Periapical Changes Research Articles

Clinical study of two luting cements used on student-treated patients: An interim report

A long-term clinical test has been started to compare a zinc phosphate with a polycar☐ylate cement as luting materials for crowns and fixed partial dentures. The present report includes an evaluation of two groups of student-treated patients regarding their suitability for this type of testing, as well as certain clinical and radiographic criteria recorded 6 and 18 months after insertion of the restorations. No significant differences were observed regarding the composition of the patients or the type of treatment. No loosening of restorations and no differences between the two groups in other respects such as subjective complaints, clinical symptoms, carious lesions, or periapical changes were observed. So far, both cements seem equally suitable as luting materials.

Immune components in normal and inflamed human dental pulp

Normal and inflamed human pulpal tissues were examined for the presence of humoral immune components. The results indicate that normal pulpal tissue is essentially devoid of components necessary for localized immunoglobulin synthesis as shown by the absence of any immunoglobulin-containing cells (ICC). Tissue fluorescence was observed only in the unwashed samples and mainly with the fluoresceinated IgG reagent. This fluorescence was essentially eliminated by prewashing prior to the application of the fluoresceinated antiserums. On the other hand, inflamed pulpal tissues showed the presence of various ICC. IgG ICC were preponderant, constituting more than 60 per cent of ICC observed. Significant numbers of IgA and IgE ICC were also observed in each sample examined; whereas IgM ICC were present in only 3 of 12 specimens. At the tissue level, fluorescence was observed both in unwashed and prewashed tissues, predominantly with the labelled IgG antiserum. The presence of ICC, as well as extracellular immunoglobulin in inflamed pulpal tissue suggests that the potential exists for immune mechanisms to contribute to the pathological periapical changes seen as sequelae to pulpal inflammation.

Periapical destructions caused by experimental pulpal inoculation of Streptococcus mutans in rats

The development of pulpal and periapical changes in rat molars was studied after inoculation of Streptococcus mutans (GS-5) into the pulp chamber. Before injection into the pulp Streptococcus mutans was cultured on a special collagen substrate and “trained” to break down collagen. The destruction of the alveolar bone periapically could be demonstrated both roentgenologically and histopathologically. Large numbers of inflammatory cells in the pulp chamber and the periapical area, as well as carious dentin, were present. The pulpally inoculated bacteria could also be recovered from the systemic blood. The identity between the pulpally inoculated bacteria and the bacteria recovered from the blood was proved by gel precipitation.

Roentgenographic study of vital abutment teeth

A study was conducted to determine the frequency with which pulp lesions caused in preparation of vital teeth for fixed restorations lead to periapical changes. All diagnoses were made using roentgenograms. The material consisted of 642 vital abutment teeth which were examined just after cementation and 1, 2, and 4 year intervals. The results emphasize the value of follow-up roentgenographic examinations following restorative procedures on abutment teeth for fixed partial dentures.

Hyperthyroidism: Report of a case exhibiting periapical changes

The generalized accelerated metabolic rate found in hyperthyroidism is characterized by well-known skeletal changes that have been reported in the medical literature. A perusal of the pertinent references and published papers does not specifically describe osseous changes of the mandible or maxilla due to hyperthyroidism. A case of hyperthyroidism (Graves' disease) that exhibited periapical rarefactions which filled in completely upon surgical treatment is presented. An interesting feature of this case is that the radiographic record, intact over a sixteen-year period, disclosed the first evidence of periapical rarefaction more than two years before the clinical subjective symptoms of hyperthyroidism sent the patient to her physician. It is not to be construed that henceforth periapical rarefactions should be considered pathognomonic of generalized metabolic disease. However, this case emphasizes once again that not all apical radiolucencies are of pulpal origin.