Access Cavity Preparation and Localization of Root Canals Using Guides in 3D-Printed Teeth with Calcified Root Canals: An In Vitro CBCT Study.

Pulp canal obliteration (PCO) is a significant complication in endodontics that can occur due to various factors. Cone beam computed tomography (CBCT) is a useful diagnostic tool for identifying root canal anatomy and variations, and guided endodontics is emerging as an alternative treatment solution for teeth with partially or entirely obliterated pulpal canals. However, the accuracy of CBCT-guided 3D-printed guides on different materials and layer thicknesses is not well understood. Therefore, this study aimed to evaluate the accuracy of guides prepared using CBCT images on 3D-printed teeth with stereolithography (SLA) using three different materials and two different layer thicknesses. This study found that 3D-printed guides were accurate and reliable for accessing 3D-manufactured obliterated teeth and reaching the apical area. No significant differences in distance or angle measurements were found when different guide materials were used, suggesting that materials can be selected based on availability and cost. These findings contribute to the knowledge base regarding the effectiveness of 3D printing technology in guided endodontics and can help to identify the most suitable materials and techniques for this application.

Cone-Beam Computed Tomography as a Prediction Tool for Osteoporosis in Postmenopausal Women: A Systematic Literature Review.

This literature review was conducted to analyze the capability of cone-beam computed tomography (CBCT) to accurately identify low bone mass density in women. A systematic search of MEDLINE, Embase, Scopus, Google Scholar, the Cochrane Library, and Science Direct was performed to identify relevant articles, and the Cochrane risk of bias criterion was used to determine the methodological quality of the included studies. All ten included studies assessed primary research on the capacity of CBCT to accurately diagnose insufficient bone mineral density. All relevant data were extracted, and the results were summarized narratively. The results indicated that the CBCT has good sensitivity and specificity and high accuracy in predicting osteoporosis. Four of the included studies measured qualitative values, while the others concentrated on quantitative values and found lower values in osteoporosis patients compared to those of osteopenic and healthy patients. All the studies compared CBCT grayscale values with dual energy X-ray absorptiometry scores, which strengthened our confidence in the accuracy of CBCT's diagnostic capability. CBCT is considered a feasible predictive tool for detecting patients who are at risk of osteoporosis, although further research is needed to confirm the evidence and enhance its common use among health care professionals.

Effect of Primary Stabilisation on Osseointegration of Implants With Local and Systemic Zoledronic Acid Application.

ABSTRACT: Primary stabilization (PS) is defined as initial tight fit during the surgical placement of an implant. Tight implant placement is quite difficult in cases where bone quality and quantity are insufficient. Zoledronic acid (ZA) is a powerful bisphosphonate that prevents bone resorption. The aim of this study is to investigate the effect of local and systemic ZA application on osseointegration in titanium implants with and without PS. Male Sprague Dawley rats were divided into 2 main groups, with PS, PS + (n = 24), and without primary stabilisation, PS - (n = 24). These main groups were divided into control (n = 8), 2mg/1 mL local ZA (n = 8) and 0.1mg/kg systemic ZA (n = 8) groups. All of the subjects were sacrificed after a 4-week recovery period. Bone implant connection (BiC) and thread filling (TF) (%) of the samples was analyzed according to the non-decalcified histological analysis method. In terms of BiC percentages and TF, statistically significant differences were found between the groups with and without PS and between the ZA treatment groups ( P < 0.05). The common effect of PS and ZA use on the percentage of BIC was found to be statistically significant ( P < 0.05). The common effect of PS and acid type on TF was not statistically significant ( P < 0.05). Within the limitations of this study, it may be concluded that systemic and local administration of ZA may increase implant osseointegration.

Evaluation of the Effects of Topical Application of Chlorhexidine, Ozone, and Metronidazole on Palatal Wound Healing: A Histopathological Study.

ABSTRACT: This study aimed to evaluate the effects of chlorhexidine, metronidazole, and ozone application on the healing of palatal wounds in diabetic rats. A defect in the form of a 4 mm-diameter wound was created on the palatal mucosa of 84 adult female Wistar albino rats, which were randomly divided into 4 groups: control, chlorhexidine, metronidazole, and ozone groups. The animals were euthanized after 3, 6, and 10 days, and wound closure was histologically assessed. On day 3, polymorphonuclear leukocytes were significantly higher in the control group than in the chlorhexidine and ozone groups ( P < 0.05). Fibrosis was higher in the ozone group than in the control and chlorhexidine groups ( P < 0.05). Vascular endothelial growth factor was higher in the metronidazole and ozone groups than in the control group ( P < 0.05). On day 6, the quantity of polymorphonuclear leukocytes was higher in the control, metronidazole, and chlorhexidine groups than in the ozone group ( P < 0.05). Vascular endothelial growth factor was higher in the ozone group than in the control, chlorhexidine, and metronidazole groups ( P < 0.05). On day 10, Vascular endothelial growth factor was higher in the control, chlorhexidine, and metronidazole groups than in the ozone group ( P < 0.05). The authors concluded that the use of chlorhexidine, ozone, and metronidazole pastes resulted in enhanced wound healing, as determined histologically.The authors suggest that ozone supplementation can be an alternative therapy to chlorhexidine in impaired wound healing in diabetes mellitus.

Effects of Systemic Propranolol Application on the New Bone Formation in Periimplant Guided Bone Regeneration.

OBJECTIVES: The aim of this experimental animal study was to evaluate the effects of systemic propranolol on new bone formation in peri-implant bone defects. MATERIAL AND METHODS: Implant slots were created 4mm long and 2.5 mm wide. After the titanium implants were placed in the sockets, 2 mm defects were created in the neck of the implants. Bone grafts were placed in these defects. Then the rats were randomly divided into three equal groups: control (n = 8), propranolol dose-1 (PRP-1) (n = 8), and propranolol dose-2 (PRP-2) (n = 8) groups. In the control group, the rats received no further treatment during the eight-week experimental period after the surgery. The rats in the PRP-1 and PRP-2 groups were given 5 mg/kg and 10 mg/kg propranolol, respectively, every three days for the eight-week experimental period after the surgery. At the end of the experimental period, the rats were euthanized. Blood serum was collected for biochemical analysis, and the implants and surrounding bone tissues were used for the histological analysis. RESULTS: There were no significant differences in the histological analysis results and the biochemical parameters (alkaline phosphatase, calcium, creatinine and phosphorus) of the groups (P > 0.05). Also, in the test groups, there was numerically but not statistically more new bone formation detected compared with the controls. CONCLUSIONS: Within the limitations of this study, propranolol did not affect the new bone formation in peri-implant defects.

Enhanced retention of a maxillofacial prosthetic obturator using precision attachments: Two case reports.

The majority of maxillary defects can be rehabilitated with conventional simple obturator prosthesis. However, inadequate retention, stability and support may be associated with the use of an obturator. Precision attachments have been used to retain obturators for some time. The use of precision attachments in a dentate maxillectomy patient can yield significant functional improvement while maintaining the obturator's aesthetic advantages. This clinical report describes the prosthetic rehabilitation of two maxillary defects with an obturator retained using extracoronal resilient precision attachments.