RESUMO
A recent study from a private endodontic practice compared "prophylactic" antibiotic (high-dose, 1-day) regimens of penicillin V and erythromycin (base or stearate) for patients who had asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL). A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred, and gastrointestinal side effects were found primarily with the erythromycins (12.4%). To ascertain whether or not similar results would occur with student operators in a dental school clinic population, the current study was undertaken. One-hundred ninety-five patients with quiescent PN/PL were randomly given either penicillin V or erythromycin (base or stearate). A 2.6% flare-up incidence was found, with no statistically significant differences for penicillin (3.1%), base (1.5%), and stearate (3.1%). No hypersensitivity responses occurred, and GI side effects were found primarily with the erythromycins (17.7%). As can be seen, the results were very similar to those of the recent endodontic practice study. Hence, it can be concluded that the results of the previous endodontic practice study were not unique to any one clinician or method. A comparison was also made between the "prophylactic" penicillin group of the current study and the placebo control group of our previous dental school clinic, student operator study (in which the methods, population, and regimen were almost identical to those of the current study). The results showed that the "prophylactic" penicillin group had significant fewer flare-ups and non-flare-up-associated swelling and pain than did the placebo group. In view of these findings and those from studies from the literature in which "prophylactic" antibiotics were not used, it is our opinion that the antibiotic regimens used in the current study should be a component of clinical endodontic therapy for quiescent PN/PL.
Assuntos
Necrose da Polpa Dentária/terapia , Eritromicina/uso terapêutico , Penicilina V/uso terapêutico , Doenças Periapicais/terapia , Tratamento do Canal Radicular , Adolescente , Adulto , Idoso , Edema/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Estudos Prospectivos , Distribuição Aleatória , Tratamento do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/métodosRESUMO
Because many failures in root canal therapy have been attributed to the use of silver cones as a filling material, it was decided to examine four roots of three teeth, each of which had been successfully treated endodontically with silver cones ranging from 24 to 34 years previously. These roots, which were resected for periodontal reasons, were examined both under the scanning electron microscope and histologically. Examination with the scanning electron microscope revealed that all four cones were moderately to severely corroded. Histologic examination of two teeth disclosed corrosion products along the entire wall and, in one instance, within the dentinal tubules and apical tissue. The corrosion products, however, were most extensive in the cone that appeared to be loose fitting within the canal. The results indicated that corrosion products occurred in all of the teeth examined. Therefore, corrosion may not be the primary factor accounting for failure in teeth endodontically treated with silver cones.
Assuntos
Materiais Restauradores do Canal Radicular , Prata , Corrosão , Cavidade Pulpar/ultraestrutura , Estudos de Avaliação como Assunto , Humanos , Microscopia Eletrônica de Varredura , Propriedades de Superfície , Fatores de Tempo , Raiz Dentária/ultraestruturaRESUMO
Grossman's sealer, eucapercha, Endo-Fill, CRCS, Sealapex, Hypocal, and sterile saline solution (0.3 ml of each) were injected into specific dorsal subdermal tissue sites of 12 guinea pigs. The animals were killed after 6 days, 15 days, and 80 days (four per time period). Analysis of tissue response showed that, overall, Sealapex and Endo-Fill had less severe inflammatory reactions than any of the other test materials. Grossman's sealer, CRCS, and Hypocal showed principally severe inflammatory responses at both 6 and 15 days, but mild reactions at 80 days. Overall, eucapercha showed less severe inflammatory responses than Grossman's sealer, CRCS, and Hypocal. Diffuse calcification was induced by the three calcium hydroxide preparations (CRCS, Sealapex, and Hypocal). Eucapercha and Endo-Fill had minute local areas of calcification. Both Grossman's sealer and CRCS did not have overall favorable histologic reactions; however, Grossman's sealer and CRCS have been used successfully clinically. Further clinical studies are needed.