Maria Georgopoulou

Pulp stones are calcified bodies in the dental pulp of the teeth in the primary and permanent dentition. They are found in healthy, diseased and even unerupted or impacted teeth. This case report presents the diagnostic management of a 22-year old female patient with general pulp calcification that coexists with molar incisor hypomineralisation and compound odontoma. The diagnostic procedure revealed several conditions that could be implicated: possible metabolic imbalance, bruxism, orthodontic treatment and genetic predisposition. Blood tests and urine analysis results excluded the possibility of metabolic imbalance. Clinical examination excluded bruxism and orthodontic treatment as implicated factors. The patient‘s family dental history revealed that the patient‘s mother also presents general pulp calcification. The aim of this article is to describe the diagnostic management of the patient and to highlight that general pulp calcification is not such a common finding; clinicians s...

To investigate the quality of root canal fillings and coronal restorations in relation to periapical status in a Greek population. A total of 320 patients who required full-mouth radiographic examination were included. The quality of root canal fillings and the periapical status, as well as the quality of coronal restorations, were assessed by radiographic criteria. Results were analyzed using random effects logistic regression models. Root canals with adequate filling length had a lower incidence of apical periodontitis than root canals with inadequate filling length (51.7% versus 63.4%, P ;= .002). Root-filled canals with adequate coronal restorations showed a lower incidence of apical periodontitis than those with inadequate restorations (47.3% versus 67.4%, P; < .001). When both root filling and coronal restoration were assessed, the incidence of apical periodontitis ranged from 39.2% to 67.6%. Quality of root canal treatment, as well as quality of coronal restoration, are strongly associated with the incidence of apical periodontitis.

Aim: The aims of the present survey were to record the views of patients on their experience of rubber dam (RD) use in an objective manner and evaluate the influence of several personal and clinical factors on patient opinion. Methodology: A simple questionnaire was distributed to 116 patients receiving root canal treatment in the Dental School of Athens University. The sample was divided into two groups; adult patients receiving treatment under RD from (a) final-year students and (b) postgraduate students. Data were analysed using: a) exact tests and b) univariate and multivariate ordinal logistic models. Results: Overall, patients' current experience and preference for future RD use were positive. Although slight differences were detected between the two groups of patients, concerning their experience and future preference, no clear trend was found. A positive association between current experience and future RD use was demonstrated among all participants (P <0.001). The pr...

A clinical study was conducted to assess the reliability of electrical and thermal pulp tests and to correlate the results with the true pulp status, as this was proved after the access opening, as well as to determine which clinical factors might be associated with the tests reliability. The results showed that pulp tests are reliable in a high grade and that there is no significant difference in their reliability.

To investigate the quality of root canal fillings and coronal restorations in relation to periapical status in a Greek population. A total of 320 patients who required full-mouth radiographic examination were included. The quality of root canal fillings and the periapical status, as well as the quality of coronal restorations, were assessed by radiographic criteria. Results were analyzed using random effects logistic regression models. Root canals with adequate filling length had a lower incidence of apical periodontitis than root canals with inadequate filling length (51.7% versus 63.4%, P ;= .002). Root-filled canals with adequate coronal restorations showed a lower incidence of apical periodontitis than those with inadequate restorations (47.3% versus 67.4%, P; < .001). When both root filling and coronal restoration were assessed, the incidence of apical periodontitis ranged from 39.2% to 67.6%. Quality of root canal treatment, as well as quality of coronal restoration, are st...

To evaluate coronal leakage and apical material extrusion of 3 obturation techniques. The coronal part of 60 freshly extracted human maxillary central incisors was removed, leaving roots 10 mm in length. After instrumentation by hand K-files and smear layer removal, the 60 roots were divided randomly into 3 groups. The roots of each group were obturated using different obturation techniques. The obturation techniques tested were cold lateral condensation, System B, and Thermafil. Leakage measurements were accomplished using fluid filtration methodology. Filling material extrusion was recorded using a yes or no statement. Results were subjected to statistical analysis using chi-square tests. Fluid filtration results revealed no significant differences among the 3 techniques tested 48 hours after obturation (P >.05). Thermafil tended to extrude significantly more material beyond the apex (P <.05). The 3 obturation techniques are equally effective at sealing the root canals. Ther...

This study was conducted to determine the incidence and degree of postobturation pain and to determine whether there is a significant relationship between pain and any clinical factors or conditions existing before, during, or at the completion of the root canal therapy. Of the 239 patients included in the study, 203 (84.9%) had no pain during the first 48 hours, 26 (10.9%) had slight pain, 5 (2.1%) had moderate pain and 5 (2.1%) had severe pain. Thirty days after obturation 3 patients had slight pain, 2 patients moderate pain and only one patient had severe pain. Meanwhile, we had to repeat the root canal therapy in 3 cases. Significant relationships were found between postobturation pain and obturation of the root canal past the apical foramen.

Aim
The aim of this study was to investigate the influence
of hydration in voids along root fillings on methylene
blue penetration.
Methodology
A total of 80 human root canals were
prepared using a step-back technique and filled with a
zinc oxide based sealer and gutta-percha. Leakage along
the fillings was measured by a transport fluid model and
classified into three categories: gross leakage (GL), slight
leakage (SL) and no leakage (NL). Specimens with NL
and SL were immersed into methylene blue (MB) 2% for
24 h (group I). Specimens with GL which had wide gaps
filled with water were randomly divided into two groups
(II, III). Transport air was applied to remove water from
gaps only in specimens of group III. All tested specimens
from groups II and III were also immersed into MB 2%
for 24 h. Each specimen was then split longitudinally
and linear measurements of dye penetration were recorded.
Results
Group III (with dry gaps) showed significantly
more dye penetration than group II. No significant
difference was found between group I and group II.
Conclusions
Methylene blue penetrates along root
fillings more easily in dry gaps than in water-filled gaps.

Summary. A clinical study was conducted to determine, first the incidence of pain after chemo-mechanical preparation of root canals, and second what clinical factors were associated with the incidence and degree of pain. Out of the 245 patients in the study 140 (57 per cent) had no pain, 52 (21 per cent) had slight pain, 30 (15 per cent) had moderate pain and 17 (7 per cent) had severe pain. Statistical analysis showed a significantly higher incidence of pain after over-instrumentation of canals during preparation.

This study was designed to evaluate the antimicrobial effectiveness of 25% citric acid, compared with 2.5% sodium hypochlorite, after time intervals of 5, 15, 30 and 60 min. Anaerobic bacterial species were isolated from infected root canals and categorized according to Gram stain as Gram-positive cocci, Gram-negative cocci, Gram-positive rods and Gram-negative rods. The experimental method used was similar to that proposed by the German society for Hygiene and Microbiology (DGHM) with slight modifications. Testing revealed that citric acid does demonstrate anti microbial properties against anaerobic bacteria, especially against cocci, but it is less effective than 2.5% sodium hypochlorite.

The aim of this study was to evaluate in vitro a possible mechanism involved in the antimicrobial action of calcium hydroxide, namely absorption of carbon dioxide from the roof canal.Twenty obligate and 20 facultative anaerobic bacteria isolated from infected root canals and identified to species level were used. For each bacterial species a standard concentration was achieved and 0.1 ml of the inoculum was spread on blood agar plates, which were consecutively incubated in an anaerobic chamber for 5–7 days.One experimental and one control group were studied: the experimental group included one plate with the bacterial species as well as one open plate containing 32 g calcium hydroxide paste at a mixing ratio of 6:4. Both plates were incubated in an anaerobic chamber for 72 h. The control group included only one plate containing the same bacterial species and was incubated under the same conditions. After a 72-h incubation, the number of the recovered bacteria were counted in both groups.Statistical analysis showed that the number of bacteria recovered from the control group was significantly lower than that of the experimental group, but no particular resistance of any bacterial species to calcium hydroxide could be detected. This finding strongly suggests that the ability of calcium hydroxide to absorb carbon dioxide may contribute to its antibacterial activity.

Aim  To investigate in vitro the influence of root-end resection and root-end cavity preparation on leakage of root filled teeth.Methodology  The root canals of 48 roots, 16 mandibular premolars (G1), 16 mandibular incisors (G2) and 16 maxillary incisors (G3), 12 mm in length, were enlarged using a modified ‘balanced force’ technique and filled with gutta-percha and sealer using lateral compaction. After setting, leakage along the canal was measured using a fluid transport model. Root-end resection and root-end cavity preparation were then performed, leaving roots 10 mm in length with root fillings of 7 mm (groups R1, R2 and R3, respectively). Fluid transport was measured again along the remaining root fillings of all groups using the same experimental conditions. Results of leakage before and after root-end resection were analysed statistically using the Kruskal–Wallis and Wilcoxon tests.Results  A total of 31% of the roots leaked before and 54% after root-end preparation; the difference was significantly different (P < 0.001). No significant differences were found either among groups G1, G2, G3 (P = 0.565) or among groups R1, R2, R3 (P =0.2628). Significant differences, however, were shown between groups G1–R1 (P = 0.0053), G2–R2 (P =0.0089) and G3–R3 (P = 0.0461).Conclusions  Root-end resection and root-end cavity preparation compromised the seal of 7 mm root fillings in all tooth groups. Increased leakage was recorded in the following order: mandibular incisors > mandibular premolars > maxillary incisors.

The aim of this study was to investigate the influence of hydration in voids along root fillings on methylene blue penetration. A total of 80 human root canals were prepared using a step-back technique and filled with a zinc oxide based sealer and gutta-percha. Leakage along the fillings was measured by a transport fluid model and classified into three categories: gross leakage (GL), slight leakage (SL) and no leakage (NL). Specimens with NL and SL were immersed into methylene blue (MB) 2% for 24 h (group I). Specimens with GL which had wide gaps filled with water were randomly divided into two groups (II, III). Transport air was applied to remove water from gaps only in specimens of group III. All tested specimens from groups II and III were also immersed into MB 2% for 24 h. Each specimen was then split longitudinally and linear measurements of dye penetration were recorded. Group III (with dry gaps) showed significantly more dye penetration than group II. No significant difference was found between group I and group II. Methylene blue penetrates along root fillings more easily in dry gaps than in water-filled gaps.

To investigate the prevalence of root filled teeth and apical periodontitis (AP) in a Greek population. A random sample of 320 patients who required full mouth periapical radiographic examination as a part of diagnostic and planning procedures were included. The age of the patients ranged from 16 to 77 years. A total of 7664 teeth were assessed and the frequency of root filled teeth and periapical status was recorded. Two observers evaluated the radiographs under standardized conditions. AP was defined as distinct periapical radiolucency or widening of the periodontal ligament space exceeding two times the normal width. Statistical evaluation of differences in proportions between groups was performed using random effects logistic regression models. The periapical status of 286 (3.7%) teeth was impossible to evaluate because of radiographic faults; these teeth were excluded from further analysis. A total of 1040 (13.6%) teeth had radiographic signs of AP and 680 (9.2%) teeth had been root filled. Of the root filled teeth, 408 (60.0%) had AP. There was no difference in the number of root filled teeth between males and females; the prevalence of root filled teeth increased with age. Significantly more molars (13.1%) and premolars (11.9%) than anterior teeth (5.8%) had been root filled (P &amp;lt; 0.001). The prevalence of AP was significantly higher (P &amp;lt; 0.001) in molars (23.9%) and premolars (14.0%) than anterior teeth (9.4%). The prevalence of AP and the frequency of root filled teeth with AP in this Greek population were higher than those found in many other European countries. The frequency of root filled teeth was comparable with findings in other epidemiological studies.

Abstract The effectiveness of calcium hydroxide and paramonochlorophenol (PMCP) was tested on anaerobic bacteria isolated from infected root canals, at time intervals 5, 15, 30 and 60 min. The experimental method used was similar to that proposed by the German Society of Hygiene and Microbiology (DGHM), with slight modifications. Testing revealed that calcium hydroxide was significantly more effective than PMCP against the total number of anaerobes. Additionaly, it was proved to be quickly and highly effective against some microorganisms related to severe clinical symptoms, such as B. melaninogenicus and P. gingivalis as well as against actinomyces species.