Acute Periapical Periodontitis Research Articles

Impact of COVID-19 on Dental Emergency Services in Cluj-Napoca Metropolitan Area: A Cross-Sectional Study.

This study aimed to assess dental care needs in Cluj region during the State of Emergency, declared due to the COVID-19 pandemic, compared to the same period of the year 2019. A descriptive retrospective analysis was conducted, which retrieved patients seeking emergency dental services at the Emergency Department of County General Hospital and “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania, the only dental service available in April 2020. Recorded data cover the month of April 2020 and is compared with the same period of 2019. During April 2020, 724 patients received dental care, whereas only 160 patients were treated in April 2019 in the same facility. The number of patients with acute apical periodontitis, abscess, and acute pulpitis was significantly higher in 2020. The percentage of patients receiving sedative filling for the treatment of acute pulpitis in 2020 was significantly higher than in 2019, while the proportion of patients receiving pulpectomy was higher in 2019. The percentage of patients receiving endodontic drainage for the treatment of acute periapical periodontitis in 2020 was higher. This study demonstrates that the COVID-19 pandemic impacted the use of medical care services and could further impact the oral health and quality of life of patients.

X-linked hypophosphatemia diagnosed after identification of dental symptoms

X-linked hypophosphatemic rickets (XLH) is a skeletal disorder with spontaneous appearance of a periapical abscess in clinically healthy-like teeth a typical dental finding. A 1Y5M boy came to our clinic with spontaneous pain in the maxillary anterior region. Clinical examinations led to diagnosis of acute periapical periodontitis in the maxillary left primary central incisor , for which root canal treatment was performed. Thereafter, a pediatrician diagnosed XLH based on elevated ALP in a blood test at 1Y10M. We should have been suspected XLH in this case even with the absence of periapical abscess.

The role of unfinished root canal treatment in odontogenic maxillofacial infections requiring hospital care

The aim of this study was to evaluate clinical and radiological findings and the role of periapical infection and antecedent dental treatment of infected focus teeth in odontogenic maxillofacial abscesses requiring hospital care. In this retrospective cohort study, we evaluated medical records and panoramic radiographs during the hospital stay of patients (n = 60) admitted due to odontogenic maxillofacial infection originating from periapical periodontitis. Twenty-three (38 %) patients had received endodontic treatment and ten (17 %) other acute dental treatment. Twenty-seven (45 %) had not visited the dentist in the near past. Median age of the patients was 45 (range 20-88) years and 60 % were males. Unfinished root canal treatment (RCT) was the major risk factor for hospitalisation in 16 (27 %) of the 60 cases (p = .0065). Completed RCT was the source only in 7 (12 %) of the 60 cases. Two of these RCTs were adequate and five inadequate. The initiation of inadequate or incomplete primary RCT of acute periapical periodontitis appears to open a risk window for locally invasive spread of infection with local abscess formation and systemic symptoms. Thereafter, the quality of the completed RCT appears to have minor impact. However, a considerable proportion of the patients had not received any dental treatment confirming the importance of good dental health. Thus, thorough canal debridement during the first session is essential for minimising the risk for spread of infection in addition to incision and drainage of the abscess. If this cannot be achieved, tooth extraction should be considered. Incomplete or inadequate canal debridement and drainage of the abscess may increase the risk for spread of endodontic infection.

The transition from pulpitis to periapical periodontitis in dogs’ teeth

The purpose of the study was to histologically analyse transition from pulpitis to periapical periodontitis on dog's teeth. Pulps of mandibular premolars (37 roots) were exposed using a low-speed handpiece. Teeth were left open to the oral environment for 20, 35, 50 and 65 days. After the experimental period animals were sacrificed. Undemineralised teeth with surrounding bone, embedded in methylmetacrylate, were prepared for standard histological analysis. All teeth with pulpitis (five roots), regardless of the experimental period, had acute serose periapical periodontitis. All teeth (15 roots) with partial pulp necrosis had subacute periapical periodontitis. Teeth with complete pulp necrosis (19 roots) had chronic periapical periodontitis and in one case suppurative apical periodontitis. The condition of the pulp correlates with the histopathological findings of periapical tissue in the open types of pulp infection. Acute periapical periodontitis begins during pulpitis and can occur before 20 days of pulp exposure in the dog.

Hypertension among dental patients attending tertiary health institution in Edo State, Nigeria.

Hypertension is one of the cardiovascular diseases which has been reported as one of the common causes of death worldwide. Some medical conditions including hypertension could alter the course of oral disease; modify dental treatment and response to such treatment. This was to determine the prevalence of hypertension among dental patients and their common presenting oral complaint. Measurement of the blood pressure of all the patients aged 18 77years who were attending the dental clinic was carried out using sphygmomanometer and stethoscope. The overall prevalence of hypertension among dental patients was 19.7% while that for unknown hypertension (hypertension detected at the dental clinic) was 10.3%. Acute periapical periodontitis and chronic marginal gingivitis were common clinical presentations. Some dental patients were unaware of their blood pressure levels. It is important for all dental patients to be screened for hypertension to avoid the complications that may arise therefrom.

Development and validation of a dental pain-screening questionnaire

Dental pain, estimated to affect 12–40% of community-dwelling adults, is a symptom of a wide range of clinical conditions. A population screening instrument is needed to study their prevalence. This project aimed to develop a questionnaire for classifying a sample of dental pain patients into three groups of common dental pain conditions, i.e. Group 1 (Acute periapical periodontitis and Irreversible pulpitis), Group 2 (Reversible pulpitis and Dentine hypersensitivity) and Group 3 (Pericoronitis). Initial items were generated through a literature review, individual unstructured patient interviews and consultation with experts. Items generated were administered to a sample of dental pain patients for self-completion. Responses were subjected to a series of factor and discriminant analyses to identify questions capable of differentiating the sample into three groups, originally categorized by clinical diagnosis, with high classification rates. The selected items were administered to a further sample of dental pain patients to test for its sensitivity and specificity in classifying the sample into three groups against the gold standard of clinical diagnosis. The final 16-item Dental Pain Questionnaire (DePaQ) was capable of correctly classifying 89.7% of dental pain cases initially categorized by clinical diagnoses. The sensitivity of the questionnaire was 0.80—Group1, 0.85—Group2 and 0.59—Group3. Specificity was 0.83—Group1, 0.89—Group2 and 0.90—Group3. The DePaQ, which can easily be administered by non-clinical personnel, may be used to collect epidemiological data on common dental pain conditions, assess dental needs for a specified population, and triage of patients seeking treatment for dental pain.

Endodontic Treatment Involving Intraoral Nevus Flammeus

<h2>Summary</h2> A maxillary central incisor with a necrotic pulp and acute periapical periodontitis was treated. The tooth was located in angiomatous tissue, which may have caused hemorrhagic and restorative problems. The endodontic treatment was completed without any complications. For patients with nevus flammeus of the gingiva who have nonreversible pulpal pathosis, endodontic treatment is an excellent treatment selection.