Radicular cysts are the most common forms of cysts in the jaws. They develop from epithelial residues in the periodontal ligament in response to periapical infection following pulpal necrosis. This condition is typically asymptomatic and mostly affects the tooth\'s apices. It primarily affects non-vital teeth and is characterized by inflammation. Cyst development is the final stage of the inflammatory process after a periapical infection; hence, it often occurs later in life. A cyst in the maxilla can occasionally spread across the maxillary sinus. Radicular cysts can be treated with surgical endodontics, the removal of the problematic tooth, enucleation with primary closure, or marsupialization and enucleation. This case report discusses a successful surgical therapy for an infected radicular cyst.

UNASSIGNED: Surgical endodontic dissatisfaction is frequently caused by an inadequate seal at the apex. The retrograde filling material utilized should prevent any contaminants from seeping into the periradicular tissue.
UNASSIGNED: (1) To evaluate push-out bond strength of mineral trioxide aggregate (MTA) Angelus, Zirconomer, and Bioactive bone cement as root-end filling material, (2) To compare push-out bond strength of three different retrograde filling materials with a universal testing machine.
UNASSIGNED: At the cementoenamel junction, 36 removed upper anterior teeth were sliced horizontally. The samples were resected 3 mm at the apical end at a 90° angle along the long axis of the tooth, following the standard protocols. With an ultrasonic tip S12 90ND, a 3 mm root-end cavity was made. The teeth were then divided into three groups at random: Group 1: MTA Angelus, Group 2: Zirconomer, and Group 3: Bioactive bone cement. With the help of small pluggers, each material was compacted in the root-end cavity. Acrylic resin was used to embed the specimens. Each specimen\'s apical section was sliced into 2-mm thick slices perpendicular to the long axis. A universal testing equipment was used to apply a compressive push-out load, and the push-out bond strength was determined in megapascals.
UNASSIGNED: Zirconomer showed higher push-out bond strength when placed in the retrograde cavity preparation, followed by MTA Angelus and then Bioactive bone cement.
UNASSIGNED: Zirconomer showed superior resistance to dislodgment when compared to MTA Angelus, followed by Bioactive bone cement.

UNASSIGNED: Racial variation exists in the incidence of orofacial granulomatosis (OFG). The epidemiology and clinical characteristics of OFG in Asian countries are poorly described.
UNASSIGNED: To describe the epidemiologic and clinical features of OFG in China from data collected on chronic odontogenic infection and studied in actual practice regarding the long-term outcome of OFG patients receiving different treatments.
UNASSIGNED: Data on demographics, medical history, chronic odontogenic infection, and the extent of disease were collected, and long-term outcomes after the end of treatments were evaluated.
UNASSIGNED: Of the 165 OFG patients, 118 (71.5%; 95% CI 64.6%-78.5%) had a chronic odontogenic infection. There was a variety of difference between OFG with and without chronic odontogenic infection. Approximately 98.3% (95% confidence interval 94.8%-100%) of OFG patients with chronic odontogenic infection who received dental treatment showed a marked response, of whom 31 patients (53.4%; 95% confidence interval 40.2%-66.7%) had complete remission.
UNASSIGNED: Endoscopic investigations were not performed for most of the patients, and more detailed data were not collected, which might have demonstrated additional systemic problems.
UNASSIGNED: OFG with chronic odontogenic infection is the major clinical pattern of OFG in China, which may be a subtype of OFG. Dental treatment should necessarily be the preferred first-line therapy for such patients.

BACKGROUND: In this case, platelet-rich fibrin (PRF) was added to guided tissue regeneration as a biomaterial in proper order for immediate planting in aesthetic area with periapical infection.
METHODS: With the history of endodontic failure in maxillary central incisor, a 34-year-old female patient required the extraction of maxillary anterior residual root and immediate implantation. Cone beam computed tomography and clinical observation were used to assess the regeneration of soft and bone tissue. Before operation, cone beam computed tomography showed the anterior residual root had serious periapical periodontitis with insufficient labial bone in the aesthetic zone. The patient underwent immediate implant placement and reconstruction of the bone substitution by modified guided bone regeneration. The barrier was a three-layer structure of PRF-collagen membrane-PRF that covered the mixture of PRF and Bio-Oss to promote both osteogenesis and soft tissue healing. At 6 mo postoperatively, the definitive crown was placed after accomplished finial impression. One-year follow-up showed a satisfactory aesthetic effect with no obvious absorption of the labial bone and soft tissue.
CONCLUSIONS: The use of PRF in combination with guided bone regeneration can serve as a reliable and simple adjuvant for immediate implanting in infected socket and result in a stable osteogenic effect with good aesthetic outcome.

No studies have focused on dental pain signs associated with periapical infection in cheek teeth (CT) of horses. Moreover, the ability of owners to recognize signs of dental pain in horses has not been reported. We hypothesized that periapical infection will usually induce pain that manifests in the behavior of the horse. Removing the infected tooth will reduce the expression of such behaviors. Owners of 47 horses whose CT had been removed because of periapical infection participated in this study. They filled an internet-based questionnaire including 23 questions about eating behavior, bit behavior, and general behavior observed before and after the operation. The number of signs exhibited by each horse before and after CT removal was compared using Wilcoxon signed-rank sum test. Values of P < .05 were considered significant. Before the operation, avoidance behaviors, such as evading the bit, difficulties in eating, and even asocial or aggressive behaviors were commonly reported by the owners. Removing the infected tooth significantly reduced the number of these behavioral patterns expressed by the horses (P < .001 for each group of behaviors), suggesting that they could be associated with dental pain. Half of the cases had been diagnosed during a routine dental examination, indicating that many owners did not realize that certain undesirable behavioral patterns of their horses might be associated with dental pain. These findings highlight the importance of training owners to recognize behavior potentially related to dental pain in horses and that routine dental examinations are essential for ensuring horses\' well-being.

A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the test in a low-income setting to identify participants with history of periodontal destruction detected as alveolar bone loss (ABL) in radiographs. This cross-sectional study included 486 women who had recently delivered in rural Malawi. The aMMP-8 test and dental panoramic radiographs were taken within 48 h of delivery. The performance of the test in comparison to radiological examinations was tested by following the standards for reporting of diagnostic accuracy studies protocol (STARD) with respective statistical measures and 95% confidence intervals. From the 486 eligible participants, 461 mothers with complete data, aged from 15 to 46 years (mean 24.8, SD 6.0) were included in the analysis. ABL was identified in 116 of 461 participants. There was 56% agreement between the aMMP-8 test results and detected ABL (yes or no) in radiographs. Calculated sensitivity of the test was 80% (72⁻87%), specificity 48% (43⁻54%), positive predictive value 34% (31⁻37%), negative predictive value 88% (83⁻91%), positive likelihood ratio 1.55 (1.35⁻1.77), and negative likelihood ratio 0.41(0.28⁻0.60). The aMMP-8 test sensitivity and negative predictive value to identify the ABL cases were relatively high, but there was additionally a high rate of test-positive results in participants without ABL, especially in young mothers, leading to low overall agreement between the test results and radiological bone loss. Further longitudinal studies are needed to examine if the test positive subjects are in risk of future bone loss before the detectable signs of periodontitis in radiographs.

This case report records the replacement of two failed endodontically treated mandibular molars with one piece zirconia implants in a patient with metal hypersensitivity. The two molars were atraumatically extracted and curetted to remove any remnants of a periapical granuloma. Immediate implant placement with primary stability was achieved using one piece WhiteSky® Bredent zirconia implants which were restored after four months with a zirconia crown. One year follow up revealed successful osseointegration with optimal form and function.

OBJECTIVE: Maternal infections are associated with intrauterine growth restriction (IUGR) and preterm birth (PTB). Dental infections are common in low-income settings, but their contribution to adverse pregnancy outcomes is unknown. We studied the epidemiology of dental periapical infections among pregnant women and their association to foetal growth restriction and the duration of pregnancy in a rural sub-Saharan African population.
METHODS: This was a cross-sectional study on the association between maternal dental periapical infections and birth outcomes, in Malawi, Africa. We assessed oral health clinically and radiologically among recently delivered women with known duration of pregnancy and measured birthweight (BW), length and head circumference of their infants.
RESULTS: Of 1024 analysed participants, 23.5% had periapical infections. Mean duration of pregnancy was 39.4 weeks, BW 2979 g and length 49.7 cm. Women with periapical infection had mean (95% CI) pregnancy duration 0.4 weeks (0.1-0.8) shorter and delivered infants with 79 g (13-145) lower BW and 0.5 cm (0.2-0.9) shorter neonatal length than women without periapical infection. The incidence of PTB was 10.0% among women with periapical infection and 7.3% among those without (adjusted difference 3.5%, 95% CI -1.1-8.1%). Corresponding prevalences for stunting were 20.9% and 14.2% (adjusted difference 9.0%, 95% CI 2.7%-15.2%). The population-attributable risk fraction attributable to periapical infection was 9.7% for PTB and 12.8% for stunting.
CONCLUSIONS: Periapical infection was associated with shorter pregnancy duration and IUGR in the study area; interventions addressing this risk factor may improve birth outcomes in low-income settings.

Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment.

BACKGROUND: Infections of teeth are highly prevalent, often leading to tooth extractions. Missing teeth can thus be considered as proxy for chronic dental infections, caries or periodontitis. We followed-up a cohort for 24 years investigating the association between missing teeth and the incidence of cancer with the hypothesis that dental chronic inflammation links to cancer.
METHODS: WHO ICD-7-9-10 malignant diagnoses were recorded from the Swedish Cancer Registry from 1985 to 2009 in 1 390 individuals who had underwent clinical oral examination in 1985. The subjects appeared periodontally healthy and thus the probable reason for tooth extractions was deep caries. Using Fisher\'s exact t-test and multiple logistic regression analysis the results were analysed for the association between cancer incidence and baseline oral health parameters and a number of other explanatory factors.
RESULTS: Of the 1 390 subjects 71 had got cancer by year 2009. The results of the multiple regression analysis showed that between any type of cancer as a dependent variable, and several independent explanatory variables, missing second molar in the right mandible and age appeared as the principle independent predictors significantly associating with cancer, with an odds ratio (95% confidence interval) of 2.62 (1.18-5.78) and 1.91 (1.06-3.43), respectively.
CONCLUSIONS: In periodontally healthy subjects extracted molars, proxy for past dental infections, seemed to predict cancer risk in the studied age group - hence supporting a role of chronic dental infection/inflammation in carcinogenesis.