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1.
Front Cell Infect Microbiol ; 11: 649925, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33816354

RESUMO

Apical periodontitis is an inflammatory disease of microbial etiology. It has been suggested that endodontic bacterial DNA might translocate to distant organs via blood vessels, but no studies have been conducted. We aimed first to explore overall extraradicular infection, as well as specifically by Porphyromonas spp; and their potential to translocate from infected root canals to blood through peripheral blood mononuclear cells. In this cross-sectional study, healthy individuals with and without a diagnosis of apical periodontitis with an associated apical lesion of endodontic origin (both, symptomatic and asymptomatic) were included. Apical lesions (N=64) were collected from volunteers with an indication of tooth extraction. Intracanal samples (N=39) and respective peripheral blood mononuclear cells from apical periodontitis (n=14) individuals with an indication of endodontic treatment, as well as from healthy individuals (n=14) were collected. The detection frequencies and loads (DNA copies/mg or DNA copies/µL) of total bacteria, Porphyromonas endodontalis and Porphyromonas gingivalis were measured by qPCR. In apical lesions, the detection frequencies (%) and median bacterial loads (DNA copies/mg) respectively were 70.8% and 4521.6 for total bacteria; 21.5% and 1789.7 for Porphyromonas endodontalis; and 18.4% and 1493.9 for Porphyromonas gingivalis. In intracanal exudates, the detection frequencies and median bacterial loads respectively were 100% and 21089.2 (DNA copies/µL) for total bacteria, 41% and 8263.9 for Porphyromonas endodontalis; and 20.5%, median 12538.9 for Porphyromonas gingivalis. Finally, bacteria were detected in all samples of peripheral blood mononuclear cells including apical periodontitis and healthy groups, though total bacterial loads (median DNA copies/µL) were significantly higher in apical periodontitis (953.6) compared to controls (300.7), p<0.05. Porphyromonas endodontalis was equally detected in both groups (50%), but its bacterial load tended to be higher in apical periodontitis (262.3) than controls (158.8), p>0.05; Porphyromonas gingivalis was not detected. Bacteria and specifically Porphyromonas spp. were frequently detected in endodontic canals and apical lesions. Also, total bacteria and Porphyromonas endodontalis DNA were detected in peripheral blood mononuclear cells, supporting their plausible role in bacterial systemic translocation.

2.
Clin Oral Investig ; 2021 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-33818684

RESUMO

OBJECTIVES: To evaluate the effect of different endodontic sealers (epoxy resin-based and bioceramic-based) and the time of post-cementation on the bond strength of a fiber post cemented with resin cement. METHODS: Forty human premolars were instrumented and divided into 4 groups. According to the type of sealer and the time of post-cementation: AH-IM (AH Plus, post-cemented immediately after root canal treatment), SP-IM (iRoot SP, post-cemented immediately after root canal treatment), AH-OW (AH Plus, post-cementation after one week), and SP-OW (iRoot SP, post-cementation after one week). In each group, the samples were submitted to push-out test, and failure mode was assessed. Levene's test, one-way ANOVA, and Kruskal-Wallis analysis were applied for statistical analysis (α = 5%). RESULTS: The highest mean push-out bond strength was obtained from the SP-IM group in the apical part (10.45 ± 5.15MPa), while the lowest was observed in samples from the AH-OW group in the middle part (2.63 ± 1.54 MPa). One-way ANOVA showed that within the same root region, the time of post-cementation had a negative influence on the bonding strength in the SP groups in the middle and apical portion (P<0.05), however, when comparing the effect of type of sealers on bonding strength between the OW groups or IM groups within the same root region, no significant difference was observed regardless of the post cementation time (P>0.05). CONCLUSIONS: The bond strength of the fiber post was higher when the post was cemented immediately after root canal treatment when the bioceramic sealer was applied. CLINICAL RELEVANCE: The correct choice of an endodontic sealer and the proper time of post-cementation may help to obtain the best quality of post-and-core restoration.

3.
J Adhes Dent ; 23(2): 167-175, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33825430

RESUMO

PURPOSE: To investigate the effects of root canal irrigants, dentin surface treatment, and timing of the restoration on the microtensile bond strength (µTBS) of a universal adhesive to deep coronal dentin. MATERIALS AND METHODS: Ninety (90) intact molars were grouped according to the irrigation protocol: group 0 (saline, control group); group 1: 5.25% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) followed by 5.25% NaOCl; group 2: 18% etidronic acid (HEDP) + 5.25% NaOCl in a single mixture. Groups 1 and 2 were divided into 2 subgroups (n = = 10) according to the time of restoration: immediate (subgroup A) and after 7 days (subgroup B). Four other groups (n = 10) were created according to the dentin surface pretreatment and received an immediate restoration: group 3: 5.25% NaOCl - 17% EDTA and AH Plus Cleaner; group 4: 5.25% NaOCl - 17% EDTA and 100% ethanol; group 5: 5.25% NaOCl + 18% HEDP and AH Plus Cleaner; group 6: 5.25% NaOCl + 18% HEDP and 100% ethanol. µTBS testing was carried out for each subgroup and interfaces were analyzed through SEM. The µTBS was analyzed with Welch statistics and the post-hoc Games-Howell test for multiple comparisons (p < 0.05). RESULTS: Statistically significant differences were observed between test groups and control groups (p < 0.001), except for group 3 (p = 0.349). No significant differences were recorded between groups 1A (27.5 ± 8.7 MPa), 2A (32.6 ± 14.5 MPa) and 3 (27.3 ± 14.3 MPa). Group 6 (48.6 ± 11.6 MPa) exhibited the highest µTBS among all tested groups. For groups 1 and 2, significantly higher values were recorded for subgroups 1B (39.3 ± 7.6 MPa) and 2B (43.8 ± 8.3 MPa) compared to subgroups 1A (27.5 ± 8.7 MPa) and 2A (32.6 ± 14.5 MPa). CONCLUSION: When using NaOCl as root canal irrigant, it is advisable to delay the placement of a post-endodontic-treatment restoration.


Assuntos
Colagem Dentária , Cimentos Dentários , Cavidade Pulpar , Análise do Estresse Dentário , Dentina , Ácido Edético , Teste de Materiais , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio
4.
Oral Health Prev Dent ; 19(1): 235-243, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33829721

RESUMO

PURPOSE: This systematic review addressed flap designs in endodontic surgery which can have an impact on the Oral Health Related Quality of Life (OHRQoL). MATERIALS AND METHODS: Four electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) to identify all studies up to November 2019 that investigated the effect of flap designs on gingival recession and quality of life among healthy adults. RESULTS: The initial search identified 2701 references. Ten studies were included in this systematic review; two were randomised clinical trials and eight were non-randomised clinical trials. Studies showed that sulcular incision increases the risk of gingival recession and decreases OHRQoL. Two studies were included in the meta-analysis in relation to gingival recession. The pooled results demonstrated that submarginal incision showed a decreased weighted mean difference in gingival recession by 0.31 mm (95% CI: 0.12 - 0.51) (p = 0.002) compared to sulcular incision. CONCLUSION: Sulcular incision flap unfavourably affect the level of gingiva and OHRQoL. All nonrandomised studies had a statistically significant bias and the sample sizes in all studies were relatively small. More gingival recession and lower OHRQoL were associated with sulcular incision. Additional investigations are warranted to provide more evidence.


Assuntos
Retração Gengival , Qualidade de Vida , Adulto , Assistência Odontológica , Gengiva/cirurgia , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(4): 311-317, 2021 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-33832030

RESUMO

Endodontic diseases, due to the high incidence rate, affect the life quality and aesthetics of patients. As an auxiliary examination method, oral radiographic examination is of great significance for the preoperative diagnosis, treatment and postoperative evaluation of endodontic diseases. The principle of choosing oral radiology methods is to provide accurate and necessary information for diagnosis and treatment while protecting the patients' interests to the greatest extent. The Society of Cariology and Endodontics, Chinese Stomatological Association, based on extensive solicitation of opinions and reference to relevant literature, has set an application guideline after extensive discussions and revisions. This guideline covers the common clinical scenarios of application of radiographic examination in the diagnosis and treatment of endodontic diseases and provides recommendations for radiological methods. Hopefully, the guideline may help the clinicians to solve the important clinical problems and to provide a scientific foundation for the application of radiographic examination in the diagnosis and treatment of endodontic diseases.


Assuntos
Endodontia , Medicina Bucal , Assistência Odontológica , Estética Dentária , Humanos
6.
BMC Oral Health ; 21(1): 185, 2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33845806

RESUMO

High-resolution micro-computed tomography is a powerful tool to analyze and visualize the internal morphology of human permanent teeth. It is increasingly used for investigation of epidemiological questions to provide the dentist with the necessary information required for successful endodontic treatment. The aim of the present paper was to propose an image processing method to automate parts of the work needed to fully describe the internal morphology of human permanent teeth. One hundred and four human teeth were scanned on a high-resolution micro-CT scanner using an automatic specimen changer. Python code in a Jupyter notebook was used to verify and process the scans, prepare the datasets for description of the internal morphology and to measure the apical region of the tooth. The presented method offers an easy, non-destructive, rapid and efficient approach to scan, check and preview tomographic datasets of a large number of teeth. It is a helpful tool for the detailed description and characterization of the internal morphology of human permanent teeth using automated segmentation by means of micro-CT with full reproducibility and high standardization.

7.
Dent Mater ; 2021 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-33846017

RESUMO

OBJECTIVES: To investigate the effectiveness of novel polymeric nanoparticles (NPs) doped with melatonin (ML) in reducing dentin permeability and facilitating dentin remineralization after endodontic treatment. METHODS: The effect of undoped NPs and ML-doped NPs (ML-NPs) was tested in radicular dentin, at 24 h and 6 m. A control group without NPs was included. ML liberation was measured. Radicular dentin was assessed for fluid filtration. Dentin remineralization was analyzed by scanning electron microscopy, AFM, Young's modulus (Ei), Nano DMA-tan delta, and Raman analysis. RESULTS: ML release ranged from 1.85 mg/mL at 24 h to 0.033 mg/mL at 28 d. Both undoped NPs and ML-NPs treated dentin exhibited the lowest microleakage, but samples treated with ML-NPs exhibited hermetically sealed dentinal tubules and extended mineral deposits onto dentin. ML-NPs promoted higher and durable Ei, and functional remineralization at root dentin, generating differences between the values of tan delta among groups and creating zones of stress concentration. Undoped-NPs produced closure of some tubules and porosities at the expense of a relative mineral amorphization. Chemical remineralization based on mineral and organic assessments was higher in samples treated with ML-NPs. When using undoped NPs, precipitation of minerals occurred; however, radicular dentin was not mechanically reinforced but weakened over time. SIGNIFICANCE: Application of ML-NPs in endodontically treated teeth, previous to the canal filling step, is encouraged due to occlusion of dentinal tubules and the reinforcement of the radicular dentin structure.

8.
Dent Med Probl ; 58(1): 39-46, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33847472

RESUMO

BACKGROUND: Diabetes is one of the most common metabolic diseases that disrupt the functioning of different body organs, including oral tissue. Some diabetic complications remain even after the control of the hyperglycemic condition. The adverse effect of hyperglycemia on the pulp structure and function has been shown previously. OBJECTIVES: The purpose of this study was to investigate the effect of the hyperglycemic state on the aging of pulp cells and evaluate the role of Wnt signaling as the underlying mechanism of this process. MATERIAL AND METHODS: The isolated pulp cells were cultured in the Minimum Essential Medium (MEM)-alpha for 7, 14 and 21 days under the influence of glucose at concentrations of 5 mM, 20 mM and 30 mM. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to evaluate cell viability, the beta-galactosidase test was applied to assess cellular senescence and gene expression was measured with quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: The results of this study showed that cell proliferation decreased following exposure to 20 and 30 mM glucose, which was accompanied by an increased number of senescent cells and an increased p21 expression. There was a significant increase in beta-catenin and Wnt1 expression in response to high glucose. Treatment with beta-catenin inducer enhanced cellular aging in the hyperglycemic state, while betacatenin inhibitor decreased the senescence response. CONCLUSIONS: The present study further confirmed the effect of the high-glucose condition on pulp cell aging and suggests a role for beta-catenin in the induction of cellular aging. Targeting the key regulators of cellular aging in pulp tissue might lead to the development of new therapies for the prevention and treatment of endodontic complications in diabetic patients.

9.
Clin Oral Investig ; 2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33844080

RESUMO

OBJECTIVE: Fusobacterium nucleatum is an important oral pathogen involved in endodontic infections. This study aimed to assess the frequency of Fusobacterium nucleatum in primary and secondary endodontic infections and its associations with the clinical features in a Brazilian population by using both culture and nested PCR methods. METHODS: A total of 100 microbial samples from patients with primary (n=50) and secondary endodontic infections (n=50) were analyzed by using culture and nested PCR methods. Strict anaerobic techniques were used for culture and identification of F. nucleatum. The DNA extracted from the samples was analyzed for the presence of target species by using species-specific primers. RESULTS: Culture and nested PCR methods detected F. nucleatum, respectively, in 11/100 and 82/100 root canals. F. nucleatum was isolated by culture from 10/50 (20%) root canals with primary infections and from 1/50 (2%) root canal with secondary/persistent infections. Nested PCR detected F. nucleatum in 42/50 (84%) root canals with primary infections and in 40/50 (80%) root canals with secondary/persistent endodontic infections. F. nucleatum was associated with spontaneous pain, tenderness to percussion, pain on palpation, swelling, tooth mobility, wet root canals, hemorrhagic exudate, tooth decay, inadequate restoration, and poor endodontic filling. CONCLUSION: F. nucleatum was found in more cases of primary endodontic infections than in cases of secondary/persistent ones. A higher prevalence of F. nucleatum was detected by using the nested PCR method than by using culture. The presence of F. nucleatum in the root canals was associated with several clinical features. CLINICAL RELEVANCE: The high prevalence of F. nucleatum in the root canals detected by molecular methods, and its association with several clinical features reveals the importance of these species in the development of apical pathologies and reinforces the need of an endodontic treatment directed to bacterial elimination.

10.
Dent J (Basel) ; 9(3)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33806915

RESUMO

Trauma is a worldwide cause of millions of deaths and severe injuries every year, all over the world. Despite the limited extension of the oral region compared to the whole body, dental and oral injuries account for a fairly high percentage of all body traumas. Among head and neck traumas, dental and facial injuries are highly correlated to sport activities, and their management can be a real challenge for practitioners of any specialty. In case of trauma directed to periodontal structures, restorative and endodontic solutions may not be sufficient to achieve a definitive and long-lasting treatment. This article aims to illustrate surgical options and appliances to prevent dental injuries that may be available to the clinicians treating dental trauma involving oral soft and hard tissues.

11.
J Clin Med ; 10(5)2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33807504

RESUMO

The presented study aimed to assess the survival rate of porcelain laminate veneers (PLV) based on a systematic review of the literature. An electronic search was last updated in February 2021. Eligibility criteria included clinical series of patients rehabilitated with PLVs published in the last 25 years, with a minimum follow-up of 3 years. Survival analysis methods were applied. Twenty-five studies were included, with 6500 PLVs. The 10-year estimated cumulative survival rate (CSR) of PLVs was 95.5%. The 10-year CSR of PLVs when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as isolated reasons for failure were 96.3%, 99.2%, 99.3%, and 99.0%, respectively. PLVs without incisal coverage had a higher failure rate than PLVs with incisal coverage. Non-feldspathic PLVs performed better than feldspathic PLVs. As a conclusion, the 10-year CSR of PLVs was 95.5%, when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as reasons for restoration failure. Fracture seems to be most common complication of PLVs, followed by debonding, with both more commonly happening within the first years after PLV cementation. PLVs with incisal coverage and non-feldspathic PLVs presented lower failure rates than PLVs without incisal coverage and feldspathic PLVs.

12.
Pathogens ; 10(3)2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33808593

RESUMO

The genus Catonella currently counts a unique species, C. morbi, isolated from periodontal pockets and associated with periodontitis and endodontic infections. This study contributed to the taxonomical and clinical knowledge of this genus by describing a novel species isolated from a saliva sample from a man in clinical gingival health following successful treatment of periodontitis. Morphological and chemotaxonomic characteristics were investigated using different growth conditions, pH, and temperature. Cellular fatty acid methyl ester (FAME) analysis was conducted by gas chromatography/mass spectrometry (GC/MS). Phylogenetic analysis based on 16S rRNA, orthologous average nucleotide identity (OrthoANI), and digital DNA-DNA hybridization (dDDH) relatedness were performed. Strain Marseille-Q4567T was found to be an anaerobic and non-spore-forming rod-shaped bacterium that grew at 28-41.5 °C (optimum 37 °C), pH 6.5-8.5 (optimum pH 7.5), and 5-10 g/L of NaCl (optimum 5 g/L). The predominant cellular fatty acid was C16:0 (64.2%), followed by unsaturated structures C18:1n9 (12.5%) and C18:2n6 (7.8%). Based on 16S rRNA sequence comparison, the closest phylogenetic neighbor was C. morbi ATCC 51271T (98.23% similarity). The OrthoANI and dDDH values between strain Q4567T and C. morbi ATCC 51271T were respectively 79.43% and 23.8%. Therefore, we concluded that strain Marseille-Q4567T represents a novel species of the genus Catonella, for which the name Catonella massiliensis sp. nov. is proposed (= CSUR Q4567).

13.
Int Endod J ; 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33797765

RESUMO

Caries results in the demineralisation and destruction of enamel and dentine, and as the disease progresses irreversible pulpitis can occur. Vital pulp therapy (VPT) is directed towards pulp preservation and the prevention of the progression of inflammation. The outcomes of VPT are not always predictable, and there is often a poor correlation between clinical signs and symptoms, and the events occurring at a molecular level. The inflamed pulp expresses increased levels of cytokines, including tumour necrosis factor (TNF)-α, interleukin (IL)-1α, IL-1ß, IL-4, IL-6, IL-8, IL-17 and IL-23, which recruit and drive a complex cellular immune response. Chronic inflammation and sustained cytokine release can result in irreversible pulp damage and a decreased capacity for tissue healing. Other chronic inflammatory diseases, such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis, are also characterised by an dysregulated immune response composed of relatively high cytokine levels and increased numbers of immune cells along with microbial and hard-soft tissue destructive pathologies. While anti-cytokine therapies have been successfully applied in the treatment of these diseases, this approach is yet to be attempted in cases of pulp inflammation. This review, therefore, focuses on the similarities in the aetiology between chronic inflammatory diseases and pulpitis, and explores how anti-cytokine therapies could be applied to manage an inflamed pulp and facilitate healing. Further proof of concept studies and clinical trials are justified to determine the effectiveness of these treatments to enable more predictable outcomes in VPT.

14.
Molecules ; 26(6)2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33804019

RESUMO

Therapeutic success in endodontic treatment depends on successful infection control. Alexidine dihydrochloride (ALX) was recently proposed as a potential alternative to 2% chlorhexidine (CHX) as it possesses similar antimicrobial properties, expresses substantivity and does not produce p-chloroaniline (PCA) when mixed with sodium hypochlorite (NaOCl). However, the products released in this reaction have not been described to date. The aim of this study was to identify detected chemical compounds formed in the reaction of ALX and NaOCl with the ultra-high-performance liquid chromatography-mass spectrophotometry (UHPLC-MS) method and assess whether precipitates and PCA are formed in this reaction. Solutions of ALX were mixed with the equivalent volume of 2% and 5.25% (w/v) NaOCl solutions. As control, 2% (w/v) CHX was mixed with 2% and 5.25% (w/v) NaOCl. Samples were subjected to the UHPLC-MS analysis. The mixture of ALX and NaOCl resulted in a yellowish precipitate formation, the amount of which depended on NaOCl concentration. Interaction of ALX and NaOCl resulted in the production of aliphatic amines. No PCA was formed when NaOCl was mixed with ALX. However, for the first time, we identified the possible products of the interaction. The interaction between NaOCl and ALX results in the formation of aliphatic amines; therefore, these compounds should not be mixed during endodontic treatment.

15.
Medicina (Kaunas) ; 57(3)2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33809673

RESUMO

Endodontic microsurgery is a highly predictable treatment option in most cases when conventional endodontic treatment is not feasible. Nevertheless, mandibular molars are still considered by clinicians to be the most difficult type of teeth, with the lowest success rate. In recent years, endodontic microsurgery has been attempted more frequently with the emergence of modern cutting-edge technologies such as dental operating microscopes, various microsurgical instruments, and biocompatible materials, and the success rate is increasing. This review describes the current state of the art in endodontic microsurgical techniques and concepts for mandibular molars. Notably, this review highlights contemporary equipment, technology, and materials.

16.
Artigo em Inglês | MEDLINE | ID: mdl-33827209

RESUMO

Bacterial/fungal biofilm-mediated persistent endodontic infections (PEIs) are one of the most frequent clinical lesions in the oral cavity, resulting in apical periodontitis and tooth damage caused by loss of minerals. The conventional root canal disinfectants are poorly bio-safe and harmful to teeth and tissues, making them ineffective in treating PEIs. The development of nanomaterials is emerging as a promising strategy to eradicate disease-related bacteria/fungi. Herein, glucose oxidase (GOx)-modified magnetic nanoparticles (MNPs) were synthesized via a facile and versatile route for investigating their effects on removing PEI-related bacterial/fungal biofilms. It is found that GOx was successfully immobilized on the MNPs by detecting the changes in the diameter, chemical functional group, charge, and magnetic response. Further, we demonstrate that GOx-modified MNPs (GMNPs) exhibit highly effective antibacterial activity against Enterococcus faecalis and Candida albicans. Moreover, the antibacterial/fungal activity of GMNPs is greatly dependent on their concentrations. Importantly, when placed in contact with bacterial/fungal biofilms, the dense biofilm matrix is destructed due to the movement of GMNPs induced by the magnetic field, the formation of reactive oxygen species, and nutrient starvation induced by GOx. Also, the in vitro experiment shows that the as-prepared GMNPs have excellent cytocompatibility and blood compatibility. Thus, GMNPs offer a novel strategy to treat bacteria/fungi-associated PEIs for potential clinical applications.

17.
Artigo em Inglês | MEDLINE | ID: mdl-33848407

RESUMO

BACKGROUND: The interest in vertical crown preparation is growing and several variations are presented in the dental literature but limited clinical outcome data exists for teeth prepared for a vertical finish line. AIM: To audit clinical outcomes for 73 teeth after vertical preparation for knife-edge zirconia crowns. METHOD: Seventy-three teeth had knife-edge zirconia crowns placed after vertical finish line preparation. The outcomes for these teeth were analysed from a retrospective audit of clinical records. RESULTS: The mean follow-up time was 21 months (SD: 10 months; range: 6-40). One tooth had to be extracted due to fracture at cervical level. One crown had to be re-made after margin fracture during try-in. No subsequent endodontic treatment was needed for any of the prepared teeth. No change in alveolar bone height was noted on radiographic follow-up. The mean bleeding score for the crowned teeth was higher than the mean bleeding score for a control tooth, but this was not statistically significant. CONCLUSION: This retrospective evaluation has shown favourable outcomes for 72 teeth after vertical preparation for knife-edge crowns. Longer follow-up is needed but the present results show that the technique is a viable procedure with potential advantages.

18.
Niger J Clin Pract ; 24(4): 621-628, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33851687

RESUMO

Background: Endodontic treatment failure is one of the most common problems encountered in dentistry. Aims: This study aimed to evaluate the causes of failure of endodontic treatment among patients in the Saudi Arabian city of Al-Kharj. Subjects and Methods: A total of 250 patients of both genders were involved in the study. Criteria confirming the failure of the endodontic treatment were pain, tenderness on pressure, periapical radiolucency, and sinus tract. Patients were selected by convenience sampling methods. A diagnostic chart was prepared to complete the investigation in three different hospitals, during a six-month period (October 2018 - March 2019). The results were analyzed statistically using Chi-square test and use of simple arithmetical methods to determine percentage and frequencies. Results: The main cause for endodontic failure was poor quality adjunctive treatment. 147 out of 179 male patients and 53 out of 71 female patients received poor quality treatment. There was a statistically significant difference between gender versus adjunctive treatment (P = 0.009) and between hospital versus adjunctive treatment (P = 0.005), and quality of adjunctive treatment between private hospital as compared to government hospital which was also statistically significant (P = 0.008). In quadrant wise distribution, first molars were the most commonly involved teeth. Inadequate filling of the root canal was (36.8%), missed canals (14.4), over-extension root canal fillings (12.8%), perforations (9.6%), instrumentation related (8.8%), and endodontic access preparation related (2.4%) in the decreasing order of frequency were seen as the most common causes of failure of endodontic treatment. Conclusion: First molars were the most commonly affected tooth in the failure of endodontic treatment. Poor adjunctive treatment and inadequate filling of the root canals were the most common causes of endodontic failure, more commonly seen in male than female patients and in private clinics/hospitals than government hospitals.

19.
Materials (Basel) ; 14(6)2021 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-33810097

RESUMO

Sterilization processes guarantee the sterility of dental instruments but can negatively affect instrument features by altering their physical and mechanical properties. The endodontic instrumentation can undergo a series of alterations, ranging from corrosion to variation in the cutting angle and then changes in the torsional properties and torsional fatigue resistance. This systematic literature review and meta-analysis aims to investigate alterations to the cutting efficiency of endodontic instruments that are induced by procedures for their disinfection and sterilization. Methodologies adopted for this investigation follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The following were used as search terms on PubMed and Scopus: "endodontic sterilization", "endodontic autoclave", "cyclic fatigue", "torsional", "cutting efficiency", "sterilization", "surface characteristics", and "corrosion". At the end of the selection process, 36 articles were identified, and seven of them are included in this systematic review. The results of a meta-analysis conducted for the use of 10 autoclaving cycles shows a standardized mean difference (SMD) of 0.80 with a p-value equal to 0.04 with respect to effect on cutting efficiency. The network meta-analysis, through direct and indirect comparison between the different autoclave cycles (0, 1, 5, 10, and 15 cycles), revealed that treatment involving 15 autoclave cycles produced the most robust results in terms of having the greatest effects in terms of altered cutting efficiency with a probability of 57.7% and a SUCRA (surface under the cumulative ranking) of 80%. The alterations in the effects on cutting efficiency appear to be triggered after five cycles of sterilization by heat (autoclave). In conclusion, the meta-analysis of the data indicates that the autoclave sterilization protocol must not be repeated more than five times to preserve cutting efficiency. Within the limitations of this review, we can therefore establish that sterilization by autoclaving alone results in steel and NiTi instruments becoming less efficient in cutting after five cycles, as measured by a reduction in cutting efficiency.

20.
J Endod ; 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33811981

RESUMO

INTRODUCTION: Regenerative endodontic procedures (REPs) are intended to repair and regenerate part of the pulp-dentin complex. The aim of this study was to systematically appraise existing evidence on the effectiveness of REPs on mature teeth with pulp necrosis and apical periodontitis. METHODS: Electronic database and hand searches were implemented on 8 databases of published and unpublished literature from inception to January 3, 2021, for the identification of randomized controlled trials (RCTs) or prospective clinical trials. Related keywords included: "regenerative", "pulp revascularization", "revitalization procedure", "necrotic mature teeth". Random effects meta-analysis was conducted assessing as main outcome treatment success. Risk of bias was assessed through the Cochrane RoB 2.0 tool and the quality of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Of 337 initial hits, four RCTs were eligible for inclusion, while 3 were included in the quantitative synthesis. Overall, there was no difference in the relative risk (RR) for successful/ unsuccessful treatment outcome between either REPs or conventional treatment (3 studies, RR= 1.03; 95% Confidence Interval: 0.92, 1.15; p=0.61; heterogeneity I-squared: 0.0%, p=0.53; Prediction Interval: 0.51, 2.09). Risk of bias ranged from low to raising some concerns, while the quality of the evidence was graded as moderate. CONCLUSIONS: Based on moderate quality evidence, REPs appear as a viable treatment alternative for mature necrotic teeth with periapical lesions, at present. Further, well-designed RCTs might also provide confirmatory evidence in this respect, while also frame a backbone for standardization of the therapeutic protocol of REPs.

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