92±6.57 and 36.80± 6.81, whereas those of RANKL were 68.81±18.59 and 36.12±14.87, respectively. Moreover, t-test revealed a significantly higher expression of IL-21 and RANKL in RCs than in PGs (P<0.05). IL-21 and RANKL were positively correlated in both PGs and RCs (P<0.05). Furthermore, IL-21 was correlated with lesion size (P<0.05).

CONCLUSIONThis study demonstrated that IL-21 is potentially involved in the pathogenesis of apical periodontitis lesions. A role in the exacerbation of chronic inflammation, as well as in bone resorption, is suspected. Further studies are required to elucidate the specific functions of IL-21 in periradicular inflammatory processes.

Humans ; Inflammation ; Interleukins ; physiology ; NF-kappa B ; metabolism ; Periapical Granuloma ; metabolism ; Periapical Periodontitis ; RANK Ligand ; Radicular Cyst ; metabolism

In stomatology, root canal therapy is a commonly used and effective treatment for dental pulp diseases and periapical diseases. However, pain may occur during or after treatment and may severely affect patients. This article aimed to analyze the mechanism and cause of pain during root canal therapy, which may reduce or relieve pain.
Humans ; Pain ; Periapical Diseases ; Root Canal Therapy

The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to describe the differential diagnosis of periapical diseases from six rare cases in clinical practice. The six rare cases are examples of situations where it is difficult to make a differential diagnosis in clinical practice. By retrospective surveys on the clinical examination, radiographs and pathological results, six patients referred to endodontic treatment in our department were analyzed for the accuracy of diagnosis and therapy. The pathoses of the six cases included two atypical radical cysts, periapical cemental dysplasia, cemento-ossifying fibroma, thymus cancer metastasis in the periapical site and tuberculosis. This report indicates that endodontists should be cognizant of a few particular circumstances when clinically treating periapical diseases.
Adult ; Aged ; Bone Neoplasms ; diagnosis ; secondary ; Diagnosis, Differential ; Female ; Fibroma, Ossifying ; diagnosis ; Fibrous Dysplasia of Bone ; diagnosis ; Humans ; Male ; Middle Aged ; Periapical Diseases ; diagnosis ; Radicular Cyst ; diagnosis ; Tuberculosis, Osteoarticular ; diagnosis