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Purpose: To systematically evaluate and compare the clinical performance of lithium disilicate (LDS)- and zirconium dioxide (ZrO2)-based ceramic monolithic crowns in the posterior dentition.Materials and Methods: Treatment was administered by two experienced general dental practitioners in two public dental health care clinics. Forty-four patients received 60 crowns randomized to be either LDS or ZrO2 and cemented with resin cement. Evaluations were performed after 3 years using California Dental Association criteria.Results: The mean follow-up time was 40 months (range: 31 to 50). No crown fractured during the observation time, and no chip-off fractures occurred. The success rate for ZrO2 was 80%, and the survival rate was 93.3%. For LDS, the success rate was 89.7%, and the survival rate was 100%. Survival after 3 years for all crowns together was 96.6%, and success was 84.7%. There was no significant difference between the two materials.Conclusion: Crowns made of monolithic translucent ZrO2 and LDS show equal and promising clinical results from a short-term perspective. There seems to be a difference between how patients and professionals rate crowns concerning esthetics (color and shape), with patients rating the restorations more favorably. [ABSTRACT FROM AUTHOR] more...

The aim of this retrospective study was to evaluate long-term clinical and radiologic outcomes of submerged and nonsubmerged guided bone regenerative treatments for peri-implantitis lesions. Strict methods of implant-surface decontamination and detoxification were performed. Data on clinical probing depth, soft tissue measures, and marginal bone level that were documented by comparative radiographs were obtained from 45 patients, for a total of 57 implants prior to treatment and at the latest follow-up. The average followup period was 6.9 years (range: 2 to 21 years). Analysis of implant-based data revealed a success rate of 70.2% for a total of 40 implants. Recurrence of periimplantitis was observed on 9 implants, and 8 implants were removed. The regenerative procedures, under a strict periodontal control, were effective in the treatment of moderate to advanced peri-implantitis lesions. [ABSTRACT FROM AUTHOR] more...

Root canal treatment of immature teeth is considered a great challenge for both the dentist and the patient. The thinness of the root canals walls and the lack of an apical barrier leads to unpredictable treatment results. Revascularization is a novel promising treatment option in the field of regenerative endodontics for management of immature necrotic permanent teeth. This case presents a successful treatment of an 8-year-old patient with a partially necrotic, immature permanent mandibular right first molar pulp by revascularization. The revascularization procedure was performed in two appointments using nitrous oxide sedation to reduce the child's anxiety during treatment. Following root canal disinfection with NaOCl, a triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline) was applied into the canal. One week later, induction of bleeding, application of MTA, and tooth restoration using a stainless steel crown were performed. At the subsequent follow-up appointments (3, 9, and 16 months) the tooth was asymptomatic. After 2 years a radiographic assessment revealed complete periapical healing and apical closure, as well as increase in root length and dentin thickness. Conclusion: This case supports the evidence of revascularization as a biological treatment option for the management of necrotic young permanent teeth. [ABSTRACT FROM AUTHOR] more...

Aim: To determine the impact of the degree of furcation involvement (FI) on the longevity of molar teeth and assess the risk variables (tooth‐ and patient‐related factors) associated with the loss of molars (LM) in individuals treated for periodontitis and monitored in a private programme of supportive periodontal care (SPC). Materials and Methods: The present retrospective cohort study included 222 individuals with 1329 molars under a 10‐year monitoring period in SPC. Periodontal clinical parameters, FI, the type of molar, pulp vitality, and other variables of interest were collected at approximately 50 days after active periodontal therapy and after 10 years. The association of tooth‐ and patient‐related factors with LM was assessed using a multilevel Cox regression analysis. Results: Two‐hundred and thirty‐five molars were extracted during the SPC period of 12.4 ± 1.9 years. Age >50 years, male gender, diabetes, smoking, and non‐compliance were identified as relevant patient‐related factors for LM during SPC (p <.05). Significant tooth‐related factors for LM were bleeding on probing (BoP) and probing depth (PD) ≥5 mm, tooth non‐vitality, and class II and III FI (p <.05). Conclusions: Class III FI, tooth non‐vitality, higher mean PD and BoP, age, male gender, diabetes, and smoking all strongly influenced the prognosis of molars during SPC. [ABSTRACT FROM AUTHOR] more...

Aim: To evaluate the impact of various predictors on the outcome of root canal retreatment in symptomatic mandibular first molars with periapical lesions after a minimum of 2 years. Methodology: One hundred and twenty previously root canal treated symptomatic mandibular first molars with periapical lesions which were diagnosed as symptomatic apical periodontitis or acute apical abscess with localized intraoral swelling were included. Root canal retreatment was performed by an experienced endodontist using a standardized treatment protocol. The teeth were followed up clinically and radiographically and the radiographic outcome was assessed using a modified periapical index scale (PAI). The cumulative success proportion and the influence of predictors on the outcome of the root canal retreatment were analysed using Kaplan–Meier analyses and log‐rank tests, and the hazard ratios for the predictors were also investigated using Univariate Cox Proportional Hazard regression analysis at a significance level of 5%. Results: Of the 120 teeth, 103 teeth were re‐examined with an 85% recall rate. The cumulative success rate was 88% in which 64% were healed and 24% were healing, and failure rate was recorded as 12%. None of the preoperative predictors, including age, gender, soft tissue tenderness, intraoral swelling, size of the lesion, PAI score, apical level and density of root canal filling before root canal retreatment, nor intraoperative predictors, such as active exudate drainage, density of root canal filling after root canal retreatment and restoration type had an influence on the outcome of root canal retreatment (p >.05). The only factor that significantly reduced the success rate of root canal retreatment was the apical level of the root canal filling; when it was more than 2 mm short of the radiographic apex in teeth where apical patency was not established, the success was significantly lower (p =.023). Conclusions: Root canal retreatment in symptomatic mandibular first molars with periapical lesions resulted in a success rate of 88%. None of the predictors had a significant influence on the outcome, except for the apical level of the root canal filling after root canal retreatment with short root fillings being associated with significantly more post‐treatment endodontic disease. [ABSTRACT FROM AUTHOR] more...

The aim of this study was to ascertain whether applying a 1% sodium fluorescein (SF) solution to the pulp chamber floor of human molars, together with a cobalt blue filter coupled to a dental operating microscope (DOM), could improve the location of root canals, compared to detection with the naked eye or with the DOM alone. Methods: Forty maxillary first molars were studied. The pulp chambers of the teeth were sequentially inspected by three endodontists in three different ways: (i) without use of a DOM and with only standard dental light for illumination; (ii) with use of a DOM (12.5x); and (iii) by application of 1% SF and canal location using a cobalt blue filter coupled to a DOM. The interclass correlation coefficient was used to assess interexaminer agreement. Kendall's W test, complemented by Wilcoxon's signed rank test, (P < 0.05) was used to conduct the statistical analysis. Results: A good level of agreement among examiners was found (interclass correlation coefficient ICC: 0.87 to 0.89). The mean number of canals located in the third inspection was 3.93, a significantly greater number than that observed in the first and second inspections, i.e. 3.68 and 3.70, respectively. Conclusions: A 1% SF solution used in conjunction with a cobalt blue filter coupled to an operating microscope enabled the location of a greater number of canals in maxillary first molars. [ABSTRACT FROM AUTHOR] more...

Purpose and methods: The distalisation of molars using clear aligners has been found to be achievable; however, the distalisation of an entire arch is still an orthodontic challenge and reported as only clinically possible using fixed appliances. To date, there has been no study on the distalisation of both dental arches using a clear aligner system. In the present report, a case is described in which the entire maxillary and mandibular arches were successfully distalised using clear aligners and miniscrews for the treatment of a bimaxillary protrusion malocclusion in a 22-year-old female patient. Pre- and post-treatment records as well as 1.5-year follow-up records are presented. Results: The distalisation of both dental arches was achieved using a V-pattern staging process by moving the second molars, then the first molars, followed by the premolars and the anterior teeth, as well as by elastics applied between precision cutouts in the aligners and the miniscrews. The dental arches were efficiently distalised by approximately 3 millimeters in the first molar areas after 13 months of treatment. A review 1.5 years post-treatment showed that the outcome was stable without significant relapse observed in the facial profile and occlusion. Conclusion: The distalisation of both dental arches is achievable using clear aligner systems by applying elastics between miniscrews and precision aligner cutouts in the treatment of a bimaxillary protrusion malocclusion. [ABSTRACT FROM AUTHOR] more...

Excluding third molars, the prevalence of tooth agenesis of permanent teeth ranges from 1.6% to 9.6%. The congenital absence of maxillary permanent canines is a rare condition with a reported prevalence of less than 0.5%. Case reports describing congenitally missing permanent canines are uncommon, and those that involve treatment are even more rare. This case report describes the orthodontic treatment of a 12-year-old male patient who presented with a congenitally missing upper left permanent canine compounded by a malformed upper right permanent canine. Additionally, the patient had a retained upper left deciduous canine, a Class I molar relationship, an anterior open bite, and proclined and protruded incisors. Treatment involved upper left first premolar substitution for the congenitally missing canine following the extraction of the upper left retained deciduous canine, the upper right first premolar, and both lower first premolars. The upper right malformed permanent canine was retained. The total treatment time was 32 months and the result remained stable 19 months later. [ABSTRACT FROM AUTHOR] more...

Aim: The most common anatomy for the maxillary first molar is the presence of four root canals. However, other configurations regarding the number of root canals have been reported. The purpose of this paper is to present two cases with five root canals diagnosed during an endodontic retreatment. Materials and methods: Diagnosis was made and the endodontic retreatment was purposed and performed. A dental operating microscope was used for better understanding of this anatomy and especially looking for possible undetected canals along the developmental lines and grooves. Results: Both cases had undergone previous root canal treatments, which had failed. Both teeth had an anatomic configuration with five root canals with previously undetected MB2 and DB2, with both mesial and distal roots presenting a Vertucci Type II root canal configuration. The recall radiographs showed periapical healing. Conclusions: Although it is an uncommon configuration, the presence of both MB2 and DB2 may be present. The failure to identify the correct anatomy and locate all root canals may lead to treatment failure. The discovery of these missed canals in the endodontic retreatment of the presented cases might have been one of the reasons for retreatment success. [ABSTRACT FROM AUTHOR] more...

Objectives: Clinical evidence demonstrating the effectiveness of implants in preventing tooth loss is limited because of the many risk factors involved in tooth loss. This retrospective cohort study investigated whether an implant in the molar region of a distal free‐end edentulous space affects the loss of the most distal tooth after 6 years, adjusting for other risk factors associated with tooth loss using propensity score matching analysis. Material and Methods: A total of 571 subjects and 1,085 teeth adjacent to a distal free‐end edentulous space were evaluated. At baseline, the 1,085 teeth were divided into two groups according to the presence or absence of a molar implant with a fixed dental prosthesis in the distal free‐end edentulous space. Propensity score matching analysis was used to reduce the effects of bias by matching teeth with and without implants according to similar background factors at baseline. The adjusted variables were age group, occlusal support status, Kennedy classification, tooth position, tooth type, restoration status, dental caries, periodontal pocket depth, and condition of the opposing tooth. Results: A total of 56 teeth (28 associated with a molar implant; 28 with no implant) were enrolled according to propensity score matching. Fisher's exact test showed that a molar implant significantly protected the tooth adjacent to the distal free‐end edentulous space (p =.01). Conclusions: Within the limitations of this retrospective cohort study, it was found that implants in free‐end edentulous spaces may be beneficial in extending the longevity of adjacent teeth. Further research will be necessary to confirm this finding. [ABSTRACT FROM AUTHOR] more...

Objectives: Carabelli is a nonmetric dental trait variably expressed as a small pit to a prominent cusp in the maxillary molars of modern humans. Investigations on the occurrence and expression rates of this trait have been conducted extensively, tracing its origin to genetic sources. However, there remains a lack of understanding about its potential role in chewing. In this study, we examine molar macrowear with the aim of reconstructing Carabelli trait occlusal dynamics occurring during chewing. Methods: We have examined 96 deciduous and permanent maxillary molars of children and young adults from Yuendumu, an Australian Aboriginal population that was at an early stage of transition from a nomadic and hunter‐gatherer way of life to a more settled existence. We apply a well‐established method, called Occlusal Fingerprint Analysis, which is a digital approach for analyzing dental macrowear allowing the reconstruction of jaw movements required to produce wear pattern specific to each tooth. Results: Carabelli trait slightly enlarges the surface functional area, especially in those molars where this feature is expressed in its cuspal form and it is closer to the occlusal plane. Moreover, the highly steep contact planes would also indicate that Carabelli wear areas contribute to increasing the shearing abilities of the occluded teeth, which are particularly important when processing fibrous and tough foods. Conclusions: The macrowear analysis suggests that Carabelli trait in the Aboriginal people from Yuendumu slightly enhanced occlusion and probably played some functional role during mastication. Future biomechanical and microwear analyses could provide additional information on the mechanical adaptation of Carabelli trait in modern human dentition. [ABSTRACT FROM AUTHOR] more...

Background: This study aimed to investigate the regenerative effects of 2,3,5,4'-tetrahydroxystilbene-2-O-β-d-glucoside (THSG)-treated human dental pulp stem cells (DPSC) on the healing of experimental periodontal defects in rats.Methods: The maxillary first molars of 30 male Sprague-Dawley rats were extracted, and after healing, bilateral periodontal defects were surgically created mesially in second molars. The defects were treated with Matrigel (as control), DPSC, or DPSC + THSG. After 2 weeks, the healed defects were evaluated using microcomputed tomography and through histological and immunohistochemical analyses.Results: In the microcomputed tomography analysis, more new bone formation in the DPSC and DPSC + THSG groups was observed compared with the control group. The periodontal bone supporting ratio in site with DPSC + THSG was significantly higher than that in DPSC. Histologically, an enhanced new bone formation and more significant periodontal attachment were observed in the DPSC + THSG group. The expression levels of proliferating cell nuclear antigen (PCNA), vascular endothelial growth factor (VEGF), and osteopontin (OPN) in the DPSC + THSG group were significantly greater than those in other groups.Conclusions: THSG-revolutionized DPSCs significantly shortened the regenerative period of periodontal defects by enhancing the cell recruitment and possibly the angiogenesis in rat models, which illustrate the critical implications for a clinical application and provide a novel tactic for periodontitis treatment. [ABSTRACT FROM AUTHOR] more...

Copyright of CES Odontología is the property of Universidad CES 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.) more...

Copyright of Kieferorthopädie: die Zeitschrift für die Praxis is the property of Quintessenz Verlags GmbH 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.) more...

The aim of this case report is to present a clinical example of successful osseointegration of an implant placed immediately following' extraction of a mandibular left first molar (tooth No. 19) with a horizontal gap of more than 2 mm and implant threads exposed within the socket, with healing by secondary intention without flap closure, bone grafting, or barrier membrane placement. The healing was photographed every day for the first week to provide photodocumentation of early healing and then was subsequently photographed weekly for the first month and monthly for the first 6 months. The outcome showed that osseointegration of an implant placed immediately in a posterior extraction site is possible without having to graft the gap around the implant. [ABSTRACT FROM AUTHOR] more...

This case report presents the root canal treatment of bilateral mandibular first molars exhibiting three roots (one mesial and two distal) and five root canals (two in the mesial and three in the distal root). This unusual anatomic variation was diagnosed with an operating microscope and confirmed with the help of spiral computerized tomography (SCT). SCT was used as a non-invasive diagnostic tool to visualize the anatomy of the roots and the root canals precisely. Anatomical variations can occur in any tooth. Therefore careful examination of radiographs and internal anatomy of teeth is essential for successful root canal treatment. [ABSTRACT FROM AUTHOR] more...

This article presents two cases of detection and management of four-rooted mandibular first molars. The occurrence of four-rooted mandibular first molars is very rare and the reported incidence is less than 1%. The cases were managed using radiographs taken from different planes (otherwise, the distolingual root of the teeth would have been missed). The contralateral side also showed the same morphological variation. [ABSTRACT FROM AUTHOR] more...

Aim: To report an uncommon case of an extraoral sinus tract of the submandibular region caused by a molar in the mandible (tooth 47). Case report: Tooth 47 presented with an insufficient coronal restoration and an absence of pain and discomfort to pressure and palpation in the periapical region. Based on oral inspection and radiographic examination, a pulp necrosis of tooth 47 was diagnosed, which had resulted in a cutaneous sinus tract. The persistent purulent drainage of the sinus tract in the submandibular region ceased during the successful root canal treatment of tooth 47. The root canal was irrigated with copious rrigant (3% sodium hypochlorite, 0.9% sodium chloride, 2% chlorhexidine) and several intracanal calcium hydroxide dressings. Conclusions: In the presented case it was observed that is challenging to diagnose a cutaneous draining sinus tract of endodontic origin. Thus, treatment of skin lesions of the face, and neck odontogenic infections should always be considered. Clinical and radiographic dental examinations can identify the tooth involved and may avoid unnecassary antibiotic or surgical therapies. Proper disinfection of the root canal system by chemo-mechanical instrumentation resulted in resolution of the sinus tract and promoted periapical healing of the tooth involved. This should therefore be considered as the treatment of choice when dealing with an odontogenic extraoral sinus tract. [ABSTRACT FROM AUTHOR] more...

This work sought to investigate the clinical efficacy of esterified hyaluronic acid for treating deep periodontal defects. Nineteen defects, 18 infrabony and one mandibular molar furcation, were treated. Defects with probing pocket depths (PPDs) of at least 6 mm were consecutively included in the study. The PPD, gingival recession, and clinical attachment level (CAL) were evaluated at each defect before treatment and 1 year after surgery. A full-thickness flap was raised and the roots were accurately planed; hyaluronic acid in the form of fibers was then packed into the defect to completely fill the space. One year after treatment, the mean PPD was reduced by 5.8 mm (range, 0 to 10 mm), gingival recession had increased by 2.0 mm (range, 0 to 6 mm), and attachment gain was 3.8 mm (range, 0 to 7 mm). [ABSTRACT FROM AUTHOR] more...

Aim: To achieve intraoral molar distalization without any extraoral appliance or patient cooperation. Methods: The intraoral distalization technique was performed on a female 12 years 8 months of age with cooperation deficiency, and the positive results are presented. The patient initially accepted the headgear planned at the beginning of treatment, but she did not wear it long enough. We therefore abandoned the use of extraoral appliances and employed intraoral distalization instead. We preferred to use a Nance button Veltri appliance we could create in our clinic. Once the patient had accepted our new treatment plan, we completed the distalization process in about 2 months. After a 2-month retention period, we completed treatment with a fixed Roth edgewise appliance and maximum anchorage in the maxilla for approximately 18 months. Results: Following treatment, a Class II Division I dental relationship became a Class I relationship in both the canine and molar regions, and a functional occlusal relationship and esthetic facial appearance were obtained. Conclusion: This appliance can be used when patient cooperation is compromised. [ABSTRACT FROM AUTHOR] more...

Bone loss at the distal aspect of mandibular second molars frequently is reported after extraction of impacted third molars. Typically, osseous grafting of the extraction site is not routinely performed. This study examined osseous healing following guided bone regeneration treatment of osseous defects distal to mandibular second molars after surgical removal of impacted mesioangularly or horizontally inclined third molars using the processed third molar as the graft material. For the study, 13 patients who required impacted third molar extractions were selected based on angulation of impaction. Patients requiring bilateral extractions were designated for a split-mouth study, while others were selected based on impaction angulation as a random study group. After surgical extraction of the third molars, the extracted teeth were stripped of any soft tissue, including the periodontal ligament, then ground and disinfected using a dentin grinding protocol to produce an autogenous dentin graft (ADG). This graft was then placed into the extraction socket and covered with a hemostatic sponge prior to site closure. Patients in the control group underwent the same procedure as those in the study group except that no ADG was placed in the socket and only a hemostatic sponge was placed prior to wound closure. Clinical and radiological examinations were performed, including panoramic radiographs and probing depths at 3 months and 12 months postoperatively. The alveolar bone level distal to the second molar was established by both probing depths and radiographic evaluation, which were compared between the two groups. At 12 months postoperative the study group showed probing distal to the second molar with a mean depth of 1.15 mm, whereas the control group showed probing with a mean depth of 4.45 mm. The authors conclude that autogenous dentin grafting is a viable option for use in the treatment of osseous defects distal to mandibular second molars following extraction of impacted third molars. [ABSTRACT FROM AUTHOR] more...

Aim: To evaluate the effect of systemic administration of probiotics on the severity of apical periodontitis (AP). Methodology: Twenty‐four male Wistar rats were used. AP was induced in the maxillary left/right first molars. The animals were arranged into groups: Control, Lactobacillus rhamnosus, and Lactobacillus acidophilus. Probiotics were administered orally for gavage (109 colony‐forming units diluted in 5 mL of water for 30 days) during the development of AP. After 30 days, cardiac puncture was performed to analyse the complete blood count. Moreover, microbiological analysis of the root canal contents and saliva was performed. Then, the animals were euthanized and the jaw removed for histopathological and IL‐10, IL‐1β and IL‐6 immunolabeling analyses. After the Shapiro–Wilk test of normality, the Kruskal–Wallis followed by Dunn's test was performed for nonparametric data, and analysis of variance followed by the Tukey test was performed for parametric data (P < 0.05). Results: No significance difference was observed in the blood profiles and in the counts of microorganisms from the saliva samples among the groups (P > 0.05). Total microorganism counts in the root canal, the inflammatory infiltrate and the immunostaining for IL‐1β and IL‐6 in AP were significantly lower in the probiotic groups when compared with the control group (P < 0.05). IL‐10 was significantly more immunolabled in the probiotic groups than in the control group (P < 0.05). Conclusion: Supplementation with probiotics (Lactobacillus rhamnosus and Lactobacillus acidophilus) had a significant effect on the severity of apical periodontitis in rats, demonstrating the anti‐inflammatory effect of probiotics on the development of apical periodontitis. [ABSTRACT FROM AUTHOR] more...

Aim: To compare the effects of three instrumentation systems, and a supplementary approach with a finishing instrument, on filling material removal during retreatment of mandibular molar canals. Methods: Sixty mesial canals from mandibular molars (Vertucci's type IV anatomy) were instrumented, filled and subjected to retreatment. After initial removal of the root canal filling material using the D‐RaCe system, the canals were randomly distributed into three groups (n = 20) according to the instrument system used for preparation: the Self‐Adjusting File (SAF), TRUShape or XP‐endo Shaper. The filling material volume in the apical 5 mm of the canals was assessed by means of micro‐computed tomography (micro‐CT) before and after retreatment. All specimens with residual filling material were subjected to a supplementary approach with the XP‐endo Finisher R instrument and another micro‐CT scan was taken. Data on the volumes of filling material and incidence of total removal were compared between groups by the general linear model for paired data and the Fisher's exact test. The effects of the refinement step were evaluated by the Wilcoxon Signed Ranks test. Results: The amount of removed material was 92.4%, 96.9% and 96.9% for the SAF, TRUShape and XP‐endo Shaper, respectively. There were no significant differences between them (P > 0.05). Canals were completely cleaned of filling material in 70% of the specimens for XP‐endo Shaper, 55% for SAF and 30% for TRUShape; the difference between XP‐endo Shaper and TRUShape was significant (P = 0.03). The supplementary step with the XP‐endo Finisher R instrument was associated with additional filling material removal of 38% (P < 0.001). Six more canals were rendered free of filling material after using this finishing instrument. Conclusions: The tested systems were equally effective in removing the mass of filling material from the apical 5 mm of molar canals. The supplementary step with the XP‐endo Finisher R instrument enhanced filling material removal. [ABSTRACT FROM AUTHOR] more...

Background: It is unclear on how children with compromised first permanent molars (cFPMs) are currently managed in the UK by either general dental practitioners (GDP) or specialists in paediatric dentistry (SPD). Aim: Explore the current attitudes to the management of compromised first permanent molars amongst UK general dental practitioners and specialists in paediatric dentistry. Design: Self‐completed online questionnaire including three clinical vignettes of 7, 9, and 15 years old with cFPM. All registered SPDs (n = 236), as of May 2017, 500 randomly selected GDPs from England, selected from a national performers list, and 52 Scottish GDPs, part of Scottish dental practice research network, were invited to complete the questionnaire. Results: About 71.6% (n = 53) of SPDs agreed that children with cFPM should be referred to a paediatric specialist for treatment planning, whereas the reverse for GDPs is true, as 86.8% (n = 138) believe they have a responsibility to treat these teeth. Responses to clinical vignettes suggest a slight preference amongst GDPs to restore cFPM, including root canal treatment, whereas SPDs have a slight preference towards extraction. Conclusion: Current pathways for cFPM, amongst UK general dental practitioners and specialists in paediatric dentistry, vary greatly between and within each professional group. [ABSTRACT FROM AUTHOR] more...

Aim: To evaluate dentine thickness from both distal ('danger zone') and mesial ('safety zone') aspects of the MB1 and MB2 canals of maxillary first molars at the furcation level using micro‐CT imaging. Methodology: One hundred maxillary first molars with two canals in the MB root were selected from a Brazilian subpopulation and scanned at a resolution of 19.6 μm in a micro‐CT device. From each specimen, two axial cross‐sectioned images were selected at 2 and 3 mm apical to the furcation level of the MB root and evaluated for the smallest dentinal thickness. Measurements were made from the outer perimeter of the MB1 and MB2 canals towards the external root surface from both distal (danger zone) and mesial (safety zone) aspects of the root. The influence of an isthmus was also considered in the analysis, and samples were classified according to the presence or absence of an isthmus in the axial sections. Non‐parametric Wilcoxon signed‐rank tests were used to compare dentinal thickness between MB1 and MB2 canals with a significant level set at 5%. Colour‐coded 3D models of dentine thickness throughout the MB root were created and evaluated qualitatively. Results: At both levels, median dentine thickness of the MB2 canal was significantly lower in both distal and mesial aspects of the root in comparison with the MB1 canal (P < 0.01). The presence of an isthmus was not a variable that influenced dentinal thickness. Colour‐coded models indicated that dentine thickness was dependent on the cross‐sectional shape of the MB root. At least 50% of the sample had <1 mm of dentine thickness at the danger zone of the MB2 canal. Conclusions: Danger zones in the MB roots of maxillary first molars were not symmetrical. MB2 canals had less dentine thickness on both aspects of the root compared to the MB1 canal. [ABSTRACT FROM AUTHOR] more...

The article presents a case study of a 67-year-old male patient presented with an existing fixed partial denture extending from the mandibular left canine to the mesial root of the left second molar. The patient was maintained on a 3-month recall program and the surgery was performed according to the IMZ protocol as part of an office surgical course. As reported, continuous communication between the restorative dentist and the laboratory implant technician ensured better results. more...

The article presents a retrospective analysis of the periodontal-prosthetic treatment of molars with interradicular lesions. The treatment of multirooted teeth with furcation involvement is considered important since the preservation of posterior abutment teeth enables oral rehabilitation using fixed bridges instead of using removable prostheses. The study involved a clinical and roentgenogeographic evaluation of patients who underwent treatment by hemisection and/or root amputation. It included the use of apically positioned flaps and osseous recontouring. more...

Because of their unique radicular anatomy, mandibular molars require careful treatment planning for post-and-core fabrication. Indications for post-and-core fabrication for endodontically treated mandibular molars are discussed, and immediate and cast post-and-core techniques are reviewed. An alternative design for a cast post and core is also presented. [ABSTRACT FROM AUTHOR] more...

Clinical experiences with light-hardened glass-ionomer-resin restorative cement indicate that it has improved properties compared to self-hardening glass-ionomer cements. Wear resistance and other material strengths are improved so that the material can be considered for conservative Class I restorations in permanent teeth. This article details occlusal restoration of a permanent molar with one light-hardened glass-ionomer-resin cement and discusses the potential for such restorations. [ABSTRACT FROM AUTHOR] more...

This report describes the surgical and orthodontic management of a 3-year old girl with an unerupted primary maxillary second molar impacted by an odontoma and a dentigerous cyst. Following surgical removal of the odontoma and dentigerous cyst, further surgical intervention and orthodontic traction were required to bring the primary maxillary second molar into correct occlusion with resultant proper functioning and good periodontal health. [ABSTRACT FROM AUTHOR] more...

The article discusses dental restoration of a carious primary maxillary second molar with glass ionomer-silver cermet cement as a long-term restorative material. It also describes some other uses of the material in primary and young permanent teeth. The glass ionomer-silver cermet cement has been used in situations including for restoration of lingual surfaces, for cementing stainless steel crown restorations, in repairs of stainless steel crown occlusal surface, and to replace silver amalgam restorations in primary teeth that are fractured or require replacement. Results showed that the overall experience with this cement in young patients were favorable. However, the longevity of glass ionomer-silver cerment cement restorations in the mouth is stated to be still uncertain. more...

The article describes the procedure for the adaptation and placement of a stainless steel crown restoration for the treatment of a damaged primary molar. It states that a stainless steel crown restoration for a damaged primary molar is performed to eliminate the carious tooth structure in a vital tooth and preserve the pulp, to reestablish proper occlusal contacts and to reestablish the normal mesiodistal coronal dimension. It describes the methods of increasing the occlusal surface thickness of stainless steel crown forms as well as creating a tooth-colored facade for cosmetically prominent crown surfaces. more...

The article presents a case study of a man who was suffering from intermittent pain on the right side of his face. After clinical examination, the pain was localized in the mandibular right second molar where there was an extensive carious lesion on the distal surface. A large free denticle within the distal canal of a mandibular molar was found. The radiograph of the tooth revealed the presence of the denticles. more...

The article analyzes the problems which may arise due to the failure to replace the mandibular first molar when the second molar is present and the third molar is missing. The person with stated condition, as reported, may face any of about 10 problems including, unhealthy condition of tissue, mesial tilting of the mandibular second molar, and distal plunger cusp. The problems, as reported, may result in, unesthetic appearance, potential for periodontal disease and caries, and tongue traumatization. Dentists, as reported, may face several problems during treatment planning and restoring the dentition, in the stated condition including, a rotated premolar creates occlusal problems, and open embrasure space requires overcontouring of the crown to restore contact. more...

The article discusses a study which assesses the effectiveness of a formocresol preparation utilized for a pulpotomy technique for the treatment of abscessed primary molars. The study reports the findings of the treatment of non-vital primary molars with draining fistulae with another mummifying agent. Twenty children with non-vital pulps in either the first or second primary molars were studied and treated with a combination of formaldehyde and tricresol in glycerin. It is concluded that the treatment of primary molars with fistulous draining tracts through pulpotomy technique is successful, but dependent on the objective of the operator. more...

The article discusses the use of performed steel crowns in pedodontics as long-term temporary coverage. It states that the use of such dental technique in restoring severely broken permanent molars can provide long-term and stable temporary coverage in the mixed dentition until comprehensive care can be instituted. Moreover, caries in permanent teeth should be restored by means of performed steel crowns. In permanent molars, the preformed steel crown may be considered as a long-term temporary measures. more...

The article offers information on the ectopic eruption of permanent molars and discusses the method for its management. It discusses a survey of the literature on ectopic eruption. A case history is utilized to present a method of managing ectopic eruptions. An eight year old patient showed bilateral maxillary first permanent molar ectopic eruptions. It was observed that there was severe crowding in both arches of the patient which would require serial extractions. After undergoing an entire procedure of correction of ectopic eruptions, it is now expected that the first permanent molars will erupt normally. more...

A case of an unerupted mandibular left permanent first molar, a partially erupted permanent second molar, and a congenitally absent third molar in a 12-year-old girl Is described. The permanent first molar, being dilacerated and impacted, required surgical exposure of the crowns of the first and second molars and distalization of the second molar, with the help of a space regainer, to bring the molars into occlusion. [ABSTRACT FROM AUTHOR] more...

The purpose of the present research is to study the radiographic visibility of the periodontal ligament in third molars from a northern Chinese population to determine if this methodology could be used for the 18-year threshold. A total of 1300 conventional orthopantomograms from 650 males and 650 females of northern Chinese subjects aged between 15 and 40 years were analyzed. The radiographic visibility of the periodontal membrane of fully mineralized third molars was assessed using the stages described by Olze et al. (2010). Stage 0 first appeared at the age of 17.05 years in males and at the age of 18.76 years in females. Stage 1 was first detected at 18.52 years in males and 19.59 years in females. Stage 2 was first achieved by males at the age of 22.33 years and by females at the age of 21.37 years. The earliest appearance of stage 3 was 26.85 years in males and 24.92 years in females. If stage 1 is determined, it is possible to prove that an individual has already attained the age of 18 years. Stages 2 and 3 can be used to determine that a person is over 21 years of age. However, it should also be noted that in 271 cases of tooth 38 and 255 cases of tooth 48, the visibility stage could not be reliably assessed because of fused roots or narrowed furcations. Therefore, this method seems to be of limited value for age estimation in the Chinese population. [ABSTRACT FROM AUTHOR] more...

Background. The etiology of molar-incisor hypomineralization (MIH) remains unknown. Studies indicate that it is multifactorial, and that genetic and environmental factors are involved. Research with twins provides important subsidy to investigate the Influence of genetics and environmental factors that act during pregnancy on the etiology of alterations. Aim. This cross-sectional study evaluated the agreement of molar incisor hypomineralization (MIH) between monozygotic and dizygotic twin pairs and the association with environmental factors. Design. The sample consisted of 167 pairs of twins (8-15 years old), 94 monozygotic and 73 dizygotic. The parents answered a questionnaire on sociodemographic data and pre-, peri-, and postnatal health. A dental examination was performed by two calibrated examiners (Kappa >0.88) for MIH diagnosis, following the criteria proposed by the European Academy of Pediatric Dentistry in 2003. Results. The prevalence of MIH was 29.3%. There was greater concordance of MIH between monozygotic twins for affected first molars and permanent incisors (P = 0.0012) and pairs of twins assessed (P = 0.0211). The presence of MIH was associated with family income between one and two wages (P = 0.009, prevalence ratio [PR] = 3.82, confidence interval [CI 95%] 1.40-10.44), above two wages (P = 0.007, PR = 4.60, 95% CI: 1.51-14.05), and gestational hemorrhage (P = 0.032, PR = 5.70, 95% CI: 1.16-28.14). Conclusions. The greater concordance in the diagnosis of MIH among monozygotic twins indicates a genetic influence, although environmental factors, such as family income and hemorrhage during pregnancy, are also associated with the occurrence of MIH. [ABSTRACT FROM AUTHOR] more...

Background: Managing orthodontic treatment is often very difficult for the orthodontist. Many devices are used during the orthopedic phase of orthodontic treatment, always with different functions. We describe a case of orthodontic management treated with the Equilibrator O.S.A. device (equilibrator designed by Ovidi, Santi, and Aprile for Eptamed SRL; Cesena, Italy; www.eptamed.com ).Case Presentation: A healthy 10-year-old white boy presented with a skeletal class II, division 1 malocclusion, molar class II, exhibiting an overjet of 7 mm prior to treatment. For treatment, we only used the Equilibrator O.S.A. device.Conclusions: We successfully treated an orthopedic/orthodontic case with a particular device that we describe here. [ABSTRACT FROM AUTHOR] more...

Purpose This in-vitro study tested the fracture resistance of endodontically treated molars with Mesial-Occluso-Distal (MOD) cavities restored with fibre reinforced composite material everX posterior in comparision with hybrid composite and ribbond fiber composite. Materials and methods Fifty intact freshly extracted human mandibular first molars were collected and were randomly divided into five groups (n = 10). Group 1: positive control (PC) intact teeth without any endodontic preparation. In groups 2 through 6 after endodontic procedure standard MOD cavities were prepared and restored with their respective core materials as follows: group 2, negative control (NC) left unrestored or temporary flling was applied. Group 3, Hybrid composite (HC) as a core material (Te-Econom Plus Ivoclar Vivadent Asia) group 4, Ribbond (Ribbond; Seattle, WA, USA) + conventional composite resin (RCR) group 5, everX posterior (everX Posterior GC EUROPE) + conventional composite resin (EXP) after thermocycling fracture resistance for the samples were tested using universal testing machine. The results were analysed using ANOVA and Tukey’s HSD post hoc tests. Results Mean fracture resistance (in Newton, N) was group 1: 1568.4 ± 221.71 N, group 2: 891.0 ± 50.107 N, group 3: 1418.3 ± 168.71 N, group 4:1716.7 ± 199.51 N and group 5: 1994.8 ± 254.195 N. Conclusion Among the materials tested, endodontically treated teeth restored with everX posterior fiber reinforced composite showed superior fracture resistance. [ABSTRACT FROM AUTHOR] more...

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Objective The objective was to examine the effects of repetitive local administration of adiponectin on experimental tooth movement in rats. Materials and methods The maxillary right first molar of male Wistar rats (n = 24) was moved mesially for 14 days, with local adiponectin injections (0.2 or 2 μg) every third day. Micro-computed tomography was performed at days 0, 6 and 14 and molar movement, bone density and bone volume fraction were calculated from the scans. Changes in extracellular matrix collagen and cell numbers in the periodontal ligament were analyzed histologically, and levels of circulating cytokines were measured by Luminex and ELISA. Results Adiponectin injections induced a reduction in tooth movement after 12 and 14 days compared to controls. No tooth movement was observed between days 3 and 14 in the group receiving the highest dosage (2 μg) of adiponectin. Differences in bone density and bone volume fractions between treatment and control groups were not identified. Relative size and morphology of collagen fibrils, and cell number in the periodontal region after adiponectin injections were unchanged compared to controls. Levels of circulating adiponectin or other selected factors in plasma were not influenced by the adiponectin injections. Conclusions Submucosal injections of adiponectin prevented experimental tooth movement in rats. The effect was dosage-dependent and local. Adiponectin injections caused no detectable changes in bone density, periodontal cell number or collagen content. [ABSTRACT FROM AUTHOR] more...

Aim Tooth loss prediction could improve decision-making for periodontally affected molars. We analysed the costs of removing all, none or only those molars predicted to be at-risk for extraction during supportive periodontal therapy ( SPT). Methods This is a model-based study using a German private payer perspective. Building mainly on cost and effectiveness data from 2039 molars (301 patients) which received long-term SPT, five (exemplary) prediction/decision strategies were compared: Retaining all molars, removing molars with furcation involvement ( FI) ≥ I/ ≥ II/ III, or removing all molars. Each strategy came with different proportions of molars correctly or erroneously (false positively) removed. Retaining as well as removing molars had long-term cost implications (via SPT or tooth replacement). Using Monte-Carlo microsimulations, we estimated the lifetime costs of an average population in our cohort and evaluated what accuracy a prediction method needed to have to save costs in different risk groups. Results Removing only molars with FI III (1188 Euro) and removing no molars (1195 Euro) were significantly less costly than removing all molars (1454 Euro). Prediction methods needed to be highly specific in most populations to avoid unnecessary tooth loss and the associated high costs. Conclusions Removing molars prior to SPT should be decided cautiously. [ABSTRACT FROM AUTHOR] more...

Background: This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries: their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces. Types of studies reviewed: This is an update of the ADA 1008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of seolants (available on the U.S. market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. Results: The guideline panel formulated 3 main recommendations. They concluded that seolants ore effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nanuse of sealants or use of fluoride varnishes. They also concluded that seolonts could minimize the progression of non-cavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of I type of sealant material over the others. Conclusions and practical implications: These recommendations ore designed to inform practitioners during the clinical decision-making process in relation to the prevention of occlusal carious lesions in children and adolescents. Clinicians are encouraged to discuss the information in this guideline with patients or the parents of patients. The authors recommend that clinicians re-orient their efforts toward increasing the use of seolants on the occlusal surfaces of primary and permanent motors in children and adolescents. [ABSTRACT FROM AUTHOR] more...

Aim To describe the clinical characteristics and radiographic findings of horizontal root fractures (HRF) in posterior teeth without a history of dental trauma. Methodology A total 24 patients and 31 HRF cases in 28 posterior teeth were collected from 2006 to 2015. Clinical examinations and radiographic imaging were evaluated. Value of confidence intervals of the proportions was calculated for data presentation. Results The number of males (54%) was similar to females (46%). The patients were predominantly between 50 and 70 years of age (75%). Most HRF cases were found in nonendodontically treated teeth (79%), without crown and bridge restorations (82%), and maxillary molars (54%). Many roots of maxillary molars had developed HRF, and the probability was nearly equal. Fractured teeth usually presented with periodontal and apical bone loss, and most patients (92%) were diagnosed with full mouth chronic periodontitis. Tooth wear was another common clinical feature amongst these patients. Conclusions HRF in posterior teeth without dental trauma occurred mainly in patients aged between 50 and 70, in nonendodontically treated teeth, teeth with attrition but without crown and bridge restorations, maxillary molars and with periodontal and periapical bony destruction. Periodontal condition, occlusal wear and patients' age at diagnosis were the possible related factors. HRF in posterior teeth without dental trauma is a diagnostic challenge and even misdiagnosed. A thorough clinical examination, radiographic analysis and recognition of the clinical characteristics are helpful in the early diagnosis and treatment of HRF. [ABSTRACT FROM AUTHOR] more...

Aim To evaluate the frequency of dentinal micro-cracks after root canal filling procedures with GuttaCore (GC), cold lateral compaction (CLC) and warm vertical compaction (WVC) techniques in mandibular molars using micro-computed tomographic analysis. Methodology Thirty mesial roots of mandibular molars, with a type II Vertucci's canal configuration, were prepared to working length with a Reciproc R40 instrument and randomly assigned to one of the three experimental groups ( n = 10), according to the technique used for root filling: GC, CLC or WVC. The GC group was filled with a size 40 GC obturator, whilst CLC and WVC groups used conventional gutta-percha cones. AH Plus sealer was used in all groups. The specimens were scanned at an isotropic resolution of 14.25 μm before and after root canal preparation and after root filling. Then, all pre- and postoperative cross-sectional images of the roots ( n = 41 660) were screened to identify the presence of dentinal defects. Results Overall, 30.75% ( n = 12 810) of the pre- + post-filling images displayed dentinal defects. In the GC, CLC and WVC groups, dentinal micro-cracks were observed in 18.68% ( n = 2510), 15.99% ( n = 2389) and 11.34% ( n = 1506) of the cross-sectional images, respectively. All micro-cracks identified in the post-filling scans were also observed in the corresponding post-preparation images. Conclusion Root fillings in all techniques did not induce the development of new dentinal micro-cracks. [ABSTRACT FROM AUTHOR] more...

Aim: The aim of this retrospective study was to evaluate the clinical and radiographic success of pulpotomy on primary molars performed by dental students compared to that performed by an expert operator.Methods: The study was conducted on 142 second primary molars in 102 children. The patients were randomly selected from the available records. The test group (treated by dental students) included 51 subjects (28 males and 23 females, mean age: 7.2 ± 1) and the control group included 51 children (29 males and 22 females, mean age: 7.4 ± 1.2 years). After pulpotomy, a clinical and radiographic evaluation after 12 months was performed. Chi-square test and odds ratio were calculated and significance level was set at p < 0.05.Results: The success rate was significantly lower, 81.6% (p < 0.05), in the test group than in the control group (93%). The test group showed less clinical and radiographic success (86% and 80%, resp.) compared to the control group (97.2% for clinical success and 93% for radiographic success).Conclusions: Pulpotomy with MTA is an effective method that ensures a good percentage of success. The clinical experience of the operator is a contributing factor. [ABSTRACT FROM AUTHOR] more...

Introduction: Symmetric transverse expansion is the main outcome of the early treatment in subjects with unilateral functional posterior crossbite. The aim of this study was to analyse mesial rotation and mesialization of upper first molars as sagittal parameters to be corrected in the treatment of these patients during the mixed dentition. Methods: Digital dental cast measurements (rotation and mesialization) were performed in a sample of 48 subjects with unilateral posterior crossbite (UPXB; 19 males and 29 females, mean age 10.2 ± 1.2 years) and in a control group of 35 subjects with normal Class I occlusion (17 males and 18 females, mean age 9.9 ± 1.3 years). An independent sample t-test, the Mann-Whitney test, Fisher's exact test, and Pearson correlation were used for statistical comparison. Results: The amount of upper molar rotation was significantly greater in the experimental group when compared with the control group. A clinically significant 'upper molar rotation' (UMR) was present in 66.7 per cent of the subjects with UPXB versus 5.7 per cent of the control group. The UMR group presented also a significant mesialization of upper first molars when compared with the control group. In the experimental group, there was a significant difference between rotation and mesialization in the right and left side and a correlation has been found between these two variables and the amount of Class II molar relationship at the crossbite side. Limitations: This is an epidemiological case-control study and the discussed effects of an early correction of the asymmetric upper molars' migration are only speculations based on an association relationship. Conclusions: The findings of this study show an asymmetric upper first molars' migration (rotation and mesialization) in unilateral functional posterior crossbite versus a control group. An early evaluation and correction of the molars' migration during the mixed dentition should be considered in order to obtain a correct inter-occlusal sagittal molar relationship, space for an adequate eruption of permanent teeth, and perhaps reduce the need of a following fixed appliance treatment in the permanent dentition. [ABSTRACT FROM AUTHOR] more...