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Role of bone imaging
JOURNAL OF ENDODONTICS I VOL 7, NO 1, JANUARY1981
LETTERS TO THE EDITOR
Author questions references to his article Two articles on root canal therapy in general dental practice have been published in the Journal of Endodontics. by Barbakow, Cleaton-Jones, and Friedman. The first article appeared in the Journal in Feb 6(2): 456-460, 1980, and the second one appeared in March 6(3): 485-489, 1980. Both articles referred to statements I made in A cto Odontologica Scandanavica 34(2): 89-105, 107-116, 1976. I feel that the references they cited were inaccurate. Therefore, and without further comments, I feel obliged to state that I studied a selected group of patients from a teaching clinic, and did not state: 1) "that females frequently have root canal therapy more often than males because they have more time for treatment" (p 459); or 2) "that 6% of general practitioners in Scandinavia underfill root canals" (p 489). Olav Molven Odontology, University of Bergen School of Dentistry, Bergen, Norway
Criticism only half right according to authors Thank you for inviting me to reply to our collegue, Dr. Molven, whose letter concerns inaccuracies in two recent papers. Concerning point 1, I feel that we correctly referred to his work, which reads as follows: "There is an overrepresentation of female patients in the sample. This is not unexpected. Marken and Arwill (1956) found that married women were overrepresented among patients attending a university dental clinic. Although it has been shown that women are more diligent in seeking dental care
than men (Smedby, 1972: Hel6e, 1973), the chief explanation of the overrepresentation might be that women more often than men have time available for this type of dental service." Regarding Dr. Molven's second point, be did not report that 6% of general practitioners in Scandinavia underfill root canals. This inaccuracy occurred during editing. Our viewpoint was correctly stated in the first paper as follows: "Molven reported that general practitioners in Scandinavia usually underfilled root canal (60%)." For the latter inaccuracy, we offer our humble apologies. P. Cleaton-Jones Professor, Experimental Odontology Director, Dental Research Institute Johannesburg, South Africa
Role of bone imaging This issue contains a second report on bone scanning as a diagnostic toot (p 36). The following letter to the editor wds sent in response to the first article by iV. Telfer, S.H. Abelson, and R. Witmer, "Role of bone imaging in the diagnosis of active root canal infection," which appeared in the Journal of Endodontics in May 1980. I read the article "Role of bone imaging in the diagnosis of active root canal infection" by Telfer and others in the May I980 issue of the Journal with a good deal of interest. They describe a new diagnostic tool, radioactive bone imaging, and point out that a radionuclide image of the jaw can show focal activity at the site of periapical infection even though such teeth may present a normal radiographic appearance. We must admire the ingenuity of the authors; at the same time, it
should be pointed out that much simpler methods for establishing tooth vitality have been available for many years. Why not drill a test cavity, or even better, why not use a dry ice pulp test? 1-3 Dry ice has a temperature o f - - 7 8 C and the cold is conducted through metal crowns and porcelain. In the case of bonded crowns, dry ice is best applied to the metal found at the gingival crevice. The apparatus was designed by Obwegeser 4 and has been in widespread use in Switzerland since 1962. Marketed in the USA by the Union Broach Company, it is available as a benchtop model. Introduced in Australia in 1964, it has been used as a wall model and found widespread acceptance not only among endodontists and other specialists but also among those in general dental practice. The wall model uses a CO2 cylinder distributed by a company marketing medical gases. Replacement of cylinders is an easy matter. The wall model also occupies no bench space. Pulp testing using dry ice is a completely noninvasive method of vitality testing. E. H. Ehrmann, DDS Melbourne, Australia
References 1. Grossman, L.I.(ed.). Transactions of the Fifth International Conference on Endodontics, Philadelphia, Universityof Pennsylvania, 1973, p 171. 2. Grossman, L.I. Endodontic practice, Philadelphia, Lea & Febiger, 1978, p 24. 3. Ehrmann, E.H. Pulp testers and pulp testing with particular reference to the use of dry ice. Aust Dent J 22:4,272-279, 1977. 4. Obwegeser, H., and Steinhauser, E. Ein neues Ger~it zur Vitalit~.tsprfifung der Z~ihne mit Kohlens~ureschnee. SchwiezMschr Zahnheilk, 73:12, 1001-1002, 1963.
LETTERS TO THE EDITOR
Author questions references to his article Two articles on root canal therapy in general dental practice have been published in the Journal of Endodontics. by Barbakow, Cleaton-Jones, and Friedman. The first article appeared in the Journal in Feb 6(2): 456-460, 1980, and the second one appeared in March 6(3): 485-489, 1980. Both articles referred to statements I made in A cto Odontologica Scandanavica 34(2): 89-105, 107-116, 1976. I feel that the references they cited were inaccurate. Therefore, and without further comments, I feel obliged to state that I studied a selected group of patients from a teaching clinic, and did not state: 1) "that females frequently have root canal therapy more often than males because they have more time for treatment" (p 459); or 2) "that 6% of general practitioners in Scandinavia underfill root canals" (p 489). Olav Molven Odontology, University of Bergen School of Dentistry, Bergen, Norway
Criticism only half right according to authors Thank you for inviting me to reply to our collegue, Dr. Molven, whose letter concerns inaccuracies in two recent papers. Concerning point 1, I feel that we correctly referred to his work, which reads as follows: "There is an overrepresentation of female patients in the sample. This is not unexpected. Marken and Arwill (1956) found that married women were overrepresented among patients attending a university dental clinic. Although it has been shown that women are more diligent in seeking dental care
than men (Smedby, 1972: Hel6e, 1973), the chief explanation of the overrepresentation might be that women more often than men have time available for this type of dental service." Regarding Dr. Molven's second point, be did not report that 6% of general practitioners in Scandinavia underfill root canals. This inaccuracy occurred during editing. Our viewpoint was correctly stated in the first paper as follows: "Molven reported that general practitioners in Scandinavia usually underfilled root canal (60%)." For the latter inaccuracy, we offer our humble apologies. P. Cleaton-Jones Professor, Experimental Odontology Director, Dental Research Institute Johannesburg, South Africa
Role of bone imaging This issue contains a second report on bone scanning as a diagnostic toot (p 36). The following letter to the editor wds sent in response to the first article by iV. Telfer, S.H. Abelson, and R. Witmer, "Role of bone imaging in the diagnosis of active root canal infection," which appeared in the Journal of Endodontics in May 1980. I read the article "Role of bone imaging in the diagnosis of active root canal infection" by Telfer and others in the May I980 issue of the Journal with a good deal of interest. They describe a new diagnostic tool, radioactive bone imaging, and point out that a radionuclide image of the jaw can show focal activity at the site of periapical infection even though such teeth may present a normal radiographic appearance. We must admire the ingenuity of the authors; at the same time, it
should be pointed out that much simpler methods for establishing tooth vitality have been available for many years. Why not drill a test cavity, or even better, why not use a dry ice pulp test? 1-3 Dry ice has a temperature o f - - 7 8 C and the cold is conducted through metal crowns and porcelain. In the case of bonded crowns, dry ice is best applied to the metal found at the gingival crevice. The apparatus was designed by Obwegeser 4 and has been in widespread use in Switzerland since 1962. Marketed in the USA by the Union Broach Company, it is available as a benchtop model. Introduced in Australia in 1964, it has been used as a wall model and found widespread acceptance not only among endodontists and other specialists but also among those in general dental practice. The wall model uses a CO2 cylinder distributed by a company marketing medical gases. Replacement of cylinders is an easy matter. The wall model also occupies no bench space. Pulp testing using dry ice is a completely noninvasive method of vitality testing. E. H. Ehrmann, DDS Melbourne, Australia
References 1. Grossman, L.I.(ed.). Transactions of the Fifth International Conference on Endodontics, Philadelphia, Universityof Pennsylvania, 1973, p 171. 2. Grossman, L.I. Endodontic practice, Philadelphia, Lea & Febiger, 1978, p 24. 3. Ehrmann, E.H. Pulp testers and pulp testing with particular reference to the use of dry ice. Aust Dent J 22:4,272-279, 1977. 4. Obwegeser, H., and Steinhauser, E. Ein neues Ger~it zur Vitalit~.tsprfifung der Z~ihne mit Kohlens~ureschnee. SchwiezMschr Zahnheilk, 73:12, 1001-1002, 1963.