Search

This study intended to help practitioners selecting the appropriate motion according to their level of expertise for glide path and complete root canal preparation of curved canals in terms of instrument fracture and preparation time. A total of 160 curved root canals (angle >30°, radius <6 mm) were allocated randomly to 4 groups: A/B for expert operators and C/D for nonexpert operators. A/C were shaped with rotary and B/D with reciprocating instruments. Preparation time was registered and compared with Kruskal–Wallis non‐parametric test and Dunn's post hoc test. Instrument separation was also registered and compared with chi‐square test. A fractographic analysis was performed with scanning electron microscopy. The use of reciprocation motions allowed nonexpert operators to avoid instrument breakage during glide path and to prepare root canals faster. Experts were equally effective in rotary/reciprocating root canal shaping and faster with rotary motions than nonexpert operators, who also fractured significantly more rotary instruments. [ABSTRACT FROM AUTHOR]

Aim: To determine and classify the position of the mesial root canal orifices on the pulp chamber floor and examine their possible correlation with the radicular pattern in mandibular first molars. Materials and Methods In total, 110 extracted mandibular first molars were obtained and the positions of the orifices and the radicular pattern were observed using an operating microscope. Results: Of the mesial root canals, 61 (55.5%) had an independent pattern and 49 (44.5%) had a confluent radicular pattern. In canal orifices with symmetrical positions on the pulp chamber floor, the interorificial distance was key: 88% of canals were confluent at distances between 1 and 2 mm and 95.3% were independent at distances > 2 mm. In asymmetric positions, the canals had an independent pattern regardless of distance, with a percentage of 82.4%. Analysis of the independent and confluent radicular patterns showed a significant difference with the interorificial distance (P = 0.0004). Conclusion: A significant correlation was seen between the position of the mesial root canal orifices on the pulp chamber floor and an independent or confluent radicular pattern in the mandibular first molars. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to investigate the association between periodontal disease (PD) and inflammatory bowel disease (IBD), and its two major forms Crohn's disease (CD) and ulcerative colitis (UC). We searched articles in PubMed/MEDLINE, Web of Science, and LILACS published until March 2020. Observational studies evaluating the coexistence of PD in IBD and reported values of clinical periodontal parameters, or radiographic bone loss; and IBD diagnosis established by clinical, radiological, endoscopic and histological criteria were deemed eligible. A total of 9 studies were included (33,216 individuals). Only one study reported longitudinal data on IBDs onset in patients with PD. Several case-control studies reported coexistence. Meta-analysis showed that the presence of PD was associated with IBD (2.78 [95%CI 1.36–5.69]). PD was strongly associated both with CD (3.41 [95%CI 1.36–8.56]) and UC (3.98 [95%CI 2.02–7.87]). This review presents clear evidence for an association between PD and IBDs. Future studies should avoid non-longitudinal designs and focus on addressing direction. PD screening may be included in the multidisciplinary management of IBD patients. The mere theoretical possibility that PD may predispose to IBDs may be of key significance due to the rising incidence of diseases. [ABSTRACT FROM AUTHOR]

Introduction: Dens invaginatus is a malformation of the tooth during embryonic development that presents in several morphological types. This article reports a case of a type II dens invaginatus with an extensive periradicular lesion that was treated successfully. Methods: Three-dimensional imaging, cone beam computed tomography (CBCT) was used to identify the morphology of dens invaginatus and to help devise a treatment plan. Nonsurgical and surgical endodontic treatments were performed to achieve a favourable outcome. Conclusions: Understanding both the configuration of the internal root canal and irregularities of the external root using CBCT can ensure predictable and successful results, as in this case. The 2-year follow-up showed complete healing of the periapical pathosis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Dentistry & Research is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Laser irradiation has been introduced in endodontic treatment due to its bactericidal effect. The aim of this study is to evaluate the bactericidal efficacy of a 940 nm diode laser alone or in combination with 5% sodium hypochlorite (NaOCl) against mature biofilms of E. Faecalis. Methods: Sixty-eight (60 for the three groups, 4 for SEM and 4 as negative controls) single-rooted human central incisors were prepared and contaminated with E. Faecalis. After two weeks of incubation, specimens were randomly divided in three groups; group 1 (n =20), the teeth were irradiated with a 940 nm diode laser; group 2 (n=20), specimens were rinsed with 5%NaOC1; group 3 (n=20), the teeth were rinsed with 5% NaOC1 and then were irradiated with 940 nm diode laser. Four teeth were used to observe the biofllms by SEM. Intracanal bacteria sampling was done, and the samples were plated to determinate the CFU count. Results: At 24 hours and 7 days, group 3 showed a significant difference (P=0,02; P0,00) in disinfection if compared to group 1 but did not show this difference if compared to group 2 (P=1, P=0,66), although group 3 obtaining a more extensive disinfection. Groups 1 and 2 did not show difference after 24 hours (P=0,09) but showed a significant difference 7 days afterwards (P=0,04). Conclusion: The combination of sodium hypochlorite and diode laser light (940 nm) has a synergistic effect, intensifying the bactericidal action. [ABSTRACT FROM AUTHOR]

Statement of Problem: Gingival irritation is a common side effect of at-home bleaching, but how the design of the bleaching tray affects its occurrence is unclear., Purpose: The purpose of this randomized clinical trial was to determine whether a direct relationship is present between the design of bleaching trays and the risk of gingival irritation during at-home bleaching treatments., Material and Methods: This clinical trial was registered at ClinicalTrials.gov. (NCT06371664). Seventy-two participants were randomly assigned to 2 experimental groups: extended bleaching tray (3 mm) and nonextended bleaching tray (1 mm). Over a period of 3 weeks, participants underwent a nightguard dental bleaching treatment (6 to 8 hours) using 16% carbamide peroxide gel. Gingival irritation was evaluated subjectively by participants daily and objectively by clinicians at each visit. Tooth sensitivity was recorded daily using a 5-point numerical scale. Tooth color measurements were also made with a dental spectrophotometer. The risk of gingival irritation and the risk and intensity of tooth sensitivity were analyzed with the Pearson chi squared test and Fisher exact test. The color analysis was conducted with the Student t test (α=.05)., Results: Subjectively, the risk of gingival irritation was 66.7% in the extended group and 47.2% in the nonextended group, showing no statistically significant difference (P>.05). However, objectively, the risk of gingival irritation was significantly higher in the extended group (88.9%) compared with the nonextended group (63.9%) (P=.01(95% CI 1.06 to 1.83). Tooth sensitivity intensity was significantly higher in the extended tray group (P<.001), although the design did not significantly influence the risk of tooth sensitivity (P>.05). No significant differences were found between groups regarding color change (P>.05)., Conclusions: The use of an extended bleaching tray design increases the risk of gingival irritation and the intensity of tooth sensitivity. Therefore, the nonextended tray is recommended to minimize adverse reactions., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Nowadays, traumatic dental injuries (TDIs) have a growing prevalence and incidence worldwide, reaching their highest numbers in school-age children. The management of dental avulsion requires an important challenge for the clinicians and the prognosis depends on an immediate and an appropriate emergency action. In this regard, primary school teachers are in a privileged position to assist injured children. Objective: To assess the knowledge and attitudes of primary school teachers regarding the proper management of dental avulsion in schoolchildren., Material and Methods: This cross-sectional study was conducted in Spain, including teachers from schools distributed throughout the Spanish territory, selected randomly. The sample consisted of 240 teachers. An ad hoc questionnaire, distributed in physical and online formats, was used to assess their knowledge on the proper management of dental avulsion in schoolchildren., Results: A very high response rate was obtained (80%). The majority of the participants were unable to reimplant the tooth (76.3%), and they lacked knowledge of the appropriate medium for its optimal preservation (85.8%)., Conclusions: This study suggests that there is an inadequate level of knowledge about the management of dental avulsion injuries among primary school teachers in Spain. It would be necessary to design educational strategies to improve this situation. Key words: Primary school teachers, traumatology, avulsion, knowledge., Competing Interests: The authors declare that they have no conflict of interest. This research received no specific grant from any funding agency in the public, commercial, or not- for- profit sectors., (Copyright: © 2024 Medicina Oral S.L.)

The BOPT technique (Biologically Oriented Preparation Technique) was proposed by Loi et al. (1) and has become a popular form of vertical preparation for complete crowns with promising results. In this procedure, the clinician can operate on the gingival tissue during preparation and modify its structure in thickness and height by adding modifications on the provisional restoration. However, one of the main challenges in this technique is the transference of information about the gingival tissue to the laboratory technician, who will place the margin of the restoration randomly in a space determined by two marks on the working cast. The technique proposed enables the accurate transmission of the exact point where the margin of the restoration needs to be placed. Furthermore, it facilitates the recording of conventional impression materials and intraoral scanners due to the compression of polytetrafluoroethylene (PTFE) tape into the sulcus, which allows to arrest bleeding or intracrevicular liquid and is easily registered irrespective of the method of impression used. Key words: Vertical preparation, BOPT, PTFE, emergence profile, digital impression, conventional impression., Competing Interests: Conflicts of interest None declared., (Copyright: © 2023 Medicina Oral S.L.)

Background: The aim of this study was to evaluate the fracture and defects observed in ProTaper Next files discarded after a normal clinical use., Material and Methods: 571 ProTaper Next rotary instruments were collected after clinical use from the clinic of endodontics over 12 months. The length of the files was measured using a digital caliper to determine any fracture, later all the files were evaluated under a stereomicroscope to observe defects such as unwinding, curving or fracture. The data obtained were analyzed using a chi-square and z test., Results: 13.83% of the discarded files showed defects, the most frequent defect was fracture (7.53%). The highest rate of fracture was observed in the X1 (17.04) files (19.87%). The presence of deformations without fracture was also more frequent in the 17.04 file (11.8%)., Conclusions: Because of the relatively high incidence of deformation of smaller files, these instruments should be considered as a single use. It is important not to exceed the maximum uses recommended by the manufacturer to reduce the risk of cyclic fatigue, the main cause of fracture of the files (79.07%). It is also important to observe each file after use to discard small defects or fractures. Key words: Clinical use, deformation, fracture, M-Wire, ProTaper Next., Competing Interests: Conflict of interest statement: The authors have declared that no conflict of interest exist.

Anterior teeth with subgingival fractures require a complex treatment plan that addresses biologic, functional and aesthetic factors. This case report describes the management of a crown-root fractured maxillary left central incisor. An interdisciplinary approach was used to restore the tooth due to the complex nature of the treatment. Orthodontic extrusion was performed to move the fracture line above the alveolar bone and periodontal surgery to recontour the altered gingival margin. Finally, the incisor was restored performing a root canal retreatment with a fiber post and a full ceramic crown. The treatment resulted in secured periodontal health and good aesthetics. Key words: Crown-root fracture, orthodontic extrusion, crown lengthening, root canal retreatment, full ceramic crown., Competing Interests: Conflict of interest statement: The authors have declared that no conflict of interest exist.

Background: One of the causative factors of root defects is the increased friction produced by rotary instrumentation. A high canal curvature may increase stress, making the tooth more susceptible to dentinal cracks. The purpose of this study was to evaluate dentinal micro-crack formation with the ProTaper NEXT and ProTaper Universal systems using LED transillumination, and to analyze the micro-crack generated at the point of maximum canal curvature., Material and Methods: 60 human mandibular premolars with curvatures between 30-49° and radii between 2-4 mm were used. The root canals were instrumented using the Protaper Universal® and Protaper NEXT® systems, with the aid of the Proglider® system. The obtained samples were sectioned transversely before subsequent analysis with LED transillumination at 2 mm and 8 mm from the apex and at the point of maximum canal curvature. Defects were scored: 0 for no defects; and 1 for micro-cracks., Results: Root defects were not observed in the control group. The ProTaper NEXT system caused fewer defects (16.7%) than the ProTaper Universal system (40%) ( P <0.05). The ProTaper Universal system caused significantly more micro-cracks at the point of maximum canal curvature than the ProTaper NEXT system ( P <0.05)., Conclusions: Rotary instrumentation systems often generate root defects, but the ProTaper NEXT system generated fewer dentinal defects than the ProTaper Universal system. A higher prevalence of defects was found at the point of maximum curvature in the ProTaper Universal group. Key words: Curved root, Micro-crack, point of maximum canal curvature, ProTaper NEXT, ProTaper Universal, Vertical root fracture., Competing Interests: Conflict of interest statement:The authors declare that no competing interests exist.

Background: Irrigation of the root canal system is an essential step in the endodontic treatment. The aim of this article is to introduce continuous apical negative-pressure ultrasonic irrigation (CANUI), a new irrigation concept, and compare the characteristics of this new technique with current devices for activating the irrigant., Material and Methods: CANUI is designed for cleaning and disinfecting the root canal system. The device consists of a tube inside another tube that allows the continuous ultrasonic exchange of fresh irrigant, as the irrigant is simultaneously aspirated apically. The coronal and apical tubes are 0.75 and 0.3 mm in diameter, respectively. It is composed of a nickel-titanium microcannula suitable for the working length of curved canals., Results: The CANUI technique has the advantages of apical negative pressure (to avoid apical extrusion of the irrigant) and continuous ultrasonic irrigation (continuous refreshment of the irrigant and forced introduction into the canal ramifications)., Conclusions: The CANUI technique could improve the irrigation technique of dentists to reach more disinfection in endodontic treatments. Key words: Apical negative pressure, continuous ultrasonic irrigation, irrigation in curved canals, irrigation systems., Competing Interests: Conflict of interest statement:The authors deny any conflict of interest.

Background: The efficacy of endodontic irrigation procedures can be compromised by the complexity of the root canal system. Delivering irrigants to the apical third of curved canals presents a particular challenge to endodontists. This study compared the effects of two ultrasonic irrigation techniques on the penetration of sodium hypochlorite into the main canal and simulated lateral canals of curved roots in extracted teeth., Material and Methods: Two sets of simulated lateral canals were created at 2, 4, and 6 mm from the working length in 60 single-rooted teeth (6 canals/tooth, n = 360 canals). The teeth were randomly divided into three experimental irrigation groups: group 1 (n = 20), positive pressure irrigation (PPI); group 2 (n = 20), passive ultrasonic irrigation (PUI); and group 3 (n = 20), continuous ultrasonic irrigation (CUI). To assess the irrigation solution penetration, 20% Chinese ink (Sanford Rotring GmbH, Hamburg, Germany) was added to a 5% sodium hypochlorite solution and delivered into the curved root canals. The penetration of contrast solution into the simulated lateral canals was scored by counting the number of lateral canals (0-2) penetrated to at least 50% of the total length., Results: The CUI group showed significantly higher ( P < 0.05) irrigant penetration into the lateral canals and into the apical third of the main canals. The PPI group showed significantly lower sodium hypochlorite penetration ( P < 0.001) into the main and lateral canals compared with that in the CUI and PUI groups. Significantly higher irrigant penetration was observed in the PUI group than the PPI group., Conclusions: Using CUI as the final rinse significantly increased the penetration of irrigant solution into the simulated lateral canals and apical third of curved roots. Key words: Continuous ultrasonic irrigation, curved root canals, passive ultrasonic irrigation, positive pressure irrigation, root canal irrigation., Competing Interests: The authors deny any confict of interest.

Orofacial granulomatosis is defined by permanent or recurrent swelling of orofacial tissues with different multiform and multifocal clinical patterns. An 11-year old boy presented with a 2-month history of mucosa enlargement. Intraoral examination revealed an erythematous, polylobulated, exophytic lesion with a smooth surface located in retromolar mucosa, non-tender and non-infiltratated to palpation. The diagnosis was inflammatory lesion compatible with pyogenic granuloma and laser excision was decided. Haematological parameters were within normal range, as well as chest Xrays. These findings lead to a diagnosis of non-symptomatic orofacial granulomatosis, whose early diagnosis can minimize the impact of systemic-related disorders, like Chron's disease. Key words:Laser, orofacial granulomatosis, childhood, oral lesions, diagnosis.