The purpose of this study was to determine the prevalence and demographic predictors of pulpal and/or periradicular disease in an urban population. A total of 210 subjects were recruited from a population of patients that were screened for acceptance to the dental school clinics. The diagnosis of pulpal and/or periradicular disease was made using the following data: radiographic interpretation, patient's history of previous pain and chief complaint, and objective pulpal testing. Objective pulpal testing included percussion, palpation, electric pulp test, and cold. The unit of observation was the individual, not the tooth. The overall prevalence of endodontic disease among the study sample of the screening patient population was 39.52%. Controlling for gender, patients in the 30-39 age group were 3.05 times more likely to have pulpal disease than patients in the 18-29 age group (OR=3.05, 95%CI 1.04-8.9). Controlling for age, men were 1.82 times more likely to have pulpal disease than women (OR=1.82, 95%CI 1.01-3.26). Non-white patients were 2.69 times more likely to have pulpal disease than white patients (OR=2.69, 95%CI 1.51-4.81). Patients who earned less than $25,000 were 2.06 times more likely to have pulpal disease compared to those who earned more than $25,000 (OR=2.06, 95% CI 1.15-3.69). Overall, this data provides valuable information for identifying vulnerable populations and addressing the policy goals of the U.S. Surgeon General.

The purpose of this study was to test the predictive ability of specific questions in diagnosis of pulpal and periradicular disease in a dental school population. 210 patients were recruited to fill out a questionnaire, and undergo a clinical examination for pulpal and/or periradicular disease.The Questionnaire asked if the patient had in the last 6 months: 1. a toothache that kept them up at night 2. a toothache that required pain killers 3. facial swelling caused by a tooth 4. injury to any teeth 5. a broken tooth 6. a tooth darker in color than the surrounding teeth 7. a bump, pimple, or boil on the gums. 8. a toothache after eating or drinking something hot or cold 9. repeated sharp pain in the same area while chewing 10. A toothache or facial swelling that caused them to visit an emergency room.Examiners were blinded to the responses on the questionnaire and then, based on the clinical examination and testing, determined the presence or absence of endodontic disease. The data was analyzed using univariate logistic regression models.Results: The most predictive questions were #1 and #2 (p-value Conclusion: Patients with pain that wakes them at night or that requires analgesics were greater than 3 times more likely to have endodontic disease at the time of examination.

Symptomatic apical periodontitis (SAP) is indicative of inflammation of the periodontal ligament. It may or may not be accompanied by radiographic changes and may occur with vital or necrotic pulpal diagnosis. Purpose of this study was to analyze clinical and radiographic presentations of SAP in a retrospective electronic dental chart and digital radiograph review utilizing the endodontic diagnostic template note of predoctoral dental school patients presenting with SAP. The aim was to determine prevalence of periapical radiolucencies (PARLs) in SAP, association of SAP to pulpal diagnosis, and define associated radiographic changes. Most prevalent pulpal diagnosis with SAP was symptomatic irreversible pulpitis (44%). A tooth presenting with SAP was more likely to have an intact lamina dura, but presented with a PARL 38% of the time. When a PARL was present the most common pulpal diagnosis was pulp necrosis however, 24.5% of teeth presented with a vital pulp diagnosis and lesions <2mm.

Abstract The purpose of this study was firstly to evaluate the optical instrument tracking system integrated to the MRI scanner as a guidance facility in performing bone biopsy and secondly to develop and evaluate clinical musculoskeletal applications of interventional MRI at 0,23T. The clinical results and feasibility of MR-guided bone biopsy (n=14), periradicular nerve root therapy (n=61), discography (n=12) and percutaneous laser therapy of osteiod osteomas (n=5) were studied. Bone biopsies were performed with the optical instrument tracker and bone biopsy set modified for the tracker system. The biopsy system and optical tracker mounting proved to be safe and reliable tool for bone biopsies. 14 consecutive bone biopsies and 13 fine needle aspirations were performed under MR-guidance. The clinical accuracy of MR-guided bone biopsy was 95%. The periradicular therapy was applied to the anatomical region of lumbosacral area of 61 consecutive patients with sciatic pain. Procedural success rate was 98,5%. Of patients, 51,5% had good or excellent effect with regard to radicular pain from procedure. The therapy effect achieved with MR-guided procedure was comparable to that achieved with conventional techniques. MR-guided discography technique and imaging protocol was developed as part of diagnostic pain provocation for patients suspected for intervertebral pain source at lumbosacral area. 34 MR-guided discographies were performed on 12 patients. In all patients positive or negative pain provocation response was obtained. Laser induced thermal therapy for osteiod osteoma was studied in MRI. The initial guidance of the instrument and monitoring of the thermal procedure were done under MRI control. All the 5 patients were successfully treated. The MR-guidance in musculoskeletal applications seems safe and accurate.