Survivability of endodontically treated cracked tooth: A systematic review.

BACKGROUND: Literature evidence describes various treatment protocols that have been employed for the effectiveness in improving survival and addressing associated symptoms of cracked teeth. OBJECTIVE: This systematic review investigates the survivability of endodontically treated cracked teeth and associated assessments, focusing on various treatment protocols. METHODS: The PRISMA guidelines were utilised for guiding the article selection framework of this review. A comprehensive search of relevant literature was conducted in May 2023 across various databases, and studies meeting the inclusion criteria were selected. Data extraction, guided by a standardized form, captured crucial details, including study characteristics, treatment protocols, and treatment outcomes, enhancing the consistency and accuracy of information collection. Data extraction and synthesis was done by two reviewers independently. The Newcastle Ottawa tool was used to measure the methodological quality of the study. Six observational studies were eventually included. RESULTS: Mandibular molars are particularly prone to developing cracks, with research indicating a heightened susceptibility to this dental issue. Studies reveal that endodontically treated cracked teeth boast robust overall survival rates ranging from 75.8% to 100%. The risk of bias assessment, utilizing the Newcastle Ottawa scale, indicated a moderate risk across studies, highlighting the necessity for careful interpretation of findings. CONCLUSION: Endodontically treated cracked teeth show marked success in survival, with the incorporation of crowns post-endodontic treatment significantly enhancing longevity and resilience.

Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study.

Background: Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases. Aim: To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively & post-operatively. Materials and methods: The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel's index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment. Results: The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell's index. Conclusion: As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.

Histopathologic Feature of Hyalinization Predicts Recurrence of Conventional/Solid Multicystic Ameloblastomas.

The histologic properties of tumors seem to affect their biological behavior, and the same holds good for solid multicystic ameloblastoma (SMA), a benign, locally destructive lesion. Hyalinization is one such histological factor that has been demonstrated to correlate with the biological behavior of neoplasms. The present study aimed to analyze the correlation between the severity of hyalinization (SOH) and the recurrence potential of SMAs. The study was performed on formalin-fixed, paraffin-embedded (FFPE) diagnosed archival cases of SMA, follicular SMA (n = 35) and plexiform SMA (n = 25). The cases were evaluated for SOH and scored from 0-3, and the correlation between SOH and recurrence was analyzed for statistical significance. The clinical parameters of the lesion were analyzed for statistical correlation with recurrence. The SOH significantly correlated with the recurrence of SMA (p = 0.001). The histologic type did not influence the biological behavior of SMA. The location of SMA in the body of the mandible (p = 0.036), multilocular radiolucency (p = 0.001) and root resorption (p = 0.002) also showed strong statistical correlation with recurrence. It is evident from the present study that hyalinization strongly correlates with the biological behavior of SMA. Future studies with advanced investigations could validate the presence of hyalinization and identify the origin of the hyalinized product in SMAs.

Depleting levels of endogenous anti-oxidant superoxide dismutase in oral sub-mucous fibrosis: A systematic review and meta-analysis.

Objective: The systematic review is aimed to assess the antioxidant status by superoxide dismutase level in oral sub-mucous fibrosis using available literature. Materials and methods: A literature search was accomplished electronically in Pubmed (MeSH), Science Direct, Scopus, Web of Science core collection, Cochrane, and Cross-reference, using the keywords such as 'oral submucous fibrosis,' 'antioxidant status' and 'superoxide dismutase.' Results: Of the 352 articles identified, only 16 satisfied the selection criteria and were included in the systematic review. Among the selected, six studies were included for serum level analysis of superoxide dismutase. The assessment showed a significant reduction of serum superoxide dismutase in oral submucous fibrosis patients than in control (p < 0.004). The mean difference in serum superoxide dismutase concentration between oral submucous fibrosis and healthy subjects was -86.23 U/ml (95% CI -145.30, -27.17). The serum SOD level was significantly reduced as the disease progressed to stage I or stage II (p < 0.001) compared to the control group. Conclusion: The studies showed significantly lower levels of superoxide dismutase in various human samples of patients with OSMF. Therefore, further studies are required to estimate antioxidant status using different biomarkers of oral submucous fibrosis concerning different stages of the disease in order to augment future therapy. Clinical relevance: Assessment of antioxidant activity helps to identify the patients at risk of malignant transformation. It serves as a reliable guide to validate therapy. It serves as a marker of prognosis in patients suffering from oral submucous fibrosis.

Anxiety and Depression Among Dentists in the Kingdom of Saudi Arabia.

Purpose: Dentists face a great deal of professional stress, in dental school and in practice. Their personal, as well as professional lives, get affected negatively by stress and poor mental health. This study aims to evaluate anxiety and depression among dentists of Abha in kingdom of Saudi Arabia. Materials and Methods: A cross-sectional study was carried out among 246 registered dentists of Abha to assess anxiety and depression. Participants willing to participate, and completely filled questionnaire were included in study. Data regarding demography, work-related characters, lifestyle and self-reported physical and mental status were collected. Mental status was measured by using pre validated questionnaire Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). Data were analyzed using Statistical Package for Social Sciences (SPSS 20) by IBM. Descriptive statistics, Pearson correlation, independent t test and one way ANOVA were used to analyze the data at the significant interval of p≤0.05. Results: Different levels of anxiety and depression were noticed both in males and female dentist. There was no statistical difference in the mean scores between males and females. There was a statistical difference of anxiety and depression scores noticed among dentist working in government institution, with five to ten years of experience. Habits of smoking were shown to significantly affect the risk of anxiety and depression scores. Conclusion: Dentist due to nature of the practice are prone for anxiety and clinical depression. Stress coping methods should be included in dental curriculum which would indirectly improve professional abilities and personal life.

Assessment of Separation Impact and Perception of Discomfort on Various Orthodontic Separators: A Comparative Clinical Study.

AIM: This study aimed to evaluate the extent of separation and perception of pain and discomfort with the use of three different orthodontic separators. MATERIALS AND METHODS: A total of sixty participants (26 males and 34 females) aged between 18 and 25 years were enrolled in this study. Participants were divided into three experimental groups: Group I: elastomeric separator, Group II: Dumbbell separators, and Group III: Kesling Separators. All the participants were asked to revisit 24 h after separator placement, and the effect of separation obtained by three different types of separators was measured. The space generated between premolars and molars was recorded separately on days 1, 3, and 7. The visual analog scales were used to assess pain. RESULTS: The mean age in Dumbbell separators group was slightly more (23.32 ± 2.28) compared to Kesling Separators and Elastomeric separator group (22.46 ± 1.20 and 21.10 ± 1.19 years, respectively). The extent of separation on days 1, 3, and 7 was more in Group II study participants (0.20 ± 0.02, 0.32 ± 0.05, and 0.48 ± 0.07 mm, respectively) compared to other groups. A statistically significant (P = 0.022) difference was noted on day 7 in terms of no pain being recorded more in Group II participants, followed next by Groups III and I. CONCLUSION: This study concluded that the Dumbbell separators produce acceptable separation with negligible pain and discomfort when compared to elastomeric separators and Kesling separators.

Evaluation of Knowledge and Preparedness Among Indian Dentists During the Current COVID-19 Pandemic: A Cross-Sectional Study.

PURPOSE: The current scenario of the COVID-19 pandemic has forced dentists to prepare themselves by updating their knowledge and receive training to face the present and after effects of COVID-19. The present survey was thus conducted to assess the knowledge, risk perception, attitude, and preparedness of the dentists in India about COVID-19. MATERIALS AND METHODS: A cross-sectional online survey was carried out among registered dentists in India. A self-administered, anonymous, questionnaire comprising of 25 close-ended questions was circulated to gather the relevant information. A total of 765 dentists submitted a response, out of which 646 complete responses were included in the statistical analysis. Pearson's Chi-square test was used for inter-group statistical comparison. RESULTS: The majority (80.8%) of the dentists had a fair knowledge about the characteristics of COVID-19. Nearly 60.7% and 49.7% of the dentists had taken infection control training and special training for COVID-19, respectively. Nearly 50% of the dentists had the perception that COVID-19 is very dangerous. Only 41.8% of the dentists were willing to provide emergency services to patients. Most of the dentists had an opinion that there is a need to enhance personal protective measures. During the survey, it was found that varied technological advances are offered to dentists to ensure good clinical practice. They also concurred that there was a need to standardize the tools and measures available to carry out dental practices. CONCLUSION: In the present study, Indian dentists have presented satisfactory knowledge with adequate preparedness as the majority of them had a fair level of knowledge with significantly higher knowledge among female respondents and those with post-graduation studies. Dentists should make judicious utilization of all the precautionary measures to safely practice dentistry. As we are going through an evolutionary phase where new advances are expected to evolve, dentists will definitely emerge successfully out from the crisis of the COVID-19 pandemic.

A Scanning Electron Microscope Analysis of Sealing Potential and Marginal Adaptation of Different Root Canal Sealers to Dentin: An In Vitro study.

AIM: The present study aimed to evaluate the sealing potential and marginal adaptation of different root canal sealers to dentin. MATERIALS AND METHODS: A total of sixty human lower premolars of the permanent dentition that were extracted were used for this study. The visible debris and calculus were removed from the extracted teeth ultrasonically and were kept for 2 hours in 2.5% sodium hypochlorite and stored in normal saline till next use. A low-speed diamond disc was used to section all the teeth samples at the cementoenamel junction. Later, cleaning and shaping of the canals was done. Based on the sealer used, the samples (each group consisting of 20 samples) were divided randomly into three groups: group I-bioceramic sealer, group II-resin-based sealer, group III-MTA-based sealer. All split samples were visualized under scanning electron microscope (SEM) at apical and coronal thirds of root canal, the marginal gap at root dentin and sealer interface were assessed. RESULTS: The highest marginal adaptation (5.60 ± 0.12) was demonstrated by EndoSequence BC sealer, followed immediately by ProRoot MTA sealer (4.48 ± 0.12) and EndoREZ sealer (2.10 ± 0.54). A statistically significant difference (p = 0.001) was seen between the EndoSequence BC and ProRoot MTA sealer for apical and coronal marginal adaptation. Also, a statistically significant difference (p < 0.05) was found between EndoSequence BC sealer vs EndoREZ sealer at coronal and EndoSequence BC sealer vs EndoREZ sealer and EndoREZ sealer vs ProRoot MTA sealer at apical third. CONCLUSION: The present study concluded that significant and better sealing ability and marginal adaptation was demonstrated by EndoSequence BC (bioceramic sealer) when compared to ProRoot MTA sealer (MTA-based sealer) and EndoREZ sealer (resin-based sealer). CLINICAL SIGNIFICANCE: Numerous endodontic sealers enter the market with various factors to attain acceptable seal. According to current study bioceramic sealer, is the appropriate sealer that hermetically seals all the margins.

Differentiation Between Benign and Metastatic Cervical Lymph Nodes Using Ultrasound.

PURPOSE: The oral cavity is the most common site for squamous cell carcinoma, which has a distinct predilection for lymphatic spread before distant systemic metastasis. The cervical lymph node status is a very important consideration in the assessment of squamous cell carcinoma. Ultrasound is a noninvasive and inexpensive technique that can be used to differentiate between the benign and metastatic nodes. So the aim of this study was to evaluate reliability of ultrasound for such differentiation and to correlate them with histopathological finding. MATERIALS AND METHODS: A total of 200 lymph nodes from 38 patients histopathologically proven for oral squamous cell carcinoma who underwent surgical neck dissection were considered. The patients underwent ultrasound examination of cervical lymph nodes prior to surgical neck dissection. The lymph nodes were differentiated into benign and metastatic based on the assessment of size, shape, shortest diameter/longest diameter (S/L ratio), margin, and internal architecture, and also the internal echo structure of the lymph nodes and histopathological findings were analyzed. RESULTS: On correlation of ultrasonographic diagnosis with histopathological evaluation for metastatic lymph nodes, the overall accuracy of ultrasonographic analyses was 77.83%, and the sonographic criterion of irregular margin showed the highest predictability followed by the size. The correlation of internal echo structure with histopathological findings was highly variable. CONCLUSION: The ultrasound parameters such as size, shape, margin, S/L ratio, and internal echo structure might assist in differentiation between benign and metastatic lymph nodes. Combining these findings should raise the accuracy, as each sonographic parameter has some limitation as a sole criterion.

Modified roll technique for soft tissue augmentation in prosthetic rehabilitation: A case report.

There are various causes for residual alveolar ridge defects, most common being the collapse of the cortical plate during extraction. Localized defects of alveolar ridge affect prosthetic restoration due to poor emergence profile of the pontic. Various soft tissue augmentation procedures have been recommended for the correction of these defects. Abrams's roll technique has been widely used for soft tissue ridge augmentation in the maxillary anterior region where aesthetics is a prime concern. The original Abrams's roll technique has been modified and revisited by many authors to overcome the limitations. The present clinical case report discusses the modified roll technique as an option to treat alveolar ridge deformity. The current procedure resulted in expectable ridge augmentation, uneventful healing, and good aesthetic outcome. Hence this modified technique can be selected for the treatment of mild to moderate Seibert class I ridge defects in the aesthetic zone.

Prosthodontic Management of a Pediatric Patient with Christ-Siemens-Touraine Syndrome: A Case Report.

Ectodermal dysplasias (ED) are a group of rare genetic disorders characterized by congenital defects involving two or more ectodermal structures. Christ-Siemens-Touraine syndrome or hypohidrotic ectodermal dysplasia is the commonest form of ED. Hypohidrotic ectodermal dysplasia (HED) is an X-linked disorder characterized by excessively dry skin due to the absence of sweat glands (anhidrosis), sparse body hair especially on the scalp and eyebrows (hypotrichosis), brittle nails, absence of sebaceous glands (asteatosis) and malformed or absent teeth. Oral manifestations include oligodontia or complete anodontia, conical teeth, underdeveloped alveolar ridges, generalized spacing and delayed eruption of permanent teeth. This case report discusses a classical case of HED and the options for rehabilitation in a growing patient. A thorough knowledge about the clinical manifestations of ED will lead to proper diagnosis and appropriate treatment plan thereby leading to significant improvements in esthetics, phonetics and masticatory function in ED patients, which in turn leads to improved quality of life in these individuals. HOW TO CITE THIS ARTICLE: Abdulla AM, Almaliki AY, Shakeela NV, et al. Prosthodontic Management of a Pediatric Patient with Christ-Siemens-Touraine Syndrome: A Case Report. Int J Clin Pediatr Dent 2019;12(6):569-572.