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Background and objective Pediatric dentists face a serious challenge when encountering cases of primary teeth lost too soon due to systemic disorders such as diabetes mellitus, congenital heart disease, and chronic kidney disease. Prompt identification and treatment are necessary to minimize problems in these patients. This study aimed to better understand and enhance clinical outcomes in pediatric dentistry treatment by investigating diagnostic modalities and early therapy methods for kids who lose their primary teeth too soon because of systemic disorders. Methodology We conducted a retrospective observational study to examine the early loss of primary teeth in children aged 6-10 years with a history of systemic diseases at Naseer Teaching & MMC-General Hospital, Peshawar; Hayatabad Medical Complex, Peshawar; DHQ Teaching Hospital, Kohat; and Fauji Foundation Hospital, Multan from January to December 2022. After carefully gathering data from medical records, a sample of 360 patients meeting the inclusion criteria was examined. SPSS Statistics version 27 (IBM Corp., Armonk, NY) was used for the statistical analysis. Demographic characteristics, clinical manifestations, and management approaches were compiled using descriptive statistics. For categorical data, frequency distributions and percentages were determined, and for continuous variables, means and standard deviations (SD) were calculated. Regression analysis was conducted to analyze relationships between related variables and treatment outcomes. A p-value <0.05 was considered statistically significant. Results The majority of patients were aged between six and eight years, and the cohort had an equal gender distribution. Dental problems including malocclusion (n=175, 48.61%) and early tooth loss (n=245, 68.06%) were common, as were systemic illnesses like genetic disorders (n=45, 12.50%) and endocrine abnormalities (n=67, 18.61%). Diagnostic procedures were often carried out, such as radiographic exams (n=256, 71.11%) and blood tests (n=123, 34.17%). Dietary supplements (n=60, 16.67%) and dental procedures (n=75, 20.83%) constituted the bulk of the treatment. Significant treatment outcomes that demonstrated the efficacy of the therapies were as follows: high patient satisfaction (n=213, 59.17%), improved oral health (n=255, 70.83%), and symptom relief (n=187, 51.94%). Conclusion Our findings highlight the significant impact of certain practical methods for identifying and treating early tooth loss in pediatric patients with systemic illnesses, leading to patient satisfaction in terms of symptom relief and enhanced dental health.
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OBJECTIVES: This study aimed to compare the effectiveness of an experimental root canal irrigant and 17% Ethylene-di-amine tetra acetic acid for removal of the smear layer in the coronal, middle and apical portions of the root canal. MATERIALS AND METHODS: Ninety human single rooted maxillary and mandibular teeth were selected for this study. The teeth were randomly divided into two experimental groups and one control group as follows: Group A (Ethanolic extract of Sapindus Mukorossi), Group B (17% EDTA), and Group C (Distilled water). The root canals of all three groups were prepared with stainless steel K-files by means of the standard step-back technique and irrigated with 5.25% sodium hypo chloride. The teeth were decoronated, following the irrigation and divided longitudinally into two-halves and visualized using scanning electron microscope (SEM) for the amount of smear layer present utilizing the three-point score system. The observations were noted both before and after the treatment. Nonparametric tests were applied for the comparison and p-value ⩽ 0.05 was considered as statistically significant. RESULTS: It was evident from that smear layer was completely removed in coronal portion of 27 out of 30 teeth in-group A. For middle and apical areas of group A, 24 and 19 teeth showed complete smear layer removal. In-group B it was found that there were 24, 21, and 3 teeth at coronal, middle and apical, areas respectively where smear layer were completely absent. Intra group comparison showed a significant difference (p = 0.002) in smear layer removal was found for group A at coronal, middle and apical thirds. Similarly, a significant difference (p = 0.001) was also found for group B; however heavy smear layer was found among the three parts of the canal for group C. CONCLUSIONS: Ethanolic extract of Sapindus Mukorossi have higher effectiveness in removing the smear layer from the root canal in comparison to 17% EDTA.
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Ácido Edético , Irrigantes do Canal Radicular , Tratamento do Canal Radicular , Sapindus , Camada de Esfregaço , Raiz Dentária , Humanos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/efeitos dos fármacos , Ácido Edético/farmacologia , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular/métodos , Camada de Esfregaço/tratamento farmacológico , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/efeitos dos fármacos , Tratamento do Canal Radicular/métodos , Extratos Vegetais/administração & dosagem , Extratos Vegetais/uso terapêutico , Doenças Dentárias/tratamento farmacológico , Doenças Dentárias/terapia , FitoterapiaRESUMO
Erosive beverages cause dissolution of natural teeth and intra-oral restorations, resulting in surface characteristic changes, particularly roughness and degradation. The purpose of this study was to evaluate the surface roughness and topography of a dental ceramic following immersion in locally available erosive solutions. A total of 160 disc specimens of a nano-fluorapatite type ceramic (12 mm diameter and 2 mm thickness) were fabricated and equally distributed into two groups (n = 80) and then evenly distributed among the following five testing groups (n = 16): lemon juice, citrate buffer solution, 4% acetic acid, soft cola drink, and distilled water which served as a control. The surface roughness (Ra) and topography were evaluated using a profilometer and scanning electron microscope at baseline, 24 h, 96 h, and 168 h respectively. Data were analyzed using ANOVA and Tukey's multiple comparisons (p ≤ 0.05). Surface changes were observed upon exposure to all acidic beverages except distilled water. Amongst all immersion media, 4% acetic acid produced the most severe surface roughness across all time periods (i.e., baseline, 24 h, 96 h, and 168 h). A statistically significant difference in the surface roughness values between all immersion media and across all four time intervals was observed. Erosive agents had a negative effect on the surface roughness and topography of the tested ceramic. The surface roughness increased with increased storage time intervals.
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Bebidas , Cerâmica , Teste de Materiais , Propriedades de Superfície , ÁguaRESUMO
The success of dental restorations depends mainly on the ability to bond to other filling materials and tooth substances, in order to resist the multitude of forces acting on the bond within the oral cavity. Although the shortcomings of composite resins have been significantly reduced over the past three decades, microleakage due to shrinkage under masticatory loads is unavoidable. In order to overcome such problems, two materials laminated with matched properties can be used to achieve optimum results. The sandwich technique is an approach in which dentine is replaced by glass ionomer cement (GIC), and enamel is replaced by composite resin. In the past, numerous materials have been proposed with adequate properties to be used in this manner, but the results are conflicting in terms of bonding to the various forms of GIC, and the appearance of microcracks or gap formation during functional loading. This study aimed to evaluate the shear bond strength (SBS) and mode of failure between the following core materials: composite resins (CR) (Methacrylate Z350™, Ceram X™, and Spectrum™) with a base material of glass ionomer cement (GIC, Ketac Molar™). Eight samples were made with the help of polytetrafluoroethylene sheets (TEFLON, Wilmington, DE, USA). Each sheet consisted of holes which were 4 mm in diameter and 2 mm in thickness. The combination of materials was sandwiched. The samples were stored in distilled water and then placed in an incubator for 24 h in order to ensure complete polymerization. The samples were thermocycled for 500 cycles between 5-55 °C/ 30 s. Following thermocycling, SBS testing was performed using a universal testing machine. Additionally, scanning electron microscopy (SEM) was performed on representative samples for the bond failure analysis between GIC and the composite resins. The Ceram-X™ nanocomposite showed significantly higher bond strength than Methacrylate Z350™ or Spectrum™ (p = 0.002). The Methacrylate Z350™ and the Spectrum™ composite specimens demonstrated a similar SBS (p = 0.281). The SBS of the Ceram X™ to GIC was the highest compared to Methacrylate Z350™ and Spectrum™. Therefore Ceram X™ may produce a better bond with GIC, and may protect teeth against recurrent caries and failure of the restoration. Methacrylate Z350™ is comparable to Spectrum™ CR and can be used as an alternative. A combination of adhesive and mixed failure was observed in Methacrylate Z350™ CR and GIC, while adhesive failure was predominantly found in both Ceram X™ and Spectrum™ with GIC restorations.
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A vital feature of conservative dentistry is the adhesion of the restorative material to the tooth structure for restoration of the tooth substance lost due to dental decay, trauma, or dental imperfections. In a perfect world, a restorative material should generate a lasting adhesion by bonding the restoration with tooth tissues. The ingress of micro-organisms, oral fluids, molecules, and ions through microscopic spaces due to faulty adhesion between restoration and tooth structure is known as microleakage. This study is focuses on the evaluation of adhesive failures between the restorative materials. In the past, studies have focused more on the bonding potential of a restorative material with the tooth surface. Therefore, there is need to carry out a study that compares the microleakage between resin-based restorative materials in a sandwich manner with and without the intermediate bonding layer after immersion in 2% methylene blue dye at different time intervals. The restorative materials used were composite Ceram X Mono plus (DENTSPLY) and Z350 (3M ESPE), Vitremer resin modified glass ionomer cement (RMGIC) (3M ESPE), smart dentine replacement SDR (3M ESPE), Bond NT (DENTSPLY), and Universal Bond (3M ESPE). A light emitting diode (LED) was used to cure the specimens. Artificial saliva was used as a storage medium for the specimens. Thermocycling of specimens was carried out at 500 cycles/30 s and 1000 cycles/30 s. The world health organization (WHO) grading tool for microleakage was used to analyze fluid ingress in the specimens through disclosing by 2% methylene blue dye. The statistical analysis was carried out with one-way analysis of variance (ANOVA) and Tukey post hoc test, keeping the level of significance at p ≤ 0.05. In Grade 0 = 85 samples, Grade 1 = 10 samples, Grade 2 = 7 samples, Grade 3 = 16 samples, and in Grade 4 = 2 samples were identified. This study describes that no microleakage was observed in SDR and resin composite groups as compared to Vitremer and resin composite groups.