Alfred L. Frank

Long-term evaluation of surgically placed amalgam fillings.

The coauthors of this article had developed the clinical impression that whereas surgically placed amalgam fillings are successful on a short-term basis, the long-term prognosis for these cases may not be nearly as favorable. In order to test this hypothesis, as many patients as could be contacted, either directly or indirectly, who had been treated before 1981 were evaluated. Excluded from this study were cases for which failure could be attributed to any reason other than failure from the amalgam reverse filling. Therefore, all cases included had to demonstrate periapical healing prior to ultimate breakdown. On this basis, 60 of 104 teeth (57.7%) were considered to be successful and 44 teeth (42.3%) were determined to be failures.

An in vivo evaluation of Endex electronic apex locator

Because of technical problems and hazards of radiation, dentists have desired alternative ways to determine the working length during root canal therapy. Attention has turned to electronic devices for measuring root canal length. Several such devices are now available. They show promise but their accuracy is hampered because moisture in the root canal can result in inaccurate responses. Recently, a new device, Endex, has been introduced, claiming ease of operation and accuracy in moist environments. Ten operators used the Endex to measure 185 root canal lengths (in 99 teeth). Endex measurements were compared with radiographic measurements. The Endex located the apical constriction accurately within +/- 0.5 mm in 89.64% of moist canals.

Predictable endodontic and periodontic failures as a result of radicular anomalies

Abstract A pathosis that is associated with developmental radicular anomalies is described. Such conditions are easy to diagnose only when the diagnostician is aware of their existence. At present, since these anomalies constitute unresolvable periodontal problems, extraction of the involved teeth is the treatment of choice.

Endotoxic activity in periapical lesions

Thirty tissue samples were examined histologically and classified as being inflamed (apical granulomas) or noninflamed (scars or noninflamed cysts). The samples were then homogenized in pyrogen-free water and treated to remove interfering substances. The presence of endotoxin was then determined by means of the limulus assay; 75 percent of the inflamed tissues were positive for endotoxin, while only 20 percent of the noninflamed tissues contained endotoxin. The presence of endotoxin was thus highly correlated (p = 0.015) with the presence of inflammation in these tissues.

Diagnosis and treatment of extracanal invasive resorption.

Extracanal invasive resorption is not a well-defined phenomenon. This article describes its clinical, radiographic, and histological characteristics. Treatment of affected teeth based on the location of the resorptive defect is also described.

External-internal progressive resorption and its nonsurgical correction.

The pathologic resorptive entity of external-internal progressive resorption is distinct from external or internal resorption. External-internal progressive resorption is redefined and described. More facile and more predictable treatment modalities are possible based on this redefinition and description.

Nonendodontic therapy for supraosseous extracanal invasive resorption

Supraosseous extracanal invasive resorption involves cervical root dentin in a resorptive process that does not invade the pulp. A treatment procedure is described wich permits pulp preservation; the technique is illustrated with case histories.

An evaluation of the Giromatic endodontic handpiece

Abstract The Giromatic handpiece has been discussed. It has been found that many of the claims of the manufacturer and distributor have been grossly exaggerated. However, rather than unequivocally condemn this instrument, I have suggested a procedure to correlate its usage with accepted endodontic procedures. It can be of assistance in the mechanical preparation of the fine and curved canal. However, it is not to be considered the only tool for use in this procedure. The purpose of this article is not to endorse the Giromatic handpiece as a mechanical panacea but rather, to demonstrate the instruments shortcomings and to offer a guide to its best utilization.

Removal of silver points and fractured posts by ultrasonics

The ultrasonic principle can be used for the removal of intact or fractured cemented silver points and posts. The rationale of removal and a specific technique was presented.

Survival of the endodontic endosseous implant

The endodontic endosseous implant (EEI) enjoyed wide use in the United States after it was introduced in the 1960s. For various reasons including incorrect case selection, improper use of the materials, and poor preparation for the implant a high number of failures resulted. Following opposition by some members of the dental community, the procedure fell into disuse. The authors of this article had treated a number of cases with the endodontic endosseous implant from 1965 to 1975, many of which did fail. However, we have noted some remarkable very long-term successes with the technique, two of which are presented here. We suggest that the endodontic endosseous implant should not be discarded totally, but, with further research to improve the materials and technique, it still may be used in carefully selected cases.