Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

Asgary, Saeed,Verma, Prashant,Nosrat, Ali The Korean Academy of Conservative Dentistry 2018 Restorative Dentistry & Endodontics Vol.43 No.2

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

Surgical management of a failed internal root resorption treatment: a histological and clinical

Asgary, Saeed,Eghbal, Mohammad Jafar,Mehrdad, Leili,Kheirieh, Sanam,Nosrat, Ali The Korean Academy of Conservative Dentistry 2014 Restorative Dentistry & Endodontics Vol.39 No.2

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

Asgary, Saeed,Fazlyab, Mahta The Korean Academy of Conservative Dentistry 2014 Restorative Dentistry & Endodontics Vol.39 No.2

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

Necrosis of intact premolar caused by an adjacent apical infection: a case report

Asgary, Saeed,Marvasti, Laleh Alim The Korean Academy of Conservative Dentistry 2013 Restorative Dentistry & Endodontics Vol.38 No.2

Although periapical inflammatory lesions are usually resulted by infection in the root canal system, this rare case showed that a periapical lesion related to an infected tooth may cause pulpal necrosis in adjacent intact tooth, with no history or clinical signs of caries, disease, trauma or developmental anomaly. This case also suggests that the periapical lesion can be treated conservatively, without surgical intervention. Furthermore, this case highlights the importance of prompt treatment of apical periodontitis before the lesion becomes extensive as well as follows up of large lesions.

Effect of Ethanolic Extract of Juglans regia L. on Blood Sugar in Diabetes-Induced Rats

Sedigheh Asgary,Sahar Parkhideh,Amirreza Solhpour,Hossein Madani,Parvin Mahzouni,Parivash Rahimi 한국식품영양과학회 2008 Journal of medicinal food Vol.11 No.3

Walnut is one of the medicinal plants used in traditional Iranian medicine as a treatment for diabetes, but little scientific documentation supports its antidiabetic action. This study is designed to evaluate the antidiabetic effect of ethanolic walnut leaf extract. Twenty-four male Wistar rats were divided into four groups: nondiabetic rats, alloxan-induced diabetic rats with no treatment, alloxan-induced diabetic rats treated with ethanolic extracts of Juglans regia (200 mg/kg), and alloxan-induced diabetic rats treated with glibenclamide (0.6 mg/kg). Fasting blood sugar decreased meaningfully in diabetic rats treated with J. regia and diabetic rats treated with glibenclamide. Insulin level increased and glycosylated hemoglobin decreased significantly in diabetic groups receiving either glibenclamide or J. regia compared with the diabetic group with no treatment. The histological study revealed that the size of islets of Langerhans enlarged consequentially as compared with diabetic rats with no treatment. Effects of administering glibenclamide or extract of J. regia on all parameters discussed above showed no difference, and both tended to bring the values to near normal. Our data show the ethanolic extract from leaves of J. regia has a dramatic antidiabetic effect on diabetes-induced rats.

Necrosis of intact premolar caused by an adjacent apical infection: a case report

Saeed Asgary,Laleh Alim Marvasti 大韓齒科保存學會 2013 Restorative Dentistry & Endodontics Vol.38 No.2

Although periapical inflammatory lesions are usually resulted by infection in the root canal system, this rare case showed that a periapical lesion related to an infected tooth may cause pulpal necrosis in adjacent intact tooth, with no history or clinical signs of caries, disease, trauma or developmental anomaly. This case also suggests that the periapical lesion can be treated conservatively, without surgical intervention. Furthermore, this case highlights the importance of prompt treatment of apical periodontitis before the lesion becomes extensive as well as follows up of large lesions.

Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach

Saeed Asgary,Mahta Fazlyab 대한치과보존학회 2014 Restorative Dentistry & Endodontics Vol.39 No.2

As long as the prognosis of teeth remains a matter of concern, the endodontic-periodontal relationship will be considered a challenge for the clinician. Many etiologic factors, including bacteria, fungi, and viruses, plus other contributing factors, such as trauma, root resorptions/perforations, and dental malformations, play a role in the co-occurrence of endodontic and periodontal lesions. Whatever the cause, a correct diagnosis on which to base the treatment plan is the key to successful maintenance of the tooth. This article reports the successful endodontic management of a furcation lesion in a mandibular molar that was nonresponsive to a previous periodontal surgical graft. The case had presented a diagnostic challenge for the clinicians, and this article reviews the key points that can lead to a correct diagnosis and treatment planning.

Surgical management of a failed internal root resorption treatment: a histological and clinical report

Saeed Asgary,Mohammad Jafar Eghbal,Leili Mehrdad,Sanam Kheirieh,Ali Nosrat 대한치과보존학회 2014 Restorative Dentistry & Endodontics Vol.39 No.2

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

Nosrat, Ali,Peimani, Ali,Asgary, Saeed The Korean Academy of Conservative Dentistry 2013 Restorative Dentistry & Endodontics Vol.38 No.4

Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Triple antibiotic paste: momentous roles and applications in endodontics: a review

Parhizkar, Ardavan,Nojehdehian, Hanieh,Asgary, Saeed The Korean Academy of Conservative Dentistry 2018 Restorative Dentistry & Endodontics Vol.43 No.3

This study investigated the latest findings and notions regarding 'triple antibiotic paste' (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.