scholarly journals Conservative management of periapical cysts – A case series

2021 ◽  
Vol 12 (6) ◽  
pp. 122-125
Author(s):  
Devakumari Shanmugam ◽  
Vijhayapriya Thanasekar ◽  
Nandini Biradar ◽  
Bhavanirekha Natarajan ◽  
Neil Dominic
Keyword(s):  
Bone Formation ◽  
Surgical Management ◽  
Conservative Management ◽  
Root Canal ◽  
Periodontal Ligament ◽  
Case Series ◽  
Root Canal Therapy ◽  
Tooth Mobility ◽  
Surgical Options

Non vital teeth with periapical cysts do not respond to routine root canal therapy alone. Conventional RCT (root canal therapy) should be combined with conservative management of cysts or surgical management. Contemporary options for non-surgical management are repeated intra canal dressing with Ca (OH)2, aspiration and decompression techniques. Repeated intra canal dressing with Ca(OH)2 and Iodoform (Metapex) was advocated in 15 of our patients for a period of eight years from 2011-2019. The healing of the lesions was excellent with respect to bone formation, reestablishment of periodontal ligament and reduction in tooth mobility on follow up of six months to one and a half years. This case series gives insight of successful non-surgical management of periapical cysts. We reiterate the effectiveness of non-surgical management of periapical cysts as it was well observed in our case series. The promising prognosis of non-surgical management of periapical cysts can render the surgical options antediluvian.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712199455
Author(s):  
Nicola Maffulli ◽  
Francesco Oliva ◽  
Gayle D. Maffulli ◽  
Filippo Migliorini
Keyword(s):  
Surgical Management ◽  
Revision Surgery ◽  
Case Series ◽  
Sports Participation ◽  
Patellar Tendinopathy ◽  
Symptom Duration ◽  
Level Of Evidence ◽  
Training Time ◽  
The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

scholarly journals BiodentineTM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 720
Author(s):  
Xuan Vinh Tran ◽  
Lan Thi Quynh Ngo ◽  
Tchilalo Boukpessi
Keyword(s):  
Root Canal ◽  
Periodontal Ligament ◽  
Clinical Signs ◽  
Apical Periodontitis ◽  
Permanent Teeth ◽  
Definitive Treatment ◽  
Capping Agent ◽  
Root Canal Therapy ◽  
Pulp Capping ◽  
Irreversible Pulpitis

Vital pulp therapy, including direct pulp capping and partial and full pulpotomy, is primarily indicated for immature or mature permanent teeth with reversible pulpitis. Mature permanent teeth with irreversible pulpitis are frequently treated with root canal therapy. This report presents two cases of full pulpotomy using BiodentineTM in mature permanent teeth with irreversible pulpitis and acute apical periodontitis. The periapical radiograph illustrated a deep carious lesion extended to the pulp with apical radiolucency lesion or widened periodontal ligament space. Full pulpotomy with a tricalcium silicate-based cement was chosen as the definitive treatment. After decayed tissue excavation under a rubber dam, the exposed pulp tissue was amputated to the level of the canal orifice with a new sterile bur. BiodentineTM was applied as the pulp capping agent after hemostasis was obtained and for temporary restoration. The clinical signs disappeared quickly after the treatment. After one month, the coronal part of the temporary restoration was removed, and a composite resin was placed over the capping agent as a final restoration. At two-year follow-ups, the teeth were asymptomatic. Radiographs showed healing of the periapical lesion and periodontal ligament. BiodentineTM full pulpotomy of mature permanent teeth with irreversible pulpitis and apical periodontitis can be an alternative option to root canal therapy.

scholarly journals Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Alastair Faulkner ◽  
Alistair Mayne ◽  
Fraser Harrold
Keyword(s):  
Outcome Measures ◽  
Surgical Management ◽  
Conservative Management ◽  
Morton’S Neuroma ◽  
Significant Difference ◽  
Morton's Neuroma ◽  
One Year ◽  
Patient Related Outcome ◽  
Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

scholarly journals Surgical Management of Necrotizing Sialometaplasia of Hard Palate: A Case Report

2020 ◽  
Vol 03 (12) ◽  
Author(s):  
Indu Palanivel ◽  
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Surgical Management ◽  
Conservative Management ◽  
Hard Palate ◽  
Complete Regression ◽  
Self Healing ◽  
Healing Period ◽  
Necrotizing Sialometaplasia

Necrotizing Sialometaplasia is rare and in the oral cavity it accounts <1% of all biopsied lesion. For decades Necrotizing Sialometaplasia were treated by conservative management as it is a self healing lesion. The progressive healing period was reported from 2 weeks to 3 months in the literature. Is necrotizing sialometaplasia a self-limiting disease? Here we report a case of non-healing necrotizing sialometaplasia which was treated by surgical management. Complete regression of the lesion was evident after the surgical management and no recurrence until two years of follow-up.

scholarly journals An Endodontic Enigma: A Case Report of External Inflammatory Root Resorption-2 years Follow up

2018 ◽  
Vol 10 (1) ◽  
pp. 37-39
Author(s):  
Shahnaz Sultana Beauty ◽  
Shahana Dastagir Sunny ◽  
Md Ali Asgor Moral ◽  
Md Shamsul Alam
Keyword(s):  
Case Report ◽  
Calcium Hydroxide ◽  
Root Canal ◽  
Root Resorption ◽  
Root Structure ◽  
Root Canal Therapy ◽  
Dentinal Tubules ◽  
Living Body ◽  
Subsequent Loss

In dentistry,root resorption is the breakdown or destruction and subsequent loss of the root structure of a tooth caused by living body cells attacking part of the tooth. When the damage extends to the whole tooth is called tooth resorption. Severe root resorption is very difficult to treat and often requires the extraction of teeth. Root canal therapy has been shown to be a verysuccessful means of treating inflammatory resorption. It has been recommended to include a calcium hydroxide paste in the root canal therapy to enhance the success of the treatment out come. Calcitonin has also been suggested as an interim root canal medicament to assist in the inhibition of osteoclastic bone and dentin resorption. Calcitonin penetrates the dentinal tubules in the out word direction, thus exerting a direct effect DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13833 City Dent. Coll. J Volume-10, Number-1, January-2013

Effect of Different Obturation Techniques on the Prognosis of Endodontic Therapy: A Retrospective Comparative Analysis

2016 ◽  
Vol 17 (7) ◽  
pp. 582-586 ◽  
Author(s):  
Jyoti Sachdeva ◽  
Anurag Sarin ◽  
Ajai Gupta ◽  
Shobhit Sachdeva
Keyword(s):  
Comparative Analysis ◽  
Clinical Significance ◽  
Analysis Of Variance ◽  
Root Canal ◽  
Root Canal Therapy ◽  
Quality Of Treatment ◽  
Significant Difference ◽  
Level Of Significance

ABSTRACT Introduction Success of root canal therapy (RCT) is largely dependent upon the quality of biomechanical preparation and obturation of the pulp canal. Improperly cleaned or shaped root canal, regardless of the type of obturation method and obturating material, cannot lead to the success of endodontic therapy. Hence, we conducted a clinical comparative analysis of two obturating techniques. Materials and methods A total of 140 patients receiving RCT at the department of Endodontic were included in the present study. The average follow-up time for the patients was 29 months (18–38 months). Patients were grouped into two depending on the type of obturating technique used. Evaluation of the clinical and radiographic follow-up records of the patients was done and analysis was made. One-way analysis of variance (ANOVA) was used for assessing the level of significance. Results The average age of the patients undergoing obturation with carrier-based obturation (CO) technique and lateral compaction (LC) technique was 43 and 48 years respectively. While comparing failure and success of the teeth at the time of follow-up, nonsignificant results were obtained. Significant difference was seen, while comparing the presence of voids and type of teeth in which endodontic therapy was performed using different obturating techniques. Conclusion Endodontic therapy done with LC obturating technique or with CO technique shows prognostic difference on the outcome or quality of treatment therapy. Clinical significance Quality of obturation is more important rather than type while performing endodontic therapy for better prognosis. How to cite this article Sarin A, Gupta P, Sachdeva J, Gupta A, Sachdeva S, Nagpal R. Effect of Different Obturation Techniques on the Prognosis of Endodontic Therapy: A Retrospective Comparative Analysis. J Contemp Dent Pract 2016;17(7):582-586.

scholarly journals Treatment Management With Long Term Follow-Up In Late-Admitted Traumatized Permanent Incisors: Case Series

2021 ◽  
Author(s):  
Ceren Çimen ◽  
Burcu Nihan Yüksel ◽  
Nurhan Özalp
Keyword(s):  
Root Canal ◽  
Case Series ◽  
Endodontic Treatment ◽  
Anterior Teeth ◽  
Long Term Follow Up ◽  
Traumatic Dental Injuries ◽  
Dental Injuries ◽  
Regenerative Endodontic Treatment

Traumatic dental injuries are particularly common in school-age children and often occur in the anterior region. Process management of cases is possible with alternative treatments according to the root development levels. This case series is aimed to present the treatment and 2-year follow-up of permanent anterior teeth with traumatic dental injuries. Case 1: An 8-year-old patient, who had a bicycle accident 20 days earlier, was diagnosed with extrusion of #31. Due to late admission to the clinic, no repositioning procedure was applied to the tooth. Regenerative endodontic treatment was performed. During the radiological follow-up, the apex was closed in the 12th month; however, it was observed that obliteration started in the root canal at the 24th month. The case is still being followed up at regular intervals. Case 2: A 13-year-old patient, who had a traffic accident 3 days prior, was diagnosed with subluxation in #11, and a root fracture was detected in the apical third of #21. In #21, root canal treatment was applied to the coronal part of the fragments. After the diagnosis of pulp necrosis in #11 in the 2nd month of the follow-up period, root canal filling was applied. During the follow-up period, no pathology was detected and no granulation tissue was formed between the fragments in #21. In traumatic dental injuries, long-term follow-up, well-timed endodontic treatments, and material selection play an important role in success. With regenerative endodontic treatment, successful results can be obtained even in treatments applied in late-admitted patients.

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