Vorschlag einer Klassifikation der Odontalgien

Zusammenfassung: Hintergrund: Die Prävalenz von Zahnschmerzen in der Bevölkerung ist beachtlich. Bislang publizierte Klassifikationen der Odontalgien erscheinen jedoch für klinische Belange nicht ausreichend strukturiert. Zudem finden nicht alle bekannten Zahnschmerzformen Berücksichtigung. Ziel dieser Abhandlung ist die Vorstellung einer verfeinerten und aktuellem Wissen genügenden Einteilung der Odontalgien und die Zusammenfassung ihrer jeweiligen Merkmale zum Zweck einer raschen Diagnosestellung. Ergebnisse: Die erarbeitete Klassifikation unterscheidet 7Schmerzformen: 1."Dentin-Schmerz" (ausgehend vom Pulpagewebe), 2."Pulpa-Schmerz" (ausgehend vom Pulpagewebe), 3.parodontaler Schmerz, 4.alveolär-ossärer Schmerz, 5.atypische Odontalgie, 6.in die Zähne übertragener (heterotoper) Schmerz, 7.Zahnschmerz in Zusammenhang mit primär psychosozialen Faktoren. Schlussfolgerungen: Die vorgeschlagene Klassifikation erscheint geeignet, die verschiedenen Formen der Odontalgien differenzierter darzustellen, als dies mit den bisherigen Einteilungen der Fall war. Ihre Brauchbarkeit bzw. Überlegenheit gegenüber anderen Klassifikationen wird sich im klinischen Alltag erweisen müsse

Efficacy of rotary instruments with greater taper in preparing oval root canals

AIM: To compare the preparation quality of two rotary systems and NiTi-hand files in oval root canals, and to evaluate the effect of canal dimensions on the preparation. METHODOLOGY: Ninety roots with oval root canals were selected. The middle third was cross sectioned at two levels and photographed. The maximum and minimum diameters of the root and canal were recorded. Teeth were distributed in three groups (n = 30) using stratified randomization, and prepared under simulated clinical conditions with Mtwo, ProTaper, or NiTi-hand files. The pre- and post-preparation photographs were traced and superimposed, the thickness of dentine removed was measured and the ratio of prepared canal outline was calculated. The impact of preparation system and canal dimensions on the quality of the preparation was evaluated using regression analysis. RESULTS: With regards to the ratio of prepared canal outline, no statistical significant difference was found between Mtwo (0.75 [95%CI: 0.69; 0.81]) and ProTaper (0.75 [95%CI: 0.69; 0.80]), but both systems performed significantly better than NiTi-hand files (0.65 [95%CI: 0.60; 0.71]). In six root canals in Mtwo-group (20%), and eight root canals in ProTaper-group (27%), the minimal thickness of dentine-wall after preparation was less than 0.5 mm. In contrast to the maximum diameter of the root canal, the minimum diameter influenced the quality of the preparation (P = 0.0006). CONCLUSIONS: No instrumentation technique was able to circumferentially prepare the oval outline of root canals. Nevertheless, instruments with greater taper (ProTaper and Mtwo) were more efficient than NiTi- hand files, but this was, in some cases, at the expense of remaining dentine-wall thickness

[Suggestion for a classification of odontalgias]

BACKGROUND: Toothache prevalence in the overall population is considerable. However, for clinical purposes, the classification schemes available do not appear to be sufficiently sophisticated. Moreover, not all known forms of dental pain are considered. A refined classification that meets current standards is therefore introduced. To facilitate diagnosis, the characteristic features of the various types of odontalgia are summarized. RESULTS: The new classification differentiates among seven different origins of pain: 1. dentinal pain (originating from the pulpal tissues), 2. pulpal pain (originating from the pulpal tissues), 3. periodontal pain, 4. alveolar-osseous pain, 5. atypical odontalgia, 6. heterotopic dental pain, 7. odontalgia associated with primary psychosocial factors. CONCLUSIONS: In our opinion, the proposed classification differentiates among the different forms of odontalgia more precisely than all previous ones. However, its viability and advantages over other available classification schemes still need to be verified in daily practice

Suggestion for a classification of odontalgias

BACKGROUND: Toothache prevalence in the overall population is considerable. However, for clinical purposes, the classification schemes available do not appear to be sufficiently sophisticated. Moreover, not all known forms of dental pain are considered. A refined classification that meets current standards is therefore introduced. To facilitate diagnosis, the characteristic features of the various types of odontalgia are summarized. RESULTS: The new classification differentiates among seven different origins of pain: 1. dentinal pain (originating from the pulpal tissues), 2. pulpal pain (originating from the pulpal tissues), 3. periodontal pain, 4. alveolar-osseous pain, 5. atypical odontalgia, 6. heterotopic dental pain, 7. odontalgia associated with primary psychosocial factors. CONCLUSIONS: In our opinion, the proposed classification differentiates among the different forms of odontalgia more precisely than all previous ones. However, its viability and advantages over other available classification schemes still need to be verified in daily practice