Analysis on the predictive value of different variables in pulp stones appearance frequency and its pulpal response to cold stimuli.

This study evaluated the presence of pulp stones in a Seville population, correlating their presence and size with state of the crown and pulp response to cold stimuli, encompassing variables such as age, gender, location (arch and teeth group). The study included 1090 teeth corresponding to 146 patients. Each patient underwent a visual examination, periapical radiographs and sensibility tests. The SPSS 25 software (SSPS, Chicago, USA) was used to carry out the statistical analysis, doing logistic regression to compare variables and Chi-square with a significance level p < 0.001. Of 1090 teeth studied, 524 were molars and 566 premolars. Of the molars, 316 showed calcifications and of the 566 premolars only 6 showed pulp stones (p < 0.001). Due to the low prevalence of premolar pulp calcifications, our study included only molars. These calcifications were significantly more common in women than in men (71.5% vs. 28.5%) and in people over 40 years. Significant differences were identified between the state of the crown and the pulp response with the presence of pulp stones, although size did not influence this association. The set of independent variables has a statistically significant effect on the criterion variable (χ2 = 260.25, p < 0.001). There was a significant association between the state of the crown and the type of pulp response with the presence of pulp stones, but not with the size of the calcification. In conclusion, the highest probability to find pulpal calcification was observed in women over 40 years old in upper molars, and though the pulpal reaction of teeth with pulpal calcification varies, frequently there is an immediate response to a cold stimulus. There is no correlation between the size of pulp stones and the condition of the crown, just as the sensitivity of the pulp did not correlate with the size of pulp stones.

Nanomaterials in Dentistry: State of the Art and Future Challenges.

Nanomaterials are commonly considered as those materials in which the shape and molecular composition at a nanometer scale can be controlled. Subsequently, they present extraordinary properties that are being useful for the development of new and improved applications in many fields, including medicine. In dentistry, several research efforts are being conducted, especially during the last decade, for the improvement of the properties of materials used in dentistry. The objective of the present article is to offer the audience a complete and comprehensive review of the main applications that have been developed in dentistry, by the use of these materials, during the last two decades. It was shown how these materials are improving the treatments in mainly all the important areas of dentistry, such as endodontics, periodontics, implants, tissue engineering and restorative dentistry. The scope of the present review is, subsequently, to revise the main applications regarding nano-shaped materials in dentistry, including nanorods, nanofibers, nanotubes, nanospheres/nanoparticles, and zeolites and other orders porous materials. The results of the bibliographic analysis show that the most explored nanomaterials in dentistry are graphene and carbon nanotubes, and their derivatives. A detailed analysis and a comparative study of their applications show that, although they are quite similar, graphene-based materials seem to be more promising for most of the applications of interest in dentistry. The bibliographic study also demonstrated the potential of zeolite-based materials, although the low number of studies on their applications shows that they have not been totally explored, as well as other porous nanomaterials that have found important applications in medicine, such as metal organic frameworks, have not been explored. Subsequently, it is expected that the research effort will concentrate on graphene and zeolite-based materials in the coming years. Thus, the present review paper presents a detailed bibliographic study, with more than 200 references, in order to briefly describe the main achievements that have been described in dentistry using nanomaterials, compare and analyze them in a critical way, with the aim of predicting the future challenges.

Knowledge and management of temporomandibular joint disorders by general dentists in Spain.

BACKGROUND: Given the importance of temporomandibular disorders (TMD), we tried to assess general dentists' knowledge regarding etiology, diagnosis, and treatment in order to understand their attitude. MATERIAL AND METHODS: A sample of 130 general dentists answered a 16-item questionnaire on three areas - etiology, diagnosis, and management of common temporomandibular disorders - as well as a question on the need for continuous education regarding TMD management in common clinical practice in Spain. Given that the descriptive statistics achieved reflect significantly different values among means in each area, a variance analysis for repeated measurements was applied in order to contrast differences among etiology, diagnosis, and management knowledge levels. RESULTS: The contrast test was based on Wilks' Lambda, which assumed a value of 0.120 (F = 467.28; p<.001), demonstrating statistically significant differences among knowledge levels in the three dimensions. The effect size for these differences, measured by partial eta squared, was very high (η2p = 0.88). Such parameters were also analyzed to search for potential differences according to professional experience, with differences being exposed as non-significant at the 0.05 level: etiology (T = 1.60; p = 0.113), diagnosis (T = - 0.17; p = 0.868), and treatment (T = 1.10; p = 0.273). CONCLUSIONS: Our study found that, even though clinicians are generally skilled regarding the knowledge of the etiologic that explain the diagnosis of TMD, they have room for improvement in terms of TMD management compared to the other two areas studied. General dentists could benefit from specific educational programs enhancing TMD management skills. Key words:Temporomandibular disorders (TMD), knowledge and management. Clinical competence, postgraduate, continuing professional development. Surveys, education,orofacial pain.

Prevalence and complications of trauma to the primary dentition in a subpopulation of Spanish children in southern Europe.

BACKGROUND: During the first years of life, when children begin to walk and socialize, they are particularly vulnerable to traumatic injuries to the primary teeth; indeed, after dental caries, such injuries are the second most frequent cause of pediatric dental consultation. Nonetheless, the reported prevalence of trauma to the primary teeth varies depending on the literature source, type of injury, the patient's age, and the most common associated complications. AIM: To analyze new epidemiological data and complications associated with traumatic injuries to the primary teeth of Spanish children. MATERIAL AND METHODS: A retrospective study was carried out in a subpopulation of 879 Spanish children in southern Europe aged between one and 7 years old, with primary and early mixed dentition. Clinical and radiological records were obtained from all pediatric patients who presented trauma to the primary teeth, with a follow-up period of 3-5 years. RESULTS: A total of 21.72% of children examined had some kind of dental trauma and the most common age range for injuries to the primary teeth was 1-3 years old. The most common injuries in deciduous teeth were subluxation (47.29% of injuries affected the periodontal ligament), intrusion (23.15%), and avulsion (13.63%). On the other hand, comparatively more complications were recorded as a result of intrusion (32 of 47 intruded teeth). CONCLUSIONS: In this Spanish subpopulation, a pediatric dental consultation as a result of traumatic dental injuries in primary dentition is most frequent in 1- and 2-year-olds, and subluxation is the commonest injury in the primary dentition. In turn, intrusion is associated with an increased frequency of complications in both the deciduous and the permanent teeth.

Effect of mineral trioxide aggregate (MTA) pulpotomies in primary molars on their permanent tooth successors.

PURPOSE: To determine the long-term success rate of white MTA pulpotomies in primary teeth and its influence upon eruption and calcification of the permanent successor, as well as other key clinical and radiographic parameters. METHODS: A total of 138 molars from participants between 2-10 years of age were included. Clinical and radiographic parameters were monitored in the primary and/or permanent successor at 6, 12, 18, 24, 30, 36, 42, and 48 months or until eruption of the permanent successor, using the contralateral tooth as control. Chi-squared test and the Spearman correlation coefficient (r) were used to evaluate potential associations and distributions between radiographic/clinical parameters (P < 0.05; 95% CI). RESULTS: Clinical alterations were observed in 1.4% of the primary molars. Unfavorable radiographic pulp responses (furcation radiolucency, internal root resorption with perforation, or external root resorption) were observed in 6.5% of the cases. Dentin bridge formation in the roots was observed in a range as low as 71.2% to a maximum of 89.9% of the cases. The presence or absence of dentin bridge formation in any of the roots was not associated or correlated with the age of the patient (P > 0.05). Reparative dentin formation in any of the the root canals was recorded in 37.3 to a 68.1% of the canals (P > 0.05). The 50 permanent successors recorded after exfoliation of the treated molars showed no alterations in color, mineralization, structure or position, and no alterations in the timing of eruption were noted.

The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms.

The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p < 0.05); 4. hypermobility scale, gender (p < 0.001), malocclusion pattern (p = 0.021); 5. TMJ function impairment, gender (p = 0.043); 6. sagittal malocclusion pattern, right temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.