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- Bergenholtz, Gunnar, 1939
(författare)
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Assessment of treatment failure in endodontic therapy
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 0305-182X. ; 43:10, s. 753-758
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Forskningsöversikt (refereegranskat)abstract
- There is a paucity of guidelines for the dental profession to assess failure of endodontic therapy. While a successful treatment can be well defined by the absence of apical periodontitis and clinical symptoms after a period of observation, failed treatment has escaped a distinct standing over the years. This article highlights aspects of significance and concludes that research ought to better explore the general health properties of persistent apical periodontitis on root-filled teeth and finally confirm the extent there is an association between apical periodontitis and adverse systemic health effects. Clearing this condition will determine whether clinicians should take a serious or relaxed attitude to persistent apical periodontitis subsequent to endodontic treatment.
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| 2. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
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Endodontics and Periodontics
- 2015
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Ingår i: Clinical periodontology and implant dentistry, 6th ed. (eds.) Niklaus P. Lang & Jan Lindhe. - Chichester, West Sussex : John Wiley&sons. - 9780470672488 ; , s. 830-860
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Bokkapitel (refereegranskat)
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| 3. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
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Inter-appointment medication with calcium hydroxide in routine cases of root canal therapy
- 2015
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Ingår i: The root canal biofilm. Editors: Chávez de Paz, Luis E., Sedgley, Christine M. & Kishen, Anil.. - Berlin Heidelberg : Springer. - 9783662474150 ; , s. 303-326
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Bokkapitel (refereegranskat)abstract
- This chapter discusses the use of an inter-appointment application of calcium hydroxide in the endodontic treatment of teeth with apical periodontitis, from a historic and evidence-based perspective. Despite a long history of clinical use and the publication of numerous in vitro, in vivo, and treatment outcome studies, strong scientific evidence in support of its use in this capacity is still not available. Today’s “best scientific evidence” is based primarily on a just a small number of studies that by today’s standard are not considered “strong.” However, given that elimination of bacteria from the root canal before placement of a root canal filling appears to enhance the treatment outcome, inter-appointment placement of calcium hydroxide could be an easy and appropriate way of promotingit. Any perceived advantage of its use, however, must be balanced by the risk of altering the physical properties of the root dentin due to its caustic action, particularly when it is present in the root canal for a long period of time. While clinical confirmation of an increased risk of root fracture in calcium hydroxide-treated fully developed teeth is still not verifiable, prudence dictates that caution should be exercised when calcium hydroxide is used in this manner in permanent teeth that are not completely developed.
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| 4. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
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Lesions of endodontic origin
- 2015
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Ingår i: Clinical periodontology and implant dentistry, 6th ed. (eds.) Niklaus P. Lang & Jan Lindhe. - Chichester, West Sussex : John Wiley&sons. - 9780470672488 ; , s. 472-501
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Bokkapitel (refereegranskat)
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| 5. |
- Bergenholtz, Gunnar, 1939, et al.
(författare)
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Olika material för direkt pulpaöverkappning
- 2017
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Ingår i: Tandläkartidningen. - 0039-6982. ; :8, s. 50-53
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Forskningsöversikt (refereegranskat)abstract
- En systematisk kunskapsöversikt om den kliniska effekten av olika material för pulpaöverkappning publicerades i Clinical Oral Investigations år 2016. Det vetenskapliga underlaget har dock stora brister, bedömer HTA-O, som här sammanfattar och kommenterar översikten.
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| 6. |
- Chavez de Paz, Luis E., et al.
(författare)
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Strains of Enterococcus faecalis differ in their ability to coexist in biofilms with other root canal bacteria
- 2015
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 48:10, s. 916-925
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Tidskriftsartikel (refereegranskat)abstract
- AimTo investigate the relationship between protease production and the ability of Enterococcus faecalis strains to coexist in biofilms with other bacteria commonly recovered from infected root canals. MethodologyBiofilms with bacteria in mono-, dual- and four-species communities were developed in flow chambers. The organisms used were Lactobacillus salivarius, Streptococcus gordonii and Actinomyces naeslundii and E.faecalis strains, GUL1 and OG1RF. Biovolume and species distribution were examined using 16S rRNA fluorescence insitu hybridization in combination with confocal microscopy and image analysis. The full proteome of the E.faecalis strains was studied using two-dimensional gel electrophoresis. Spots of interest were identified using tandem mass spectroscopy and quantified using Delta 2D software. ResultsAll bacteria formed biofilms and an anova analysis revealed that the biofilm biomass increased significantly (P0.01) between 6 and 24h. L.salivarius, S.gordonii and A.naeslundii formed mutualistic biofilm communities, and this pattern was unchanged when E.faecalis GUL1 was included in the consortium. However, with OG1RF, L.salivarius and S.gordonii were outcompeted in a 24-h biofilm. Proteomic analysis revealed that OG1RF secreted higher levels of proteases, GelE (P=0.02) and SprE (P=0.002) and a previously unidentified serine protease (P=0.05), than GUL1. ConclusionsDifferent strains of E.faecalis can interact synergistically or antagonistically with a consortium of root canal bacteria. A possible mechanism underlying this, as well as potential differences in virulence, is production of different levels of proteases, which can cause detachment of neighbouring bacteria and tissue damage.
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| 7. |
- Chow, A. T., et al.
(författare)
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Bacterial species associated with persistent apical periodontitis exert differential effects on osteogenic differentiation
- 2019
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885. ; 52:2, s. 201-210
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Tidskriftsartikel (refereegranskat)abstract
- AimTo determine if bacteria associated with persistent apical periodontitis induce species-specific pro-inflammatory cytokine responses in macrophages, and the effects of this species-specific microenvironment on osteogenic differentiation. MethodologyMacrophages were exposed to Enterococcus faecalis, Streptococcus oralis, Streptococcus mitis, Fusobacterium nucleatum, Treponema denticola or Tannerella forsythia, and levels of TNF- and IL-1 elicited were determined by immunoassay. Following treatment of MG-63 pre-osteoblasts with conditioned media from bacteria-exposed macrophages, osteogenic differentiation and viability of osteoblasts were analyzed by Alizarin Red Staining and MTS assay, respectively. Statistical analysis was carried out by one-way anova with the Tukey post-hoc test. Differences were considered to be significant if P<0.05. ResultsMacrophages exposed to Gram-positive bacteria did not produce significant amounts of cytokines. F.nucleatum-challenged macrophages produced up to four-fold more TNF- and IL-1 compared to T.denticola or T.forsythia. Only conditioned media from macrophages treated with Gram-negative bacteria decreased mineralization and viability of osteoblasts. ConclusionsGram-positive bacteria did not impact osteogenic differentiation and appeared innocuous. Gram-negative bacteria, in particular F.nucleatum elicited an enhanced pro-inflammatory response in macrophages, inhibited osteogenic differentiation and reduced cell viability. The findings suggest that the presence of this organism could potentially increase the severity of persistent apical periodontitis.
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| 8. |
- Lew, H. P., et al.
(författare)
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Isolation of Alkaline-tolerant Bacteria from Primary Infected Root Canals
- 2015
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Ingår i: Journal of Endodontics. - : Elsevier BV. - 0099-2399. ; 41:4, s. 451-456
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Alkaline-tolerant bacteria in primary infected root canals could have enhanced survival capacity against antimicrobials commonly used in root canal treatment. The aims of this study were to isolate and characterize alkaline-tolerant bacteria before endodontic treatment (S1), after chemomechariital root canal preparation (S2), and after calcium hydroxide dressing (S3). Methods: Bacteriologic samples were obtained from 43 primary infected root canals. Samples were inoculated into culture media at a pH of 9 and incubated anaerobically. The identities of bacterial isolates were determined by 16S ribosomal RNA sequencing. Results: All S1 samples were culture positive, with 70% harboring bacteria tolerating a pH of 9. Gram-positive bacteria Pseudoramibacter alactolyticus and Streptococcus spp were the most frequently isolated strains with a prevalence of 54%. Of 13 culture-positive S2 samples, 8 isolates tolerated a pH of 9, namely Streptococcus sanguinis, Enterococcus faecalis, Enterobacter cancerogen us, Streptococcus oralis, and Fusobacterium nucleatum. Seven of these 8 isolates (88%) were correspondingly isolated at S1. All 3 culture-positive S3 samples tolerated a pH of 9, namely S. sanguinis and E. faecalis, which were also isolated in the corresponding S1 and S2 samples. Conclusions: We showed that the presence of alkaline-tolerant Streptococcus and Enterococcus spp in primary infected root canals could lead to their persistence during and after root canal treatment and could pose a challenge to current treatment efficacy.
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| 9. |
- Malmberg, Leona, et al.
(författare)
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Establishment and maintenance of asepsis in endodontics – a review of the literature
- 2016
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:6, s. 431-435
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Objectives: Successful endodontic treatment depends on effective measures to eliminate and prevent infection of root canals. Initially treatment should start with isolation and disinfection of the operating field. This review makes an inventory of the available knowledge regarding its establishment and maintenance. Materials and methods: A literature search was conducted in the PubMed database in order to identify clinical trials examining disinfection or unintentional contamination of the endodontic operative field. A list of 115 articles was obtained and screened. Five relevant articles were identified. These articles were read in full text. The reference lists from these articles were checked manually for additional studies and three studies were obtained. A total of eight articles met the inclusion criteria. Results: There was a great variety in terms of aim, method, and material of the included studies. None could prove a totally reliable aseptic operative field and not one chemical, or combination of chemicals, were found in more than one study. Conclusions: No study documented complete asepsis following initial disinfection, and no study could document predictable maintenance of an established bacteria-free surface. Critical appraisal and standardization of the disinfection and aseptic procedures in endodontics are needed. © 2016 Acta Odontologica Scandinavica Society.
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| 10. |
- Mejare, I. A., et al.
(författare)
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Estimates of sensitivity and specificity of electric pulp testing depend on pulp disease spectrum: a modelling study
- 2015
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 48:1, s. 74-78
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Tidskriftsartikel (refereegranskat)abstract
- Aim To demonstrate how the spectrum of diseased pulps may influence sensitivity and specificity in diagnostic studies on pulp status. Methodology An original sample from a previous study consisting of 59 teeth scheduled for root canal treatment was used where the relationship between the response to electric pulp testing and the visual status of the pulp was evaluated. To alter the spectrum of diseased pulps, a hypothetical sample of asymptomatic teeth with deep caries lesions was added to the original sample. Sensitivity and specificity were then compared for the two samples. Results In the original sample of 59 teeth, sensitivity was 72% and specificity 90%. When the spectrum of diseased pulps was altered, sensitivity decreased to 67% and specificity increased to 97%. The change in disease spectrum also decreased the prevalence of necrotic pulps. Conclusions The spectrum of diseased pulps included in a diagnostic study on the accuracy of electric pulp testing, and indirectly also disease prevalence (here pulp necrosis), influences estimates of sensitivity and specificity. This implies that estimates of diagnostic accuracy from one study with a particular tooth population spectrum may not apply to another tooth population with a different disease spectrum.
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