Louis I. Grossman

A histopathologic and histobacteriologic study of 35 periapical endodontic surgical specimens

Biopsy specimens were obtained, during endodontic surgical procedures performed on 35 patients. Histopathologic and histo bacteriologic studies of the specimens showed that there was no correlation between the presence of various inflammatory cells and the clinical signs and symptoms of the patients. Epithelium was found in 21 specimens, but only nine lesions were diagnosed as cysts. Although bacteria were found in five specimens, in only one case were the bacteria located in the disintegrating tissue of the root canal and periapical tissue.

Roentgenologic and clinical evaluation of endodontically treated teeth

Abstract 1. 1. Four hundred thirty-two endodontically treated teeth have been evaluated by roentgenogram from 1 year to nearly 5 years postoperatively. 2. 2. Of this number, there were 198 cases of vital pulp extirpation and 234 teeth in which the pulp had died and the root canal was infected. 3. 3. Of the vital pulp extirpation cases, 90.4 per cent were considered successful on x-ray checkup. 4. 4. Of the pulpless teeth, 89.3 per cent were successful, including those with small preoperative areas of rarefaction as well as those without such areas (putrescent pulp cases). 5. 5. Of 98 teeth with definitive areas of rarefaction, complete or progressive repair occurred in 85.7 per cent. The degree of repair was not altogether related to the size of the area in this series of cases. 6. 6. The percentage of successful results is higher in teeth treated with antibiotics (93.2 per cent) than in those treated with conventional medicaments (86.8 per cent). This may be due to lack of irritation from the antibiotics used. 7. 7. Of 94 cases in which root resection was performed, progressive or complete repair occurred in 95.8 per cent. These cases are in addition to the root canal treatment cases. 8. 8. There appears to be a direct relationship between age and repair of periapical damage, the greater percentage of repair occurring in the younger age group. 9. 9. Poorly filled root canals accounted for a large percentage of failures.

Physical properties of root canal cements.

Abstract AH26, Diaket, Kerr sealer, Mynol, N2, N2 no-lead, Procosol, Roth 801, Roth 811, RC2B, Tubliseal, and zinc oxide-eugenol cement were examined for particle size, flow, setting time, adhesion, and peripheral leakage. The results varied in a wide range. An examination of the data should help the generalist or the endodontist toward a better understanding of the material he is using, and should suggest to manufacturers opportunities for improving their products.

Evaluation of the antimicrobial potential of calcium hydroxide as an intracanal medicament.

Calcium hydroxide in the form of a supernatant liquid, as a slurry, or as Pulpdent was not as effective in destroying Streptococcus faecalis in the teeth of cats, or in vitro, as compared with camphorated chlorophenol.

Antimicrobial effect of root canal cements

The antimicrobial properties of zinc oxide type cements and plastics were evidenced by small zones of inhibition in agar diffusion tests. Although N2 and RC2B produced larger zones of bacterial inhibition initially, this effect was gradually dissipated within a week to ten days with the test system used.

Guidelines for the prevention of fracture of root canal instruments

Abstract 1. Stainless steel reamers and files are preferable to carbon steel instruments because, while they may bend under excessive torque, they are less likely to break. 2. Root canal instruments should be examined both before and after use to make certain that the blades are regularly aligned. Too little or too much space between the blades is an indication that the instrument has been under strain and may break. 3. The smaller sizes of reamers and files (Nos. 10 to 30) should not be used more than twice (that is, instrumentation for more than two root canals). Rubber stops of different colors attached to the instrument are a convenient means of indicating how many times it has been used. 4. Dull instruments are likely to become lodged against dentine instead of cutting, and this promotes the chances of breakage. 5. Files break more often from the torque used in gaining a purchase on the dentine than from the act of filing against dentine. The degree of torque applied should be minimal. 6. Reamers should be twirled back and forth between the thumb and fingers, never exceeding a 180 degree are. 7. Instruments should be used in sequence of sizes, without ever skipping a size. 8. Because of the slight difference in diameter between a reamer and a file of a given size, both types of instrument should be used in narrow canals. Smaller stepwise increments in width will accrue than if either reamers or files alone are used, thus minimizing breakage of instruments. 9. Debris should be removed between the blades from time to time while one is operating with the same instrument in the root canal, as the accumulated debris retards cutting and so predisposes the instrument to breakage. 10. All root canal instruments should be used in a wet canal, preferably one which has been flooded with sodium hypochlorite, to facilitate cutting and thereby prevent breakage. 11. Chemical agents should be used along with instrumentation when necessary to facilitate cutting of dentine. 12. Where an instrument has been broken in the root canal, the prognosis is more favorable if an area of rarefaction is not present at the time of the accident.

Origin of Microorganisms in Traumatized, Pulpless, Sound Teeth

Microorganisms have been isolated from the pulp tissue or root canals of intact but traumatized teeth by MacDonald, Hare, and Wood ~ and by Brown and Rudolph. 2 It is not uncommon for an acute or chronic abscess to develop after trauma to a sound, noncarious tooth. In such abscesses, microorganisms have been isolated from the purulent material itself or from the root canal. The pathways by which microorganisms may reach the pulp are through the severed blood vessels in the periodontium (the source of the microorganisms being the gingival sulcus) or the blood stream, or both. This study was planned to determine the source of the microorganisms in traumatized, sound teeth by means of a readily identifiable test organism, Serratia marcescens, not ordinarily present in the mouths of dogs or monkeys.

Paresthesia from N2: Report of a case

A number of cases of paresthesia following the use of N2 or other paraformaldehyde-containing root canal cements have been reported. Since paresthesia is longlasting and not only an inconvenience but also disabling at times, such cements should not be used for obturating root canals.

Paresthesia from N2 or N2 substitute: Report of a case

Abstract A case of paresthesia following overfilling of root canals of a mandibular molar tooth with N2 or N2 substitute is reported.

Bacteriologic Status of Periapical Tissue in 150 Cases of Infected Pulpless Teeth

T HE bacteriologic status of the periapical tissue has been studied by cultures in one of several ways, namely, (1) by way of the root canal, (2) by extracting the tooth and culturing the root surface or attached periapical soft tissue, (3) by means of a trocar and cannula, and (4) by making a window in the labial plate of bone, as in root resection. We shall consider each of these methods in turn.