Effects of CBCT acquisition protocol and additional superimposed computerized optical impressions on the accuracy of root canal length measurements: an ex vivo study.

AIM: The purpose of the present investigation was to evaluate the accuracy of root canal length (RCL) determination according to CBCT acquisition protocol and evaluate the influence of additional superimposed computerized optical impressions. MATERIALS AND METHODS: CBCT scans with low-dose (LD) and high-definition (HD) protocols as well as computerized optical impressions of 30 extracted human molars were acquired. Sicat Endo software (Sicat) was used for CBCT RCL measurements with (LD+, HD+) and without (LD-, HD-) a superimposed optical impression. To evaluate the accuracy, absolute differences between test groups and the actual root canal length (ARCL) were calculated and statistically analyzed using the Wilcoxon rank sum test. RESULTS: Absolute differences between the ARCL and the tested measurement methods varied significantly (P < 0.05). Both higher resolution and additionally superimposed computerized optical impression improved measurement accuracy. Mean differences compared with the ARCL were 0.26 mm (HD+), 0.34 mm (HD-), 0.43 mm (LD+), and 0.66 mm (LD-). 93.4% of all measurements in the HD+ group were within the limits of ± 0.5 mm. CONCLUSION: Both resolution and superimposition of additional computerized optical impressions have a significant influence on RCL measurements using CBCT.

Clinical management of fusion in primary mandibular incisors: a systematic literature review.

Objective: Dental anomalies occurring in deciduous teeth can affect the eruption of the permanent dentition and the occlusion stability. The occurrence of dental anomalies such as double teeth during the primary dentition in the daily practice might be frequent. The study aimed to qualitatively summarize the therapeutic management of double teeth in primary incisors.Material and Methods: A systematic review regarding the therapy of primary fused incisors in the mandible was performed and the obtained data were assessed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following electronic databases were screened from 1st January, 1996 until 30th July, 2019: PubMed, Scopus, EBSCO and the archives of paediatric dental journals. The search terms were grouped in anatomic entity: (tooth OR teeth OR incisor), pathological condition: (fused OR fusion OR geminated OR double), intervention: (treatment OR intervention OR therapy OR prevention OR control OR management OR restoration), observed parameters: (primary dentition OR primary tooth OR primary teeth).Results: Ten articles met all inclusion criteria. The data disclosed the occurrence of double teeth in mandibular incisors. The main management of this clinical condition is either preventive or surgical involving the extraction of fused teeth, based on the deciduous nature of the teeth, the degree of caries and malocclusion development risk.Conclusion: An early diagnosis of dental anomalies is fundamental for the application of proper preventive strategies to avoid a potential malocclusion in permanent dentition and to maintain these teeth sound and caries-free until the eruption of the permanent dentition.

Compounds from Olea europaea and Pistacia lentiscus inhibit oral microbial growth.

BACKGROUND: In view of the increasing antibiotic resistance, the introduction of natural anti-infective agents has brought a new era in the treatment of bacterially derived oral diseases. METHODS: The aim of this study was to investigate the antimicrobial potential of five natural constituents of Olea europaea (oleuropein, maslinic acid, hydroxytyrosol, oleocanthal, oleacein) and three compounds of Pistacia lentiscus (24Z-isomasticadienolic acid, oleanolic acid, oleanonic aldehyde) against ten representative oral bacterial species and a Candida albicans strain. After the isolation and quality control of natural compounds, the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) assay were performed. RESULTS: Among all O. europaea-derived constituents, maslinic acid was the most active (MIC = 4.9-312 µg mL- 1, MBC = 9.8-25 µg mL- 1) one against oral streptococci and anaerobic pathogenic bacteria (Porphyromonas gingivalis, Fusobacterium nucleatum, Parvimonas micra), while oleuropein, hydroxytyrosol, oleocanthal and oleacein showed milder, yet significant effects against P. gingivalis and F. nucleatum. Among all P. lentiscus compounds, oleanolic acid was the most effective one against almost all microorganisms with MIC values ranging from 9.8 µg mL- 1 (P. gingivalis) to 625 µg mL- 1 (F. nucleatum, P. micra). In the presence of 24Z-isomasticadienolic acid, a mean inhibitory concentration range of 2.4 µg mL- 1 to 625 µg mL- 1 was observed for strict anaerobia. The MIC value for 24Z-isomasticadienolic acid was estimated between 39 µg mL- 1 (Streptococcus sobrinus, Streptococcus oralis) and 78 µg mL- 1 (Streptococcus mutans). All tested compounds showed no effects against Prevotella intermedia. CONCLUSIONS: Overall, maslinic acid and oleanolic acid exerted the most significant inhibitory activity against the tested oral pathogens, especially streptococci and anaerobic oral microorganisms.

Guided endodontic access of a calcified mandibular central incisor using a software-based three-dimensional treatment plan.

This case report describes the digital and clinical workflow of a guided endodontic access approach in a mandibular central incisor with pulp canal calcification (PCC). The access to the remaining pulp space was planned virtually using cone beam computed tomography (CBCT) and the Sicat Endo software (Sicat, Bonn, Germany). Sicat produced the corresponding Accessguide after matching a digitized cast model and the virtual treatment plan. The clinical access was prepared using a carbide bur with a diameter of 1.2 mm. After the root canal was localized successfully, it was disinfected chemomechanically, dried, and obturated using a warm vertical compaction technique.

Accuracy of CBCT-based root canal length predetermination using new endodontic planning software compared to measurements performed with an electronic apex locator ex vivo.

OBJECTIVE: To evaluate the accuracy of the new endodontic planning software (3D Endo Dentsply Sirona) based on cone beam computed tomography (CBCT) to predetermine root canal lengths compared with measurements performed with an electronic apex locator (Raypex 6; VDW) ex vivo. MATERIALS AND METHODS: CBCT scans of forty extracted human maxillary (n = 20) and mandibular (n = 20) molars were taken, and root canal lengths were predetermined with the 3D Endo software using the apical foramen (AF) and the adjoining cusp as references. Root canal lengths were determined with the Raypex 6 using the same references. To evaluate the accuracy, absolute differences between both methods and the actual root canal length (gold standard) were calculated and statistically analyzed. RESULTS: Differences between lengths measured with the 3D Endo and the Raypex 6 compared with the gold standard showed no significant differences (P = 0.879). Mean differences were 0.37 mm versus 0.35 mm in the maxillary molars, and 0.30 mm versus 0.31 mm in the mandibular molars. A total of 75.8% (3D Endo) and 79.1% (Raypex 6) of all measurements were within the limits of ± 0.5 mm. Both methods showed a tendency to result in short measurements (P < 0.001). CONCLUSIONS: Within the limitations of this study, the 3D Endo software enables an accurate three-dimensional (3D) predetermination of root canal lengths.

3D Endo: three-dimensional endodontic treatment planning.

This case report describes the three-dimensional (3D) endodontic treatment planning of a complex mandibular incisor using the 3D Endo software (Dentsply Sirona, Bensheim, Germany). Apart from a step-by-step description of the planning, the actual endodontic treatment is shown, and possible indications for the 3D Endo software are discussed.

Teaching model for artificial teeth and endodontic apex locators.

Artificial teeth are a useful teaching aid during endodontic education. This article describes the development of a simple and inexpensive model that can be equipped with artificial teeth. It shows that working length determination in artificial root canals using electronic apex locators is possible and that the embedding media has no influence on measurements. The model supports the application of current endodontic techniques and facilitates a validated evaluation of the treatments between students. Artificial teeth can be removed for visualization and replaced for further endodontic exercises.