Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation

2015 ◽  
Vol 49 (6) ◽  
pp. 637-639 ◽  
Author(s):  
Patrícia Hernandéz-Gatón ◽  
César Ruiz Serrano ◽  
Paulo Nelson Filho ◽  
Esther Ruiz De Castañeda ◽  
Marília P. Lucisano ◽  
...  

This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis.

2017 ◽  
Vol 41 (6) ◽  
pp. 429-441 ◽  
Author(s):  
Osama Safwat ◽  
Mona Elkateb ◽  
Karin Dowidar ◽  
Omar El Meligy

Aim: To evaluate the clinical changes in dentin of deep carious lesions in young permanent molars, following ozone application with and without the use of a remineralizing solution, using the stepwise excavation. Study design: The sample included 162 first permanent immature molars, showing deep occlusal carious cavities that were indicated for indirect pulp capping. Teeth were divided into 2 main groups according to the method of ozone treatment. Each group was further subdivided equally into test and control subgroups. Following caries excavation, color, consistency and DIAGNOdent assessments of dentin were evaluated after 6 and 12 months. Results: Regarding dentin color and consistency, no significant differences were observed following ozone application, with and without a remineralizing solution. There were no significant differences between ozone treatment, and calcium hydroxide during the different evaluation periods, except in group I cases after 6 months, concerning the dentin color. The DIAGNOdent values were significantly reduced following ozone application, with or without a remineralizing solution, as well as between test and control cases in group I after 6 months. Conclusions: Ozone application through the stepwise excavation had no significant effect on dentin color and consistency in young permanent molars. DIAGNOdent was unreliable in monitoring caries activity.


2021 ◽  
Vol 15 (5) ◽  
pp. 1214-1216
Author(s):  
M. R. Ahmed ◽  
S. Aaslam ◽  
J. H. Bukhari

Objective: To compare performance and survival of composite restorations in primary teeth using partial caries removal (PCR) versus complete caries removal (CCR). Methodology: In this trial, 70 permanent molars having deep caries lesions were selected and divided equally into CCR and PCR groups. The study duration was Jan-2018 to Jan-2020. In CCR group, complete dentin removal was done and confirmed by applying dentin detector dye for 10 seconds. In PCR group, visual & tactile criteria were followed for dentin removal. After dentin removal all cavities were filled using RMGIC cement resin. Follow-up was done at 06, 12 and 18 months. Results: Mean age in CCR group was 23.4+5.5 years and 25.6+4.9 years in PCR group. Male patients were 19 and 17 in CCR and PCR groups respectively (p= 0.59). Regarding lesion type, 25 patients in CCR were having occlusal and 5 having Occluso-proximal lesion. In PCR group, 27 teeth were diagnosed with occlusal lesion and 3 with occluso-proximal lesion (p=0.44). At 18 months’ follow-up, success rate was 100% in CCR group and 93.3% in PCR group (p=0.49). Pulp exposure occurred in 23.3% procedures in CCR group and none in PCR group. Conclusion: Partial caries removal has nearly similar success rates as that of complete caries removal and is associated with significantly less pulp exposure rate as compared to CCR. Keywords: Deep carious lesions, Partial caries removal, Complete caries removal, Randomized clinical trial


2010 ◽  
Vol 35 (4) ◽  
pp. 482-486 ◽  
Author(s):  
F. F. Lima ◽  
R. C. Pascotto ◽  
A. R. Benetti

Clinical Relevance Due to the risk of pulp exposure in deep carious lesions, stepwise excavation can be a conservative and successful option for selected cases, when signs and symptoms of a normal pulp are present.


2021 ◽  
Vol 37 (5) ◽  
pp. e276-e289
Author(s):  
Kelly Maria Moreira ◽  
Luiz Eduardo Bertassoni ◽  
Robert Phill Davies ◽  
Felipe Joia ◽  
José Francisco Höfling ◽  
...  

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Yee Woo Yap ◽  
Azillah Mohd Ali

Introduction: Dentigerous cyst is the most common odontogenic cysts that are associated with the crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization of the cyst. However, currently there are no standard assessment criteria to dictate which kind of treatment for certain cases. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an unerupted right maxillary permanent canine in an 8-year-old boy. The cyst was enucleated partially but leaving the cystic lining surrounding the unerupted canine in order to preserve the tooth. 3-year follow up revealed good healing with significant root formation and tooth eruption.


Author(s):  
Giovanni Concistrè ◽  
Antonio Miceli ◽  
Francesca Chiaramonti ◽  
Pierandrea Farneti ◽  
Stefano Bevilacqua ◽  
...  

Objective Aortic valve replacement in minimally invasive approach has shown to improve clinical outcomes even with a prolonged cardiopulmonary bypass and aortic cross-clamp (ACC) time. Sutureless aortic valve implantation may ideally shorten operative time. We describe our initial experience with the sutureless 3f Enable (Medtronic, Inc, ATS Medical, Minneapolis, MN USA) aortic bioprosthesis implanted in minimally invasive approach in high-risk patients. Methods Between May 2010 and May 2011, thirteen patients with severe aortic stenosis underwent aortic valve replacement with the 3f Enable bioprosthesis through an upper V-type ministernotomy interrupted at the second intercostal space. The mean ± SD age was 77 ± 3.9 years (range, 72–83 years), 10 patients were women, and the mean ± SD logistic EuroSCORE was 15% ± 13.5%. Echocardiography was performed preoperatively, at postoperative day 1, at discharge, and at follow-up. Clinical data, adverse events, and patient outcomes were recorded retrospectively. The median follow-up time was 4 months (interquartile range, 2–10 months). Results Most of the implanted valves were 21 mm in diameter (19–25 mm). The CPB and ACC times were 100.2 ± 25.3 and 66.4 ± 18.6 minutes. At short-term follow-up, the mean ± SD pressure gradient was 14 ± 4.9 mm Hg; one patient showed trivial paravalvular leakage. No patients died during hospital stay or at follow-up. Conclusions The 3f Enable sutureless bioprosthesis implanted in minimally invasive approach through an upper V-type ministernotomy is a feasible, safe, and reproducible procedure. Hemodynamic and clinical data are promising. This innovative approach might be considered as an alternative in high-risk patients. Reduction of CPB and ACC time is possible with increasing of experience and sutureless evolution of actual technology.


2019 ◽  
Vol 24 (2) ◽  
Author(s):  
Piotr Rożniatowski ◽  
Emil Korporowicz ◽  
Dariusz Gozdowski ◽  
Dorota Olczak-Kowalczyk

Introduction. Glass-ionomer cements and composite materials are widely used for direct restoration of carious lesions, also in young permanent teeth. However, knowledge on the effects of cariogenic factors on the quality of restorations performed using these materials, especially those covering proximal surfaces, which are more often exposed to bacterial plaque, is insufficient. Aim. The aim of the study was to assess the impact of oral hygiene and increased intensity of caries on proximal composite and glass ionomer restorations in young permanent teeth after 2 years of usage. Material and methods. Equia Fil glass-ionomer and Tetric EvoCeram composite restorations were performed in patients aged between 12 and 20 years with proximal carious lesions in premolars and molars. The clinical condition of restorations was assessed and indices such as OHI-S and D1-2DMFT (along with their increased values) were calculated at baseline, as well as during follow-up visits at 6, 12, 18 and 24 months. Correlations between clinical assessment of restorations and indices for oral hygiene and caries intensity, their increase and increased number of teeth with carious spots were evaluated. The study was approved by the Bioethics Committee of the Medical University of Warsaw (No. KB/157/2013). Results. A total of 100 proximal restorations were performed in 49 patients. After 24 months, 98 restorations (50 Equia Fil and 48 Tetric EvoCeram) were evaluated. Mean baseline OHI-S and D1-2DMFT were 1.37 and 12.04, respectively, for Equia Fil restorations, and 1.27 and 10.38 for Tetric restorations, with the following values reported during follow-up: 1.80 and 15.4; 1.63 and 12.38. Statistically significant relationships were found between OHI-S and values describing the state of materials. These values increased with increasing OHI-S and D1-2DMFT. Conclusions. Both Tetric Evo Ceram and Equia Fil restorations are susceptible to cariogenic factors.


Author(s):  
Giuseppe Speziale ◽  
Marco Moscarelli

Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months, freedom from recurrent of mitral regurgitation 2+ or greater and reoperation was 95.2%.


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