Time assessment for final restoration of endodontically treated teeth in a university clinic setting: An observational study.

Background: The aim was to quantify the time elapsed between tooth reconstruction and the end of endodontic treatment, and to assess differences according to sex, age, and tooth group. Material and Methods: A retrospective study was conducted with patient clinical records. Data relating to patient characteristics, treated teeth, endodontic treatment, and subsequent restorative treatment were recorded. Results: For this study, 355 endodontically treated teeth by undergraduate students during 2019 were included. 24 teeth (6.76 %) were not restored, more direct (86.4 %) than indirect (13.6 %) restorations were performed, and the most frequent type of restoration was complex filling. The mean elapsed time from endodontic completion to direct restoration was 7 days, with a minimum of 0 and a maximum of 90 days. For indirect restorations the mean elapsed time was 21 days. Conclusions: The median elapsed time for endodontic tooth reconstruction was 7 days (IQR = 7), however, treatment should not be considered completed until the tooth has been properly restored. In cases where an indirect restoration was also necessary, the median elapsed time was higher (21 days; IQR = 31.5).

Oral cancer awareness among dental students in a private university setting.

INTRODUCTION: There is a great deal of research on the awareness of students and professionals regarding oral cancer. The aim of this study was to find out students' opinions in their final years of dental school training who have clinic time about the importance of correct mucosal examination of the oral cavity. MATERIALS AND METHODS: A cross-sectional study was carried out and a questionnaire was designed and distributed to fourth- and fifth-year dental students. The questionnaire included demographic aspects of the participants and five closed questions related to the importance given to the exploration of the soft tissues during patient visits, the importance of the university training received, their interest in continuing education on this subject, their role as dentists in early diagnosis and whether they consider themselves prepared to diagnose oral cancer. RESULTS: A total of 214 undergraduate dental students participated in the study, 24.3% fourth year and 75.7% fifth year. Moreover, 97.7% of the students considered soft tissue examination to be important or very important, 90.2% of the students surveyed considered the university training received to be important or very important and 66.4% of the students considered that the most qualified professional to diagnose an oral lesion is the dentist. CONCLUSION: In this study, most of the students felt that graduate training in oral cancer is important, as well as soft tissue examination. In addition, the majority considered that the professional most indicated to diagnose oral lesions is the dentist. However, a very small percentage felt prepared to diagnose oral cancer themselves.

Bilateral Digitally Aided Tooth Autotransplantation: A 2-Year Case Report.

Tooth autotransplantation is an effective treatment to replace missing teeth. Digital planning can facilitate successful autotransplantation. Guiding templates are highly recommended when performing cases in healed ridges in the posterior area to reduce excessive bone loss and increase the chances of fitting the donor tooth in the new socket. This case report highlights the use of 3D planning tools and fully guided drilling templates for successful tooth autotransplantation in the posterior area. Two tooth autotransplantations were performed in a 51-year-old patient using mandibular third molars to replace hopeless mandibular first and second molars. Root canal treatments were carried out before the surgeries, and different alveoloplasty techniques were used in each recipient area. The prosthetic phase was carried out after 9 months. Both teeth were asymptomatic, functional, and exhibited no signs of resorption or apical radiolucency and showed complete regeneration of the periodontal apparatus at the 2-year follow-up.

Evaluation of the diagnostic ability of oral lesions on clinical images among undergraduate dental students.

INTRODUCTION: The dentist should be able to carry out systematic oral examinations of the mucosa of patients in order to diagnose any alterations at an early stage. MATERIALS AND METHODS: An observational, analytical, prospective, and longitudinal study was carried out. 161 students were evaluated at the beginning of their clinical practice in their 4th year of dental school (September 2019), at the beginning and at the end of their 5th year of dental school (June 2021). Thirty oral lesions were projected, and the students were asked to provide an answer; if the lesions were benign, malignant, or potentially malignant, whether they should be biopsied and/or treated and a presumptive diagnosis. RESULTS: Significant improvement (p < .001) was obtained between the 2019 and 2021 results, in relation to the classification, need for biopsy and treatment of lesions. For differential diagnosis, no significant difference (p = .985) was obtained between the 2019 and 2021 responses. Malignant lesions and PMD obtained mixed results, with the best results corresponding to OSCC. DISCUSSION: In this study, a correct lesion classification by the students was over 50%. As for the OSCC, the results were superior to the rest of the images, reaching more than 95% correct. CONCLUSION: Theoretical-practical training from universities and continuing education for graduates in relation to oral mucosal pathologies should be further promoted.

Effect of the Controlled Delivery of Chelating Agents on the Pulp Tissue Dissolution Ability of Fresh Sodium Hypochlorite Solutions.

INTRODUCTION: The purpose of this study was to evaluate pulp tissue dissolution ability of sodium hypochlorite (NaOCl) when mixed with tetrasodic etidronate (Na4HEBP) and disodic ethylenediaminetetraacetate (Na2EDTA) under controlled flow. METHODS: Bovine pulp tissue was extracted from the lower incisors of 10 bovine jaws. Pulp specimens were standardized in size (1 × 3 × 10 mm), blotted dry, and weighed (initial weight [T0]: mean (SD) = 31.98 (1.18) mg). Specimens from the same jaw were randomly assigned to 2 control (n = 3 each) and 4 experimental groups (n = 10 each): NC (negative control/distilled water), PC (positive control/6%NaOCl), G1 (3%NaOCl), G2 (3%NaOCl-17% Na2EDTA), G3 (3%NaOCl-18% Na4HEBP), and G4 (3%NaOCl-9% Na4HEBP). Distilled water and NaOCl were provided using a delivery pump under a continuous controlled rate (1 mL/min). A second pump alternately delivered either Na2EDTA or Na4HEBP at the same rate with a 30-second programmed interval. Percentage of tissue weight loss was calculated at 2, 5, and 10 minutes (T2, T5, and T10) and compared among groups with analysis of variance. Free available chlorine and pH were controlled at T0 and T10. RESULTS: No tissue remained in PC at T5. No dissolution occurred in NC. There were no significant differences in the percentage of weight loss among experimental groups at any point of time. Some remnant tissue was found in G3 (1.4% ± 2.4) and G4 (1.6% ± 2.3) at T10, whereas nothing was left in G1 and G2. CONCLUSIONS: The controlled delivery of Na2EDTA and Na4HEBP did not alter tissue dissolution ability of NaOCl when fresh solutions were mixed in the root canal.

Assessment of Clinical Parameters of Dental Anxiety during Noninvasive Treatments in Dentistry.

Dental anxiety is a matter of interest for the dentist since an anxious patient is a potential source of complications in the dental office. The main objectives of this study are to describe the correlation between dental anxiety levels and the values of physiological parameters related to dental anxiety and to study the evolution of blood pressure and heart rate over time during noninvasive dental treatments, i.e., not requiring local anesthesia. A descriptive, longitudinal, and prospective observational study was designed. The study population consisted of 200 patients who attended a university clinic for dental treatment without local anesthesia. The patients were asked to complete the Corah Dental Anxiety Scale. Afterward, blood pressure and heart rate were measured by means of a digital sphygmomanometer. Blood pressure and heart rate were taken throughout the procedure on four occasions. Most of the patients showed mild dental anxiety (5 [IQR: 3] points on Corah Dental Anxiety Scale). Significant but weak correlations were found between the level of dental anxiety and heart rate (Spearman rho: 0.166 and 0.176; p = 0.019 and 0.013; 3 min before and after treatment, respectively), as well as between the level of dental anxiety and the duration of treatment (Spearman rho: 0.191 3 min; p = 0.007). As for the evolution of physiological parameters, all patients showed a progressive decrease in values at different time points during treatment. When the types of treatment were evaluated separately, it was observed that there were statistically significant differences between them with respect to the level of dental anxiety (p = 0.006).

Differences in disinfection protocols for root canal treatments between general dentists and endodontists: A Web-based survey.

BACKGROUND: The purpose of this study was to determine whether differences exist in disinfection protocols between endodontists and general dentists. METHODS: The authors sent an invitation to participate in a Web-based survey to 950 dentists affiliated with the Spanish Board of Dentistry. Participants responded to 9 questions about irrigation protocols and other factors related to disinfection during root canal therapy. RESULTS: A total of 238 (25.05%) study participants successfully completed and returned the surveys. Among these participants, 50% were general dentists and 50% were endodontists. The authors found no statistically significant differences in respondents' first choice of an irrigant solution (that is, sodium hypochlorite), but they noted statistically significant differences in the protocols used by general dentists and by endodontists in relation to the concentration of sodium hypochlorite (P = .0003), the use and type of irrigant used to remove the smear layer (P = 5.39 × 10(-10)), the use of adjuncts to irrigation (P = 5.98 × 10(-8)), the enlargement of the apical preparation when shaping a necrotic tooth (P = .001), and the maintenance of apical patency throughout the debridement and shaping procedure (P = .04). CONCLUSIONS: General dentists and endodontists embrace different disinfection protocols. The results of the survey demonstrated that endodontists keep up to date with protocols published in the literature, whereas general dentists use protocols learned during their dental training. Both groups of clinicians should be aware of the importance of disinfection techniques and their relationship to treatment outcomes. PRACTICAL IMPLICATIONS: Controlling microorganisms during a root canal treatment, especially in cases with necrotic pulp, is essential to improve treatment outcomes. Clinicians should update their protocols and also consider referring patients to a specialist when their protocols are based on traditional techniques, especially in those cases with necrotic pulp.

Instrumentación tridimensional de sistemas de conductos mediante el sistema self adjusting file (SAF). A propósito de un caso / Tridimensional instrumentation of root canal systems through self adjusting file (SAF). A case report

Algunas de las dificultades que nos encontramos en los retratamientos son la eliminación del material de obturación intraconducto y la presencia de dentina muy contaminada por microorganismos resistentes, en muchas ocasiones asociados en biofilms. En el caso que presentamos nos ayudamos en la última fase del retratamiento de un nuevo sistema que combina instrumentación e irrigación simultáneamente, cuya principal característica es la de adaptarse a la sección transversal de los conductos y de este modo permitir alcanzar áreas en las que la instrumentación rotatoria presenta grandes limitaciones. Facilitándonos, de este modo, la eliminación de cemento y gutapercha remanentes así como dentina contaminada, respetando la anatomía original. El caso ejemplifica esta técnica clínica sobre la que hemos realizado una discusión a partir de la literatura revisada. El diente tratado, un segundo molar inferior, presenta una periodontitis apical aguda producida por una subextensión del material obturador y una deficiente condensación del mismo. Su anatomía inusual formada por un único y amplio conducto es desobturada y desinfectada para proceder a su obturación termoplástica. La evolución del caso a los 6 meses indica una mejora de la sintomatología sin signos radiográficos que indiquen patología periapical (AU)

Some of the difficulties we can find in a retreatment are the removal of the filling material and the presence of intracanal dentin heavily contaminated with resistant organisms, often associated in biofilms. In this case report we help in the last phase of treatment that combines a new simultaneously instrumentation and irrigation system whose main characteristic is to adapt to the cross section of the canals and thus allow to reach areas in which the rotary instrumentation has great limitations. In retreatments, this system provide us thereby removing residual cement and gutta percha and most infected entin, respecting the original anatomy. The present case illustrates the clinical technique on which we have made a discussion from the literature reviewed. The treated tooth presents a acute apical periodontitis with a subextensión of the root canal treatment and a poor condensation. Its unusual anatomy consists of a single large canal which is desobturated and disinfected to proceed with thermoplastic seal. The evolution of the case at 6 months indicates an improvement of symptoms without radiographic signs of apical periodontitis (AU)

Effect of apical size and taper on volume of irrigant delivered at working length with apical negative pressure at different root curvatures.

INTRODUCTION: The purpose of this investigation was to determine the effect that apical preparation size and preparation taper have on the volume of irrigant delivered at the working length for different canal curvatures using apical negative pressure irrigation. METHODS: One hundred fifty-five human teeth (55 maxillary canines and 100 mandibular molars) were used in this study. Root canals were prepared with rotary instruments to a size 35.04 and separated into 3 experimental groups according to their degree of curvature: group A (n = 50) included canal curvatures ranging from 0° to 10°, group B (n = 50) from 11° to 30°, and group C (n = 50) from 31° to 65°. Samples of each curvature group were further randomized to experimental subgroups according to the apical size and taper as follow: 35.06, 40.04, 40.06, 45.04, and 45.06. The apical third was irrigated using a microcannula and the volume of NaOCl suctioned at the working length under negative pressure was measured over a period of 30 seconds using a fluid recovery trap. Positive controls consisted of measuring the maximum volume of 5.25% NaOCl capable of being suctioned by the microcannula from an open glass vial over 30 seconds. Negative control was the volume of irrigant aspirated by the microcannula with a preparation size of 25.04 over 30 seconds. RESULTS: The volume of irrigant was significantly greater when the apical preparation size increased from 35.06 to 40.04. As the apical preparation taper increased further from 40.04 to 40.06, the volume of irrigant significantly improved in group B, but it was not significant in group A. Apical preparation sizes greater than 40.06 did not show an increase of the volume of irrigant aspirated. CONCLUSIONS: The degree of root canal curvature decreased the volume of irrigant at the working length for a given apical size and taper. An apical preparation of 40.06 significantly increased the volume and exchange of irrigant at the working length regardless of curvature.