Endodontic Reasons Research Articles

Reasons for taking radiographs in general dental practice in Dar-es-Salaam, Tanzania

This study investigated the reasons why dental practitioners at the Muhimbili Dental OPD clinic in Dar-es-Salaam take radiographs. Information was obtained from medical records at the Department of Dental Radiology for an eighteen month period, during which 28,171 patients were seen at the hospital, and of which 2,672 (9.48 per cent) were radiographed. The main reasons for taking radiographs (percentages) was to detect fractures (17.2), tumours (14.1), caries (12.5), impacted teeth (12.2), periodontal disease (11.3), and non-specific dental pain (10.4). Radiographs were also taken for orthodontic (7.0 per cent) and endodontic (6.8 per cent) reasons. Some of the reasons for taking radiographs such as hypersensitive teeth, apicectomy, neuralgia and xerostomia were previously unheard of, indicating an increasing diversity of dental services. In conclusion, there is a need to increase the utilisation of dental radiographs from the present modest level in order to meet the growing need of the increasingly informed dental population in Dar-es-Salaam.

A 3-year study of hemisectioned molars.

Over a period of 1-7 (average 2.9) years, 34 hemisectioned molars were examined clinically and radiographically. All patients were kept on a 3-6 month recall system. The indications for hemisectioning were periodontal in 9 cases and endodontic in 20 cases. In 4 cases extensive carious destruction, and in 1 case an external granuloma led to hemisectioning. Mainly mandibular molars were treated (27). Root resectioning was carried out on only 7 maxillary molars, 22 of the treated teeth were used as distal abutments for small fixed bridges. For a further 3 the same was planned. The remaining treated teeth were singly crowned. Of the 34 treated molars, 7 were considered failures, 6 for endodontic reasons (apical periodontitis) and only 1 for periodontal reasons. No correlation between failure and the length of the follow-up period was found. With 17 of the 34 molars a significant reduction in periodontal pocket depths was recorded between commencement of treatment and the final examination. No difference in periodontal pocket depth or in the height of the alveolar crest was found between hemisectioned and non-hemisectioned surfaces. The mobility of hemisectioned molars was difficult to judge because 22 of the 31 crowned teeth were used as abutments for bridges. 17 of the 22 bridges were firm, 4 showed mobility of 1 degree, and 1 mobility of 11 degrees. Of the singly crowned teeth, only 1 exhibited mobility of 111 degrees. This study indicates that the prognosis for hemisectioned teeth is favourable. Failures were primarily endodontic in origin rather than periodontal. Periodontal damage can be kept to a minimum by regularly reviewing oral hygiene standards. Treated teeth may be used as abutments for small bridges if attention is paid to achieving optimal articulation.