Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey.

AIMS: The aims of this study were to investigate the prevalence of apical periodontitis (AP) in diabetes mellitus (DM) patients compared with nondiabetic patients and to examine the effect of glycemic control on the prevalence of AP. MATERIALS AND METHODS: Radiographs of a group of DM patients were compared with those of a matched nondiabetic group to identify AP. The diabetic group was subdivided according to the level of glycemic control into two subgroups: A well-controlled DM and a poorly controlled DM. The periapical index score was used to assess the periapical status. All groups were compared in regard to the presence of AP lesions, the number of end-odontically treated teeth (ET), and the percentage of failure of endodontically treated teeth (AP/ET ratio). Statistical Package for the Social Sciences (SPSS version 20.0, Chicago, Illinois, USA) was used for all the analyses; p ≤ 0.05 was considered as statistically significant. RESULTS: The prevalence of AP was higher in diabetic group than in the nondiabetic group (13.5 vs 11.9% respectively). Diabetic group had more teeth with endodontic treatment ET compared with nondiabetic group (4.18 vs 1.82% respectively); this difference was statistically significant (p = 0.001) along with higher AP/ET ratio (27.7 vs 19.3 respectively). The poorly controlled DM group had a higher prevalence of AP lesions compared with the well-controlled DM group (18.29 vs 9.21 respectively). This difference was statistically significant (p = 0.001); they also had a higher percentage of ET (5.55 vs 3.13% respectively) and AP/ ET ratio (32.0 vs 21.8% respectively). CONCLUSION: This survey demonstrates a higher prevalence of AP in DM patients compared with nondiabetic group, with an increased prevalence of persistent chronic AP. Compared with a well-controlled diabetic group, a poor glycemic control may be associated with a higher prevalence of AP and increased rate of endodontic failures. CLINICAL SIGNIFICANCE: Counseling diabetic patients, particularly those with poor glycemic control, about the risk of failure of endodontic treatment can be part of planning management, which could include refereeing diabetic patients who need endodontic treatment for consultant care.

Multicenter retrospective study of cement-retained implant-supported anterior partial prostheses: success and restoration evaluation.

PURPOSE: The aim of this multicenter study was to evaluate implant success and restorative complications of cement-retained implant-supported anterior partial prostheses in Jordan. MATERIALS AND METHODS: A retrospective study of all implants with a minimum of 1-year follow-up were used to support fixed, cement-retained restorations from April 2000 until March 2007. The cement-retained implants were loaded with either single- or multiple-tooth replacements. The Fisher exact test was performed to test the presence of any statistically significant difference in success concerning gender or arch of placement. RESULTS: Eighty-seven implants were placed in the anterior region of the mandible or maxilla in 49 patients at multiple clinical practices in Jordan. The age of the patients ranged from 17 to 85 years. Eighteen implants were placed in the mandible and 69 in the maxilla. Three maxillary implants in 2 male patients had 3-mm horizontal bone loss. Those 3 implants are still functioning and were considered surviving implants but not successful implants. Therefore, the implant cumulative survival rate for both arches and genders was 100%. The implant cumulative success rate was 95.78%. Three crowns (maxillary) were dislodged. No significant differences were revealed regarding gender or arch of placement (P > .05). CONCLUSIONS: Cement-retained implants exhibited high survival and success rates among a Jordanian population.

An in vitro evaluation of the antimicrobial activity of nine root canal sealers.

AIM: The purpose of this in vitro study was to analyze the antimicrobial activity of root canal sealers by using the agar diffusion test (ADT). METHODS AND MATERIALS: Three categories of root canal sealers were included in the study: resin-based sealers (4), zinc oxide-based sealers (3), and calcium hydroxide-based sealers (2). The microbial strains used were: S. aureus (2 strains), C. albicans (2 strains), and E. faecalis (1 strain). Statistical analysis was conducted using a one-way analysis of variance (ANOVA). Tests of differences were analyzed using the Tukey's test with a value of p < 0.05 considered statistically significant. RESULTS: The antimicrobial activity of root canal sealers was ranked in descending order as follows: Sealite Regular, Cortisemol, Dentalis KEZ, AH26, Sealapex, Acroseal/Topseal, and Endorez/AH plus. CONCLUSION: Root canal sealers showed different inhibitory effects depending on their types and the bacterial strains tested. Root canal sealers containing formaldehyde and eugenol proved to be effective against the microorganisms studied. CLINICAL SIGNIFICANCE: The incorporation of antimicrobial components into root canal sealers may become an essential factor in preventing the re-growth of residual bacteria and control of bacteria re-entry into the root canal system.

Canal configuration in the mesio-buccal root of maxillary first molar teeth of a Jordanian population.

The purpose of this study was to investigate the canal configuration in the mesio-buccal root of maxillary first molar teeth of a Jordanian population using a clearing technique. One hundred extracted maxillary first molars were collected from Jordanian patients. After a standard access preparation, canals were stained, decalcified, dehydrated, and then rendered clear. The prevalence of a second canal in the mesio-buccal root was 77.32%. Types IV and II canal systems were the most common types with prevalence of 35.05% and 27.83%, respectively. Additionally, 28.86% showed lateral canals mostly located in the apical third and 37.11% had intercanal communications, mainly in the middle third of the root. It was concluded that the prevalence of mesio-palatal canals was high and Types IV and II canal systems were the most prevalent.

Gingival and periodontal changes in patients undergoing in vitro fertilization treatment: A clinical study.

AIMS: The aim of this study was to investigate the effect of in vitro fertilization (IVF) treatment on different parameters of periodontal status. SETTINGS AND DESIGN: This was a clinical observational study. MATERIALS AND METHODS: One hundred and seventy-nine patients who underwent IVF treatment according to the standard IVF protocols were examined using the simplified oral hygiene, gingival index (GI), sulcus bleeding index (SBI), and determining the clinical attachment loss (CAL). A full-mouth examination except for the third molars was performed at 4 sites per tooth (mesiobuccal, distobuccal, mesiolingual, and distolingual). Periodontal evaluation was performed before infertility treatment, at the end of infertility treatment, and 14 days after embryo transfer. STATISTICAL ANALYSIS: The Kruskal-Wallis or Fisher's tests were used to compare the median or mean values as appropriate. RESULTS: The oral hygiene index simplified was 0.49, 0.32, and 0.37 at pretreatment, on the day of human chorionic gonadotropin (HCG) trigger, and on the day of the pregnancy test, respectively. The GI showed significant differences before and after treatment. The mean GI was 0.13 at pretreatment compared to 0.51 and 0.53 on the days of HCG trigger and of the pregnancy test, respectively. The same trend was seen for SBI. There were no differences in CAL among the three examinations. There was no difference between the two groups except for GI (0.71 vs. 0.48 for a positive pregnancy test vs. nonpregnancy, respectively). CONCLUSIONS: IVF medications and a superphysiological condition affect oral health, particularly gingival and periodontal statuses, and likely complicate the relationship between infertility, sex hormones, and infertility management. Larg-scale studies are needed to confirm the effect of such treatment on oral health.

Abutment rotational displacement of external hexagon implant system under lateral cyclic loading.

PURPOSE: This in vitro study investigated the effect of lateral cyclic loading with different load positions and periods on abutment rotational displacement (RD) of external hexagon implant system. MATERIALS AND METHODS: Four groups of five implant assemblies each were used. Each assembly consisted of Brånemark System Mk IV implant (Nobel Biocare AB, Göteborg, Sweden), CeraOne abutment (Nobel Biocare AB), and a cement-retained casting. A cyclic load of 50 N was applied centrally and perpendicular to the long axis of the implant for groups A and B for 0.25 and 0.50 x 10(6) cycles, respectively, while for groups C and D, the same load was applied at 4-mm distance eccentrically for 0.25 and 0.50 x 10(6) cycles, respectively. The displacement was evaluated by hand drawing a longitudinal line across the implant-abutment interface. Before and after loading, the lateral distance between two reference points on the abutment and implant was measured under high resolution (x200) and the difference formed the RD value. The data were analyzed with one-way analysis of variance and compared with Tukey test (alpha=0.05). RESULTS: Group D had the highest mean of RD value (55.00 +/- 1.871 microm), while group A had the lowest (2.800 +/- 0.837 microm). Groups A and B had a high statistically significant difference in RD values, as compared to groups C or D (p < .001). Moreover, group C had statistically significant difference from group D (p=.011). Conversely, no statistical significance was obtained when group A was compared with group B. CONCLUSION: Within the limits of this in vitro study, the RD of the external hexagon joint components occurred significantly under eccentric lateral loading when compared to centric loading. The displacement increased significantly with longer period of eccentric lateral loading.

Root canal morphology of the mesiobuccal root in maxillary first molars of a Jordanian population.

This in vitro study investigated the presence of second (MB2) root canals and the number of apical foramina found in mesiobuccal roots of the permanent maxillary first molars; in addition, the study evaluated the effectiveness of magnification to detect MB2 canals. One hundred extracted maxillary first molars were collected from Jordanian patients. The number of roots (as well as their morphology) was investigated. The number of canal orifices in mesiobuccal root was assessed, with and without magnification, and findings were compared. The number of apical foramina and the distance between mesiobuccal and second canal orifices were investigated under magnification. Of the 97 specimens that were subject to additional investigation, all teeth had three separated roots, except for three specimens that had either mesiobuccal or distobuccal roots fused with the palatal root. The number of MB2 canals that were detected increased from 55 (56.7%) to 61 (62.9%) teeth when magnification was used. Within the limits of this in vitro study, it was concluded that the Jordanian population had a high percentage of MB2 canals in the mesial buccal roots. Moreover, the use of clinically used magnifying devices increased the number of MB2 canals detected.

Women's oral and dental health aspects in humanitarian missions and disasters: Jordanian experience.

OBJECTIVE: The study aimed to review oral and dental health aspects in female patients presented to Jordanian Royal Medical Services (RMS) international humanitarian missions over a 3-year period. DESIGN AND METHOD: Analysis of humanitarian missions of RMS data and records over a 3-year period (2011-2013) in regard to women's oral and dental health issues was done. The data were analyzed in regard to the number of women seen, the presenting conditions, and the prevalence of oral and dental diseases and procedures in these cases. RESULTS: During the 3-year period, 72 missions were deployed in four locations (Gaza, Ram Allah-West Bank, Jeneen-West Bank, and Iraq). The total number of females seen in this period was 86,436 women, accounting for 56 percent of adult patients seen by RMS humanitarian missions. Dental Clinics were deployed to only two missions (Iraq and Gaza), during which they received 13,629 visits; of these, 41 percent were females (5,588 patients), 29 percent were males, and 30 percent were in the pediatric age group. Trauma accounts for only 7 percent of the cases, while nonacute dental problems (caries and gingivitis) were responsible for the majority of cases (31.6 and 28.7 percent, respectively). CONCLUSION: RMS dental services during humanitarian mission deployment are a vital part of comprehensive healthcare. Women usually seek more dental care than men, with the majority of treatments for nonacute conditions. RMS experiences demonstrate the tremendous need for a well-defined preparedness plan for deployment of humanitarian missions that considers the contributions of all types of health professionals, the appropriate mobile technology to respond to emergent health risks, and a competent workforce ready and able to respond. Such preparation will require our dental education programs to develop disaster preparedness competencies to achieve the desired level of understanding.

Prevalence and severity of gingivitis in school students aged 6-11 years in Tafelah Governorate, South Jordan: results of the survey executed by National Woman's Health Care Center.

BACKGROUND: A cross-sectional census was conducted on 994 public school students aged 6-11 years living in 3 different parts of Tafeleh Governorate-South of Jordan, to determine the prevalence, and severity of gingivitis and to evaluate the oral hygiene habits among them as a part a survey executed by National Woman's Health Care Center. All students were examined for gingival index (GI) and plaque index (PI), information about oral hygiene habits was recorded. RESULTS: Only 29.8 % had healthy gingiva, 38.5 % had mild gingivitis, 31.4 % had moderate gingivitis, and 0.3 % had severe gingivitis. The difference between both genders was not statistically significant P > 0.05. 36.8 % of the examined students never brushed their teeth. Average gingival index (GI) and average plaque index (PI) were 0.77 and 0.61 respectively. CONCLUSIONS: Fair oral hygiene with mild to moderate gingivitis is highly prevalent among Tafelah school children. This study indicated that oral health status among schoolchildren in Tafelah is poor and needs to be improved. Long-term school based oral health education programme is highly recommended.

Detection of a second mesiobuccal canal in the mesiobuccal roots of maxillary first molar teeth.

OBJECTIVE: The aim of the present study was to determine whether the MB2 canal in the mesiobuccal root (MBR) of maxillary first molars could be identified through a clinical access cavity preparation, with and without magnification. STUDY DESIGN: One hundred extracted maxillary first molar teeth were collected. After a clinical access cavity preparation with careful use of bur to locate any additional canal (dentine troughing), the MB2 canals were located in 2 stages. Stage I was located with unaided vision and stage II was located under moderate magnification with x3.5 magnifying dental loupes. All specimens were stained, rendered transparent, and then classified. The number of canals detected by stage was analyzed statistically by a chi-square test. Statistical significance was considered to be P < or = .05. RESULTS: Under magnification, the number of detected MB2 canals was increased from 55 (56.7%) to 61 (62.9%) teeth. Cleared teeth showed 77.32% of MB2 canals. The effectiveness of MB2 location was 73.3% and 82.7% in stage I and stage II, respectively. There was no statistically significant difference between the 2 methods of detecting the MB2 canal (P = .3). CONCLUSIONS: The use of magnification enhanced the ability to detect the MB2 canals, although the difference was not statistically significant. The MB2 canals could not be detected in 16.5% of the teeth, mainly because of pulpal calcification.