Database analysis of a French type 2 diabetic population shows a specific age pattern of tooth extractions and correlates health care utilization.

AIMS: To assess the relationship between type 2 diabetes and tooth loss and the predictive value of health behavior and routine dental care in regard to both dental and medical follow-ups. METHODS: Cross-sectional study from a national database of a French population of railways transport workers was conducted with a descriptive analysis between registered diabetic patients and non-diabetic subjects. The relationship between oral health and diabetes was measured by tooth extraction prevalence in regard to the frequency of scaling-prophylaxis sessions and the number of medical and dental appointments. RESULTS: The prevalence of tooth extractions in the type 2 diabetic population is 1.88 higher than the non-diabetic population. Diabetic patients tend to undergo dental extractions earlier and more often than non-diabetic individuals. They also have more medical appointments and less dental check-ups and scaling sessions than the non-diabetic population. CONCLUSION: Measured by tooth loss, type 2 diabetic patients have a significantly earlier detrimental oral status when compared to the non-diabetic population. They exhibit a different pattern in health care utilization of outpatient medical resources. Oral health surveillance is not correctly addressed by the medical and dental coverage of these diabetic patients. Emphasis should be directed on specific dental care programs aimed at preventing tooth loss.

The use of mineral trioxide aggregate in one-visit apexification treatment: a prospective study.

AIM: To assess the outcome of apexification using mineral trioxide aggregate (MTA). METHODOLOGY: Fifty-seven teeth with open apices on 50 patients referred for root canal treatment received an apexification procedure in one appointment with MTA by the same operator. Patients were recalled at 6 months, 12 months and every year thereafter. Blind to the treatment record, two examiners assessed the pre-treatment, post-treatment and control radiographs of the study patients in a dark room using a magnifier. Each apex visible on the radiographs was scored with the periapical index (PAI), and the size of the apical lesion was measured. The presence of an apical bridge was also noted. Kappa-Cohen test was used for examiners calibration. The paired t-test was used for statistical analysis of apical healing. RESULTS: Forty-three cases were included with at least 12 months follow-up. When considering the PAI score and the decrease in size of the apical lesion, healing occurred in 81% of cases. CONCLUSION: Apexification in one step using an apical plug of MTA can be considered a predictable treatment, and may be an alternative to the use of calcium hydroxide.

Radiographic evaluation of the prevalence and technical quality of root canal treatment in a French subpopulation.

AIM: This study was undertaken to examine the prevalence and technical quality of root fillings and the periapical status of endodontically treated teeth in a French subpopulation. METHODOLOGY: Full-mouth periapical radiographs were obtained from 208 consecutive adult patients seeking care within the dental service provided by the Hôtel-Dieu in Paris. The occurrence and technical quality of root fillings were assessed for each root according to the position and the density of the obturation. The periapical status was evaluated using the Periapical Index Scoring System. The type of coronal restoration and the presence of posts were also noted. RESULTS: Of the 8743 roots included in the survey, 23% were root-filled. An acceptable standard of treatment was found in 21% of roots with 16% of these cases associated with signs of periapical disease. In roots with unacceptable root-fillings, 27% had periapical pathology. A post was seen in 26% of the root-filled canals, with 29% of these cases associated with periapical pathology. An intracoronal restoration existed in 30% of the filled roots, of which 22% exhibited a periapical lesion. An extra-coronal restoration was present in 60% of the filled roots, of which 24% had radiographic signs of periapical pathology. The remaining 10% of filled roots that had no coronal restoration were associated with periapical pathology in 33% of cases. At least one periapical lesion was seen in 63% of the patients. CONCLUSION: The results demonstrate a high prevalence of root-filled teeth and poor technical quality of treatment. Roots presenting with acceptable root fillings were associated with a lower prevalence of periapical pathology (P < 0.001). Posts in roots were associated with periapical pathology significantly more than in roots without posts (P < 0.001).

Influence of operator experience on canal preparation time when using the rotary Ni-Ti ProFile system in simulated curved canals.

AIM: The aim of this study was to determine the influence of operator experience on the time needed for canal preparation when using a rotary nickel-titanium (Ni-Ti) system. METHOD: A total of 100 simulated curved canals in resin blocks were used. Four operators prepared a total of 25 canals each. The operators included practitioners with prior experience of the preparation technique, and practitioners with no experience. The working length for each instrument was precisely predetermined. All canals were instrumented with rotary Ni-Ti ProFile Variable Taper Series 29 engine-driven instruments using a high-torque handpiece (Maillefer, Ballaigues, Switzerland). The time taken to prepare each canal was recorded. Significant differences between the operators were analysed using the Student's t-test and the Kruskall-Wallis and Dunn nonparametric tests. RESULTS: Comparison of canal preparation times demonstrated a statistically significant difference between the four operators (P < 0.001). In the inexperienced group, a significant linear regression between canal number and preparation time occurred. CONCLUSION: Time required for canal preparation was inversely related to operator experience.