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OR 51 Evaluation of an electronic apex locatOR in vital and necrotic canals
262 • Journalof Endodontics
Vol. 23, No. 4, April 1997
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Evaluation of an Electronic Apex Locator in Vital and Necrotic Canals. C r a i g A. D u n l a p , D . D . S . * ; C i n d y R. Rauschenberger, D.D.S., M.S.; Nijole A. R e m e i k i s , D . D . S . ; E l l e n A. B e G o l e , PhD. The purpose of this study was to determine the accuracy of canal length determinations in both vital and necrotic canals as provided by an electronic apex locator. Specimens were obtained from patients waiting to have teeth extracted. After informed consent was obtained, local anesthetic was administered, and a rubber dam was applied. Standard access cavity preparations were then made on the experimental teeth. The p u l p w a s c o n s i d e r e d v i t a l if b l e e d i n g w a s p r e s e n t in t h e p u l p c h a m b e r ; t h e p u l p w a s c o n s i d e r e d n e c r o t i c if n o b l e e d i n g w a s p r e s ent. Canal length measurements were made to the apical constriction using an elect r o n i c a p e x l o c a t o r ( R o o t ZX, J. M o r i t a Corp. Tustin CA). The files were cemented into position, and the teeth were extracted 29 t e e t h c o n t a i n i n g 34 c e m e n t e d f i l e s w e r e studied, and the distance from the file tip to the apical constriction was measured.
The Root ZX was 82.3% accurate to within U . 5 m m of the apical constriction. There was no statistical difference in the ability of the Root ZX to accurately d e t e r m i n e the apical c o n s t r i c t i o n in teeth with vital or necrotic canals. This study spported in part by a grant from the Research and Education F o u n d a t i o n of the A.A.E.
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Periodontal healing after systemic use of amoxicillin and tetracycline after replanration of dogs teeth. V. SAE-LIM~, C-Y. WANG, M. TROPE. U. of North Carolina, Chapel Hill The use of systemic penicillin after an avulsion injury has been recommended to decrease the incidence of resorption complications. Tetracycline antibiotics have been reported to possess antiresorptive properties in addition to as antimicrobial actions. The purpose of this study was to evaluate systemic administration of amoxicillin to tetracycline for the inhibition of root resorption after replantation. Teeth of five beagle dogs were used. Half of the teeth were endodontically treated to inhibit subsequent inflammatory root resorption of pulpal origin and in the other half the pulps were extir- pared and infected with the plaque of the d o g The teeth which were endodontically treated were extracted and left to bench dry for one hour to ensure replacement resorption after replantation (RR Group). The teeth with the infected canals were extracted and the mid-root damaged with a fissure bur after which they were immediately replanted, ensuring inflammatory root resorption (IR Group). Immediately after re- plantation, half of teeth (dogs) were given systemic amoxicillin for i0 days while the other half re- ceived tetracycline for the same period. Controls for each group did not receive antibiotic coverage. Results: For the RR group, control teeth exhibited severe replacement and inflammatory root resorption. Systemic administration of amoxicillin and tetracycline resulted in no inflammatory root resorption and a significantly lower incidence of replacement resorption. No difference between amoxicillin and tetracycline groups was found. For the IR group the incidence of inflammatory resorption was significantly lowered for both antibiotics but again, no difference between the antibiotics was found. Both antibiotics were effective in decreasinq the incidence of root resorption. No difference in efficacy between the two antibiotics was found.
Tooth Replantation Success in Dogs with Saline, Milk, Dry and HBSS. Y.T. Jou*, R. Wong, SH. Baek, Y.Y. Hsu, H. Plenk, Jr.", S. Kim (U. of Penn., Philadelphia, USA) (fU. of Vienna,, Austria). A viable endodontic surgical treatment alternative for teeth that can not be treated conventionally, is extraction and post treatment replantation. As the extraoral time may be longer than the periodontal ligament cells (PDL) are likely to survive, extracted teeth are placed into various solutions advocated to keep the PDL alive. The purpose of our study was to evaluate the effectiveness of such solutions on the success of replanted teeth. Two beagle dogs were anesthetized with PropofoV ~ (0.7 mg/kg) and Isoflurane 2%-3% Root canal treatments were performed on premolars. Subsequently, the teeth were sectioned at the bifurcation, each root was extracted and apical resection and retrograde" filling were performed extraorally. The extraoral teeth were stored ~n isotonic saline, milk, Hank's Balanced Salt Solution (HBSS), or were kept dry on a sterile gauze for fifteen minutes. After replantation of the sectioned teeth, composite splints were made for each individual tooth to stabilize the roots. The dogs were sacrificed 6 months postoperatively, the jaws were sectioned, Giomsa stained, and microradiographic and histologic evaluations were made. Teeth placed in milk showed large abscess formation and full facio-lingual resorption of the coronal aspect. There was also considerable resorption of the dentin-cementum complex and apical ankylosis. The dry preparation showed less resorption, but greater ankylosis than the milk preparation. The saline group also showed less resorption than the milk group, and PDL fibers ran aberantly parallel to the root surface. Only HBSS showed a normal PDL space and a near normal PDL. Results of the study indicate that tooth re,plantation with Hanks Balanced Salt Solution provided the most favorable histological and microradio~raphic outcome.
ORIO°_._~_t Assessment of the viability of PDL cells using a collagenase assay. R.PILEGGI*,T.DUMSHA,V.DESPOTIS & J.E.NOR. The University of Michigan, Ann Arbor The University of Maryland, Baltimore The length of the extra-alveolar time and the storage media prior to replantation are significant factors which can determine the long term prognosis for replanted teeth. Several studies have examined various storage media in an attempt to determine the ideal material for stodng avulsed teeth (Blomlof et al 1983; Trope et a l 1992; Gamson et al, 1992; Lipps e t a / 1994).The purpose of this study was to compare the number of viable PDI_ cells with 30 minutes dry time in different storage media using a collagenase method. Twenty-four freshly extracted human teeth were divided into 6 groups. The positive and negative controls corresponded respectively to 0 minutes and 8 hours dry times. The teeth were stored dry for 30 minutes, immersed in four different experimental media (HBSS, milk,saline,water) for 45 minutes and then treated separately in centrifuge tubes with collagenase, dispase grade II and PBS. The specimens were centrifuged for 5 minutes at 800 rpm and the cells labelled with Trypan Blue. The number of viable and non-viable PDL cells was counted with a hemocytometer and analyzed. An ANOVA demostrated no statistically significant differences between HBSS and milk regarding the viability of PDL cells. Within the parameters of this studv it appears that milk is an eauallv viable alternative to H B ~ for storaae of avulsed teetl~.
Vol. 23, No. 4, April 1997
m
O~ I
Evaluation of an Electronic Apex Locator in Vital and Necrotic Canals. C r a i g A. D u n l a p , D . D . S . * ; C i n d y R. Rauschenberger, D.D.S., M.S.; Nijole A. R e m e i k i s , D . D . S . ; E l l e n A. B e G o l e , PhD. The purpose of this study was to determine the accuracy of canal length determinations in both vital and necrotic canals as provided by an electronic apex locator. Specimens were obtained from patients waiting to have teeth extracted. After informed consent was obtained, local anesthetic was administered, and a rubber dam was applied. Standard access cavity preparations were then made on the experimental teeth. The p u l p w a s c o n s i d e r e d v i t a l if b l e e d i n g w a s p r e s e n t in t h e p u l p c h a m b e r ; t h e p u l p w a s c o n s i d e r e d n e c r o t i c if n o b l e e d i n g w a s p r e s ent. Canal length measurements were made to the apical constriction using an elect r o n i c a p e x l o c a t o r ( R o o t ZX, J. M o r i t a Corp. Tustin CA). The files were cemented into position, and the teeth were extracted 29 t e e t h c o n t a i n i n g 34 c e m e n t e d f i l e s w e r e studied, and the distance from the file tip to the apical constriction was measured.
The Root ZX was 82.3% accurate to within U . 5 m m of the apical constriction. There was no statistical difference in the ability of the Root ZX to accurately d e t e r m i n e the apical c o n s t r i c t i o n in teeth with vital or necrotic canals. This study spported in part by a grant from the Research and Education F o u n d a t i o n of the A.A.E.
0~ I
Periodontal healing after systemic use of amoxicillin and tetracycline after replanration of dogs teeth. V. SAE-LIM~, C-Y. WANG, M. TROPE. U. of North Carolina, Chapel Hill The use of systemic penicillin after an avulsion injury has been recommended to decrease the incidence of resorption complications. Tetracycline antibiotics have been reported to possess antiresorptive properties in addition to as antimicrobial actions. The purpose of this study was to evaluate systemic administration of amoxicillin to tetracycline for the inhibition of root resorption after replantation. Teeth of five beagle dogs were used. Half of the teeth were endodontically treated to inhibit subsequent inflammatory root resorption of pulpal origin and in the other half the pulps were extir- pared and infected with the plaque of the d o g The teeth which were endodontically treated were extracted and left to bench dry for one hour to ensure replacement resorption after replantation (RR Group). The teeth with the infected canals were extracted and the mid-root damaged with a fissure bur after which they were immediately replanted, ensuring inflammatory root resorption (IR Group). Immediately after re- plantation, half of teeth (dogs) were given systemic amoxicillin for i0 days while the other half re- ceived tetracycline for the same period. Controls for each group did not receive antibiotic coverage. Results: For the RR group, control teeth exhibited severe replacement and inflammatory root resorption. Systemic administration of amoxicillin and tetracycline resulted in no inflammatory root resorption and a significantly lower incidence of replacement resorption. No difference between amoxicillin and tetracycline groups was found. For the IR group the incidence of inflammatory resorption was significantly lowered for both antibiotics but again, no difference between the antibiotics was found. Both antibiotics were effective in decreasinq the incidence of root resorption. No difference in efficacy between the two antibiotics was found.
Tooth Replantation Success in Dogs with Saline, Milk, Dry and HBSS. Y.T. Jou*, R. Wong, SH. Baek, Y.Y. Hsu, H. Plenk, Jr.", S. Kim (U. of Penn., Philadelphia, USA) (fU. of Vienna,, Austria). A viable endodontic surgical treatment alternative for teeth that can not be treated conventionally, is extraction and post treatment replantation. As the extraoral time may be longer than the periodontal ligament cells (PDL) are likely to survive, extracted teeth are placed into various solutions advocated to keep the PDL alive. The purpose of our study was to evaluate the effectiveness of such solutions on the success of replanted teeth. Two beagle dogs were anesthetized with PropofoV ~ (0.7 mg/kg) and Isoflurane 2%-3% Root canal treatments were performed on premolars. Subsequently, the teeth were sectioned at the bifurcation, each root was extracted and apical resection and retrograde" filling were performed extraorally. The extraoral teeth were stored ~n isotonic saline, milk, Hank's Balanced Salt Solution (HBSS), or were kept dry on a sterile gauze for fifteen minutes. After replantation of the sectioned teeth, composite splints were made for each individual tooth to stabilize the roots. The dogs were sacrificed 6 months postoperatively, the jaws were sectioned, Giomsa stained, and microradiographic and histologic evaluations were made. Teeth placed in milk showed large abscess formation and full facio-lingual resorption of the coronal aspect. There was also considerable resorption of the dentin-cementum complex and apical ankylosis. The dry preparation showed less resorption, but greater ankylosis than the milk preparation. The saline group also showed less resorption than the milk group, and PDL fibers ran aberantly parallel to the root surface. Only HBSS showed a normal PDL space and a near normal PDL. Results of the study indicate that tooth re,plantation with Hanks Balanced Salt Solution provided the most favorable histological and microradio~raphic outcome.
ORIO°_._~_t Assessment of the viability of PDL cells using a collagenase assay. R.PILEGGI*,T.DUMSHA,V.DESPOTIS & J.E.NOR. The University of Michigan, Ann Arbor The University of Maryland, Baltimore The length of the extra-alveolar time and the storage media prior to replantation are significant factors which can determine the long term prognosis for replanted teeth. Several studies have examined various storage media in an attempt to determine the ideal material for stodng avulsed teeth (Blomlof et al 1983; Trope et a l 1992; Gamson et al, 1992; Lipps e t a / 1994).The purpose of this study was to compare the number of viable PDI_ cells with 30 minutes dry time in different storage media using a collagenase method. Twenty-four freshly extracted human teeth were divided into 6 groups. The positive and negative controls corresponded respectively to 0 minutes and 8 hours dry times. The teeth were stored dry for 30 minutes, immersed in four different experimental media (HBSS, milk,saline,water) for 45 minutes and then treated separately in centrifuge tubes with collagenase, dispase grade II and PBS. The specimens were centrifuged for 5 minutes at 800 rpm and the cells labelled with Trypan Blue. The number of viable and non-viable PDL cells was counted with a hemocytometer and analyzed. An ANOVA demostrated no statistically significant differences between HBSS and milk regarding the viability of PDL cells. Within the parameters of this studv it appears that milk is an eauallv viable alternative to H B ~ for storaae of avulsed teetl~.