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.

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.

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.

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.

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.

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.

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.

Simulation of the effect of inclusions length and angle on the failure behavior of concrete structure under 3D compressive test: Experimental test and numerical simulation

Mohammad Saeed Amini,Vahab Sarfarazi,Kaveh Asgari,Xiao Wang,Mojtaba Moheb Hoori 국제구조공학회 2023 Steel and Composite Structures, An International J Vol.46 No.1

Man-made structure materials like concrete usually contain inclusions. These inclusions affect the mechanical properties of concrete. In this investigation, the influence of inclusion length and inclination angle on three-dimensional failure mechanism of concrete under uniaxial compression were performed using experimental test and numerical simulation. Approach of acoustic emission were jointly used to analyze the damage and fracture process. Besides, by combining the stress–strain behavior, quantitative determination of the thresholds of crack stress were done. concrete specimens with dimensions of 120 mm × 150 mm × 100 mm were provided. One and two holes filled by gypsum are incorporated in concrete samples. To build the inclusion, firstly cylinder steel tube was pre-inserting into the concrete and removing them after the initial hardening of the specimen. Secondly, the gypsum was poured into the holes. Tensile strengths of concrete and gypsum were 2.45 MPa and 1.5 MPa, respectively. The angle bertween inclusions and axial loadind ary from 0 to 90 with increases of 30. The length of inclusion vary from 25 mm to 100 mm with increases of 25 mm. Diameter of the hole was 20 mm. Entirely 20 various models were examined under uniaxial test. Simultaneous with experimental tests, numerical simulation (Particle flow code in two dimension) were carried out on the numerical models containing the inclusions. The numerical model were calibrated firstly by experimental outputs and then failure behavior of models containing inclusions have been investigated. The angle bertween inclusions and axial loadind vary from 0 to 90 with increases of 15. The length of inclusion vary from 25 mm to 100 mm with increases of 25 mm. Entirely 32 various models were examined under uniaxial test. Loading rate was 0.05 mm/sec. The results indicated that when inclusion has occupied 100% of sample thickness, two tensile cracks originated from boundaries of sample and spread parallel to the loading direction until being integrated together. When inclusion has occupied 75% of sample thickness, four tensile cracks originated from boundaries of sample and spread parallel to the loading direction until being integrated together. When inclusions have occupied 50% and 25% of sample thickness, four tensile cracks originated from boundaries of sample and spread parallel to the loading direction until being integrated together. Also the inclusion was failed by one tensile crack. The compressive strength of samples decease with the decreases of the inclusions length, and inclusion angle had some effects on that. Failure of concrete is mostly due to the tensile crack. The behavior of crack, was affected by the inclusion length and inclusion number.

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

Ali Nosrat,Ali Peimani,Saeed Asgary 대한치과보존학회 2013 Restorative Dentistry & Endodontics Vol.38 No.4

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

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

Ali Nosrat,Prashant Verma,Saeed Asgary 대한치과보존학회 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.