Roots and Root Canals Characterization of Permanent Mandibular Premolars Analyzed Using the Cone Beam and Micro Computed Tomography-A Systematic Review and Metanalysis.

This current paper aims to review the literature on the root canal configuration (RCC) and root structure of permanent mandibular premolars. To find the published scientific literature on the RCC of mandibular premolars up to July 2022, a systematic search of four electronic databases was performed. The studies were selected, rendering to a predetermined point of reference: "mandibular 2nd premolar", "root and canal system", "morphology of root and canal", "root and canal configuration", and "morphology", along with "anatomy" and "mandibular premolars". Cross-referencing along with screening through the bibliographies of the chosen articles resulted in the identification of further studies. In the current study, we examined 30 different articles, and we chose them based on the quality of research investigations. From 3471 retrieved studies, a total of 15981 mandibular 2nd premolars were observed in 30 studies. The mean JBI score for studies assessing the structure of the root, as well as the root canal of the mandibular 2nd premolar, was 7.78 ± 0.81. We have found a pooled prevalence of 91.82% for Vertucci class I root canal morphology and 78.63% pooled prevalence of single-rooted mandibular second premolar. A total of 8677 mandibular 1st premolars were observed in 22 studies. The mean JBI score for studies assessing the structure and anatomy of the root, as well as root canal of mandibular 1st premolar, was 7. 95 ± 0.85. We have found a pooled prevalence of 74.34% for Vertucci class I root canal morphology and 85.20% pooled prevalence of single-rooted mandibular 1st premolar. Mandibular first and second premolars were mostly single-rooted teeth (89.5-100%). The most frequently seen RCC is a 1-1-2-/2 (type V-Vertucci's), followed by 1-1-2-/1 (type IV- Vertucci's; type III-Weine's), and finally RCC 2-2-2-1 (type IV-Vertucci's; type III-Weine's). Presently, the imaging of CBCT is the most used research approach for studying Mn2Ps' structural characteristics.

The Effects of Low-frequency Vibration on Aligner Treatment Duration: A Clinical Trial.

Objectives: The aim of this study was to investigate the effectiveness of an orthodontic tooth movement acceleration device (AcceleDent, OrthoAccel Technologies, Houston, Texas) when used during an aligner treatment. Materials and Methods: Adult patients who began an aligner treatment (Lineo, Micerium Lab, Avegno, Italy) were allocated to two treatment groups. The first one (Group A), with a 7-day aligner change regimen, used the AcceleDent device for 20 min per day, whereas the second one (Group B) changed the aligners every 14 days and did not use any device. The registered outcomes were the possibility of completing the treatment, the number of aligners needed and treatment duration in the two groups. Moreover, we assessed patients' perception of pain during the first week of treatment. Results: Twenty-four patients were allocated to Group A or B depending on the acceptance of AcceleDent use. Patients which used AcceleDent (Group A) completed the treatment using each aligner for fewer days than those belonging to Group B (9.0 ± 1.0 and 15.4 ± 1.2 days, respectively) (P < 0.001). As a secondary outcome, a significant difference was found in pain perception during the first week of treatment between the two groups (P < 0.05). Conclusions: This controlled clinical trial shows that is possible to apply a 7-day change regimen together with AcceleDent use and successfully complete an aligner treatment with a significant saving of time when compared to a standard 14-days change regimen. Finally, the use of this device allowed reduction in pain perception during the orthodontic treatment.

Videocapillaroscopy of the Oral Mucosa in Patients with Diabetic Foot: Possible Diagnostic Role of Microangiopathic Damage?

INTRODUCTION: Diabetic foot represents one of the most serious and expensive complications of diabetes and is subject to a high percentage of amputations that are almost always preceded by ulcers ascribable to neuropathy and/or vasculopathy. Videocapillaroscopy (VCS) can be a valuable aid in order to uncover morpho-structural anomalies in the vascular bed, both at the level of the oral mucosa and at the level of the terminal vessels of the lower limb. MATERIALS AND METHODS: Sixty subjects divided into 4 groups were enrolled: 15 healthy subjects; 15 patients with diabetes for more than 10 years without ulcerative foot lesions; 15 patients with neuropathic diabetic foot (clinical diagnosis, MDNS); 15 patients with ischemic diabetic foot (clinical diagnosis, ABI, lower limb doppler). A complete videocapillaroscopic mapping of the oral mucosa was carried out on each patient. The areas investigated were: labial mucosa, the retro-commissural region of the buccal mucosa, and the vestibular masticatory mucosa (II and V sextant). RESULTS: The analysis of the morphological and densitometric characteristics of the capillaries revealed the following: a significant reduction in capillary density in neuropathic (mean ± SD 7.32 ± 2.1) and ischemic patients (mean ± SD 4.32 ± 3.2) compared to the control group of patients (both diabetic mean ± SD 12.98 ± 3.1 and healthy mean ± SD 19.04 ± 3.16) (ANOVA test and Bonferroni t test p < 0.05); a reduction in the average length of the capillaries and a significant increase in tortuosity (ANOVA test and Bonferroni t test p < 0.05). In the neuropathic patients, a recurrent capillaroscopic pattern that we defined as "sun" was found, with capillaries arranged radially around an avascular area. CONCLUSIONS: The data obtained from this preliminary study suggest a potential diagnostic role of oral capillaroscopy in the early and subclinical identification of microangiopathic damage in patients with diabetic foot.

Permanence of Modifications in Oral Microcirculation in Ex-Smokers.

BACKGROUND The aim of this study was to assess the long-term effects of smoking and to investigate the permanence of this damage to the oral microcirculation. MATERIAL AND METHODS We recruited 75 patients and divided them into 3 groups: group 1 was composed of 25 healthy non-smokers, group 2 was composed of 25 healthy current smokers, and group 3 was composed of 25 healthy ex-smokers. Video-capillaroscopic examination was performed on all patients. The video-capillaroscopic investigation was performed on patients in sitting position, always with the same light source, at the same room temperature (23°C), in the morning, with the same operator (GAS), and was repeated many times for every area under investigation. An enlargement of 200× allowed us to explore point-by-point all the morpho-structural characteristics of the capillaroscopic field. For non-parametric data, we evaluated the visibility of the loops and their position in relation to the surface of the mucosa. The evaluated parametric data were length of capillary loop, diameter of the loop, capillary tortuosity, and capillary density. RESULTS Our study clearly shows there was no remission of vascular damage, even 13 years after smoking cessation. CONCLUSIONS Our research shows that that the effects of smoking are still visible in ex-smokers, even at 13 years after cessation and also that ex-smokers are still subject to the risk of oral pathologies in the interval of time that we considered.

Tooth-implant connection in removable denture.

When the patient cannot be rehabilitated with a fixed denture, or when he does not succeed in adapting to a traditional removable denture, a possible alternative solution consists in the use of a limited number of implants, placed in strategic positions in the arches of the patient, and subsequently connected to their residual teeth. The aim of this review is to evaluate the progress made on connections between teeth and implants in removable denture, to analyze their advantages and disadvantages and to compare the survival rate, both of the teeth and of the implants used as abutments, present in the various studies taken into examination, with the aim of being able to evaluate the effectiveness of this rehabilitative option. The concept of preserving residual teeth, even if these are unfavorably distributed, and inserting a minimum number of implants in strategic positions, thanks to which an area of favorable support for the denture can be created, seems reasonable; this will guarantee a better adaptation of the patient to the denture, as well as an improvement in the quality of life. The study of articles present in literature suggests that the survival rate of the implants in removable dentures, supported by teeth and implants through traditional systems of anchorage, appears to be quite high. However, further studies with a higher level of evidence, more representative test subjects and a longer follow-up period are necessary, in order to confirm the validity of this rehabilitative solution.

Changes of oral microcirculation in chemotherapy patients: A possible correlation with mucositis?

The aim of this investigation is to appraise labial oral microcirculation in chemotherapy patients to clarify the effects of cytotoxic agents on oral microvessels. Twenty-five patients with diagnosis of head and neck tumors were recruited in the study. All the patients were submitted to chemotherapy. Labial oral microcirculation was evaluated on labial mucosa using oral videocapillaroscopy. The statistical significance was checked with the Mann-Whitney U-test (P < 0.05). The analysis of videocapillaroscopic patterns showed statistically significant variations relative to the diameter of the incoming loop; the diameter of the outgoing loop; and loop tortuosity. This study shows that capillary alterations to patients who receive chemotherapy occur in labial oral microcirculation.

Oral microcirculation in post-menopause: a possible correlation with periodontitis.

OBJECTIVES: The reduction in the level of oestrogen, typical in menopause, has some effect on the health of the oral cavity. In fact, post-menopausal women present more severe periodontal disease than pre-menopausal women. Numerous factors can be held to be responsible for this increase, among which are the effects of oestrogens on the oral epithelium, on the salivary glands, on bone tissue and on the endothelium. Our double blind study aims to evaluate the possible variations in oral microcirculation in post-menopausal women. METHODS: Twenty-seven women in post-menopause (age: Mean ± SD: 57.3 ± 8.73) and 27 women in pre-menopause (age: Mean ± SD: 27.77 ± 3.56) were examined. Oral microcirculation was investigated using oral videocapillaroscopy. RESULTS: The study showed significant differences between cases and controls for the following parameters: decrease in diameter of loops (mean ± SD: 0.038 ± 0.008; 0.045 ± 0.005), increase in tortuosity (mean ± SD: 3.83 ± 1.13; 1.83 ± 1.06) in labial mucosa and decrease in density in periodontal mucosa (Mean ± SD: 28.86 ± 10.92; 89.62 ± 17.83). CONCLUSION: The decrease in periodontal density may compromise the epithelium tropism, making it prone to inflammation. The tortuosity may indicate a greater permanence of inflammatory factors, increased in post-menopausal women.

Chronic hyperplastic candidosis: a pilot study of the efficacy of 0.18% isotretinoin.

Management of oral candidiasis depends on an accurate diagnosis, identification and elimination of predisposing factors, and, often, use of antifungal agents. Chronic hyperplastic candidosis (CHC) is considered a premalignant lesion of the oral mucosa, occurring as speckled or homogeneous white lesions. If the lesions are untreated, a minor proportion may become dysplastic and progress to carcinoma. The traditional treatment of this lesion is based on the use of antifungal agents. The aim of this study was to examine the efficacy of 0.18% isotretinoin for treatment of nystatin-resistant candidiasis. Isotretinoin was administered topically twice a day for one month to six patients affected by nystatin-resistant CHC. In all six patients, daily antimycotic topical therapy with nystatin for 30 days had failed to resolve the candidal stomatitis. After one month of isotretinoin treatment, five of the six patients were negative for Candida, whereas in untreated control patients the situation was unchanged. Only one patient with suspected sicca syndrome was found to have oral Candida 15 days after the last administration of isotretinoin. None of the patients had any complaints about the medication. These findings suggest that 0.18% isotretinoin applied twice a day for one month is able to suppress nystatin-resistant candidiasis.

Morphological characteristics of microcirculation in oral lichen planus involving the lateral border of the tongue.

Oral lichen planus (OLP) is a chronic mucosal condition commonly encountered in dental practice. Lichen planus is believed to represent an abnormal immune response in which epithelial cells are recognized as foreign, secondary to changes in the antigenicity of the cell surface. It has various oral manifestations. The aim of the study was to evaluate the morphological characteristics of microcirculation of lingual lichen planus (LLP). Twenty patients (10 patients with LLP and 10 healthy patients) were examined by means of videocapillaroscopy. The left margin of the lingual mucosa was examined in each patient. The capillary loop length, loop diameter, and capillary density were analyzed on every capillaroscopic image. The results obtained using videocapillaroscopic software were subjected to statistical analysis. The density, loop length, and total diameter showed statistically significant differences. A remarkable increase in capillary density was shown. The microcirculation of LLP can be studied "in vivo" with the help of videocapillaroscopy, and it could be an indicator of the evolutionary condition of LLP, useful for the evaluation of the evolution or regression phases of the disease.

Oral microcirculation observed in vivo by videocapillaroscopy: a review.

Capillaroscopy is a non-invasive diagnostic technique that is fundamental in viewing peripheral circulation and in studying microangiopathies. The morphological study of microcirculation is of fundamental importance, mainly because the microvascular bed is directly involved in the etiopathogenesis of autoimmune disorders and acute and chronic inflammatory pathological conditions. The value of capillaroscopic investigation as a diagnostic means in cases of peripheral microcirculation disorders has been confirmed by numerous studies. Other studies used capillaroscopic investigations to evaluate microcirculation damage not as a complication of disease (diabetes), but as its initial stage, and therefore to make a diagnosis. Capillaroscopy is an interesting method of studying microcirculation, because of the possibility of studying small vessels in vivo by means of a microscope. Today, it has become more reliable, thanks to the development of observation tools (photography, videomicroscopy). This review describes in detail various aspects of the microcirculation of the oral mucosa.

Microvascular abnormalities in patients with rheumatoid arthritis.

Microvascular involvement represents one of the first apparent steps in many autoimmune diseases such as rheumatoid arthritis (RA). Early in the disease, peripheral microangiopathy may be easily recognized and studied by videocapillaroscopy. The aim of this study has been to observe the differences in labial microcirculation between healthy patients and patients suffering from RA. A total of 30 healthy patients and 30 patients suffering from RA were examined. The patients with conditions known to compromise microcirculation, such as diabetes, hypertension, or some pharmacological treatments were not included in the study. All the patients were non-smokers. Labial capillaroscopy was used to investigate the characteristics of microcirculation. Visibility, course, tortuosity, as well as the possible presence of microhemorrhages, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. The investigation was simple, non-invasive, and repeatable for each patient. In patients suffering from RA, it was possible to observe a reduced caliber of capillaries, as well as greater elongated capillaries, in comparison to controls. This study shows that capillary alterations in patients suffering from RA occur in labial mucosa microcirculation; such evidence could be extremely important in the diagnosis of suspected RA.

The effect of cigar smoking on the lingual microcirculation.

The aim of this study was to analyze the lingual microcirculation in vivo and to evaluate the effects on it of cigar smoking, using computerized videocapillaroscopy. Twenty-five healthy nonsmokers and 25 healthy smokers were examined. For each subject we evaluated the visibility, course, tortuosity, and any images characteristic of capillary loops, as well as the possible presence of microhemorrhages, the average caliber of the capillary loops, and the number of capillary loops visible per square millimeter. The investigation of the lingual mucosa revealed capillary loops with a course parallel to the surface. In smokers, capillary loops had a smaller caliber (P < 0.001) and there was a higher number of detectable capillary loops (P < 0.001). An important correlation between capillary tortuosity and cigar smoking (P < 0.001) was observed. Our research shows that chronic smoking induces significant changes in lingual capillary morphology, caliber, and number.