Endodontic microsurgery is defined as the treatment performed on the root apices of an infected tooth, which was unresolved with conventional root canal therapy. Recently, the advanced technology in 3-dimensional model reconstruction based on computed tomography such as cone beam computed tomography has opened a new avenue in application of personalized, accurate diagnosis and has been increasingly used in the field of dentistry. Nevertheless, direct intra-oral localization of root apex based on the 3-dimensional information is extremely difficult and significant amount of bone removal is inevitable when freehand surgical procedure was employed. Moreover, gingival flap and alveolar bone fenestration are usually required, which leads to prolonged time of surgery, thereby increasing the chance of trauma as well as the risk of infection. The purpose of this case report is to present endodontic microsurgery using the guide template that can accurately target the position of apex for the treatment of an anterior tooth with calcified canal which was untreatable with conventional root canal therapy and unable to track the position of the apex due to the absence of fistula.
Apicoectomy ; Cone-Beam Computed Tomography ; Dentistry ; Diagnosis ; Fistula ; Humans ; Microsurgery ; Printing, Three-Dimensional ; Root Canal Therapy ; Tooth

Endodontic treatment of primary molars is a great challenge to the dentists because of their complex morphology. However, there have been limited controlled in vivo studies about filling materials for primary teeth. Hence, the aim of this study is to evaluate and compare histologic responses of different calcium hydroxide canal filling materials that are used in daily clinical practice.Pulpectomies were performed in 132 teeth of the dogs. The root canals were randomly filled with either Vitapex® (n = 44), Metapex® (n = 44), or Metapaste® (n = 44). After 4 or 13 weeks, respectively after operation, the dogs were sacrificed, and teeth were processed for histologic examinations. Inflammatory reaction was evaluated and scored in a blind manner. The Fisher's exact test and Kruskal-Wallis test were used to compare the tested groups.In 4-week-group, all inflammatory responses were in normal range except for fibrosis. In 13-week-group, increased response to various inflammation reaction was shown compared to the 4-week-group. However, there were no statically significant differences between the tested groups in all inflammatory reaction.Overall, there were no significant differences among three materials in responses of apical tissues and all of them showed favorable tissue responses.
Animals ; Calcium Hydroxide ; Dental Pulp Cavity ; Dentists ; Dogs ; Fibrosis ; Humans ; Inflammation ; Molar ; Pulpectomy ; Reference Values ; Tooth ; Tooth, Deciduous

Sexual dysfunction is a common condition in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect, resulting in a negative effect on treatment compliance. It is known that hyperprolactinemia is a major cause of sexual dysfunction. Based on the blockade of dopamine D2 receptors, haloperidol, risperidone, and amisulpride are classed as prolactin-elevating antipsychotics, while olanzapine, clozapine, quetiapine, ziprasidone, and aripiprazole are classed as prolactin-sparing drugs. Risperidone and the other typical antipsychotics are associated with a high rate of sexual dysfunction as compared to olanzapine, clozapine, quetiapine, and aripiprazole. With regard to treatment in patients suffering from sexual dysfunction, sildenafil was associated with significantly more erections sufficient for penetration as compared to a placebo. Subsequent studies are needed in order to provide physicians with a better understanding of this problem, thereby leading toward efficacious and safe solutions.
Antipsychotic Agents ; Benzodiazepines ; Clozapine ; Compliance ; Dibenzothiazepines ; Haloperidol ; Humans ; Hyperprolactinemia ; Piperazines ; Purines ; Quinolones ; Receptors, Dopamine D2 ; Risperidone ; Stress, Psychological ; Sulfones ; Sulpiride ; Thiazoles ; Aripiprazole ; Quetiapine Fumarate ; Sildenafil Citrate

OBJECTIVES: The aim of this study was to evaluate the various NiTi rotary instruments regarding their ability to provide a circular apical preparation. MATERIALS AND METHODS: 50 single canal roots were selected, cut at the cementodentinal junction and the coronal 1/3 of the canals was flared using Gates Glidden burs. Samples were randomly divided into 5 experimental groups of 10 each. In group I, GT files, Profile 04 and Quantec #9 and #10 files were used. In Group II Lightspeed was used instead of Quantec. In Group III, Orifice shaper, Profile .06 series and Lightspeed were used. In Group IV, Quantec #9 and #10 files were used instead of Lightspeed. In Group V, the GT file and the Profile .04 series were used to prepare the entire canal length. All tooth samples were cut at 1 mm, 3 mm and 5 mm from the apex and were examined under the microscope. RESULTS: Groups II and III (Lightspeed) showed a more circular preparation in the apical 1mm samples than the groups that used Quantec (Group I & IV) or GT files and Profile .04 series.(Group V)(p < 0.05) There was no significant difference statistically among the apical 3, 5 mm samples. In 5 mm samples, most of the samples showed complete circularity and none of them showed irregular shape. CONCLUSIONS: Lightspeed showed circular preparation at apical 1 mm more frequently than other instruments used in this study. However only 35% of samples showed circularity even in the Lightspeed Group which were enlarged 3 ISO size from the initial apical binding file (IAF) size. So it must be considered that enlarging 3 ISO size isn't enough to make round preparation.
Nickel ; Titanium ; Tooth

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.
Anesthesia, General ; Calcium Hydroxide* ; Calcium* ; Debridement ; Female ; Humans ; Mandibular Nerve* ; Molar ; Neuroma ; Osteotomy ; Paresthesia ; Prognosis

PURPOSE: Laparoscopic subtotal cholecystectomy (LSC) can be an alternative surgical technique for difficult cholecystectomies. Surgeons performing LSC sometimes leave the posterior wall of the gallbladder (GB) to shorten the operation time and avoid liver injury. However, leaving the inflamed posterior GB wall is a major concern. In this study, we evaluated the clinical outcomes of standard laparoscopic cholecystectomy (SLC), LSC, and LSC removing only anterior wall of the GB (LSCA). METHODS: We retrospectively reviewed the medical records of laparoscopic cholecystectomies performed between January 2006 to December 2015 and analyzed the outcomes of SLC, LSC, and LSCA. RESULTS: A total of 1,037 patients underwent SLC. 22 patients underwent LSC; and 27 patients underwent LSCA. The mean operating times of SLC, LSC, and LSCA were 41, 74, and 68 minutes, respectively (P < 0.01). Blood loss was 5, 45, and 33 mL (P < 0.05). The mean lengths of postoperative hospitalization were 3.4, 5.4, and 5.8 days. Complications occurred in 24 SLC patients (2.3%), 2 LSC patients (9%), and 1 LSCA patient (3.7%). There was no mortality among the LSC and LSCA patients. CONCLUSION: LSC and LSCA are safe and feasible alternatives for difficult cholecystectomies. These procedures help surgeons avoid bile duct injury and conversion to laparotomy. LSCA has the benefits of shorter operation time and less bleeding compared to LSC.
Bile Ducts ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Gallbladder ; Hemorrhage ; Hospitalization ; Humans ; Laparotomy ; Liver ; Medical Records ; Mortality ; Retrospective Studies ; Surgeons

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.
Adult ; Anatomic Variation ; Apicoectomy ; methods ; Cone-Beam Computed Tomography ; methods ; Dental Pulp Cavity ; diagnostic imaging ; pathology ; Glass Ionomer Cements ; therapeutic use ; Humans ; Male ; Maxilla ; Molar ; diagnostic imaging ; pathology ; Periapical Periodontitis ; therapy ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; methods ; Tooth Replantation ; methods

Congenital melanocytic nevus (CMN) is a benign condition that either is present at birth or develops in the first weeks of life. Surgical removal is typically performed to improve cosmetic appearance and reduce the risk of malignant transformation. In this report, we present the case of a 26-year-old woman with a medium-sized CMN on her left breast. The nevus measured 14×8 cm, and the patient desired a single-stage excision. However, this approach would result in a large skin defect that would be challenging to reconstruct using a local flap or skin graft. Moreover, it could potentially compromise the maintenance of natural sagging and the contour of the breast. Consequently, we opted to place a thin thoracodorsal artery perforator free flap following the removal of the CMN. The patient was satisfied with the overall surgical results. By utilizing this free flap for reconstruction, we successfully preserved the natural shape and contour of the breast without complications such as postoperative hypertrophic scarring or contracture at the recipient site.

This study intended to evaluate noise level of dental handpieces and the effects of noise cancelling devices. An ear model was designed to measure the level of the noise delivered to the inner ear during dental handpiece operation. The level of noise was measured in various conditions using the ear model and the portable noise meter. Noise level was measured again after applying of 4 different noise cancelling devices to the model ear.
The noise level of dental handpieces was 82.5 - 84.4 dB. When 4 types of noise canceling devices were applied, the noise level reduced to 67.4 - 73.8 dB. All 4 devices had statistically significant effect in reducing the noise of the handpiece.
Considering the intensity and exposure time, noise in dental clinics can cause hearing damage to dentists. For protection from the risk of occupational hearing damages, noise canceling devices can be recommended.

Background: Various materials, commonly called fillers, have been developed and are now used for cosmetic and reconstruction purposes. Indiscriminate injections of illegal and unknown substances have various side effects, among which foreign body granulomas are particularly difficult to treat. Surgical resection can be considered for small and well-defined foreign body granulomas, but complete resection is often impossible for wide facial granulomas, and postoperative deformities may occur. Therefore, this study presents cases where foreign bodies were evaluated using imaging studies and removed through minimally invasive procedures depending on their characteristics. Methods: Thirty-five patients with chronic granulomas after illegal filler injections treated from 2012 to 2019 were enrolled. Clinically, these granulomas were classified into cystic and infiltrating groups according to the imaging study patterns. Patients in the cystic group underwent puncture and drainage, and those in the infiltrating group were first treated with intralesional laser treatment and then suctioned. If the results were insufficient, surgical removal combined with a lifting procedure was performed. Results: All 35 patients were women, and their average age was 51 years. Surgery was successful in almost all cases, but four cases of insufficient removal and contour deformity were encountered during follow-up. Two patients underwent reoperation and two patients improved naturally. Conclusions In this study, we classified the characteristics of granulomas using preoperative imaging studies. Aesthetically favorable results were obtained using puncture and drainage and tumescent suction, along with, if necessary, surgical removal accompanied by a lifting procedure when removing facial foreign body granulomas.