Root filled teeth in two parallel Danish cohorts: A repeated longitudinal cohort study.

AIM: The aim of the study was to compare the frequency of root filled teeth and quality of root fillings (RFs) in two parallel, Danish cohorts each examined over 10 years and to evaluate factors associated with apical periodontitis (AP) and extraction of root filled teeth. METHODOLOGY: Two randomly selected cohorts (C1, C2) from Aarhus (age: 20-64 years) were followed for approximately 10 years, with full-mouth radiographic surveys performed at 5-year intervals (C1: 1997-2003-2008; C2: 2009-2014-2019). Frequency of root filled teeth, quality of RFs and coronal restorations, periapical status and tooth extraction were registered. Logistic regression analyses compared C1 with C2 for baseline and follow-up periods and assessed variables associated with AP (PAI-based) and extraction of root filled teeth. RESULTS: C1 included 330 and C2, 170 individuals, mean age 42.9 and 47.3 years, respectively, who attended all three radiographic examinations. The relative frequency of root filled teeth was lower in C2 than C1 at baseline (C1: 4.7%, C2: 3.6%; p < .001) and after 10 years (C1: 5.7%, C2: 4.2%; p < .001). The relative frequency of new RFs was lower in C2 than in C1 (p = .02). C2 had fewer short/long RFs at baseline than C1; quality of new RFs or coronal restorations was similar in C1 and C2. The risk of tooth extraction (p = .93) and risk of AP (p = .37) at 10-year follow-up was similar between the two cohorts. For both C1 and C2, root filled teeth with AP at baseline had increased risk of having AP (p < .001) or having been extracted (p < .001) at follow-up. Risk of extraction was higher for root filled premolars (p = .01) and molars (p = .01) than anteriors. Risk of AP at follow-up was higher for root filled molars (p < .001). Furthermore, inadequate quality of RFs (p = .02) and coronal restorations (p = .04) increased the risk of AP at follow-up in C1 and C2. CONCLUSIONS: The frequency of root filled teeth and new RFs decreased and little to no change in new RFs' quality, AP, or tooth extraction was seen over time (1997-2019). Root filled molars and teeth with AP at baseline had increased risk of AP and extraction.

Longitudinal study of endodontic and periapical status of an adult Danish population examined in 2009, 2014, and 2019: a repeated cohort study.

OBJECTIVE: To describe endodontic changes in an adult Danish population (C2;2009-2014-2019) and compare them with a similar cohort (C1;1997-2003-2008). MATERIAL AND METHODS: A randomly selected cohort (C2) with three full-mouth radiographic examinations. The frequencies of teeth, apical periodontitis (AP), root filled teeth, and lost teeth in C2 were compared to a similar cohort (C1) using regression analyses; effect of age, cohort, and period was assessed. RESULTS: C1 had 330 and C2, 170 participants (mean age, C1: 42.9; C2: 47.3 years, p < .001). The proportion of individuals with no AP was similar in C1 and C2 (p = .46). C2 had a higher proportion of individuals with no root filled teeth (p < .001) and no tooth loss (p = .02) than C1. The proportion of AP and root filled teeth increased with age in both cohorts. C2 had fewer root filled teeth and lost teeth, fewest lost teeth in the youngest age groups. CONCLUSIONS: In C2, the prevalence of teeth with AP and root fillings increased with age, and few teeth were lost. Change in proportion of AP was similar in two cohorts; fewer root filled teeth and lost teeth in C2. The proportion of lost teeth in C2 showed cohort effect for older age groups.

Trends of endodontic and periapical status in adult Danish populations from 1997 to 2009: A repeated cross-sectional study.

AIM: To compare the endodontic and periapical status of two similar adult Danish populations examined in 1997-1998 and 2007-2009, respectively. METHODOLOGY: Two populations from Aarhus County, Denmark (age range: 20-64 years) were randomly selected using the Danish Civil Registration System. Full-mouth intraoral radiographs (14 periapical, 2 bitewing) of 616 individuals in 1997-1998 (C1: 16 018 teeth) and 398 individuals in 2007-2009 (C2: 10 668 teeth) were taken to ascertain the number of teeth, presence of root fillings (RFs) and apical periodontitis (AP) using the periapical index (PAI). T-tests with unequal variances were used to assess differences between C1 and C2 with respect to age and the number of teeth. Multivariable and multinomial logistic regression analyses were used to assess the effect of cohort, age and tooth type on the prevalence and relative frequency of RFs and AP. RESULTS: Mean age and mean number of teeth were higher in C2 than C1 (age; C1: 42.3 years, C2: 44.6 years; p = .003), (teeth; C1: 26.0, C2: 26.8; p < .001). The prevalence of root filled teeth was lower in C2 than C1 (C1: 51.8%, C2: 45.0%; p = .03); however, the prevalence of AP was similar (C1: 42.0%, C2: 45.0%). The relative frequency of root filled teeth was lower in C2 than C1 (C1: 4.8%, C2: 3.6%; p = .004), although the individuals were older in C2. The relative frequency of AP was similar in the two cohorts (C1: 3.3%, C2: 3.6%; p = .42). The relative frequency of AP in non-root filled teeth doubled from 0.9% in C1 to 1.8% in C2. C2 had higher PAI scores than C1 for root filled and non-root filled teeth, despite age correction (p ≤ .0007). CONCLUSIONS: Two similar general Danish populations examined, respectively, in 1997-1998 and 2007-2009, were associated with a decreasing trend in the prevalence and relative frequency of RFs over the decade. There was no difference in relative frequency of AP in root filled teeth, but an increase in relative frequency of AP in non-root filled teeth. Further population-based studies including analysis of non-root filled teeth using the full-scale PAI and quality assessment of restorations are recommended.

Do in vitro solubility studies on endodontic sealers demonstrate a high level of evidence? A systematic review.

OBJECTIVE: To systematically review the quality of evidence of available in vitro solubility studies on endodontic sealers according to prespecified evidence criteria. MATERIAL AND METHODS: This systematic review was based on the PRISMA guidelines and the AMSTAR measurement tool. A systematic duplicate search of the literature on endodontic sealer solubility studies was conducted in PubMed and Embase databases (until 18 October 2017). Mapping terms to subject headings and free text terms were used and combined with hand searching before exclusion of duplicates. Studies specifically dealing with endodontic sealer solubility were selected. The evidence level was graded (low, medium or high) independently by two investigators following systematic data extraction in pilot forms, which was based on prespecified evidence criteria and the modified CONSORT checklist for in vitro studies on dental materials. RESULTS: The search retrieved 1053 articles, from which 88 were assessed in full. From the 63 articles retained in the final analysis, 11 were classified as having moderate and 52 as low quality of evidence (0 high). The studies graded as low had low sample size (n < 10) and/or insufficient details to allow replicability. Most of the studies did not conform to the modified CONSORT checklist and did not include parameters considered relevant in the prespecified criteria. CONCLUSIONS: Existing in vitro studies on the solubility of endodontic sealers do not demonstrate a high quality of evidence. Most of these studies do not present systematic reporting nor employ relevant parameters prespecified in our evidence criteria.

Comparison of the serum immunoglobulin IgM level in diabetic and nondiabetic patients with chronic periodontitis.

AIM: To evaluate and compare the serum IgM level in diabetic and nondiabetic patients with chronic periodontitis. MATERIALS AND METHODS: A total of 60 patients were selected for the study and divided into four groups, diabetic with periodontitis, diabetic without periodontitis, nondiabetic with periodontitis and nondiabetic without periodontitis (control) were analyzed for the quantitative estimation of serum immunoglobulins M by turbidimetric immunoassay. The serum of the diabetic and nondiabetic patients was evaluated and turbidimetric method was used for immunological assay by using Quantia IgM turbidimetric immunoassay for estimation of immunoglobulin IgM in human serum. The data for the level of immunoglobulin thus obtained were compared with clinically healthy patient taken as control. Sugar level was estimated the by checking the random blood sugar level by glucose test kit based on end point and kinetic assay and compared with the HbA1c percentage of the patients, by using NycoCard Reader. RESULT: The group A patients having diabetes with periodontitis showed nonsignifcant increase in serum IgM level as compared to controls and other groups. Group B showed signifcance of p = 0.074. Group C showed signifcance of p = 0.982 and group D showed signifcance of p = 0.520. There was signifcant increase in HbA1c with an increase percentage serum IgM. CONCLUSION: In the present study, significantly high concentrations of the IgM in serum of diabetic and nondiabetic patients were found as compared to the healthy subjects who had neither diabetes nor periodontitis. CLINICAL SIGNIFCANCE: By this study, we can emphasize on the fact of the importance of the immune system and its correlation with glycemic control, especially in patients diagnosed with periodontitis, also suggests that the alteration in immune response in poorly controlled diabetic patients may contribute to the pathogenesis of periodontitis and is the cause of increased incidence of periodontitis in patients with diabetes.

Dimensional changes of endodontic sealers-An in vitro model simulating a clinical extrusion scenario during 18 months.

OBJECTIVES: To examine the dimensional changes of endodontic sealers during 18 months using three-dimensional (3D) surface scanning and subtraction radiography in a novel in vitro sealer-extrusion model. MATERIAL AND METHODS: Fifty endodontically instrumented acrylic teeth were randomly allocated to five groups (n = 10) filled with Apexit Plus, AH Plus, BioRoot RCS, TubliSeal EWT, and gutta-percha (control). Freshly mixed sealers were intentionally extruded during obturation. All teeth were immersed in a physiologic solution for up to 18 months. Blinded 3D surface scans (resolution: ~10 µm) and digital radiographs of the teeth were obtained at baseline (immediately after obturation); and then after 1 week, and at 1, 3, and 18 months. For blinded assessment of sealer dimensional change, 3D models and radiographs were superimposed using specific software. Volumetric differences, root mean square (RMS), and area change from subtraction radiography measured at each period within each sealer group were thereafter calculated. Repeated measures analyses were done with Bonferroni adjustment for multiple comparisons; standard errors, p values, and 95% confidence intervals (CI) were reported. RESULTS: Analyses of the volumetric data confirmed significant, progressive material loss for Apexit Plus when compared to the other investigated sealers or the control group (p ≤ 0.02). Immersion period significantly influenced the volumetric dimensional changes of Apexit Plus already after 1 month (p < 0.01). For TubliSeal EW, the effect of the immersion period on the dimensional changes was noted after immersion for 3 months (p ≤ 0.02), while for BioRoot RCS this was evident only at 18 months (p < 0.01). Same trends were noted for the RMS data, whereas progressive dimensional changes using subtraction radiography only revealed significant changes for Apexit Plus (p = 0.01). CONCLUSIONS: The largest dimensional changes were shown by Apexit Plus, followed by Tubliseal EWT and BioRoot RCS. AH Plus remained stable throughout 18 months.

Sterilizing Endodontic Files by four different sterilization methods to prevent cross-infection - An In-vitro Study.

BACKGROUND: Aim of the study was to compare 4 different methods of sterilizing endodontic files in dental practice. MATERIALS & METHODS: The present study was performed on 100 K-files, 21 mm long and of size 25. Of these, 20 files were taken as control group, and the remaining 80 files were divided into 4 groups of 20 files each and they were tested for the efficacy of sterilization with different methods: Autoclave, glass bead, glutaraldehyde and CO2 laser. RESULTS: The study showed that the files sterilized by autoclave and lasers were completely sterile. Those sterilized by glass bead were 90% sterile and those with glutaraldehyde were 80% sterile. CONCLUSION: The study concluded that autoclave or laser could be used as a method of sterilization in clinical practice and in advanced clinics; laser can be used also as a chair side method of sterilization. How to cite this article: Raju TB, Garapati S, Agrawal R, Reddy S, Razdan A, Kumar SK. Sterilizing Endodontic Files by four different sterilization methods to prevent cross-infection - An In-vitro Study. J Int Oral Health 2013; 5(6):108-12 .