Search

Purpose: To evaluate the effectiveness of low-level laser therapy (LLLT) on dental pain felt during cavity preparation of carious lesions in permanent teeth of adults. Methods: The study was carried out on 88 teeth with dental caries requiring class I restorations in 24 subjects with a pain score > 7 but < 10 measured using a 0-10 visual analogue scale (VAS) in a preliminary test of pain threshold (PTPT) for each subject receiving a class I cavity preparation on another tooth without local anesthesia. The 88 teeth included were randomly allocated to test and control groups, each with 44 teeth. All teeth were treated with LLLT prior to the mechanical preparation of the cavity without local anesthesia, except that the laser device was kept in idle mode in the control group. After cavity preparation, subjects scored pain intensity using the VAS. The Wilcoxon test was used to analyze data and the values with P< 0.05 were considered significant. Results: All subjects scored a pain reduction in the test group compared with the control group (P< 0.0001), with a reduction of 42% and 16%, respectively, compared to pain felt during the PTPT. The use of LLLT prior to mechanical preparation of a cavity by lowering pain intensity might reduce the quantity of drugs used for pain control required during restorative procedures. (Am J Dent 2018;31:267-271 ).

Aim This review aims to summarise our understanding of the destructive role of acid environment and metalloproteinases in dentin caries progression using a review process. Method The acids resulting from consumption of sugars by acidogenic and aciduric bacteria can cause demineralisation of the tooth surface, but are not able to cause caries-like lesions. The appearance of such lesions requires the activation of enzymatic proteolysis in an acidic environment for degradation of the dentin organic matrix, leading to cavity formation. Bacterial collagenases have long been considered responsible for organic matrix destruction; host cell-derived matrix metalloproteinases (MMPs) have recently been considered to be involved in the dentinal matrix destruction of carious lesions. Discussion and conlusion MMPs are initially synthesised as inactive zymogens to be activated in acid environment of dentinal fluid during the carious process, resulting in destruction of the collagenous matrix. The role of acid environment on enamel and dentin demineralisation and the role of salivary and dentinal MMPs in dentin progression of caries has encouraged general dentists to include the monitoring of oral environment not only by control of bacterial oral flora in caries treatment protocol, but mainly by inhibition of dentinal and salivary MMPs through the use of toothpaste and/or mouthwash containing specific active agents.

Many attempts have been made in the last fifteen years for the better understanding of molecular mechanisms underlying dental tissue response to an injury i.e. caries, dental trauma, restoration and/or preparation, providing for new dentin formation, tertiary dentin. Tertiary dentin represents dental tissues of two variants “reactionary” and “reparative” ones, sharing the inductive nature but characterized by different healing processes, related to the extent of tooth injury. This paper discusses the current knowledge about tooth response to injury by reviewing the literature.

Purpose: To evaluate the margin quality of direct resin composite restorations comparing the enameldentin adhesive standard procedure with additional use of adhesive layer at the external outline. Methods: A total of 648 teeth with Class I occlusal lesions in molars and premolars were randomly selected and distributed into two groups of 324 each in order to compare the margin quality with two restoration strategies. Lesions were sealed with the standard adhesion procedure for direct resin composite restorations (Group 1) and with an additional procedure of enamel adhesive on the outer boundary of the finished restoration (Group 2). Evaluation of marginal quality at 6, 12, 24, 36 and 48 months was performed and described as good marginal adaption or as poor quality defined as Inadequacy A (IA): overhanging resin or change of color; Inadequacy B (IB): the presence of a gap at the enamel-composite interface that retained the probe tip; or Inadequacy C (IC) presence of gap at the enamel-composite interface with explorer tip penetration of more than 1 mm. Results: Data showed a higher number of Inadequacy A for restorations with the additional technique for marginal seal (Group 2): 16 of 24 total (57%) at 6 months; 28 of 37 total (76%) at 12 months; 36 of 44 total (82%) at 18 months; 22 of 33 total (67%) at 24 months; 14 of 21 total (70%) at 36 months and 16 of 25 total (64%) at 48 months. The Inadequacy B and C of marginal seal were more prevalent for restorations without the additional marginal seal (Group 1): 18 of 28 total (64%) at 12 months with inadequacy B; 19 of 25 total (76%) with inadequacy B and 16 total (100%) with inadequacy C at 18 months; 9 of 17 total (53%) with Inadequacy B and 13 total (100%) with Inadequacy C at 24 months; 12 of 17 total (70%) with Inadequacy B and 9 of 13 total (73%) with Inadequacy C at 36 months; 14 of 24 total (58%) with Inadequacy B and 7 of 11 total (63%) with Inadequacy C at 48 months.

(1) Background: Dentine Hypersensitivity (DH) is a frequent clinical problem that causes long-term painful discomfort to patients and is a diagnostic and therapeutic challenge for dentists. The aim of this research was to verify the efficacy of a Sodium Fluoride (NaF) gel and the VivaSens® varnish used alone or in combination with a Creation Soft Diode Laser (DL) to treat DH pain. (2) Methods: The study included 121 Non-Carious Cervical Lesions (NCCLs) in 48 patients who complained of DH pain of variable intensity, between 4 and 7 points in VAS, after application of a cold stimulus. Four study groups of 12 patients each were created and subjected to four different types of treatment. Group 1 comprised 27 NCCLs with a total VAS score of 142, who received a topical treatment of NaF. Group 2 comprised 34 NCCLs with a total VAS score of 179, who were treated with NaF in association with DL. Group 3 comprised 31 NCCLs with a total VAS score 172, who received the VivaSens varnish. Group 4 comprised 29 NCCLS with a total VAS score of 155, who were treated with VivaSens in association with DL, using a power of 0.2 Watt in continuous emission and a fiber of 400 µm diameter. (3) Results: The results for each NCCL were evaluated by the cold stimulus response and recorded according to the VAS at the end of each treatment (t1) as well as after one week (t2), 1 month (t3), and 6 months (t4). All treatments resulted in pain relief at all study times, but the best results were obtained for Group 4 at t1, with a total VAS score of 26, and for Group 2 at t2, t3, and t4, with total VAS scores of 41, 51, and 65, respectively. (4) Conclusions: The treatment with VivaSens allowed pain relief immediately after its application, but the greatest long-term benefits (t2, t3, and t4) were obtained with the topical application of NaF associated with a DL.

The presence of a double-tooth requires specific complex management due to the need for differential diagnosis and following treatment choices. The aim of this report was to present a rare case of a geminated mandibular lateral incisor, treated with an orthodontic approach. A Caucasian 10.9-year-old girl presented a lower right double-tooth incisor, with a class 1 molar and a class 2 cuspid tendency on both sides. The upper arch was constricted as shown by bilaterally tendencies to cross-bite, a slightly lower midline deviation was reported and a lack of space for all four permanent cuspids was confirmed also by the panoramic X-ray. In the lower arch, there was a severe crowding of about 14 mm and a buccally ectopic left canine. Overbite was normal and Overjet minimally increased. The double-tooth was identified like a geminated tooth, for the presence of one root and one pulp canal of increased size, as shown by the radiographic examinations. The anomalous tooth was managed with an orthodontic approach associated with a progressive stripping to reshape the crown. A two-phase treatment plan was performed, based on first maxillary expansion and lip bumper and then fixed appliances, in order to achieve a proper occlusion and a better aesthetic.

(1) Background: Erosive lesions of dental enamel are steadily increasing owing to both the availability of exogenous acid and the production of endogenous acid. The aim of this study was to investigate the erosion-inhibiting potential of a diode laser irradiation and topical application of fluoride used alone or in combination on the enamel surface of extracted teeth before exposure to an acidic solution. (2) Methods: The four axial enamel surfaces of 40 healthy molars were used for four study groups: (A) no treatment; (B) application of fluoride gel for 120 s; (O) a diode laser application for 120 s; and (X) a combined laser/fluoride for 120 s. Each enamel surface was examined by SEM (scanning electron microscopy). (3) Results: At 700× magnification, it was possible to detect the enamel prisms of the test area of groups A, B, and O, while no structures such as enamel prisms were highlighted for group X because they were covered by an amorphous layer. The mean number of prisms ×1000 µm2 was 7.2 units with an SD of 0.72 for group A, 8 units with an SD of 0.96 for group B, and 4.8 units with a SD of 0.4 for group O. Student’s t-test showed no significant difference between group A and B with a p = 0.054. Group O showed a significant reduction of prims ×1000 µm2 compared with group A (p = 0.0027) and group B (p = 0.0009). Student’s t-test showed no significant difference between groups A and B with a p = 0.054. Group O showed a significant reduction of prims density with respect to group A (p = 0.0027) and group B (p = 0.0009). (4) Conclusions: This amorphous layer might be correlated with the effect of laser on enamel, which reduces both water and carbonate ion; increases the crystallinity of hydroxyapatite, and improves the mechanical properties of enamel; which is responsible for greater protection expressed by the enamel of group X against acid attacks.

The goal of this research is to assess the desensitizing effect of a diode laser on non-carious cervical lesions (NCCLs) responsible for dentin hypersensitivity (DH) in two separate output forces implemented both independently and in sequential combination modalities. A randomized controlled trial for this study was applied. Sixty-nine NCCLs responsible for DH pain with severity between 6 and 9 on the VAS scale were considered. Three study groups were developed using just one lesion from three different quadrants of the oral cavity of each patient. All treatment procedures were conducted using a laser diode (810 nm, 5 W) with varying power outputs used separately or in combination. The pain by DH was evaluated at baseline, at treatment completion, and at 15 days and 3 months after each laser procedure. Data analysis was performed using a Wilcoxon test for paired samples, a one-way ANOVA test, and an unpaired t-test. The significant reduction of the mean VAS score was estimated in each study group immediately and at 15 days and 3 months after the end of treatment and compared with the baseline mean VAS score (p-value &lt, 0.0001). The best result concerning the improvement of DH symptomatology was assessed when a combined protocol of two different output powers of the diode laser was used. The authors conclude that the diode laser (810 nm) therapy procedure combining two separate output forces (low and high power) can improve the painful symptoms of DH from NCCLs.

Aim This prospective non-randomised case-control study analysed lip muscle activity after Lip Bumper (LB) treatment thought surface electromyography. Methods The study group was composed of 40 young patients with a mean age of 10 years and 1 month, treated with LB in the lower arch, while 40 children who did not undergo any treatment, matched for sex and age with the previous sample, constituted the control group. Measurements were performed at the beginning and after 1 year for both groups. Electromyographic recordings were obtained in rest position and during the swallowing of 50 ml of water. Results In the study group, after 1 year of LB treatment, a statistically significant decrease in values was found; specifically, in upper lip muscle activities at rest position with the appliance in situ (p