ChatGPT performance in prosthodontics: Assessment of accuracy and repeatability in answer generation.

STATEMENT OF PROBLEM: The artificial intelligence (AI) software program ChatGPT is based on large language models (LLMs) and is widely accessible. However, in prosthodontics, little is known about its performance in generating answers. PURPOSE: The purpose of this study was to determine the performance of ChatGPT in generating answers about removable dental prostheses (RDPs) and tooth-supported fixed dental prostheses (FDPs). MATERIAL AND METHODS: Thirty short questions were designed about RDPs and tooth-supported FDP, and 30 answers were generated for each of the questions using ChatGPT-4 in October 2023. The 900 generated answers were independently graded by experts using a 3-point Likert scale. The relative frequency and absolute percentage of answers were described. Accuracy was assessed using the Wald binomial method, while repeatability was evaluated using percentage agreement, Brennan and Prediger coefficient, Conger generalized Cohen kappa, Fleiss kappa, Gwet AC, and Krippendorff alpha methods. Confidence intervals were set at 95%. Statistical analysis was performed using the STATA software program. RESULTS: The performance of ChatGPT in generating answers related to RDP and tooth-supported FDP was limited. The answers showed a reliability of 25.6%, with a confidence range between 22.9% and 28.6%. The repeatability ranged from substantial to moderate. CONCLUSIONS: The results show that currently ChatGPT has limited ability to generate answers related to RDPs and tooth-supported FDPs. Therefore, ChatGPT cannot replace a dentist, and, if professionals were to use it, they should be aware of its limitations.

Beyond the Scalpel: Assessing ChatGPT's potential as an auxiliary intelligent virtual assistant in oral surgery.

AI has revolutionized the way we interact with technology. Noteworthy advances in AI algorithms and large language models (LLM) have led to the development of natural generative language (NGL) systems such as ChatGPT. Although these LLM can simulate human conversations and generate content in real time, they face challenges related to the topicality and accuracy of the information they generate. This study aimed to assess whether ChatGPT-4 could provide accurate and reliable answers to general dentists in the field of oral surgery, and thus explore its potential as an intelligent virtual assistant in clinical decision making in oral surgery. Thirty questions related to oral surgery were posed to ChatGPT4, each question repeated 30 times. Subsequently, a total of 900 responses were obtained. Two surgeons graded the answers according to the guidelines of the Spanish Society of Oral Surgery, using a three-point Likert scale (correct, partially correct/incomplete, and incorrect). Disagreements were arbitrated by an experienced oral surgeon, who provided the final grade Accuracy was found to be 71.7%, and consistency of the experts' grading across iterations, ranged from moderate to almost perfect. ChatGPT-4, with its potential capabilities, will inevitably be integrated into dental disciplines, including oral surgery. In the future, it could be considered as an auxiliary intelligent virtual assistant, though it would never replace oral surgery experts. Proper training and verified information by experts will remain vital to the implementation of the technology. More comprehensive research is needed to ensure the safe and successful application of AI in oral surgery.

Comparative study of torsional and bending stress in NiTi, graphene, and GUM metal endodontic files by finite element analysis.

INTRODUCTION: This study investigates the behavior of graphene and GUM in terms of cyclic fatigue resistance and torsion through a finite element analysis on a file with an eccentric rectangular cross section and variable taper, and on a file with a centered triangular cross section, constant taper, and constant pitch. METHODS: Root canals and endodontic files were created using Catia V5R21 software. For torsional analysis, the tip of the file was fixed at 1 and 3 mm, and a moment of 2.5 N-mm was generated at the handle. For the bending analysis in curved canals (45° and 60°), the handle was kept fixed and a force of 1 N was applied at the tip while the file was kept fixed at 9 mm. RESULTS: GUM metal instruments showed better torsional resistance. On the other hand, NiTi and graphene performed better under the applied loads during flexion at 45° and 60°. CONCLUSION: GUM metal is emerging as a promising material in the field of endodontic instrument design due to its physical properties.

Unveiling the ChatGPT phenomenon: Evaluating the consistency and accuracy of endodontic question answers.

AIM: Chatbot Generative Pre-trained Transformer (ChatGPT) is a generative artificial intelligence (AI) software based on large language models (LLMs), designed to simulate human conversations and generate novel content based on the training data it has been exposed to. The aim of this study was to evaluate the consistency and accuracy of ChatGPT-generated answers to clinical questions in endodontics, compared to answers provided by human experts. METHODOLOGY: Ninety-one dichotomous (yes/no) questions were designed and categorized into three levels of difficulty. Twenty questions were randomly selected from each difficulty level. Sixty answers were generated by ChatGPT for each question. Two endodontic experts independently answered the 60 questions. Statistical analysis was performed using the SPSS program to calculate the consistency and accuracy of the answers generated by ChatGPT compared to the experts. Confidence intervals (95%) and standard deviations were used to estimate variability. RESULTS: The answers generated by ChatGPT showed high consistency (85.44%). No significant differences in consistency were found based on question difficulty. In terms of answer accuracy, ChatGPT achieved an average accuracy of 57.33%. However, significant differences in accuracy were observed based on question difficulty, with lower accuracy for easier questions. CONCLUSIONS: Currently, ChatGPT is not capable of replacing dentists in clinical decision-making. As ChatGPT's performance improves through deep learning, it is expected to become more useful and effective in the field of endodontics. However, careful attention and ongoing evaluation are needed to ensure its accuracy, reliability and safety in endodontics.

Prevalence of oral infections in chronic kidney disease patients: A cross-sectional study.

OBJECTIVES: The purpose of this investigation was to analyze the prevalence of apical periodontitis (AP) and periodontal disease (periodontitis) (PD) in Chronic kidney disease (CKD) patients in relation to their treatment phase. SUBJECTS AND METHODS: In this cross-sectional study, 188 patients with CKD were divided into two groups: patients without dialysis (WD group, n = 53) and patients on dialysis (DP group, n = 135). Panoramic radiographs were used to diagnose AP. The presence of periodontal disease was evaluated radiographically assessing alveolar bone loss. Student's t-test, chi-squared test, and logistic regression analysis were used to determine the significance of differences between groups. RESULTS: In the WD group, 55% of patients had at least one tooth with AP, whereas in the DP group 67% had at least one tooth with AP (OR = 2.11; 95% CI = 1.09-4.08; p < 0.05). PD was more prevalent in the DP group (78%) than in the WD group (36%) (OR = 6.26; CI 95% = 3.13-12.52; p < 0.01). CONCLUSIONS: Oral infections are more prevalent in the advanced stages of CKD. The treatment of PD and AP should be incorporated in the treatment planning of patients with CKD.

Influence of the use of social media on patients changing dental practice: a web-based questionnaire study.

BACKGROUND: Recent years have seen an increase in the use of social media, by the healthcare sector, including dentistry. Indeed, social media may now be important communication tools for dental practices and patients. This work analyzes the influence of patient (male and female) use of dental practice social media on their decision to change practice. The results also provide insight into the factors patients considered important when choosing a dental practice. METHODS: This study was approved by the Ethics Committee of the Universidad Europea de Madrid (No. CIPI/22.022). Using a web-based questionnaire, a cross-sectional study was undertaken involving a Spanish population that made use of dental services. The questionnaire consisted of four parts covering provision of informed consent, the collection of sociodemographic data, patient use of dental practice social media, and the factors considered important when changing dental practice. RESULTS: All participants gave their informed consent regarding inclusion. No compensation was provided for participation. 588 people responded to the questionnaire, of whom 503 were eligible for inclusion. Most respondents were female (312/503; 62%). Most (151/503; 30%) last changed dental practice during the previous 2-5 years. 208/503 (41.4%) indicated that they had visited dental practice social media. 118/503 (23.5%) indicated that they had made use of such the last time they changed dental practice; 102 of these 118 (85.6%) reported their experience to have influenced their decision to change. Respondents who had changed practice in the last 5 years had interacted with dental practice social media more than those who changed over 11 years ago (p < .05), and those who changed practice in the present/past year were more influenced by these media (p < .05). The factor considered most important was 'Facilities and technology'. No gender-based differences were seen for any measured variable (p < .05). CONCLUSIONS: Different factors affect the selection of a new dental practice, but respondents who changed practice in the last few years were more likely to have made use of dental practice social media, which, for some, influenced their final decision to change. Dental practices might do well to consider using social media as communication and marketing tools.

Manejo de técnicas de elevación de seno entre los profesionales según su experiencia actual / Management of sinus lift techniques among professionals according to their current experience

El objeto de este estudio fue investigar la influencia de la experiencia profesional en el tratamiento de maxilares atróficos y cómo afecta a las indicaciones, la incidencia de complicaciones y la tasa de éxito cuando se utilizan técnicas de elevación del seno maxilar.Se envió una encuesta a través de Google forms a odontólogos en activo que estaban familiarizados con este tipo de técnicas quirúrgicas. Se pidió a los profesionales que indicaran qué técnicas usa ban con más frecuencia en escenarios con hueso residual mayor o menor de 5 mm. También se preguntaron las compli caciones más frecuentes en el uso de las técnicas de elevación del seno maxilar y la tasa de éxito durante los primeros 12-24 meses. La encuesta alcanzó un total de 400 profesionales y la muestra se dividió en 3 grupos. El grupo A estaba compuesto por 158 profesionales con menos de 5 años de experiencia (39,5%), 87 sujetos de entre 6 y 10 años de trayectoria profesional componían el grupo B (21,75%) y el grupo C estaba compuesto por 155 sujetos con más de 10 años de experiencia (38,75%). Como conclusiones, se observó que la experiencia no es un factor decisivo en el éxito de la elevación de seno, ya que ambas técnicas gozan de gran predictibilidad. Si que existe una tendencia en los grupos más experimentados a simplificar la técnica, siendo la complicación más frecuente la perforación de la membrana de Schneider (AU)

The purpose of this study was to investigate the influence of professional experience in the management of atrophic maxilla and how it affects on indications, incidence of complications and survival rate when using maxillary sinus techniques. A survey was lunched via Google forms to active dentists that were familiar with this type of surgical techniques. The professionals were asked for indications of techniques in scenarios with residual bone greater or lesser than 5 mm. The complications more frequently encountered in the use of close and open maxillary sinus techniques and the survival rate during the first 12-24 months were also asked. The survey reached a total of 400 professionals and sample was divided in 3 groups. Group A was composed by 158 professionals with less than 5 years of experience (39.5%), 87 subjects with professional experience ranging between 6 to 10 years composed group B (21,75%) and group C was composed by 155 subjects with more than 10 years of experience (38,75%). According to the conclusions, it was observed that experience is not a decisive factor in the success of sinus lift since both techniques are highly predictable. There is a tendency in the more experienced groups to simplify the technique, the most frequent complication was the perforation of Schneider’s membrane (AU)

Using a Virtual Patient via an Artificial Intelligence Chatbot to Develop Dental Students' Diagnostic Skills.

Knowing how to diagnose effectively and efficiently is a fundamental skill that a good dental professional should acquire. If students perform a greater number of clinical cases, they will improve their performance with patients. In this sense, virtual patients with artificial intelligence offer a controlled, stimulating, and safe environment for students. To assess student satisfaction after interaction with an artificially intelligent chatbot that recreates a virtual patient, a descriptive cross-sectional study was carried out in which a virtual patient was created with artificial intelligence in the form of a chatbot and presented to fourth and fifth year dental students. After several weeks interacting with the AI, they were given a survey to find out their assessment. A total of 193 students participated. A large majority of the students were satisfied with the interaction (mean 4.36), the fifth year students rated the interaction better and showed higher satisfaction values. The students who reached a correct diagnosis rated this technology more positively. Our research suggests that the incorporation of this technology in dental curricula would be positively valued by students and would also ensure their training and adaptation to new technological developments.

Oral immune-related adverse events caused by immune checkpoint inhibitors: a retrospective study.

BACKGROUND: Immune Checkpoint inhibitors (ICI) are linked to a series of adverse systemic and/or oral side effects such as "stomatitis," "oral inflammation" and "mucositis." These oral lesions induced by target therapies and immune checkpoint inhibitors are different from traditional lesions associated with chemo/radiotherapy and they have not yet been correctly characterized. This paper aims to report retrospectively the oral immune-related adverse events caused by immune checkpoint inhibitors. METHODS: A table in electronic format was prepared and sent by e-mail to several clinical structures in order to collect, for each patient, anamnestic data, discretionary habits, systemic risk factors, the presence and number of comorbidities, and the characteristics of the oral lesions in the course of oncological therapy with anti-PD1 (nivolumab, pembrolizumab). Following the collection of anamnestic and clinical data relating to patients treated with anti-PD1 (nivolumab, pembrolizumab) and the detection of oral lesions, data analysis was carried out. RESULTS: A number of 364 patients treated with nivolumab (209) and pembrolizumab (155), administered intravenously at a therapeutic dose were selected. There have been cases of oral adverse effects in treated patients. The oral adverse effects found fell into the categories of stomatitis, xerostomia, candidiasis and taste disturbances. Analyzing the incidence of oral lesions in patients undergoing treatment with immune checkpoint inhibitors, there was no significant difference between the two drugs examined. CONCLUSIONS: Further studies are certainly needed to catalog, focus and identify in advance the adverse effects, including oral ones, in patients treated with ICI type PD1/PDL-1. It is necessary, for the benefit of patients, to pay particular attention to the adverse effects in order to recognize, treat and possibly modulate the therapy with an adequate assessment of the cost/benefit ratio and quality of life.

Propiedades físicas de utilidad clínica de los nuevos cementos selladores de endodoncia a base de silicatos. Revisión bibliográfica / Clinically useful properties of new silicate-based endodontic sealers. A literature review

Introducción: La obturación del sistema de conductos presenta un papel clave en el éxito del tratamiento de endodoncia. En un intento de mejorar las propiedades de los cementos selladores, recientemente se han introducido en el mercado los cementos selladores a base de silicatos. Por ello, al llevar a cabo la obturación del sistema de conductos, es de utilidad conocer las propiedades físicas que los diferentes cementos selladores presentan. Objetivo: El objetivo del presente trabajo fue la revisión bibliográfi ca de las propiedades físicas de utilidad clínica que presentan los nuevos cementos a base de silicatos, y compararlas con las propiedades físicas de los cementos convencionales a base de resina epóxica. Material y método: Tras establecer la pregunta de investigación adaptada, se llevó a cabo una revisión de la literatura en dos bases de datos (Medline vía Pubmed y Wiley Library vía Biblioteca Chrocane) combinando términos MeSH (Medical Subject Headings) y términos libres. Además, se llevó a cabo una búsqueda electrónica manual. Las propiedades físicas de utilidad clínica seleccionadas fueron la decoloración, capacidad de sellado, radiopacidad, tiempo de fraguado y solubilidad. Resultados: Se obtuvieron 224 estudios potenciales. Finalmente, aplicando los criterios de inclusión y exclusión, se incluyeron 22 estudios en la revisión. Los distintos estudios compararon diferentes propiedades físicas de los cementos a base de silicatos, comparándolos con los cementos a base de resina. (AU)

Introduction: In the endodontic treatment success, the fi lling of the root canal system plays a key role. To improve properties of the sealers used in these treatments, new silicate-based sealers have recently been introduced into the market. Therefore, when performing the endodontic treatment, it is useful to know the physical properties of the different sealers. Objectives: The aim of the present study was to review the literature and compare the clinically useful physical properties of the new silicate-based cements with the physical properties of conventional epoxy resin-based cements. Methods: After establishing the adapted research question, a literature review was carried out in two databases (Medline via Pubmed and Wiley Library via Chrocane Library) combining MeSH (Medical Subject Headings) and free terms. In addition, a manual electronic search was performed. The clinically useful physical properties selected were discolouration, sealability, radiopacity, setting time and solubility. Results: A total of 224 potential studies were obtained and 20 were selected for full text reading. Additionally, 4 studies were selected through electronic handsearching. After exclusion of 2 studies, 22 studies were fi nally included in the review, which analyzed the following physical properties: 2 tooth discolouration; 4 sealing ability; 11 radiopacity; 9 setting time; and 12 solubility. 9 of the selected articles evaluated several properties. (AU)

Clinical utility properties of new endodontic silicate-based sealers: a systematic review

Introduction: Filling in the root canal system plays a key role in the success of endodontic treatment. New silicate-based sealers have recently been introduced on the market to improve the properties of sealers used in these treatments. Before performing endodontic treatment, it is always useful to know the properties of different sealers. Objectives: The aim of this study was to review the literature and compare the clinically useful properties of new silicate-based sealers with those of conventional epoxy resin-based cements. Methods: After establishing the adapted research question, a literature review was carried out in two databases (Medline via Pubmed and Wiley Library via Cochrane Library) combining MeSH (Medical Subject Headings) and free terms. A manual electronic search was also performed. The clinically useful properties selected were discolouration, sealing capacity, radiopacity, setting time and solubility. Results: Of the 224 potential studies obtained, 20 were selected for reading of the full text. Another 4 studies were selected after manual electronic searching of which 2 were excluded, leaving 22 studies for inclusion in the review. The following physical properties were analysed: 2 for tooth discolouration; 4 for sealing ability; 11 for radiopacity; 9 for setting time; and 12 for solubility; 9 of the articles evaluated several properties. Conclusions: No differences in tooth discolouration were observed between silicate-based and resin sealers. No differences in sealing ability were observed in most of the studies consulted. All sealers analysed showed radiopacity values within the recommended standards. Both setting time and solubility depended on the type of sealer; with some of the silicate-based sealers having higher solubility than the resin-based. (AU)

Evaluación de la resistencia a la fractura de dientes instrumentados con Protaper Gold, Protaper Next y Waveone Gold / Evaluation of the fracture strength of teeth instrumented with protaper gold, protaper next and waveone gold

INTRODUCCIÓN: el tratamiento de conductos produce cambios físico-químicos en la dentina y una pérdida estructural significativa para el diente, lo que lo hace más susceptible a la fractura. MATERIAL Y MÉTODOS: 64 premolares mandibulares fueron decoronados y divididos aleatoriamente en cuatro grupos (n = 16): grupo control (CG) no tratado, grupo instrumentado ProTaperGold® (PTG®) (25.08), grupo instrumentado ProTaperNext® (PTN®) (25.06) y grupo instrumentado WaveOne Gold PRIMARY® (WOG®) (25.07). Durante la instrumentación, se realizó la irrigación con NaOCl al 5,25% con una jeringa Monoject® y tras la instrumentación, las muestras se irrigaron con NaOCl, EDTA 17% y NaOCl activado sónicamente. Los conductos radiculares se obturaron utilizando el sistema B&L®, y posteriormente se colocaron en bloques de resina acrílica estandarizados para ser cargados con una fuerza vertical constan-te de 0,02 mm/s hasta que se produjo la fractura de la raíz, mediante una máquina de ensayo universal (ME-405/20, Servo-sis®). Las comparaciones entre grupos se analizaron con la prueba ANOVA.RESULTADOS: No hubo diferencias esta-dísticamente significativas (p > 0,05) entre el GC y los grupos instrumentados con PTN® y WOG®; tampoco entre los grupos PTN® y WOG®. Sin embargo, se obtuvieron diferencias estadísticamente significativas entre el grupo instrumentado con PTG® y el resto de los grupos, siendo el grupo PTG® el más susceptible a la frac-tura. CONCLUSIONES: El sistema PTG® fue el que más debilitó las raíces después de la instrumentación, en comparación con los sistemas WOG® y PTN®

INTRODUCTION: root canal treatment produces physicist-chemist changes in the dentine and a significant structural loss for the tooth what makes it more susceptible to fracture. MATERIAL AND METHODS: 64 mandibular premolar were decoronated and randomly divided into four groups (n = 16): control group (CG) non-treated, ProTaper Gold(TM) (PTG(TM)) instrumented group (25.08), ProTaper Next(TM) (PTN(TM)) instrumented group (25.06) and WaveOne Gold(TM) PRIMARY (WOG(TM)) instrumented group (25.07). While shaping, cleaning was done with NaOCl 5,25% using a Monoject(TM) syringe and after shaping, roots were irrigated with NaOCl, EDTA 17% and NaOCl sonically activated. Root canals were obturated using B&L(TM) system, embedded into standardized acrylic resin blocks and load with a constant vertical force of 0,02 mm/s until root fracture was produced using a universal testing machine (ME-405/20, Servosis(TM)). Comparisons among groups were analyzed with ANOVA test. RESULTS: There were no statistically significant differences (p > 0.05) between the CG and the groups instrumented with PTN(TM) and WOG(TM); neither among PTN(TM) and WOG(TM) groups. However, statistically significant differences were obtained between the group instrumented with PTG(TM) and the rest of the groups being PTG(TM) group the most susceptible to fracture. CONCLUSIONS: PTG(TM) system was the one that weakened more the roots after the instrumentation in comparison with the WOG(TM) and PTN(TM) systems

Estudio sobre Automedicación y Ansiedad en Endodoncia / Study on Self-Medication and Anxiety in Endodontis

Objetivos. Los objetivos de este son: 1. Evaluar el consumo de medicamentos, así como la automedicación entre los individuos que acuden a realizarse una endodoncia. 2.Evaluar la mejoría de sintomatología tras la toma de medicación. 3. Evaluar la ansiedad dental entre los pacientes sometidos a tratamiento endodóntico previo a la intervención. Material y Métodos: Se realizó un estudio de tipo observacional, transversal y comparativo, consistente en una encuesta sobre pacientes mayores de 16 años que acudieron a una clínica universitaria odontológica. Resultados: Se recopilaron 167 encuestas entre septiembre de 2017 y marzo del 2018, siendo válidas 131 y no válidas 36, cuyos resultados más destacados fueron los siguientes: · Ingesta de antibióticos + analgésicos y/o AINES (40,6%)· Ingesta analgésicos y/o AINES (59,4%). Origen de esa medicación; 44,6% prescrita por el odontólogo, seguida del 42,7% que corresponde a la tomada por decisión propia, 10,8% al médico de cabecera, 2,7% a urgencias y 0% al farmacéutico y de origen homeopático. Media de ansiedad en la escala de 4,38. La media de ansiedad en mujeres: 5 y en hombres: 3,2 (p: 0.0066). Grupo con algún tipo de formación académica; media de ansiedad: 4,24 y grupo sin ningún estudio; media de ansiedad: 8,75 (p: 0.0144). Conclusiones: Los pacientes encuestados tenían una alta tendencia a la automedicación, utilizándose fundamentalmente analgésicos y/o AINES. Además, referían mejoría en el día de la intervención tras haber tomado algún tipo de medicamento. Los pacientes encuestados sufrieron un grado de ansiedad medio previo a la realización del tratamiento endodóntico

Objectives: The objectives of this study are: 1. To evaluate the consumption of medicines as well as self-medication among the individuals who undergo endodontics.2. To evaluate the improvement of symptoms after taking medication. 3. To evaluate dental anxiety among patients undergoing endodontic treatment prior to the intervention. Material and Methods: An observational, transversal and comparative study was carried out, consisting of a survey of patients over 16 years of age who attended a university dental clinic. Results: In this study 167 surveys were collected, between September 2017 and March 2018, with 131 valid and 36 invalid. Taking antibiotics + analgesics and/or NSAIDs (40.6%) and analgesics and/or NSAIDs (59.4%); Origin of that medication; 44.6% prescribed by the dentist, followed by the 42.7% prescribed by the dentist, 10.8% by the general practitioner, 2.7% by the emergency department and 0% by the pharmacist and homeopathic origin. Average anxiety on the 4.38 scale. Average anxiety in women: 5 and in men: 3.2 (p: 0.0066).Group with some type of academic training; mean anxiety: 4.24 and group without any study; mean anxiety: 8.75 (p: 0.0144). Conclusions: The patients surveyed had a high tendency to self-medication, mainly using analgesics and/or NSAIDs. They also reported improvement on the day of the intervention after having taken some type of medication. The patients surveyed suffered a medium degree of anxiety prior to the endodontic treatment

El síndrome de Groves en el paciente endodóncico: implicaciones legales y para la práctica clínica / No disponible

El doctor J. E. Groves, psiquiatra estadounidense, en un artículo publicado en el New England Journal of Medicine en 1978, fue el primero en atreverse a plantear de forma sincera y abierta la existencia de pacientes a los que definió como "odiosos" o "indeseables" (hateful patient). El paciente endodóncico que padece el "síndrome de Groves" se caracteriza por provocar en el dentista sentimientos de contratransferencia tales como el odio, la aversión, el aborrecimiento, o, incluso, el recelo, el temor y el miedo, todo ello sin que el paciente pueda ser encuadrado en un cuadro psiquiátrico específico. En este artículo se analiza, desde un punto de vista muy personal, la epidemiología, etiología, formas clínicas, el diagnóstico diferencial y el manejo terapéutico de este síndrome cuando se presenta en pacientes que necesitan tratamiento endodóncico

No disponible

Detección mediante técnica de GCMS de alto contenido de Bisfenol A en cementos de uso endodóntico / Bisfenol a; endodoncia; obturación bisphenol a determination by gcms in resin-based root canal sealers

El bisfenol A (BPA, por sus siglas en inglés) es un producto químico utilizado en la producción de policarbonatos y resinas epoxi, cuyo uso está muy extendido en la industria. El BPA puede pasar al organismo por medio de la dieta, ya que sus moléculas tienen migración probable de los recipientes fabricados con este producto a los alimentos contenidos en dichos recipientes. La presencia de BPA en los materiales de uso odontológico está muy extendida. Una gran cantidad de productos están elaborados con resinas epoxi (procedentes de la reacción entre la epiclorohidrina y el bisfenol A). El presente estudio se analizaron cuatro cementos de uso endodóntico basados en resina (Ah 26(R), Ah Plus(R), TopSeal(R) y Simpliseal(R)) a través de un procedimiento de extracción líquido-sólido y análisis en cromatógrafo de gases acoplado a espectrometría de masas. Los resultados obtenidos muestran valores alarmantemente superiores a los 5x10-6% en peso que permite la Unión Europea para la migración de BPA desde el envase al alimento, obteniéndose unos valores de 7% (Simpliseal(R)); 22% (AH 26(R)); 46% (TopSeal(R)) y 74% (AH Plus(R)). El presente estudio es pionero en el estudio de la concentración de BPA en materiales endodónticos

Bisphenol A (BPA) is a compound used in the production of polycarbonates and epoxy resins and is widely used in the industry. BPA can be passed into the body through the diet, since its molecules can easily migrate from the containers made with BPA to the food in those containers. The presence of BPA in dental materials is very common. A large number of products are made with epoxy resins (from the reaction between epichlorohydrin and bisphenol A). This study analyzed four resin-based endodontic cements (Ah 26(R), Ah Plus(R), TopSeal(R) and Simpliseal(R)) using a liquid-solid extraction procedure and gas chromatograph analysis coupled to mass spectrometry. The results obtained show alarmingly higher values than the 5x10-6% by weight that the European Union allows for the migration of BPA from packaging to food, obtaining values of 7% (Simpliseal(R)), 22% (AH 26(R)), 46% (TopSeal(R)) and 74% (AH Plus(R)). This study is a pioneer in the investigation of the concentration of BPA in endodontic materials

Estudio de la composición química de cuatro marcas de gutapercha - parte I. Análisis cualitativo de compuestos orgánicos volátiles / Study of the chemical composition of four brands of gutta percha - part I. Qualitative analysis of volatile organic compounds

En el presente estudio se analizó la composición química de cuatro marcas de gutapercha (Autofit, Endosequence, Wave One Gold y Dia-ProT) para su uso en técnicas de condensación vertical con ola de calor desde un punto de vista cualitativo, utilizándose la microextracción en fase sólida con posterior análisis mediante cromatografía de gases acoplada a espectrometría de masas para realizar dicho análisis y obtener referencia de los compuestos orgánicos volátiles (COVs) presentes en las muestras. Los resultados arrojaron diferencias en la composición de las marcas, con solo cuatro COVs similares en todas las muestras. La mayoría de los compuestos encontrados tiene origen vegetal, pero resultó de interés el Butyl hydroxy Toluene (localizado en todas las muestras) que se encuentra en el Grupo 3 de la clasificación de la International Agency for Research on Cancer, en los cuales no hay evidencia de posible carcinogénesis demostrada pero su uso está siendo limitado por diversos estados. La identificación de los COVs resulta de especial interés para evitar la aparición de eventos adversos en tratamientos de endodoncia y debe tenerse en cuenta por las autoridades sanitarias a la hora de establecer controles sobre la comercialización de productos sanitarios odontológicos (AU)

In the present study chemical composition of four brands of gutta-percha (Autofit, Endosequence, Wave One Gold and Dia-ProT) was analyzed for use in warm vertical condensation techniques from a qualitative point of view, using microextraction in solid-phase with subsequent analysis by gas chromatography coupled to mass spectrometry to perform such analysis and to obtain reference of the volatile organic compounds (VOCs) present in the samples. The results showed differences in the composition of the marks, with only four similar VOCs in all the samples. Most of the compounds found are of plant origin, but Butyl hydroxy Toluene (present in all samples) belongs to Group 3 of the International Agency for Research on Cancer classification, in which there is no evidence of possible demonstrated carcinogenesis, but its use is being limited by several countries. The identification of VOCs has a special interest to avoid the occurrence of adverse events in endodontic treatments and should be consider by the health authorities when establishing controls on the commercialization of dental health products (AU)

Aplicación de nuevas tecnologías en el uso del índice Smith y Knight para el desgaste dental / New technologies use in the application of the Smith & Knight index for dental wear

El propósito de este trabajo es aplicar la tecnología actual usando los escáneres intraorales para posibilitar un diagnóstico más objetivo del desgaste dental. Se realizó un estudio de evaluación de desgaste sobre 53 alumnos de Odontología, utilizando como medio de registro de ambas arcadas el escáner intraoral True Definition 3M® (ESPE, Seefeld, Germany). Para evaluar el desgaste se utilizó el índice Smith & Knignt aplicándolo a las superficies vestibular, palatina/lingual y oclusal/incisal desde el primer incisivo incisivo a primer molar en ambas arcadas. Los resultados mostraron una mayor superficie de desgaste en el grupo ántero-incisal (superior) por palatino, caninos por incisal, primeros premolares superiores e inferiores por oclusal. Las localizaciones de las superficies de desgaste encontradas en este estudio concuerdan con los datos hallados en la literatura científica. El escáner intraoral se muestra, en las condiciones de este estudio, como una herramienta eficaz en la detección del desgaste dental (AU)

The purpose of this paper is to apply current technology using intraoral scanners to enable a more objective diagnosis of dental wear. An evaluation study on 53 Denstritry students using as a recording medium of both arches intraoral scanner True Definition 3M was performed. To assess the Smith & Knignt wear index was used by applying to, palatal / lingual and occlusal / incisal from the incisor to first molar buccal surfaces. The results showed increased wear surface in the anteriorincisal group (superior) palatal, incisal canines, occlusal upper first premolars and first molars occlusal. The locations of the wear surfaces found in this study are consistent with data found in the scientific literature. The intraoral scanner is shown under the conditions of this study, as an effective tool in the detection of dental wear (AU)

Estudio analítico de MTA-Angelus(R) y Biodentine(R) con técnicas SPME-GCMS y AFM / Analytical studies of MTA Angelus and Biodentine materials by SPME-GCMS and AFM techniques

Introducción: El objetivo del estudio fue obtener información analítica sobre la pureza química y homogeneidad de los materiales de uso endodóntico MTA-Angelus® y Biodentine®. Material y métodos: Se analizaron ambos materiales mediante la técnica de microextracción en fase sólida (SPME), combinada con cromatografía de gases acoplada a espectrómetro de masas (GC-MS) para separar e identificar los compuestos orgánicos volátiles (COVs) contenidos. Por otro lado, utilizando microscopía de fuerza atómica (AFM) se estudió la topografía y rugosidad de las superficies de dientes tras la realización de obturaciones a retro in vitro con ambos cementos. Resultados: Se identificaron diversos COVs en ambos materiales mediante SPME GCMS. Entre los compuestos detectados, destacaron el alfa - metilestireno (presente en MTA-Angelus(R)) y el diclorometano (detectado tanto en MTA-Angelus(R) como en Biodentine(R)) que son potencialmente tóxicos y perjudiciales para la salud. Los resultados del estudio con AFM demostraron la existencia de diferencias en la superficie de los cementos. Las imágenes y rugosidad finales fueron más homogéneas en Biodentine®. Conclusiones: Los cementos endodónticos MTA-Angelus® y Biodentine® contienen ciertos compuestos perjudiciales para la salud. Se evidencia la necesidad de un control más exigente de los riesgos para la salud de estos. El estudio AFM mostró que Biodentine® presenta un superficie más homogénea (AU)

Introduction: The aim of this research was to obtain analytical information about the chemical purity and the homogeneity of the endodontic materials MTA Angelus(TM) and Biodentine(TM). Methods: On the one hand, solid phased microextraction-gas chromatography-mass spectrometry (SPME-GCMS) was carried out with MTAAngelus and Biodentine materials, isolating and identifying the contained volatile organic compounds (VOCs). On the other hand, atomic force microscopy (AFM) was used to study topography and roughness aspects on teeth after in vitro root end fillings with both materials. Results: First, several VOCs have been detected by SPME-GCMS in both materials. It is noteworthy alpha methylstirene (identified in MTA Angelus(TM)) or dichloromethane (detected both in MTA Angelus(TM) and Biodentine(TM)) due to its potential toxicity and harmful health effects. Secondly, AFM study showed differences among the surface materials. Final images and roughness results showed more homogeneous cement in the Biodentine product. Conclusions: Endodontic cements MTAAngelus and Biodentine contains some harmful health compounds. The need of a stricter health risks control of both materials became evident. AFM study demonstrated a more homogenous surface in Biodentine (AU)

Efecto de distintos protocolos de irrigación en la resistencia a la fractura de dientes tratados endodónticamente / Effect of different irrigation protocols in the fracture resistance of endodontically treated teeth

Introducción: El objetivo del tratamiento endodóntico es la prevención y eliminación de una infección microbiana en el sistema de conductos radiculares gracias a la instrumentación, irrigación y obturación. Como pieza clave del tratamiento, la irrigación se tiene que enfrentar a diversos problemas siendo uno de ellos su posible efecto en la erosión dentinaria. Objetivo: Cuantificar la erosión dentinaria causada por distintas secuencias de irrigación, mediante la resistencia a la fractura. Material y métodos: Se seleccionaron 60 dientes unirradiculares que fueron instrumentados y montados en acrílico autopolimerizable, con espacio que simulaba el ligamento periodontal, y fueron divididos en dos grupos a los que se realizó un protocolo de irrigación con EDTA y NaClO (de 1 y 20 minutos respectivamente) y otro sin irrigación como control. Las muestras fueron posteriormente sometidas a una máquina de ensayos dinámicos de materiales que aplicó fuerza constante hasta fractura. Resultados: La media de la carga de rotura fue similar en los tres grupos, observándose ligeras diferencias del grupo 1 (NaClO 1 minuto) con el resto y mas variabilidad entre las muestras de dicho grupo. Conclusiones: En las condiciones de este estudio, la resistencia del diente no se ve afectada entre irrigar 1 minuto o 20 minutos de NaClO, después de eliminar el barrillo dentinario (AU)

The objectives: in endodontic therapy are prevention and the elimination of a microbial infection in the root canal system. This is done with instrumentation, irrigation and the adequate sealing of the root canals. A key factor in achieving a successful treatment is irrigation; nevertheless, irrigating has potential secondary detrimental effects, such as dentinal erosion. Objective: Quantifying the dentinal erosion in teeth caused by diverse irrigation protocols, and measuring its resistance to fracture. Material and Methods: A selection of 60 teeth with one canal was made. They were instrumented and placed in an acrylic base, and a simulation of the periodontal ligament was created. The teeth were divided in three groups. The first two, followed an irrigation protocol of EDTA and NaClO (1 or 20 minutes, depending on the group), and the third, a control group. The teeth were then subjected to pressure until fracture was achieved. Results: The average load in which the teeth were able to fracture was similar in the groups. However, there were slight differences between group 1 (NaClO, 1 minute), in comparison with the other groups. Conclusions: In this study, we determined that after removing the smear layer, there is no difference (1 or 20 minutes NaClO) in the resistance until fracture (AU)