The Middle Pleistocene (MIS 12) human dental remains from Fontana Ranuccio (Latium) and Visogliano (Friuli-Venezia Giulia), Italy. A comparative high resolution endostructural assessment.

The penecontemporaneous Middle Pleistocene sites of Fontana Ranuccio (Latium) and Visogliano (Friuli-Venezia Giulia), set c. 450 km apart in central and northeastern Italy, respectively, have yielded some among the oldest human fossil remains testifying to a peopling phase of the Italian Peninsula broadly during the glacial MIS 12, a stage associated with one among the harshest climatic conditions in the Northern hemisphere during the entire Quaternary period. Together with the large samples from Atapuerca Sima de los Huesos, Spain, and Caune de l'Arago at Tautavel, France, the remains from Fontana Ranuccio and Visogliano are among the few mid-Middle Pleistocene dental assemblages from Western Europe available for investigating the presence of an early Neanderthal signature in their inner structure. We applied two- three-dimensional techniques of virtual imaging and geometric morphometrics to the high-resolution X-ray microtomography record of the dental remains from these two Italian sites and compared the results to the evidence from a selected number of Pleistocene and extant human specimens/samples from Europe and North Africa. Depending on their preservation quality and on the degree of occlusal wear, we comparatively assessed: (i) the crown enamel and radicular dentine thickness topographic variation of a uniquely represented lower incisor; (ii) the lateral crown tissue proportions of premolars and molars; (iii) the enamel-dentine junction, and (iv) the pulp cavity morphology of all available specimens. Our analyses reveal in both samples a Neanderthal-like inner structural signal, for some aspects also resembling the condition shown by the contemporary assemblage from Atapuerca SH, and clearly distinct from the recent human figures. This study provides additional evidence indicating that an overall Neanderthal morphological dental template was preconfigured in Western Europe at least 430 to 450 ka ago.

Evaluation of chemical and morphological changes in radicular dentin after different final surface treatments.

The aim of this study was to evaluate the chemical and morphological effects of different lasers as a final surface treatment for endodontic therapy through energy dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM) respectively. Twenty-five maxillary canines were selected and instrumented with K3 system. Roots were randomly distributed into five groups (n = 5) according to the surface treatment: GI (distilled water), GII (NaOCl + EDTA), GIII (NaOCl + EDTA + 980 nm diode laser), GIV (NaOCl + EDTA+ 1,064 nm Nd:YAG laser), and GV (NaOCl + EDTA+ 2,780 nm Er, Cr:YSGG laser). Lasers were applied for 20 s and samples were bisected, exposing the treated surface and then subjected to elements quantification by EDS and morphological evaluation by scanning electron microscope (SEM). EDS data were submitted to ANOVA-two way, and SEM scores were submitted to two-way Kruskal-Wallis and Dunn's tests. The EDS analysis showed no difference for the chemical elements and Ca/P ratio between groups (p > .05). Statistical analysis showed more intense results for GV and less intense results for GI (p < .05). The GIII showed an amorphous organic matrix surface, while GV provided greater removal of intertubular dentin forming craters, and GIV promoted dentin fusion. The EDS method used in this study was not able to verify any chemical changes in root canal dentin; Nd:YAG, Er, Cr:YSGG, and 980 nm diode laser were capable of modifying the dentin morphology, correlating characteristics features for each one, which are essential clinical knowledge to establish the correct indication for each case. RESEARCH HIGHLIGHTS: EDS was not able to verify any chemical changes in root canal dentin after 980 nm diode, Nd:YAG and Er;Cr:YSGG laser treatments Nd:YAG, Er, Cr:YSGG, and 980 nm diode laser modified dentin morphology, correlating characteristics features for each one.

Supplementary Steps for Removing Hard Tissue Debris from Isthmus-containing Canal Systems.

INTRODUCTION: The purpose of this ex vivo study was to evaluate the percentage reduction of accumulated hard tissue debris (AHTD) in the mesial root canal system of mandibular molars under different final irrigation regimens by means of micro-computed tomographic imaging. METHODS: Sixty curved mesial roots of mandibular molars with 2 independent canals joint apically by an isthmus (Vertucci type II) were selected. Specimens were scanned at a resolution of 12.5 µm, anatomically matched, and distributed into 3 groups (n = 20) according to the preparation protocol: Self-Adjusting File (SAF; ReDent Nova, Ra'anana, Israel), Reciproc (VDW GmbH, Munich, Germany), and Revo-S (Micro-Mega, Besançon, France) systems. Then, each group was subdivided into 2 subgroups (n = 10) according to the final irrigation protocol with the SAF or EndoVac system (Discus Dental, Culver City, CA). The percentage volume and percentage reduction of AHTD after root canal preparation and final irrigation protocols were statistically compared using 1-way analysis of variance, the paired sample and the independent Student's t tests. The level of significance was set at 5%. RESULTS: Within groups, the mean percentage volume was significantly reduced after the final irrigation procedures in either the SAF (from 1.52%-1.78% to 1.01%-1.20%) or EndoVac (from 2.11%-2.23% to 1.31%-1.52%) subgroups (P < .05). In the experimental groups, the mean percentage reduction of AHTD ranged from 29.15%-39.90% after the irrigation protocols, with no statistical difference between groups (P > .05). CONCLUSIONS: None of the irrigation approaches succeeded in rendering the mesial root canal system free of AHTD. A similar percentage reduction of AHTD was achieved after final irrigation protocols using either the SAF or EndoVac system.

The Effect of Maxillary First Molar Root Length on the Success Rate of Buccal Infiltration Anesthesia.

INTRODUCTION: Several variables may influence anesthesia success in maxillary molars. This investigation was conducted to evaluate the effect of root length on the success rate of infiltration injections of 2% lidocaine with 1:80,000 epinephrine. METHODS: One hundred maxillary first molars with irreversible pulpitis were treated. After the administration of a buccal infiltration injection of 2% lidocaine with 1:80,000 epinephrine, the patients' pain during dentin cutting, pulp exposure, and root canal instrumentation were evaluated using the Heft-Parker visual analog scale. No or mild pain was considered as success. Data were analyzed by the point-biserial correlation test and receiver operating characteristic curve analysis. RESULTS: Overall, 61% of the teeth had successful anesthesia after the administration of a single buccal infiltration injection of anesthetic solution. The point-biserial correlation test showed that the teeth that had palatal and distobuccal roots with longer root lengths showed significantly higher anesthesia failure (P < .05). However, receiver operating characteristic curve analysis did not show a clinically useful cutoff point of root length corresponding with anesthesia failure. CONCLUSIONS: Maxillary first molars having irreversible pulpitis with longer roots may have more anesthesia failures after a single buccal infiltration injection with 2% lidocaine and 1:80000 epinephrine.

Efficacy of ultrasonic activation of NaOCl and orange oil in removing filling material from mesial canals of mandibular molars with and without isthmus

Objectives The aim of this study was to evaluate the volume of remaining filling material after passive ultrasonic irrigation (PUI) of sodium hypochlorite (NaOCl) and orange oil in mesial canals of mandibular molars, with and without isthmus. Material and Methods Thirty mesial roots of mandibular molars were divided according to the presence or absence of isthmus. Canals were prepared and filled (Micro-CT #1). Filling was removed using rotary instruments, and specimens were sub-divided into three groups according to the irrigation procedures: Conventional – conventional irrigation with NaOCl, PUI/NaOCl – PUI of NaOCl (three activations, 20 seconds each), and PUI/orange oil – PUI of orange oil (Micro-CT#2). Specimens were enlarged using the X2 and X3 ProTaper Next instruments and submitted to the same irrigation protocols (Micro-CT #3). Results No differences were found between the experimental groups in each stage of assessment (P>0.05). The volume of residual filling material was similar to that in Micro-CT #2 and Micro-CT #3, but lower than that observed in Micro-CT #1 (P<0.05). When groups were pooled according to the presence or absence of an isthmus, volume of residual filling material was higher in specimens presenting isthmus (P<0.05). Conclusions PUI of NaOCl or orange oil did not improve filling removal. Isthmus consists in an anatomical obstacle that impairs the removal of filling material.

Efficacy of ultrasonic activation of NaOCl and orange oil in removing filling material from mesial canals of mandibular molars with and without isthmus.

OBJECTIVES: The aim of this study was to evaluate the volume of remaining filling material after passive ultrasonic irrigation (PUI) of sodium hypochlorite (NaOCl) and orange oil in mesial canals of mandibular molars, with and without isthmus. MATERIAL AND METHODS: Thirty mesial roots of mandibular molars were divided according to the presence or absence of isthmus. Canals were prepared and filled (Micro-CT #1). Filling was removed using rotary instruments, and specimens were sub-divided into three groups according to the irrigation procedures: Conventional - conventional irrigation with NaOCl, PUI/NaOCl - PUI of NaOCl (three activations, 20 seconds each), and PUI/orange oil - PUI of orange oil (Micro-CT#2). Specimens were enlarged using the X2 and X3 ProTaper Next instruments and submitted to the same irrigation protocols (Micro-CT #3). RESULTS: No differences were found between the experimental groups in each stage of assessment (P>0.05). The volume of residual filling material was similar to that in Micro-CT #2 and Micro-CT #3, but lower than that observed in Micro-CT #1 (P<0.05). When groups were pooled according to the presence or absence of an isthmus, volume of residual filling material was higher in specimens presenting isthmus (P<0.05). CONCLUSIONS: PUI of NaOCl or orange oil did not improve filling removal. Isthmus consists in an anatomical obstacle that impairs the removal of filling material.

Effect of low-level laser therapy on dental root cementum remodeling in rats.

OBJECTIVE: To investigate the amount of the cementum layer formed over the rat's dental root surfaces by daily application of low-level laser therapy (LLLT) for 2 weeks. METHODS: Twelve female Sprague-Dawley (SD) rats were divided into two groups: six rats received daily LLLT (Ga-Al-As, 830 nm), and six rats received no treatment (control). The treatment lasted 2 weeks. In vivo Micro-CT imaging analyzed the root's hard tissue volumetric changes. The cementum thickness was evaluated histologically. RESULTS: Total cementum thicknesses in the LLLT group increased significantly (p = 0.015) compared to the control group. This significant increase in the cementum thickness, verified histologically, was not detectable during in vivo Micro-CT imaging, which showed no significant difference between the groups regarding the root hard tissues volumetric changes over the 2-week evaluation period. CONCLUSION: Two weeks of daily application of LLLT significantly increased rat's dental root cementum thickness as determined histologically. However, in vivo Micro-CT imaging failed to accurately reveal this cementum growth as it was not possible to differentiate dentinal changes.

Manejo endodóntico de un primer premolar maxilar con tres raíces / Endodontic management of a three-rooted maxillary first premolar

Objetivo: informar el manejo endodóntico de un primer premolar maxilar con tres raíces, mediante tratamiento de conductos adecuado a estos casos. Caso clínico: un paciente de sexo femenino, de 25 años de edad, se presentó a la consulta con un diagnóstico de pulpitis irreversible asintomática en la pieza 14. A partir de los hallazgos clínicos y radiográficos iniciales -que hacían sospechar una alteración en el número de conductos-, se comprobó la presencia de tres conductos radiculares. Esta situación obligó a realizar el tratamiento endodóntico con cuidados específicos para localizar todos los conductos radiculares y prevenir desgastes excesivos y/o perforaciones. Conclusión: el diagnóstico oportuno de esta variación anatómica permite establecer modificaciones en el protocolo del tratamiento de conductos, a fin de evitar el debilitamiento excesivo o, incluso, la perforación de su estrecha anatomía radicular (AU)

Manejo endodóntico de un primer premolar maxilar con tres raíces / Endodontic management of a three-rooted maxillary first premolar

Objetivo: informar el manejo endodóntico de un primer premolar maxilar con tres raíces, mediante tratamiento de conductos adecuado a estos casos. Caso clínico: un paciente de sexo femenino, de 25 años de edad, se presentó a la consulta con un diagnóstico de pulpitis irreversible asintomática en la pieza 14. A partir de los hallazgos clínicos y radiográficos iniciales -que hacían sospechar una alteración en el número de conductos-, se comprobó la presencia de tres conductos radiculares. Esta situación obligó a realizar el tratamiento endodóntico con cuidados específicos para localizar todos los conductos radiculares y prevenir desgastes excesivos y/o perforaciones. Conclusión: el diagnóstico oportuno de esta variación anatómica permite establecer modificaciones en el protocolo del tratamiento de conductos, a fin de evitar el debilitamiento excesivo o, incluso, la perforación de su estrecha anatomía radicular

Root canal morphology of Chalcolithic and early bronze age human populations of El Mirador Cave (Sierra de Atapuerca, Spain).

This study provides a morphological characterization of the inner anatomy of the root canals of permanent first and second molars in Chalcolithic and early Bronze Age human fossils using cone-beam computed tomography. The general evolutionary trend in present-day human dentition is related to morphological simplification. As little is known about when this trend appeared in Homo sapiens populations, the aim of this work is to test the presence of modern radicular morphology 4,400 years ago. Fifty-four permanent first and second maxillary and mandibular molars of 17 individuals were included in the study. All maxillary first and second molars showed three separate roots. Almost all the lower molars analyzed (100% of first molars and 75% of second molars) had two separate roots. More differences in the canal system configuration were documented in the maxillary mesiobuccal roots than in the palatal or distobuccal roots. The most variable tooth in root and canal configuration is the maxillary second molar. It should be pointed out that 12.5% of the teeth analyzed showed a C-shaped root configuration.

Surface of root cementum following air-polishing with bioactive hydroxyapatite (Ca and P mapping). A pilot study.

Air-polishing is a well-known and common technique to remove plaque, tartar and different kind of stains from teeth, using abrasive materials. Commonly used cleaning powders contain Al (aluminium) which is still controversial in terms of its inertness and harmfulness for human body. Nowadays, new air-polishing materials, including biomaterials, are being introduced. In particular, biomaterials the structure of which imitates that of natural tissue are very promising materials of reparative and reconstructive features. The purpose of the study was to assess in vitro the influence of natural hydroxyapatite on cementum surface and to assess superficial qualitative distribution of such elements as calcium and phosphorus before and after air-polishing. Four teeth extracted for periodontal reasons were airpolished. Bioactive hydroxyapatite (prepared in the Cracow Institute of Technology) was a cleaning powder with particle size of up to 10 µm. Bioactive natural hydroxyapatite is a very effective cleaning powder, which removes efficiently tartar from cementum surface and does not cause any damage. The qualitative analysis of cementum images after air-polishing with natural hydroxyapatite showed that the cementum surface was fully saturated with such elements as calcium and phosphorus, which was not observed on control cementum images.

Variability in permanent tooth size of three ancient populations in Xi'an, northern China.

OBJECTIVES: This paper compares permanent dental dimensions between three ancient populations that belonged to the same biological population throughout a temporal range of 2000 years to detect temporal trends and metric variation in dentition. MATERIALS AND METHODS: The samples analysed were dental remains of 4502 permanent teeth from 321 individuals, which were excavated from three archaeological sites: Chang'an (1000-1300 years BP), Shanren (2200 years BP) and Shaolingyuan (3000 years BP) in the Xi'an region (northern China). For each tooth three standard measurements were taken: Mesiodistal (MD) diameter of crown, labiolingual or buccolingual (BL) diameter of crown and length of root (LR). RESULTS: Three ancient population samples generally displayed the same dental dimensions (p>0.05), whereas some tooth types varied. The Shaolingyuan had larger canine and the smallest maxillary second molars and the Chang'an had the largest mandibular first molars in the MD dimension. The Shanren had the smallest maxillary third molars and mandibular central incisors, and the Chang'an had the smallest maxillary lateral incisors in the BL dimension. In the LR measures, statistically significant differences of five tooth types showed that the Chang'an were smaller than the Shaolingyuan and the Shanren. Comparisons of coefficients of variation for teeth showed that the length of root and third molar usually displayed greater variation. CONCLUSIONS: Decreasing or increasing trend for crown size does not occur between the ancient populations, while changes in crown size of a few tooth types fluctuate. The root size is more variable than the crown size and is likely to reflect a degenerated trend in a few tooth types.

Morphological features of the maxillary incisors roots and relationship with neighbouring anatomical structures: possible implications in endodontic surgery.

The purpose of this study was to investigate the relationship between the root apex of the upper incisors and neighbouring anatomical structures as well as the morphology of the root-end foramen after apicoectomy. Fifty-seven patients requiring endodontic surgical treatment for a maxillary anterior root were enrolled. A preoperative diagnostic computed tomography (CT) scan was analysed to determine: the distance between the anterior wall of the nasopalatine duct and the central (CI-ND) incisor root 4mm from the apex; and the distance between the floor of the nasal cavity and the tip of either the central (CI-NF) or the lateral (LI-NF) incisor root. After apicoectomy, root-end foramen endoscopic pictures were taken in order to characterize their morphology. Fifty-nine central and 26 lateral incisors were evaluated. The average CI-ND was 4.71 ± 1.26 (SD) mm. The average CI-NF was 10.62 ± 2.25 mm. The average LI-NF was 13.05 ± 2.43 mm. The foramen shape after apicoectomy was ovoid to circular in about 90% of cases in both central and lateral incisors. A sound knowledge of the anatomical relationships at the surgical site is essential for the clinician to perform a safe endodontic surgical procedure.

Nonlinear visco-elastic finite element analysis of porcelain veneers: a submodelling approach to strain and stress distributions in adhesive and resin cement.

PURPOSE: To assess under load the biomechanical behavior of the cementing system of feldspathic vs alumina porcelain veneers. MATERIALS AND METHODS: A 3D model of a maxillary central incisor, the periodontal ligament (PDL) and the alveolar bone was generated. Incisors restored with alumina and feldspathic porcelain veneers were compared to a natural sound tooth. Enamel, cementum, cancellous and cortical bone were considered isotropic elastic materials; conversely, dentin was designated as orthotropic. The nonlinear visco-elatic behavior of the PDL was considered. The adhesive layers were modelled using spring elements. A 50-N load at a 60-degree angle to the tooth's longitudinal axis was applied and validated. Stress concentration in the interfacial volumes of the main models was identified and submodelled in a new environment. RESULTS: Regarding tooth structure, strain concentrations were observed in the root dentin below the CEJ. As to the cement layer, tensile stresses concentrated in the palatal margin of the adhesive complex. CONCLUSION: Despite the effects on tooth deformation, the rigidity of the veneer did not affect the stress distributions in the cement layer or in the adhesive layers. In both cases, the palatal and cervical margins seemed to be the most stressed areas.

The Neanderthalian molar from Hunas, Germany.

In this paper, we present a well-preserved isolated human molar found in 1986 in the Hunas cave ruin, south-east Bavaria. The tooth was located at the bottom of layer F2, which belongs to a long stratigraphic sequence comprising faunal remains as well as archaeological levels (Mousterian). A stalagmite from layer P at the base of the stratigraphic sequence was recently dated to 79.373+/-8.237 ka (base) and 76.872+/-9.686 ka (tip) by TIMS-U/Th (Stanford University). We identified the tooth as a right (possibly third) mandibular molar. Characteristic parameters such as crown and root morphology, fissure pattern, enamel thickness, occlusal and interproximal wear, dental dimensions and indices, and radiological features indicate that the Hunas molar represents the tooth of a Neanderthal. This is corroborated by both the palaeontological and archaeological findings (Mousterian) of layer F2.

Morphological and anthropological aspects of human triangular deciduous lower first molar teeth.

The crown and root morphology, and bilateral occurrence of human deciduous lower first molars that exhibited a triangular occlusal outline, taken from excavated samples of Japanese, Jomonese and Iraqi origin, were investigated. The crowns of triangular teeth had smaller mesiodistal and larger buccolingual diameters than normally shaped deciduous lower first molars. An elongated buccolingual diameter was derived from the buccal projection of the distobuccal cusp and lingual projection of the portion between the metaconid and distolingual cusp. In this analysis, all triangular deciduous lower first molars in which root morphology could be observed were accompanied by additional distolingual roots. Correlation between the right- and left-hand sides of this trait was high.

Deciduous dental morphology of the prehistoric Jomon people of Japan: comparison of nonmetric characters.

Morphological variations of the deciduous dentition are as useful as those of the permanent dentition for determining the biological affinities of human populations. This paper provides material on morphological variations of deciduous teeth of the prehistoric Japanese population from the Late and the Latest Jomon Period (ca. 2000-ca. 300 B.C.). The expression of nonmetric traits of the deciduous teeth in the Jomon sample shows a closer affinity with modern Japanese and Native American samples than with American White, Asiatic Indian, and African samples. However, the frequency of shoveling in deciduous upper incisors in the Jomon sample is lower than those in modern Japanese and Native American samples. The Jomon sample also expresses a much higher frequency of cusp 6 in deciduous lower second molars than seen in modern Japanese, Ainu, and Native American samples. The frequency in the Jomon sample is equal to that in the Australian Aboriginal sample, which shows cusp 6 most frequently among the samples compared. A somewhat low incidence of incisor shoveling in the Jomon sample was also reported in the permanent dentition (Turner [1976] Science 193:911-913, [1979] Am. J. Phys. Anthropol. 51:619-635, [1987] Am. J. Phys. Anthropol. 73:305-321, [1990] Am. J. Phys. Anthropol. 82:295-317; T. Hanihara [1992] Am. J. Phys. Anthropol. 88:163-182, 88:183-196). However, the frequency of cusp 6 in the Jomon sample shows no significant difference from those of Northeast Asian or Native American samples in the permanent dentition (Turner [1987] Am. J. Phys. Anthropol. 73:305-321; T. Hanihara [1992] Am. J. Phys. Anthropol. 88:163-182, 88:183-196). Evidently, some nonmetric traits express an inter-group difference only in the deciduous dentition.

Effects on pulp and dentin of iontophoresis of sodium fluoride on exposed roots in dogs.

Experiments were performed on young permanent teeth in which there was demonstrable active dentin formation. Following surgical exposure of roots and removal of cementum with scalers, 1 percent sodium fluoride in aqueous solution was applied either topically or with direct-current iontophoresis. Two levels of current, therapeutic or five times therapeutic, were used. Observation periods were 7 and 80 days. There were no demonstrable histologic or ultrastructural alterations of the underlying pulp; nor was there a resultant change in the rate of dentin formation. While exposure of root surface dentin alone (negative control) produced no alterations, grinding the surface (positive control) caused noticeable changes in dentin, odontoblasts, and pulp.