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The aim of the study was to collect data about the prevalence and risk factors of apical periodontitis in a population of endodontically treated patients. The study group included 151 patients (52 males, 99 females; mean age 48.36 ± 15.708 yrs.) with 391 endodontically treated teeth (mean follow-up of 5.25 ± 1.759 yrs.). According to the initial tooth diagnosis, root-filled teeth were divided into Group A, root-filled teeth treated for pulpitis or for the purpose of prosthetic pulpectomies (vital pulp group), and Group B, root-filled teeth with non-vital pulp (necrotic pulp). Clinical and radiographic evaluation of the root and its periapical area were performed to establish the success/failure of endodontic therapy, the quality of the root canal fillings (length, density, taper), and coronal restoration. The presence of recurrent caries, periodontal pathology, or endo-periodontal lesions were also recorded. Univariate and multivariate analyses were used to determine the risk factors for apical periodontitis and calculate their odds ratios (ORs). For the root-filled vital pulp tooth group, the highest risks for apical periodontitis are associated with inadequate homogeneity (OR 30.938), periodontitis (OR 9.226), and over-filling (OR 8.800). For the root-filled non-vital pulp tooth group, the highest risks are associated with periodontitis (OR 4.235) and age over 60 yrs. (OR 4.875). For the necrotic pulp tooth group, multivariate analysis identified an age > 60 yrs., filled molars, intracanal posts, poor coronal restoration quality, under-filling, and periodontitis as significant combined risk factors. Inadequate root canal filling and periodontitis in both groups were risk factors associated with most cases of apical periodontitis. Other risk factors include age > 60 yrs., poor coronal restoration quality, and the presence of intracanal posts in root-filled teeth with necrotic pulp. [ABSTRACT FROM AUTHOR]

Supernumerary teeth represent isolated dental anomalies which may be present on the midline (mesiodens), in the premolar or molar region. Among the etiological factors are local factors, but they can also appear as manifestations of genetic syndromes. Familiarization with this anomaly is important for orthodontists, pedodontists and general dentists who frequently consult children at an early age. Supernumerary teeth can cause clinical complications. Early detection based on clinical and radiological examination and subsequent orthodontic and surgical interventions reduce the risk of occlusal disorders of the dental-maxillary apparatus.

Aim. The aim of study was to assess the root-filled teeth with periapical lesions by using Periapical and Endodontic Status Scale (PEES) index. Materials and method. The study group included 166 filled root canals (70 molars and premolars) in 42 patients (gender: 12 males, 32 females; mean age 35.90 ± 10.571 yrs.) treated in Clinical Base of Faculty of Dental Medicine, U.M.F. "Grigore T.Popa" Iasi. The evaluation of root canals and periapical areas was performed by using the two components of Periapical and Endodontic Status Scale (PEES) index, COPI and ETTI. Results. Distribution of COPI components in the study group was as follows: COPI D: 30,7% D1, 69,3% D3; COPI R: 27,1% R1, 70,5% R2, 2,4% R3; COPI S: S1 16,3%, S2 21,7%, S3 62%. Distribution of ETTI components in the study group was as follows: ETTI L: 42,2% L1, 43,4% L2, 5,4% L3, 5,4% L4, 3,6% L5; ETTI H: 36,7% H1, 63,3% H2; ETTI CS: 10,8% CS1, 89,2% CS2; ETTI CF: 3,6% CF1, 9% CF2, 5,4% CF3, 81,9% CF5. Conclusions. In endodontically treated teeth with apical periodontitis, PEES indices allowed to detect 62% of root canals with periapical lesions with diameter over 5 mm, while more than two thirds of teeth roots had periapical lesions extended in cortical bone (69,3%) affecting more than one root (70,2%). All teeth roots with apical radiolucency and non-treated root canals as well as roots with perforations or resorptions had apical lesions with diameter over 5 mm extended in cortical bone. The presence of apical radiolucency more than one root was associated to overfilling or root resorption. [ABSTRACT FROM AUTHOR]

This article discusses several studies on the effects of different root canal irrigation solutions on the removal of smear layer and the roughness of the dentin surface. The results show that the combination of 20% EDTA with 5.25% NaOCl is more effective in removing smear layer compared to other solutions, but it also increases the roughness of the dentin surface. Another study found that physiological serum had the lowest surface roughness values compared to other irrigation solutions. The document also provides a list of references to other scientific articles and studies on root canal irrigation and its effects on dentin. [Extracted from the article]

This article presents the findings of a study on the prevalence of apical periodontitis in root-filled teeth. The study found that 46.3% of the teeth had periapical lesions, and the prevalence varied based on demographic and clinical factors. The article highlights the advantages of using cone-beam computed tomography (CBCT) in diagnosing and monitoring the outcomes of root canal treatment. The study concludes that CBCT examination and the CBCT-PAI index are reliable tools for evaluating the healing process of chronic periapical lesions. The research also suggests that inadequate root canal filling and poor coronal marginal sealing contribute to treatment failure. [Extracted from the article]

This article discusses the use of cone beam computed tomography (CBCT) in assessing the success or failure of endodontic treatment in root-filled teeth. The study found that 49.2% of the root-filled teeth showed signs of chronic apical periodontitis, indicating failure of the treatment. The distribution of CBCT-PAI indices was significantly influenced by factors such as age, follow-up period, dental group, quality of coronal restoration, and quality of endodontic treatment. The study confirms previous research that identified these factors as risk factors for endodontic failure. CBCT was found to be a valuable tool in detecting periapical lesions and assessing treatment outcomes. The article emphasizes the importance of CBCT in improving the assessment and management of endodontic treatment outcomes. [Extracted from the article]

Aim of study. The assessment of the postoperatory healing processes in guided tissues regeneration by association of plasma rich in growth factors (PRGF) with xenograft. Materials and method. The study group included 24 edentulous patients, candidates to dental implants (age 30-65); the patients were planned for pro-implant procedures by alveolar augmentation and guided tissues regeneration techniques with delayed implantation (6-8 months). The patients were selected from Clinical Base of Dental Education, Faculty of Dental Medicine, U.M.F. ˝Gr.T.Popa˝ Iasi and 2 private dental practices. The informed consent was obtained. The patients required guided bone regeneration technique to improve alveolar bone parameters in implant sites areas with moderate and severe defects. A combination of xenograft (Hypro-Oss, BioImplon) and Plasma Rich in Growth Factors (PRGF, Endoret) was used as grafting material. The postoperatory healing processes were monitorised by recording of the rate of complications and success rate. Results. The association of plasma rich in growth factors (PRGF) with xenografts materials is associated with postoperatory complications in only 6-12% cases and has 94% success rate în pro-implant alveolar augmentation. Conclusion.PRGF technology can be used for new combinations with potential to increase the clinical effectiveness of the guided tissues regeneration techniques in oral surgery.

Aim of study. The aim of study was to asses the bone volum gain in guided bone regeneration techniques using various grafting materials. Materials and method. Results. The highest mean values for parameter bone height (11,28 mm), in the alveolar augmentation procedures, were recorded in the study group that combined xenograft Hypro-Oss and PRGF, followed by xenograft SmartBone group (9,83 mm), and allogenuous material OsteoBiol (8,55 mm). The highest mean values for parameter bone width (2,00 mm), in the alveolar augmentation procedures, were recorded in the study group that combined xenograft Hypro-Oss and PRGF, followed by allogenuous material OsteoBiol group (1,96 mm), and xenograft OsteoBiol (1,83 mm). The changes of osteodensity, in the alveolar augmentation procedures, were highest in the xenograft SmartBone group (197,5HU) and allogenuous material OsteoBiol group (180HU), and the lowest osteodensity chages were recorded Hypro-Oss & PRGF test group (151,39HU). Conclusions. The use of the mixed graft Hypro-Oss and PRGF conducted to the highest gain of alveolar bone height and width but the lowest osteodensity values, comparing to xenografts from the new generation of graft materials.

This article examines the effects of pretreating dentin with a 2% chlorhexidine solution and subjecting it to cariogenic attack on the marginal adaptation of glass ionomer cement (GIC) to dentin walls. The study found that pretreatment with chlorhexidine did not significantly affect the marginal adaptation of GIC to dentin, but cariogenic attack did have a negative impact on the interface between the material and dentin. The study emphasizes the need for further validation through in vitro and in vivo studies and provides insights for the use of GIC. [Extracted from the article]

This article from the Romanian Journal of Oral Rehabilitation discusses the dental anomaly known as taurodontism and its challenges in pediatric dentistry. Taurodontism is characterized by an enlarged pulp chamber and a lack of constriction at the cement-enamel junction. It can appear as an isolated anomaly or be associated with syndromes and abnormalities. The article highlights the difficulties in endodontic treatment and emphasizes the need for clinicians to review the best treatment options for taurodontic teeth. The text discusses the challenges and management of taurodontic teeth, which have unique anatomical variations. The root canal system of taurodontic teeth can be complex and difficult to access. The treatment may involve careful exploration, magnification, and ultrasonic irrigation. Extraction of taurodontic teeth can be complicated due to the dilated apical third, but it may also be easier due to the large body and small surface area. Taurodontic teeth may have favorable periodontal prognosis in certain cases. Prosthodontic treatment should avoid post placement and consider the strength of the tooth. Taurodontism can also be associated with genetic syndromes and systemic conditions. Dental practitioners should be aware of these changes and use appropriate techniques for endodontic and prosthodontic management. [Extracted from the article]

The present study aimed at assesssing - by clinical, histological and radiological investigations - the influence of some external factors on the pulp-dentin complex, and at providing a causal interpretation of the structural changes observed. Materials and methods. Clinical and radiological exams were performed on 65 old patients with ages between 60-75, and also on 40 young patients with ages between 20-35, presenting different dental-periodontal pathologies. The pulp-dentin complex was submitted to a morphopathological examination, to highlight the structural changes observed at microscopic level. Fragments of dental pulp were imersed in a 4% formaldehyde solution with phosphate buffer 0.1 M., pH 7.2, for 12-14 hours, at a temperature of 4°C, and 3-5 µm thick slices were prepared. The slices were coloured with hematoxylin-eosine (HE), by the trichromic technique - Masson. Photographies were taken with a Zeiss microscope, with Kodak 200 ASA. Results. Significant differences were observed, between the two groups of patients, as to the external factors that produce structural changes on pulp-dentin organ. In the group of young patients dental caries and coronal fillings prevailed, while the group of old patients was mostly associated with atrition and chronic marginal periodontitis. Out of the 40 young patients, 30 presented chronic dental caries (75%), while, among the 65 old patients, only 24 presented dental caries (36.9%). The percentages of coronary fillings between the two study groups were close, which could be considered as one of the causes producing changes in the pulp-dentin organ, following aggresive preparation of cavities, the action of materials used for the protection of pulp-dentin complex or of the materials used for coronry fillings. Conclusions. Dental pulp has a remarkable ability to counteract the action of harmful factors, producing a mineral barrier and stimulating the reparatory processes. Changes in the endodontic space can be produced in both experimental groups, but more intensely and more frequently in the old patients. The endodontic space is modified, both physiologically and pathologically, including deposition of secondary or tertiary dentin (reactionary or reparative dentin), as well as pulp reactions, such as: inflammation, fibrosis, calcium degeneration or vacuolisis. At cell level, microsocopic images showed a decrease of the odontoblasts number and sizes, as well as a reduced fibroblasts/fibrocytes ratios. These changes are associated with progressive vascular and nervous changes, that can be considered both theis cause and effect. These pathological transformations are related with a more difficult preparation of the endodontic space and can be considered as having a major role in the failure of endodontic therapy. [ABSTRACT FROM AUTHOR]

Objective: Periapical granulomas, chronic periapical osteitis produced particularly by the bacterial continuous agression from the endodontic space, can develop accordingly, or they can transform in epithelial or cystic granulomas, their diagnosis being more difficult to determine at these stages. This study aimed to emphasize a few aspects that can conduce to an easier diagnosis establishment. Materials and method: 78 patients with periapical chronic periodontitis have been evaluated in order to assess their evolution to epithelial or cystic granulomas. These cases were monitorised during the endodontic treatment and, were necessary, endodontic surgery was performed and samples for the histopathologic exam were drawn, in order to make an accurate diagnose. Results: From the 78 cases of teeth with chronic periapical periodontitis, 18 required surgical approach: 4 curettages, 5 apicectomies, 9 extractions, from which 7 were labeled as cystic granulomas, after the microscope examination. Conclusions: Untill the comming out of an accurate diagnosis method for these lesions, the practitioner must consider all possible data from the anamnesis to the clinic and radiographic exam, the only relyable method to establish a correct diagnosis being the histopathologic exam. [ABSTRACT FROM AUTHOR]

Unlabelled: The study aimed to assess the prevalence and severity of periodontal disorders as well as possible correlations between periodontal status and parameters as follows: sex, age, dental group., Material and Method: Study group included 143 subjects (58-males, 84-females) aged between 15-65 years. The assessment of periodontal status was performed using CPITN indices (gingival inflammation, periodontal pockets depth) and Rateitschak indices (alveolar resorption degree visible on ortopantomographs). The correlations between age group, sex, dental group and CPITN indices, alveolar resorption degree and periodontal status were performed. Data were processed and submitted to statistical analysis., Results: The results regarding CPITN indices distribution were as follows: CPITN 0-6%, CPITN 1-8%, CPITN 2-22%, CPITN 3-47%, CPITN 4-17%. The results regarding alveolar resorption degree were as follows: absent-37%, small-28%, moderate-24%, severe-11%. The prevalence of chronic periodontitis was 60% and rapid progressive periodontitis were associated with 4.2% patients., Conclusion: The investigation of CPITN indices and alveolar resorption degree represent efficient tools for the assessment of periodontal status and treatments needs in epidemiological studies.

Unlabelled: Our study aimed to assess the possibilities of healing in periapical lesions following endodontic therapy, using a standardised technique., Material and Methods: Study group included 34 patients with 15-45 age. 40 teeth with periapical granuloma and periapical difuse osteitis were endodontically treated. All teeth presented radicular obturations with adequate length and density consisting of gutaperca points and antiseptic sealer (Endoflas, Sanlor). Optimum coronal sealing was provided through prosthetic restorations or composite resins associated with glassionomer cements. All treated teeth were radiographically monitorised on a 24 months time interval. Periapical Index (PAI) were used for assessment of periapical healing processes. Recorded data were used for statistical analysis in SPSS 16 trial., Results: The assessment of periapical status after 24 months showed a complete periapical healing for 42.5% teeth (PAI 1-2), partial periapical healing for 52.5% teeth and 5% endodontic failures. Median values for PAI indices decreased from an initial 4.75 value to 4.30 after 3 months, 3.33 after 12 months and 2.60 after 24 months. Wilcoxon tests confirm significant statistical differences between PAI indices at different time intervals., Conclusions: Adequate radicular obturation associated with optimum coronal sealing provide a favourable environment for periapical healing processes, providing success in endodontic therapy of chronic apical periodontitis. Time interval represents a major factor that influences periapical remineralisation degree.