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Aim: To assess the prevalence of acute periapical abscesses (PAs) in patients with a history of extracranial carotid artery aneurysms (ECAA). Materials and methods: History of acute PAs and ECAA diagnosis was retrieved by searching the appropriate query in the database. All cases were diagnosed for acute PAs by calibrated dentists for patients admitted to urgent care. The odds ratio (OR) for the prevalence of acute PAs and its association with history of ECAA were then calculated. Results: The prevalence of acute PAs in patients with a history ECAA was significantly higher as compared to the general hospital patient population (p < 0.0001). The OR was 5.5. Females were more affected than males by 1.7 folds (p < 0.001). Whites were more affected than African Americans by 1.6 folds (p < 0.00001). Conclusions: The high prevalence of acute PAs in patients with a history of ECAA may suggest an association between these two conditions warranting a thorough medical examination.

Aim: To assess the prevalence of acute periapical abscesses (PAs) in patients infected with herpes simplex type 1 (HS-1) and herpes zoster (HZ). Materials and methods: Integrated data of hospital patients was used. History of HS-1 and HZ diagnosis was retrieved by searching the appropriate query in the database. All cases were diagnosed for acute PAs by calibrated dentists in a hospital setting for patients admitted to urgent care. Diagnosis was made based on clinical examination and imaging data confirming the diagnosis of acute PAs without sinus tract. The odds ratio (OR) for the prevalence of acute PAs and its association with history of HS-1 and HZ were then calculated. Results: The prevalence of acute PAs in patients with a history HS-1 was 2.43% as compared to 0.59% in the general patient population of the hospital. The OR was 4.12 and the difference in prevalence was statistically significant (p < 0.0001). The prevalence of acute PAs in patients with a history HZ was 2.78% as compared to 0.59% in the general patient population of the hospital. The OR was 4.71 and the difference in prevalence was statistically significant (p < 0.0001). Conclusions: Under the conditions of this study, it appears that the prevalence of acute PAs is significantly higher in patients with a history of HS-1 and HZ infections and may warrant an antiviral therapy in certain resistant periapical abscesses.

Aim: The aim of this study was to assess the prevalence of acute periapical lesions in patients with pSS. Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for pSS and acute periapical abscess was retrieved by searching the appropriate query in the database. The patient population analyzed was mixed, presenting with different disease conditions including periapical abscesses without sinus. The different diagnoses were coded using the international coding systems ICD 10. Diagnosis was made by calibrated dentists in a hospital setting based on clinical examination and imaging data. Patients with ICD 10 diagnosis code of acute periapical abscess were recorded and the prevalence of acute periapical abscesses in patients with primary Sjögren syndrome were compared to the prevalence in the total hospital patient population. The odds ratio (OR) for the prevalence of acute periapical abscesses and its association with pSS were calculated with a 95% confidence interval and the statistical difference between the groups was assessed. Results: The odds ratio (OR) for the prevalence of acute apical abscesses and its association with pSS were calculated and analyzed statistically. The prevalence of periapical abscesses in patients with pSS was 1.87% as compared to 0.58% in the general patient population of the hospital. The OR was 3.11 and the difference was statistically significant (p<0.0001). Conclusions: Under the conditions of this study, it appears that the prevalence of acute periapical abscesses is significantly higher in patients with pSS. [ABSTRACT FROM AUTHOR]

Background: Achieving a good apical seal for root canals is known to be associated with good mineral trioxide aggregate (MTA) adaptation to dentin. Aims: This study aims to compare the marginal adaptation of MTA with root dentin between orthograde and retrograde application techniques using micro-computed tomography (micro-CT) analysis. Settings and Design: Fifty-two single-rooted human teeth were divided into four equal groups: (Group 1) Retrograde MTA (RMTA), (Group 2) Orthograde MTA (OMTA), (Group 3) Etched RMTA (ERMTA), and (Group 4) Etched OMTA (EOMTA). Materials and Methods: For Group 1, 3-mm retrograde cavities were prepared and filled with MTA. For Group 2, the apical 6 mm of the canals were filled with MTA and sealed with sealer cement and warm gutta-percha. In Groups 3 and 4, canals were treated the same as Groups 1 and 2, respectively, except that before placing the MTA, canals were irrigated with 17% ethylenediaminetetraacetic acid (EDTA). After 48 hours, all the teeth were analyzed using a micro-CT scanner. Statistical Analysis: Mean dentin-MTA contact and the mean length and width of each gap was analysed using one-way analysis of variance (ANOVA). Statistical significance was set at an α level of 5%. Results: No significant difference in gap volumes was observed in the dentin-MTA adaptation in both orthograde and retrograde application techniques. However, significant difference in the gap volumes was observed between RMTA and ERMTA (P = 0.045). Etching significantly improved the MTA-Dentin adaptation (P < 0.05). The type of application technique did not significantly improve the dentin-MTA adaptation, instead with the use of 17% EDTA, a significant improvement could be achieved. Conclusion: Within the limitations of the present study, it concludes that MTA adaptation to dentin tooth structure is not significantly different between an orthograde and retrograde approach. However, the use of EDTA significantly improved the MTA-Dentin adaptation. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to survey the opinion of endodontists in the United States regarding their approach to treatment of cracked teeth., Materials and Methods: A survey assessing the opinions of 3,500 endodontists in the United States was administered over a 4-week period. It consisted of a hypothetical clinical case and eight different treatment scenarios. Participants were asked to select one of the two treatment options: (A) informing the patient of the presence of a crack, reinforcing the tooth, and continuing with endodontic treatment; and (B) extraction of the tooth followed by replacement with an implant supported crown or fixed partial denture., Results: When the crack extended across the distal marginal ridge with no associated probing depths, 92.65% endodontists preferred to continue with endodontic treatment and reenforcing the tooth. When the crack extended across the distal marginal ridge and was associated with a probing depth of 6 mm, 80% preferred extraction of the tooth. When the crack extended across the mesial marginal ridge up to the orifice of the mesiolingual canal with no associated probing depth, 82.78% preferred to continue with the treatment. When the crack was associated with a 6-mm probing depth, 83.79% preferred tooth extraction. When the crack extended across the mesial marginal ridge and down into the mesiolingual canal with/without associated probing depth, 91.13% and 63.54% preferred tooth extraction, respectively. When the crack involved both mesial and distal marginal ridges and extended across the pulp chamber, 79.74% preferred tooth extraction. When a split tooth was presented, 98.48% preferred tooth extraction., Conclusion: It appears that the presence of a 6-mm periodontal pocket is considered an important factor by most American endodontists when deciding whether to preserve the cracked tooth or extract it., Clinical Significance: There is no consensus among dentists regarding the best approach to treat cracked teeth. Conclusive studies evaluating clinical approaches of endodontists regarding treatment of cracked teeth are lacking. Therefore, surveyed opinion of endodontists in the United States regarding their approach to treatment of cracked teeth was done to try to reach the best clinical decision regarding this dilemma.