RESUMO
Despite their high success rates, peri-implantitis can affect the stability and function of dental implants. Various treatment modalities have been investigated for the treatment of peri-implantitis to achieve re-osseointegration. An electronic literature search was performed supplemented by a manual search to identify studies published until January 2022. Articles that evaluated re-osseointegration in peri-implantitis sites in animal models following laser therapy or antimicrobial photodynamic therapy (aPDT) were included. Case reports, case series, systematic reviews, and letters to the editor were excluded. Risk of bias and GRADE assessment were followed to evaluate the quality of the evidence. Six studies out of 26 articles identified on electronic search were included in this review. The studies included animal studies conducted on canine models. Four out of six studies reported a higher degree of re-osseointegration following treatment of implants with laser therapy. The findings suggest that laser decontamination shows potential in enhancing re-osseointegration, particularly with the Er: YAG laser, which effectively decontaminated implant surfaces. However, conflicting outcomes and limitations in the evidence quality warrant caution in drawing definitive conclusions. Based on the limited available evidence, laser therapy may show a higher degree of re-osseointegration of implants than mechanical debridement.
Assuntos
Implantes Dentários , Peri-Implantite , Fotoquimioterapia , Animais , Lasers , Osseointegração , Peri-Implantite/radioterapiaRESUMO
Background and Objectives. To differentiate the intensity of postoperative pain after primary molar pulpectomy employing manual instrumentation versus two single-file systems with different kinetics (the XP-Endo shaper file with adaptive instrumentation vs. the Kedo-SG blue file with continuous rotation instrumentation). Materials and Methods. This three-arm, single-blind, randomized clinical trial included assessing 75 healthy children between 4 to 9 years who required pulpectomy for primary molars (mandibular first and second). The three groups each had an equal number of children. Children in Group 1 had their teeth instrumented with the XP-endo Shaper, children in Group 2 had their teeth instrumented with the Kedo-SG Blue file, and children in Group 3 had their teeth instrumented manually using K-files. The degree of postoperative pain was measured using a four-point pain scale at 6-, 12-, 24-, 48-, and 72-h following therapy. Each participant's parent received five flashcards with four faces and a word characterizing each face. The data were analyzed using Kruskal-Wallis and chi-square tests. The level of significance was set to 5%. Results. During the follow-up period, there was a significant difference in postoperative pain intensity between the three groups. The XP-endo shaper was associated with considerably decreased post operative at the 6- and 12-h interval followed by Kedo-SG. The highest post-operative discomfort across the groups was related to the patients who underwent manual instrumentation. Conclusion. In comparison to rotary and manual instrumentation, postoperative pain severity was reduced with adaptive instrumentation.
Assuntos
Pulpectomia , Preparo de Canal Radicular , Criança , Humanos , Incidência , Método Simples-Cego , Dor Pós-OperatóriaRESUMO
Dental caries is indeed the biggest cause of tooth loss, particularly in the primary dentition. In primary teeth with carious pulp involvements, endodontic intervention in the form of pulpotomy (removal of only the coronal pulp) or pulpectomy (removal of coronal and radicular pulp) is advocated. Pulpectomy can be laborious and time-consuming, especially when using traditional hand endodontic files to shape root canals. In paediatric dentistry, motorised nickel-titanium (Ni-Ti) rotary instrumentation has proved significant in enhancing the quality of pulpectomy. In primary dentition, however, these files may leave more than half of the root canals unaltered by instrumentation, just as they do in permanent dentition. The XP-endo® Shaper is a revolutionary heat-dependent endodontic file that uses an asymmetrical rotating motion to address the maximum area of the root canal space, resulting in anatomic root canal instrumentation. The case series describes the use of this novel XP-endo® Shaper file for anatomic root canal instrumentation in primary molars with irreversible pulpitis. The purpose is to demonstrate the efficacy and advantages of this cutting-edge endodontic treatment method. This case series can be an informative resource for other endodontic specialists by providing a practical illustration of how adaptable instrumentation can be utilised to successfully treat a patient. In conclusion, The use of the XP-endo Shaper® for pulpectomy demonstrated faster and instrumentation that was confined with the original shape of the canals, although further research is required to fully utilise these findings.
Assuntos
Cárie Dentária , Criança , Humanos , Cavidade Pulpar , Pulpectomia , Assistência Odontológica , Dente DecíduoRESUMO
OBJECTIVES: To compare gingival tissue healing at surgically manipulated periodontal sites and at sites receiving implants and healing abutments with machined (MS) vs laser-microtextured (LMS) surface placed with one-stage protocol. MATERIAL AND METHODS: Twenty-four non-smoking patients each received two implants with one-stage protocol in a split-mouth design on the same jaw. In each patient, one implant with a MS collar and one immediate healing abutment with a MS, and one implant with a LMS collar and one immediate healing abutment with a LMS were used. Soft tissues healing at surgically manipulated periodontal tissues (T+) and at non-surgically manipulated periodontal tissues (T-) at MS implant sites and at LMS implant sites were compared by means of clinical and biochemical parameters at baseline and at 1-2-3-4-6-8 and 12 weeks. RESULTS: PD and BoP mean values were statistically higher in MS than LMS implant sites (p<0.05). During early healing phase (1-4 weeks), MS and LMS peri-implant tissues and periodontal tissues at T(+) showed no statistically significant difference in crevicular fluid volume changes (p>0.05). Between 6 and 12 weeks, compared with T(+), no statistically significant difference in crevicular fluid volume and IL-6 and IL-1ß concentrations was noted in LMS implant sites (p>0.05), while statistically significantly higher mean values were noted in MS implant sites (p<0.05). CONCLUSIONS: Compared with T(+) and T(-), both MS and LMS implant sites presented a higher pro-inflammatory state in the early phase after surgery (1-4 weeks). At 12 weeks, only MS implant sites kept a higher pro-inflammatory state, while at LMS implant sites, it becomes similar to T(+) and T(-).
Assuntos
Implantes Dentários , Interleucina-6 , Biometria , Humanos , Lasers , BocaRESUMO
Previous studies assessed the involvement and impact of periodontal bacteria in preeclamptic women with chronic periodontitis. To explore further, the current study aimed to associate periodontal viruses and bacteria with mir155 levels in placental tissues of preeclamptic women with generalized chronic periodontitis. Four-hundred 45 pregnant women, 18-35 years of age, were selected and divided into four groups (controls, A, B, and C) where the Controls included 145 systemically and periodontally healthy pregnant women Group A-100 systemically healthy pregnant women with chronic periodontitis, Group B- 100 preeclamptic women with chronic periodontitis, Group C- 100 preeclamptic women without chronic periodontitis. Age, BMI, SES, and periodontal parameters such as PI, BOP, PPD, and CAL were noted. Periodontal pathogens such as Tf, Td, Pg, Pi, Fn, HSV, EBV, and HCMV were tested in subgingival plaque, placental tissues, and mir155. We observed that PI, BOP, PPD, CAL, Tf, and EBV were highly significant in Group B. We found a higher number of periodontal bacteria, viruses, and mir 155 in Group B showing a higher risk of preeclampsia. More genetic studies in this field are advised to ascertain the role of periodontopathogens and mir 155 in preeclampsia and periodontal inflammation. What is already known on this subject? Periodontal diseases pose an increased risk of developing preeclampsia and delivering preterm and/or low-birth-weight babies. What do the results of this study add? Periodontal variables such as PI, pocket depth, BOP, and clinical attachment levels, were found to be increased in the preeclamptic women with chronic periodontitis. The significant difference was seen in the relative fold expression of mir155 with higher gene expression of mir155 in groups B and A as compared to group C and controls. What are the implications of these findings for clinical practice and/or further research? In our study, mir155 correlation with the periodontal parameters and periodontal pathogens further strengthen the evidence of periodontal inflammation as a risk of preeclampsia in pregnant women especially when associated with chronic periodontitis. mir155 can be considered to be one of the genetic biomarkers and can be used as a diagnostic tool for the early detection of PE.
Assuntos
Bactérias/patogenicidade , Periodontite Crônica/genética , Periodontite Crônica/microbiologia , MicroRNAs/genética , Placenta/patologia , Pré-Eclâmpsia/genética , Pré-Eclâmpsia/microbiologia , Vírus/patogenicidade , Adolescente , Adulto , Estudos de Casos e Controles , Periodontite Crônica/complicações , Feminino , Humanos , Recém-Nascido , Placenta/metabolismo , Pré-Eclâmpsia/etiologia , Gravidez , Adulto JovemRESUMO
OBJECTIVES: To retrospectively evaluate the conditions of the peri-implant tissues in treated patients with chronic periodontitis (CP) and in patients without chronic periodontitis (noCP). MATERIALS AND METHODS: A chart review was used to evaluate 267 implants, 134 placed in 42 CP treated patients and 133 placed in 46 noCP patients. The primary outcome was to evaluate the condition of the peri-implant tissues (health, peri-mucositis, and peri-implantitis). The secondary outcome was to evaluate the possible association of some variables, such as, Plaque Index (PI), Bleeding Index (BI), probing pocket depth (PD), bleeding on probing (BoP), bone level (BL), loading time, type of implant placement and loading protocol, type of prosthesis, type of bone, implant manufacturer, and implant diameter and length, with the implant health condition. RESULTS: The analysis of patient files revealed that after 10-15 years of loading (mean loading time 13.4 ± 2.07 years), six noCP patients (13%) experienced implant loss with a total of nine implants (6.7%) lost. The remaining 124 implants were classified: 54 (43.5%) as healthy, 45 (36.3%) with peri-implant mucositis, and 25 (20.2%) with peri-implantitis. Twelve CP subjects (28.5%) experienced implant loss with a total of 19 implants (14.1%) lost. The remaining 115 implants were classified: 34 (29.5%) as healthy, 40 (34.7%) with peri-implant mucositis and 41 (35.6%) with peri-implantitis. Compared with noCP subjects, only treated CP subjects with recurrent periodontal disease (RPD) showed differences statistically significant (p < .05). CONCLUSIONS: After 10-15 years of loading, in CP patients treated in a private practice setting, most implants (70.1%) were classified with some type of peri-implant inflammation. In patients with RPD, a higher tendency for implant loss and peri-implant biologic complications was found.
Assuntos
Perda do Osso Alveolar , Periodontite Crônica , Implantes Dentários , Peri-Implantite , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/etiologia , Prática Privada , Estudos RetrospectivosRESUMO
Torsional stresses are one of the most frequent causes of intracanal separation of nickel-titanium endodontic instruments, which represents a great concern of endodontists. For this reason, torsional resistance of rotary instruments has been deeply investigated by determining all parameters that can influenced it, that can be summarized in: (1) Tooth-related factors, (2) Strategy-related factors and (3) Instrument-related factors. This study was conducted to examine the influence of shaft length on torsional resistance of a nickel-titanium rotary instrument and if it should be considered as an Instrument-related factor. With this aim, 120 Twisted Files Adaptive M-L (TFA M-L) NiTi instruments (SybronEndo, Orange, CA, USA) were divided into 6 experimental groups (n = 20), according to instruments length and size: Group 1, 20 TFA M-L1 25/08 23 mm; Group 2, 20 TFA M-L1 25/08 27 mm; Group 3, 20 TFA M-L2 35/06 23 mm; Group 4, 20 TFA M-L2 35/06 27 mm; Group 5, 20 TFA M-L3 50/04 23 mm; and Group 6, 20 TFA M-L3 50/04 27 mm. All instruments were submitted to a static torsional test, blocking each instrument at 3 mm from the tip and rotating it until its fracture. Torque to Fracture (TtF) and fragments length were registered and all data were statistically analyzed. Results showed that Groups 2, 4 and 6 had a higher TtF, respectively, than Groups 1, 3 and 5, which differ from the former just for shaft length. Group 6 showed the highest torsional resistance (1.31 ± 0.08 Ncm), whilst Group 1 the lowest (0.40 ± 0.08 Ncm). According to that, it can be stated that the longer the instrument, the higher the torsional resistance is, proving that shaft length should be considered as an important factor about torsional resistance.
Assuntos
Níquel , Titânio , Ligas Dentárias , Instrumentos Odontológicos , Desenho de Equipamento , Falha de Equipamento , Teste de Materiais , Preparo de Canal Radicular , Estresse Mecânico , Torque , Torção MecânicaRESUMO
We proposed to perform a comparative analysis of growth factors, cytokines, and chemokine receptors on the salivary cells in the saliva obtained from trigeminal neuralgia (TN) and normal subjects. Saliva was collected from TN and healthy subjects. Salivary cells were isolated by centrifugation. The expression of the cell surface marker was analyzed by flow cytometry. A cytometric bead array was done to measure the levels of cytokines and growth factors on the flow cytometer. Saliva from TN subjects showed lower growth factor levels of Angiopoietin-2, bFGF, HGF, SCF, TGF-α, and VEGF and higher cytokine levels of IL-1ß, TNF-α, CCL2, IL-17A, IL-6, and CXCL8, as well as higher expression levels of chemokine receptors CCR1 (CD191), CR3 (CD11b), CCR2 (CD192), CXCR5 (CD185), and CCR5 (CD196) in the cells from TN saliva. A certain set of cytokines and growth factors in the saliva, as well as chemokine receptors on salivary cells, could be a useful tool in the diagnostics and prognostics of trigeminal neuralgia. Trigeminal neuralgia is one of the significant pathological conditions in the class of chronic diseases around the world. Many targeted approaches are being tried by various research groups to utilize the information of the inflammatory microenvironment to resolve the pathology of chronic TN.
Assuntos
Citocinas/análise , Peptídeos e Proteínas de Sinalização Intercelular/análise , Neuralgia do Trigêmeo/metabolismo , Adulto , Biomarcadores/análise , Quimiocinas/análise , Feminino , Citometria de Fluxo/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Saliva/química , Neuralgia do Trigêmeo/fisiopatologiaRESUMO
BACKGROUND: Growth factors and cytokines responsible for the regenerative potential of the dental pulp mesenchymal stem cell secretome (DPMSC-S) are implicated in oral carcinogenesis. The impact and effects of these secretory factors on cancer cells must be understood in order to ensure their safe application in cancer patients. OBJECTIVE: We aimed to quantify the growth factors and cytokines in DPMSC-S and assess their effect on oral cancer cell proliferation. MATERIALS AND METHODS: DPMSCs were isolated from patients with healthy teeth (n = 5) that were indicated for extraction for orthodontic reasons. The cells were characterized using flow cytometry and conditioned medium (DPMSC-CM) was prepared. DPMSC-CM was subjected to a bead-based array to quantify the growth factors and cytokines that may affect oral carcinogenesis. The effect of DPMSC-CM (20%, 50%, 100%) on the proliferation of oral cancer cells (AW123516) was evaluated using a Ki-67-based assay at 48 h. AW13516 cultured in the standard growth medium acted as the control. RESULTS: VEGF, HCF, Ang-2, TGF-α, EPO, SCF, FGF, and PDGF-BB were the growth factors with the highest levels in the DPMSC-CM. The highest measured pro-inflammatory cytokine was TNF-α, followed by CXCL8. The most prevalent anti-inflammatory cytokine in the DPMSC-CM was IL-10, followed by TGF-ß1 and IL-4. Concentrations of 50% and 100% DPMSC-CM inhibited Ki-67 expression in AW13516, although the effect was non-significant. Moreover, 20% DPMSC-CM significantly increased Ki-67 expression compared to the control. CONCLUSIONS: The increased Ki-67 expression of oral cancer cells in response to 20% DPMSC-CM indicates the potential for cancer progression. Further research is needed to identify their effects on other carcinogenic properties, including apoptosis, stemness, migration, invasion, adhesion, and therapeutic resistance.
Assuntos
Meios de Cultivo Condicionados/farmacologia , Citocinas/metabolismo , Polpa Dentária/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Células-Tronco Mesenquimais/metabolismo , Neoplasias Bucais/metabolismo , Adolescente , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Separação Celular , Meios de Cultivo Condicionados/análise , Citocinas/análise , Polpa Dentária/citologia , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/análise , Células-Tronco Mesenquimais/citologia , Neoplasias Bucais/patologia , Cultura Primária de Células , Adulto JovemRESUMO
Background and Objectives: Oral cancer is the 6th most common cancer in the world and oral leukoplakia is an oral potentially malignant disorder that could develop into oral cancer. This systematic review focusses on randomized clinical trials for recombinant adenovirus p-53 (rAD-p53) therapy for the treatment of oral leukoplakia and cancer. Materials and Methods: We searched for research articles on various databases such as Pubmed/Medline, Embase, CNKI (China National Knowledge Infra-structure), Springerlink, cochrane and Web of sciences from 2003 to 2020. MeSH (Medical Subject Headings) terms were used for the search. Inclusion criteria included original research, randomized clinical trials and articles only in English language. Exclusion criteria were any articles that were not research articles, not randomized trials, non-human studies, etc. The articles were further graded on the Jadad scale. Results: 578 articles were assessed from various databases; only 3 articles were found to be appropriate for this review. Thus, meta-analysis was not performed because of heterogeneity and lack of data. In the three studies, whether rAD-p53 was used as a standalone therapy or with other therapies, there was a beneficial effect of the therapy. Furthermore, there were no serious adverse events and the only adverse events reported were fever, pain at the local injection site, flu-like symptoms and lowered WBC count. Conclusions: Thus, we can conclude that this therapy has a potential for beneficial therapeutic effects and further clinical trials with more patients need to be performed to get better understanding of the effect of rAD-p53 therapy, which probably will pave the way to its approval in other parts of the world.
Assuntos
Adenovírus Humanos , Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Carcinoma de Células Escamosas/terapia , China , Humanos , Leucoplasia Oral/terapia , Neoplasias Bucais/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço , Proteína Supressora de Tumor p53RESUMO
Moringa oleifera (MO), or the common drumstick possesses antioxidant properties, and its pods, seeds, leaves, and bark have been used for the treatment of inflammatory and cancerous conditions. This systematic review attempts to synthesize original studies of MO extracts in cell lines to determine their specific antiproliferative, antioxidant, anti-inflammatory, and related effects. The literature was obtained from PubMed central, the Cochrane registry, and other sources including Google Scholar, and Embase. Studies fulfilling the inclusion criteria were selected. Custom data collection forms were employed and two independent evaluators compiled the relevant information. Eighteen studies were selected after applying inclusion and exclusion criteria. In most studies, MO leaves had more potent properties compared to other parts of the plant. Ethyl acetate and ethanolic extractions improved the potency of the extract. Effects were selective (different for normal cells and cancer cells) and dose-dependent. Anticancer and antioxidant activities were consistently reported, with effects exerted at the genetic and molecular levels. MO extracts potentially could be employed for therapeutic applications. The optimal sources, preparation protocols, and dosages have been researched, though further scrutiny is needed for a comprehensive formulation. Keywords: Anticancer, Anti-inflammatory, Antioxidant, Moringa oleifera.
Assuntos
Moringa oleifera , Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Linhagem Celular , Extratos Vegetais/farmacologiaRESUMO
AIM AND OBJECTIVE: The present study aims to evaluate the difference in torsional resistance of two reciprocating nickel-titanium (Ni-Ti) rotary files: WaveOne Gold and EdgeOne Fire. MATERIALS AND METHODS: A total of 40 nickel-titanium rotary instruments (n = 40): 20 WaveOne Gold Small (WOGS) and 20 EdgeOne Fire Small (EOFS) were divided into two groups. Each instrument was tested using a torsional resistance device already validated in previous studies to evaluate and compare torsional resistance. The static torsional test was implemented by blocking each instrument at 3 mm from the tip and rotating it until fracture with a reciprocating motion. Torque to fracture (TtF) and fragment length (FL) were measured and statistically analyzed. RESULTS: Statistical analysis of TtF found significant differences between the two groups (p<0.05). The EOFS showed higher TtF if compared to WOGS, with a mean value and a standard deviation of 3.05 ± 0.07 (N cm) against 2.97 ± 0.08 (N cm). Data for FL showed no significant differences (p>0.05) between the two groups. CONCLUSION: According to the results of this study, it is reasonable to assert that EOFS instruments showed a higher torsional resistance if compared to the WOGS. CLINICAL SIGNIFICANCE: As evidenced by this study, EOFS should be considered as a safer solution, in terms of torsional resistance, if compared to WOGS, reducing the risk of intracanal separation due to excessive torsional load.
Assuntos
Níquel , Titânio , Ligas Dentárias , Instrumentos Odontológicos , Desenho de Equipamento , Temperatura Alta , Teste de Materiais , Preparo de Canal Radicular , Torção MecânicaRESUMO
AIM: The aim of this systemic review is to investigate these parameters by analyzing the characteristics of fractured instruments to determine which is the most relevant mechanical stress that induces intracanal separation in vivo. BACKGROUND: The fracture of nickel-titanium (Ni-Ti) instruments is a result of flexural fatigue and torsional fatigue. An electronic search was conducted in MEDLINE database, Web of Science, and Cochrane following preferred reporting items for systematic reviews and meta-analyses guidelines. Data were collected and the key features from the included studies were extracted. Overview quality assessment questionnaire scoring assessed the quality of the articles. A total of 12 articles were selected, where the lowest score was 13. REVIEW RESULTS: Considering Ni-Ti rotary instruments, this overall evaluation comprehends 939 broken instruments with an incidence of fracture of 5%. Out of the 12 selected articles, 10 studies revealed that flexural failure was the predominant mode (range of 62-92%). It appears that motion plays an important role when it comes to mechanisms of fracture. The majority of defects found in hand-operated instruments were in the form of torsional failure. Although the major cause of separation of rotary instruments is flexural fatigue, smaller instruments show more torsional fracture than the larger instruments. The average fragment length was found to be 2.5 mm and 3.35 mm, respectively, for torsional failure and flexural failure. The risk of bias depends on fractographic analysis. CONCLUSION: Flexural fatigue is the predominant mode of fracture in rotary Ni-Ti instruments. The type of motion and size of the instrument seem to affect the mechanism of fracture. Fragment length may show a strong association with the type of fracture mechanism. CLINICAL SIGNIFICANCE: This systemic review found that flexural fatigue is the most relevant mechanical stress that induces intracanal separation in vivo. Moreover, in clinical practice, the fragment length might be an excellent indicator of the type of fracture.
Assuntos
Níquel , Titânio , Ligas Dentárias , Instrumentos Odontológicos , Desenho de Equipamento , Falha de Equipamento , Incidência , Preparo de Canal Radicular , Estresse Mecânico , Torção MecânicaRESUMO
AIM AND OBJECTIVE: The aim and objective of this study was to evaluate and compare the cutting efficacy of two different nickel titanium rotary instruments by a novel methodology: the operative torque (torque and time needed to progress toward the apex). MATERIALS AND METHODS: Ten fresh extracted upper first premolars with two canals were instrumented with a KaVo (Biberach, Germany) and a KaVo 1:1 handpiece at 300 rpm with maximum torque set at 2 N. One canal was instrumented with ProGlider NiTi rotary instruments (Dentsply Sirona Endodontics, Ballaigues, Switzerland), with tip size of 16.02, and the other one with EgdeGlidePath rotary instrument (EdgeEndo, Albuquerque, New Mexico). Mean instrumentation time, mean torque values, and maximum torque values were evaluated for each instrument. The significance level was set at p <0.05. RESULTS: EdgeGlidePath instruments reached the working length in significantly less time with a significantly smaller amount of torque when compared to ProGlider (p >0.05). No instruments exhibited flute deformation or underwent intracanal failure. CONCLUSIONS: Operative torque is related to the capability to cut dentin and progress toward the apex: the smaller the torque values, the higher the cutting ability (and safety). Operative torque is also dependent on debris removal and irrigation techniques. Nevertheless, both operative torque and instrumentation time are clinically relevant parameters for evaluating instruments' performance (i.e., cutting ability). CLINICAL SIGNIFICANCE: Operative torque during endodontic instrumentation helps understanding the overall performance in terms of both cutting efficiency and safety.
Assuntos
Níquel , Preparo de Canal Radicular , Ligas , Ligas Dentárias , Instrumentos Odontológicos , Cavidade Pulpar , Desenho de Equipamento , Alemanha , Titânio , TorqueRESUMO
PURPOSE: We aimed to retrospectively evaluate the radiographic and clinical results and the success rate of short implants with a laser-microgrooved collar (≤7.5 mm) placed in the posterior areas after up to 3 to 5 years of function and the possible influence of several variables-such as gender, periodontitis, smoking habit, location, implant stability at placement, and prosthetic fixation design-on implant marginal bone loss (MBL). MATERIALS AND METHODS: A chart review was used for this multicenter study, which involved 5 private dental clinics. All patients had been treated with short dental implants with a laser-microgrooved collar from January 2012 to December 2015. RESULTS: A total of 174 patients (99 male and 75 female patients; mean age, 51.6 ± 2.8 years) with 254 implants were evaluated. Seven short implants failed. The cumulative success rate was 97.2%, without a statistically significant difference between implants placed in the posterior maxilla and mandible. The mean MBL was 0.18 ± 0.7 mm at the mesial aspect and 0.19 ± 0.6 mm at the distal aspect. No statistical relationships were found between MBL and gender, periodontitis, smoking habit, location, implant stability at placement, and prosthetic fixation design. CONCLUSIONS: At the end of the 3- to 5-year follow-up period, short implants with a laser-microgrooved collar (≤7.5 mm) in the posterior areas yielded a relatively high cumulative success rate. The laser-microgrooved collar implant maintained stable marginal bone levels. No investigated variable was statistically associated with MBL.
Assuntos
Perda do Osso Alveolar , Implantes Dentários , Boca Edêntula , Implantação Dentária Endóssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Lasers , Masculino , Mandíbula , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Root canal treatment is one of the most challenging practices in dentistry as the complexity and the variability of the endodontic space can often lead the operator to create false trajectories or missing canals. The technical advances in the development of even more efficient and resistant endodontic instrument reached important results in the last few years with the adoption of NiTi alloys and thermal treatments, which could increase the flexibility and the resistance of the instruments.1,2.
Assuntos
Endodontia , Ligas , Ligas Dentárias , Assistência Odontológica , Humanos , Tratamento do Canal RadicularRESUMO
During the long history of their evolution, higher organisms, including mammals, have learnt to take great advantage from living in close contact with selected populations of microbes.1 By living in close contact, animals and microbes underwent a progressive and mutual co-evolutive process that is believed to be a major driving force in the development of adaptive immunity of vertebrates.2.
Assuntos
Fatores Biológicos , Microbiota , AnimaisRESUMO
In the last decades, the use of nickel-titanium (Ni-Ti) rotary instruments has become the most effective and popular method among endodontists for shaping root canals, even if there are still concerns regarding the increased risks of intracanal breakage or weakening of the instruments.1,2 So manufacturers started to modify the cross-sectional geometrical aspects of the files in order to improve their resistance to torsional and cyclic fatigue. Design is a major feature in determining instruments' properties including cutting efficiency, removal of debris, stresses generated during instrumentation, and the relative resistance to these stresses; however, a perfect design is not existing and any change in design is likely to provide some advantages but also some disadvantages.3,4.
Assuntos
Níquel , Titânio , Estudos Transversais , Ligas Dentárias , Instrumentos Odontológicos , Desenho de Equipamento , Falha de Equipamento , Preparo de Canal RadicularRESUMO
Endodontic treatments tend to have very high successful rates in spite of the fact that they are quite an invasive, difficult procedure, especially in complex anatomies. Some complications can arise during or after a root canal procedure due to poor understanding of the anatomy and iatrogenic errors mainly during instrumentation. While some of these problems can be anticipated, many can never really be predicted.1-3 As a consequence, retreatment has become a well-defined field of knowledge and expertise in endodontics, since most complications can be solved with proper surgical or nonsurgical retreatments.4 Reinfection or persistent infections: Root canal treatment can fail due to a persistent bacterial infections or reinfections. These include inadequate shaping, cleaning, and obturation procedures, poor restorations, and exposure through a fracture. The remedies are dependent on the primary cause of the reinfection and the affected parts. Persistent infection is the major cause of short-term endodontic failures.5.
Assuntos
Endodontia , Tratamento do Canal Radicular , RetratamentoRESUMO
The role of nickel-titanium (NiTi) in the production of endodontic instruments increased in the last few decades; therefore, the way of evaluation of its performance increased as well. Nowadays, there are several ways to evaluate NiTi instruments, divided into static and dynamic tests. The static ones are cyclic fatigue tests, torsional resistance tests, flexibility, and cutting efficiency tests. These methodologies have been deeply used to evaluate some of the metallurgical properties of the instruments on the market. Up-to-date, we know very well the behavior of NiTi under static conditions, but these knowledges are too fragmented to be relevant for understanding and evaluating the complexities of intracanal instrumentation. Starting from the purpose to introduce the variable of movement in the testing procedure, some dynamic tests have been proposed, such as dynamic cyclic fatigue test.1,2 Although these kinds of studies were capable of evaluating more precisely the behavior of rotary instruments inside the root canal, they could not take into account, at this moment, the complexities of stresses that instruments undergo during the shaping procedure.3-5 Therefore, some of these tests are not accepted anymore by the scientific community and on the contrary they do not help the general practitioner to orientate in the large amount of rotary instruments present on the market.6 This tends to withdraw the general dentistry from the scientific literature, wearing a groove between the practice and the science.7 Starting from these ideas, in the last couple of years some authors started to think the proper way to real-time evaluation of the performance of NiTi rotary instruments inside the root canal. To do so, a countable and repeatable measurement of instrument's developed stresses was needed. Setzer and Böhme8 first used the torque generated by Revo-S, Vortex, and ProFile to evaluate their performance during instrumentation. The so-called "operative torque" is the summation of torque generated in each point of the instrument during its simultaneous movement around its own axis and up and down inside the canal. The recorded values are influenced by both torsional and flexural stresses, becoming this way a reliable method to analyze, evaluate, and compare the performance of NiTi instruments inside the root canal.9 This methodology is applicable for not only in vitro but also in vivo measurement, as demonstrated by Gambarini et al.10 The main drawback of this kind of evaluation is the not well-determined correlation between the torsional and the flexural stresses; therefore, it is still unpredictable how each influence the other. In conclusion, the potential of real-time torque measurement is wide and still unexplored, but further studies are needed to better understand how torque is developed inside the root canal.