Use of bioactive materials and limited FOV CBCT in the treatment of a replanted permanent tooth affected by inflammatory external root resorption: a case report

BACKGROUND

Inflammatory external root resorption is one of the possible complications of replantation of an avulsed tooth. Several studies have shown that limited FOV CBCT is an efficient diagnostic support and in treatment planning of these cases in paediatric patients because of its high resolution combined with low radiation doses. The recent literature has suggested that Biodentine is an effective material for resolution of inflammatory root resorption.

CASE REPORT

This article describes the successful therapy of a replanted tooth affected by inflammatory root resorption. In the present case, a CBCT exam was performed to detect the extent of the damage, and the canal was filled with Biodentine in the apical third. At present, the threated tooth is asymptomatic, and the twelve months follow-up examination showed healing of periradicular hard tissues.

Post Placement Affects Survival of Endodontically Treated Premolars

Clinical evidence is lacking regarding the influence of the amount of residual coronal dentin and of post placement on the failure risk of endodontically compromised teeth. The aim of this prospective clinical trial was to assess whether these factors significantly affect the two-year survival of restored pulpless premolars. A sample of 210 individuals provided six experimental groups of 40 premolars in need of endodontic treatment. Groups were defined based on the amount of dentin left at the coronal level. Within each group, in half of the teeth selected at random, a fiber post was inserted inside the root canal, whereas in the remaining half of the premolars, no post was placed. All teeth were covered with a crown. The Cox regression analysis revealed that post placement resulted in a significant reduction of failure risk (p < 0.001). Failure risk was increased for teeth under the “no ferrule” (p = 0.001) and “ferrule effect” conditions (p = 0.004).

Effect of Green Tea-Added Tablets on Volatile Sulfur-Containing Compounds in the Oral Cavity

OBJECTIVES

A controlled, clinical, double-blind, cross-over study was conducted to assess the efficacy of sugar-free tablets containing green tea extract on oral volatile sulfur-containing compounds (VSC) versus placebo tablets for 30 minutes.

METHODS

To join the study, subjects had to have at least 24 teeth, no report of oral and systemic diseases, and no removable dentures. All eligible participants had to avoid professional oral hygiene and drugs for two weeks, to not be menstruating, to avoid brushing their teeth and tongue, to not smoke, to not consume alcohol, coffee or tea, nor onion, garlic, or licorice for six hours before the test. Moreover, they had to score a level of VSC ≥ 75 ppb at the basal measurement. Subjects were entered into their respective groups after a minimum 48-hour wash-out period. The test tablet (0.7 g) contained 0.05% green tea extract (equivalent of 1 mg polyphenols for three tablets); the control tablet was identical but without the active agent. The OralChroma2™ device was utilized to evaluate VSC in the oral air. The levels were recorded at baseline, after sucking three tablets in succession, and after 30 minutes. Data were analyzed with SPSS software and significance was set at α = 0.05.

RESULTS

54 subjects completed the trial (23 men, 31 women). None reported problems linked to green tea. The mean reductions in VSC level from baseline at the end of tablet sucking were 34% (p < 0.001) in the control and 55% (p < 0.001) in the test group; after 30 minutes, reductions were 7% in the control (p = NS) and 26% (p < 0.005) in the test group. The comparisons between the two groups after baseline adjustment showed a statistically significant difference in reductions both at the end of the sucking period (p < 0.01) and after 30 minutes (p < 0.01).

CONCLUSIONS

Tablets containing green tea extract can statistically significantly reduce the oral VSC levels immediately, and after 30 minutes. Moreover, the test tablets reduced oral VSC significantly more than the control tablets.

In vivo and in vitro Permeability of One-step Self-etch Adhesives

Adhesive dentistry should effectively restore the peripheral seal of dentin after enamel removal. We hypothesize that non-rinsing, simplified, one-step self-etch adhesives are effective for minimizing dentin permeability after tooth preparation procedures. Crown preparations in vital human teeth were sealed with Adper Prompt, Xeno III, iBond, or One-Up Bond F. Epoxy resin replicas were produced from polyvinyl siloxane impressions for SEM examination. Dentin surfaces from extracted human teeth were bonded with these adhesives and connected to a fluid-transport model for permeability measurements and TEM examination. Dentinal fluid droplets were observed from adhesive surfaces in resin replicas of in vivo specimens. In vitro fluid conductance of dentin bonded with one-step self-etch adhesives was either similar to or greater than that of smear-layer-covered dentin. TEM revealed water trees within the adhesives that facilitate water movement across the polymerized, highly permeable adhesives. Both in vitro and in vivo results did not support the proposed hypothesis.

In vivo Fluid Movement through Dentin Adhesives in Endodontically Treated Teeth

Fluid transudation through simplified dentin adhesives can occur in bonded vital crown dentin, since these adhesives behave as permeable membranes after polymerization. The effect of adhesive permeability in endodontically treated teeth is unknown. This study examined the hypothesis that in vivo fluid movement through simplified adhesives occurs when they are applied to root canals. Dowel spaces were prepared in endodontically treated teeth with single root canals. Six adhesives were applied to the intra-radicular dentin of canal walls. Impressions were obtained with polyvinyl siloxane, and replicas were fabricated with the use of polyether impression material. Replica hemisections were gold-coated for SEM examination. Fluid transudation was evident on the adhesive surfaces of all simplified total-etch and self-etch adhesives. Conversely, most of the specimens bonded with the control three-step total-etch adhesive were devoid of fluid droplets. Permeability of simplified adhesives results in water movement, even in root-treated dentin. This may adversely affect the coupling of auto-/dual-cured resin cements.

Is pit and fissure sealing of buccal surfaces useful in reducing incidence of caries of first permanent molars?

AIM

The aim of the study was to establish whether caries prevalence on the buccal surfaces of first lower permanent molars (FLPMs) can be compared to those on the occlusal surfaces in order to justify the utility of extending pit and fissure sealing also to the extra-occlusal surfaces.

MATERIALS AND METHODS

Design: an observational study was carried out in the children population (n=779) aged ≤14 years (mean age 7.68, SD 3.53) that presented at the Paediatric Dentistry Department of the University of Perugia. In the study were included 460 patients, and absolute frequency (number) of FLMP occlusal and buccal caries, together with their ratio and their difference in percentage, were recorded and analysed. Moreover, FLMP buccal caries variation related to age, sex and parent's nationality were calculated.

RESULTS

Among the 460 children included (243 males) aged 5-14 years, 103 erupted FLPMs were analysed. Of their decayed surfaces (n=115), the occlusal surfaces were 62 (53.9%) and the buccal surfaces 53 (46.1%); the absolute frequency ratio was 1.17 and the percentage difference was 7.8%. The female gender was significantly related to buccal caries of FLPMs [OR = 2.66 (95% CI; 1.27-5.59; p=0.0096)] as was the age ranging between 10-14 years [OR = 2.73 (95% CI; 1.36-5.50; p =0.004)]. The parents nationality was not significantly related to buccal caries [Odds Ratio =1.47 (95% CI; 0.70-3.06; p = 09040)].

CONCLUSIONS

The similar caries susceptibility of buccal and occlusal surfaces of FLPMs stimulates further comparative studies about the usefulness of extending pit and fissure sealing to the buccal surfaces in addition to the occlusal prophylactic intervention, particularly with regard to the female sex and during the early eruption stages of these teeth.

Effect of Reciproc endodontic treatment with three different post space preparation instruments on fiber post retention

PURPOSE

To assess the effect of three different drills used for post space preparation on fiber post retention after Reciproc endodontic treatment.

METHODS

30 human upper incisors were endodontically treated using Reciproc and warm vertical gutta-percha compaction. Teeth were sealed coronally using Fuji VII, then stored in 0.5% T chloramine solution at 4 degrees C. After 1 week, teeth were randomly assigned to three groups (n = 10) that differed for the drill type used for post space preparation: Group 1: Calibrated drill; Group 2: Largo drill; Group 3: MTwo drill. Illusion posts were luted into the root canals using Gradia Core. After 24 hours, posted roots were transversally cut into 1 mm-thick slices for thin-slice post push-out testing. Two slices per apical, middle, and coronal thirds were obtained, resulting in a total of 6 slices per tooth. Thin-slice push-out test was conducted using a universal testing machine. Post push-out strength was measured in MPa. For the fracture analysis, the specimens were observed using a stereomicroscope at x40 magnification and classified as adhesive [between post-cement (P-C) or dentin-cement (D-C) interface], cohesive (within the post or adhesive cement) and mixed (adhesive and cohesive fractures occurred simultaneously). Between-group differences in post retentive strength were statistically analyzed (Kruskal-Wallis ANOVA, Dunn's Multiple Range test, P > 0.05). Differences in push-out strength among root levels within each group (one-way ANOVA or Kruskal-Wallis ANOVA, depending on the normality of data distribution, P> 0.05) and in failure mode distribution were also statistically evaluated (Fisher's Exact Test, P > 0.05).

RESULTS

For each group the mean of MPa values was: (1) 10.41 ± 3.56, (2) 10.98 ± 3.96, and (3) 12.11 ± 1.65. Failure mode was distributed as follows: Adhesive: (1) P-C - 23.3%, D-C - 21.7%; (2) P-C - 20%, D-C - 10%; (3) PrC - 46.7%, D-C - 13.3%; Cohesive: (1) 0.0%, (2) 3.3%; (3) 0.0%; Mixed: (1) 55.0%; (2) 66.7%; (3) 40.0%. The statistical analysis revealed the existence of significant between-group differences (P= 0.002). Group 3 measured significantly higher push-out strengths than Groups 1 and 2, which were comparable. Statistically significant between-group differences emerged also in failure mode distribution (P= 0.004). In Group 3 post-cement adhesive failures were significantly more frequent and mixed failures were significantly less frequent than in Group 2. No statistically significant differences emerged among the different root levels of the tested groups (P > 0.05).

The effect of zinc lactate and magnolia bark extract added tablets on volatile sulfur-containing compounds in the oral cavity

OBJECTIVE

A controlled, clinical, double-blind study was conducted to assess the efficacy of sugar-free tablets containing zinc lactate and magnolia bark extract (MBE) on oral volatile sulfur-containing compounds (VSC) versus placebo tablets for two hours.

METHODS

In order to join the study, subjects had to have at least 24 teeth, no report of oral and systemic diseases, and no removable dentures. All 128 eligible participants had to avoid any professional oral hygiene, refrain from taking medicines for two weeks, be not menstruating, and not brush their teeth and tongue, smoke, drink alcohol, coffee or tea, eat onion, garlic, or licorice for a six-hour period before the visit and during the test. Moreover, to join the protocol, they had to show a VSC score of ≥ 75 ppb at the baseline measurement. Each qualified subject was placed in the test or the control group using a table of random numbers. The test tablet (0.7 g) contained 0.17 mg of zinc, in the form of zinc lactate, and 0.84 mg magnolia bark extract; the control tablet was identical, but without these active agents. The OralChroma2 device was utilized to evaluate total oral VSC. Their levels were recorded at baseline, after eight minutes of sucking two tablets in succession, after one hour, and after two hours. Data were analyzed with SPSS software and the level of significance was set at α = 0.05.

RESULTS

One hundred subjects completed the trial (50 in the control group and 50 in the test group); 52 men and 48 women, mean age 38. None reported problems linked to zinc lactate or magnolia bark extract. The mean percentage reduction from baseline at the end of eight minutes of tablet sucking was 39% in the control group (p < 0.001) and 62% in the test group (p < 0.001); one hour later it was 6% in the control group and 30% in the test group (p < 0.001), and two hours later it was 2% in the control group and 18% in the test group (p < 0.001). The comparisons between the two groups after baseline adjustment showed a statistically significant difference in reductions of VSC between the test and the control tablets at the end of the sucking period (p < 0.01), after one hour (p < 0.001), and after two hours (p < 0.05).

CONCLUSION

Tablets containing zinc lactate and magnolia bark extract can statistically significantly reduce the oral VSC levels for over two hours and were statistically significantly more effective than a control tablet.

A clinical study of the efficacy of a new chewing gum containing calcium hydroxyapatite in reducing dentin hypersensitivity

OBJECTIVE

A controlled, clinical, double blind study was conducted to assess the efficacy of a sugar-free chewing gum containing calcium hydroxyapatite on dentin hypersensitivity, versus a placebo chewing gum with no active ingredients, after one and two weeks.

METHODS

One hundred and seven subjects joined the trial and were allocated into the test or the control (placebo) group by a random table. The test chewing gum contained calcium hydroxyapatite and dicalcium phosphate dihydrate; the control chewing gum was identical, but without those ingredients. Participants were required to chew two pieces of their assigned chewing gum three times a day. Dentin hypersensitivity was evaluated following three clinical test indexes (tactile, air blast, cold water) and one subjective index.

RESULTS

One hundred subjects completed the study with 50 allocated to each group. The clinical test index reductions after one and two weeks in the test group were, respectively, 36% and 54% for tactile, 35% and 66% for air blast, and 24% and 49% for cold water. The clinical test index reductions after one and two weeks in the control group were, respectively, 16% and 30% for tactile, 11% and 25% for air blast, and 14% and 31% for cold water. These reductions at one and two weeks were significant for the test group (p < 0.01). For the control group they were significant (p < 0.01) only at two weeks. The comparisons between the groups at two weeks showed a significant statistical difference between the test and the control gum for tactile (p < 0.01), for air blast (p < 0.001), for cold water (p < 0.05), and for the subjective index (p < 0.05).

CONCLUSION

In this trial, the group using the chewing gum containing calcium hydroxyapatite had a statistically significant reduction in all clinical test indexes for dentin hypersensitivity after one and two weeks, and a statistically significant reduction compared to the control gum group.

The effect of zinc acetate and magnolia bark extract added to chewing gum on volatile sulfur-containing compounds in the oral cavity

OBJECTIVE

A controlled, clinical, double-blind study was conducted to assess the efficacy of a sugar-free chewing gum containing zinc acetate and magnolia bark extract (MBE) on oral volatile sulfur-containing compounds (VSC) versus a placebo sugar-free chewing gum for two hours.

METHODS

To participate in the study, subjects had to have at least 24 of their teeth, no report of oral and systemic diseases, and no removable dentures. All 168 eligible participants had to avoid any professional oral hygiene, refrain from taking medicine for two weeks, and not be menstruating. They were also instructed not to brush their teeth and tongue, smoke, drink alcohol, or eat onion, garlic, or licorice for the six-hour period before the visit and during the test. Moreover, to join the protocol, they had to show a VSC score of > or = 75 ppb at the baseline measurement. One-hundred and twenty-three subjects (67 men and 56 women, mean age 37) met the criteria at baseline and were entered into either the test or control group by assignment from a table of randomized numbers. The test chewing gum (2.23 g) contained zinc acetate 0.012% and magnolia bark extract 0.15% in weight; the control gum was equivalent without these active agents. The OralChroma device was utilized to evaluate total oral VSC. Their levels were recorded at baseline, after ten minutes of mastication, after one hour, and after two hours. Data were analyzed with SPSS software and the level of significance was set at alpha = 0.05.

RESULTS

One-hundred and twenty-three subjects completed the trial (62 in the control group and 61 in the test group); none reported problems linked to zinc acetate or magnolia bark extract. The mean percentage reductions from baseline at the end of the 10-minute chewing were 31.2% in the control group (p < 0.05) and 50.9% in the test group (p < 0.05). One hour later the reductions were 6.9% in the control group and 27.6% in the test group (p < 0.05); two hours later the reductions were 2.3% in the control group and 13.6% in the test group. The comparison of the two groups after baseline adjustment showed a statistically significant difference (p < 0.05) in VSC reductions between the test and control chewing gums at the end of the mastication period and after one hour.

CONCLUSION

Chewing gum containing zinc acetate and magnoliabark extract can significantly reduce the oral VSC levels for more than one hour. Moreover, the test chewing gum reduces oral VSC significantly more than a control chewing gum.

Effect on dental stain occurrence by chewing gum containing sodium tripolyphosphate--a double-blind six-week trial

OBJECTIVE

A six-week controlled double-blind clinical study was conducted to assess and to measure the efficacy of a sugar-free chewing gum containing sodium tripolyphosphate (1%) on dental stain occurrence versus a placebo sugar-free chewing gum.

METHODS

One-hundred and eleven subjects who had a Lobene Modified Index for stain extent score between 0.33 and 1.5 in their frontal teeth joined this study. Each subject entered in the test or the control group using a random table which allowed for an equal distribution of smokers and habitual tea users. Participants agreed to chew two gums (two grams each) three times per day, after meals, for ten minutes over six weeks. All received the same dentifrice containing only fluoride as the active agent. After six weeks, participants were scored for dental stain with the Lobene Modified Index. Data were scored by the same blinded operator for all measurements. Comparisons between the groups with respect to baseline scores were performed using an unpaired t-test, and inside the groups with a paired t-test (alpha = 0.05).

RESULTS

One-hundred and eight subjects completed the trial; three left, but none reported problems linked to sodium tripolyphosphate. The mean difference for stain extent index after the six-week trial was 0.04 (+/- 0.08) in the control group, and -0.05 (+/- 0.08) in the test group (p < 0.001). A statistically significant reduction was also reported for intensity and composite indexes. The initial mean for stain extent index in the test group was 0.8 (+/- 0.34), and at six weeks was 0.74 (+/- 0.33; p < 0.001). The initial mean for extent index in the control group was 0.78 (+/- 0.3), and at six weeks was 0.81 (+/- 0.32; p < 0.005).

CONCLUSION

This trial showed a reduction in dental stain by a chewing gum containing sodium tripolyphosphate after six weeks.

Bond strength of composite core build-up materials to fiber-reinforced posts: a microtensile comparison between conventional and wet-ethanol bonding systems

PURPOSE

To evaluate the interfacial microtensile bond strength between a fiber-reinforced post (Rely X Post) and a core material (Multicore Flow) after placing different bonding agents.

MATERIALS AND METHODS

After post surface treatment, 50 posts were divided into 5 groups. Group 1: Adper Prompt-L-Pop; group 2: SingleBond2; group 3: ScotchBond Multipurpose Plus; group 4: experimental bonding system (wet ethanol bonding technique); group 5: control group. After core reconstruction, the samples were tested with the microtensile test. Fracture type examination and SEM observation followed. Data were statistically analyzed with Kruskall-Wallis non-parametric ANOVA.

RESULTS

Microtensile testing revealed significant differences (p < 0.001). There were no differences between groups 1 to 4, but there was a statistically significant difference between groups 1 to 4 and the control. Fracture type observations revealed more adhesive failures than cohesive or mixed ones.

CONCLUSION

The experimental bonding technique did not improve bond strength compared to the different adhesive systems tested. However, placing a bonding agent between the post and the core seems to significantly increase microtensile bond strength.

Fracture resistance of fiber posts: combinations of several small posts vs. standardized single post

PURPOSE

To determine the fracture resistance of different sizes of standardized single fiber posts and the combinations of multiple small experimental posts.

METHODS

Single posts in three different sizes (1, 2 and 3; DT Light Posts, RTD; DT), as control, and seven different combinations of experimental small posts (Abrasive Technology), reproducing the sizes of several endodontic files were cemented in endodontic resin blocks. The combinations of small posts were made combining 2-4 small posts so as to reach the sizes of standardized DT posts. The posts were loaded at an angle of 45 degrees to the long axis of the block using a crosshead speed of 1 mm/minute until specimen failure. Ten posts/combinations were tested. Statistical analysis was performed using one-way ANOVA followed by Tamhane test for the post hoc comparisons (P < 0.05).

RESULTS

For the single posts, fracture resistance increased when increasing the diameter of the post. The use of multiple posts resulted in fracture resistances comparable to that of the single post for two of the three diameters studied (DT1 and DT2). For the largest diameter (DT3), the use of multiple posts resulted in lower fracture resistances than did the single post.