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Lerdrungroj K, Banomyong D, Songtrakul K, Porkaew P, Nakornchai S. Current Management of Dens Evaginatus Teeth Based on Pulpal Diagnosis. J Endod 2023; 49:1230-1237. [PMID: 37506764 DOI: 10.1016/j.joen.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Dens evaginatus (DE) is a dental anomaly with a supernumerary tubercle projection that typically contains dentin and pulp tissue. However, the tubercle projection can fracture, exposing the dentin and potentially the dental pulp, which induces pulpal diseases. Managing DE should be primarily based on the clinical diagnosis of the pulp. METHODS The literature search in prevalence, prophylaxis, and management of dens evaginatus was performed in PubMed database as well as by manual search, in which the related contents were collected and descriptively analyzed. RESULTS Of the 264 searched literatures, 62 articles were included for this scoping review. The prophylactic management of the tubercle of DE teeth with a normal pulp should be performed as early as possible by the prep-and-fill technique or the reinforcement technique to preserve tooth vitality and continued root development, with the former reported to be superior compared with the latter. Furthermore, DE teeth with reversible pulpitis should be managed with the prep-and-fill technique. For DE teeth with irreversible pulpitis, vital pulp therapy, ie, partial or full/coronal pulpotomy, should be considered when the pulpal inflammation is limited to the coronal pulp to preserve the vitality of the radicular pulp that induces apexogenesis. A pulpectomy should be performed if the pulpal inflammation has progressed into the radicular pulp. For DE teeth with pulpal necrosis (or after pulpectomy) and immature roots, mineral trioxide aggregate apexification or regenerative endodontic procedures are the treatment options. For DE teeth with pulpal necrosis and complete root formation, nonsurgical root canal treatment is the treatment of choice. A flow chart of the decision-making for managing DE teeth based on pulpal diagnosis is proposed. CONCLUSION DE teeth should be properly managed, by prophylaxis or treatment, depending on pulpal diagnosis and related factors.
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Affiliation(s)
| | - Danuchit Banomyong
- Faculty of Dentistry, Department of Operative Dentistry and Endodontics, Mahidol University, Bangkok, Thailand
| | - Kamolthip Songtrakul
- Department of Endodontics, New York University College of Dentistry, New York, New York
| | | | - Siriruk Nakornchai
- Faculty of Dentistry, Department of Pediatric Dentistry, Mahidol University, Bangkok, Thailand.
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Lerdrungroj K, Banomyong D, Nakornchai S, Ngoenwiwatkul Y, Porkaew P. Outcomes and Predisposing Factors of Two Prophylactic Treatments in Dens Evaginatus Premolars: A Retrospective Study. J Endod 2022; 48:864-871. [DOI: 10.1016/j.joen.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
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Kotsanos N, Wong F. Restoration of Carious Hard Dental Tissues. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rezende M, Martins ACR, da Silva JA, Reis A, de Geus JL. Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology. Clin Oral Investig 2021; 26:41-64. [PMID: 34595606 DOI: 10.1007/s00784-021-04198-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies. METHODS A systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0-2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration's tool version 1.0. RESULTS A total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal's impact factor was not correlated with the overall CONSORT score (p = 0.36). CONCLUSIONS The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement. CLINICAL RELEVANCE Most RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.
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Affiliation(s)
- Márcia Rezende
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil
| | | | - Jadson Araújo da Silva
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Paraná, 84030-900, Brazil
| | - Juliana Larocca de Geus
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil.
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Torres CRG, Mailart MC, Rocha RS, Sellan PLB, Contreras SCM, Di Nicoló R, Borges AB. The influence of a liner on deep bulk-fill restorations: Randomized clinical trial. J Dent 2020; 102:103454. [PMID: 32835711 DOI: 10.1016/j.jdent.2020.103454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/31/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of a liner on the clinical performance of deep posterior restorations performed with bulk-fill composite. METHODS 30 subjects received two restorations on deep preparations in posterior teeth, without pulpal exposure, after selective carious-tissue removal in one-stage. The internal walls reached the inner quarter of dentin, but with a radiographically detectable zone of firm dentin remaining. The pulpal protection using a layer of glass ionomer composite liner (Ionoseal, Voco) was applied in just one preparation. The adhesive system Futurabond U (Voco) was applied in all preparations, which were restored with the bulk-fill pure Ormocer nanohybrid composite (Admira Fusion Xtra - Voco), in up to 4 mm thick increments. All restorations were evaluated using the FDI criteria after 7 days, 6, 12 and 24 months postoperatively. RESULTS After 24-months, 25 patients attended the recall and 50 restorations were evaluated. The Fisher's statistical analysis (5%) showed no difference between the techniques for the esthetic, functional and biological properties. No postoperative sensitivity was reported for both groups. CONCLUSION The application of a liner did not influence the clinical performance of deep restorations with bulk-fill Ormocer composite. CLINICAL RELEVANCE The application of a liner with a GIC-based material did not have a significant effect on the clinical performance of bulk-fill restorations and seems to be unnecessary for the material tested.
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Affiliation(s)
- Carlos Rocha Gomes Torres
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
| | - Mariane Cintra Mailart
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
| | - Rafael Santos Rocha
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
| | - Pablo Lenin Benitez Sellan
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
| | - Sheila Célia Mondragón Contreras
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
| | - Rebeca Di Nicoló
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
| | - Alessandra Bühler Borges
- Sao Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, São José Dos Campos, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, SP, 12245-000, Brazil.
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Chai B, Tay B, Chow C, Fuss J, Krishnan U. Treatment preferences for deep caries lesions among Australian dentists. Aust Dent J 2020; 65:83-89. [PMID: 31773749 DOI: 10.1111/adj.12740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a global disparity in managing deep caries lesions and evidence-based strategies are not always followed. The aim of this study was to gain insight into current practices of Australian dentists for deep caries management and to determine their procedural and materials choices. METHODS An online questionnaire was sent to 1988 randomly selected practitioners across Australia asking their choice of treatment in a tooth showing symptoms of reversible pulpitis and deep caries. A total of 255 (12.6%) practitioners responded. RESULTS About 85% of respondents chose selective caries removal to selective removal (SR) while 15% chose non-selective removal to hard dentine. Respondents whose preferred approach was SR had greater odds in believing that incomplete caries removal alone would not have any effect on pulp vitality (OR = 5.20) and had greater odds of thinking that peripheral seal was more important than other factors (OR = 3.50). They also had lesser odds of believing that placing a liner would reduce postoperative sensitivity (OR = 0.269) and lesser odds of thinking that removal of all bacteria or carious dentine was important when placing a restoration (OR = 0.196). CONCLUSION Most Australian dentists reported practising evidence-based carious tissue removal strategies and accepted the concept of selectively leaving carious dentine under a sealed restoration.
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Affiliation(s)
- Byy Chai
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Byx Tay
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Cyt Chow
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - J Fuss
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - U Krishnan
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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Tjäderhane L, Tezvergil-Mutluay A. Performance of Adhesives and Restorative Materials After Selective Removal of Carious Lesions: Restorative Materials with Anticaries Properties. Dent Clin North Am 2019; 63:715-729. [PMID: 31470925 DOI: 10.1016/j.cden.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Selective carious tissue-removal strategies require specific considerations in selection of restorative materials. A tight marginal seal placed over hard dentin and sound enamel is essential. For selective removal of carious tissue with permanent restoration, bioactive materials, such as high-viscosity glass-ionomer cement (HV-GIC) or calcium silicates, may be preferred over caries-affected firm or leathery dentin to improve remineralization. HV-GICs have the best clinical evidence of caries-arresting effect and demonstrate sufficient longevity as long-term provisional restorations that can later be used in open or closed sandwich restorations. As with any material, oral health maintenance remains important for long-term survival of restorations.
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Affiliation(s)
- Leo Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, PO Box 41, Helsinki 00014, Finland; Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, University of Oulu, Oulu, Finland.
| | - Arzu Tezvergil-Mutluay
- Department of Cariology and Restorative Dentistry, Adhesive Dentistry Research Group, Institute of Dentistry, Turku University Hospital, TYKS, University of Turku, Lemminkäisenkatu 2, Turku 20520, Finland
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Schenkel AB, Veitz‐Keenan A. Dental cavity liners for Class I and Class II resin-based composite restorations. Cochrane Database Syst Rev 2019; 3:CD010526. [PMID: 30834516 PMCID: PMC6399099 DOI: 10.1002/14651858.cd010526.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure. This is an update of the Cochrane Review first published in 2016. OBJECTIVES The objective of this review was to assess the effects of using dental cavity liners in the placement of Class I and Class II resin-based composite posterior restorations in permanent teeth in children and adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 12 November 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 10) in the Cochrane Library (searched 12 November 2018), MEDLINE Ovid (1946 to 12 November 2018), Embase Ovid (1980 to 12 November 2018) and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 12 November 2018). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomized controlled trials assessing the effects of the use of liners under Class I and Class II posterior resin-based composite restorations in permanent teeth (in both adults and children). We included both parallel and split-mouth designs. DATA COLLECTION AND ANALYSIS We utilized standard methodological procedures prescribed by Cochrane for data collection and analysis. Two review authors screened the search results and assessed the eligibility of studies for inclusion against the review inclusion criteria. We conducted risk of bias assessments and data extraction independently and in duplicate. Where information was unclear we contacted study authors for clarification. MAIN RESULTS Eight studies, recruiting over 700 participants, compared the use of dental cavity liners to no liners for Class I and Class II resin-based composite restorations.Seven studies evaluated postoperative hypersensitivity measured by various methods. All studies were at unclear or high risk of bias. There was inconsistent evidence regarding postoperative hypersensitivity (either measured using cold response or patient-reported), with a benefit shown at some, but not all, time points (low-quality evidence).Four trials measured restoration longevity. Two of the studies were judged to be at high risk and two at unclear risk of bias. No difference in restoration failure rates were shown at 1 year follow-up, with no failures reported in either group for three of the four studies; the fourth study had a risk ratio (RR) 1.00 (95% confidence interval (CI) 0.07 to 15.00) (low-quality evidence). Three studies evaluated restoration longevity at 2 years follow-up and, again, no failures were shown in either group.No adverse events were reported in any of the included studies. AUTHORS' CONCLUSIONS There is inconsistent, low-quality evidence regarding the difference in postoperative hypersensitivity subsequent to placing a dental cavity liner under Class I and Class II posterior resin-based composite restorations in permanent posterior teeth in adults or children 15 years or older. Furthermore, no evidence was found to demonstrate a difference in the longevity of restorations placed with or without dental cavity liners.
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Affiliation(s)
- Andrew B Schenkel
- New York University College of DentistryCariology and Comprehensive Care345 East 24th StreetNew YorkUSA10010
| | - Analia Veitz‐Keenan
- New York University College of DentistryDepartment of Oral Maxillofacial Pathology, Radiology and Medicine345 East 24th StreetNew YorkUSANY 10010
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Schenkel AB, Peltz I, Veitz‐Keenan A. Dental cavity liners for Class I and Class II resin-based composite restorations. Cochrane Database Syst Rev 2016; 10:CD010526. [PMID: 27780315 PMCID: PMC6461160 DOI: 10.1002/14651858.cd010526.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure. OBJECTIVES The objective of this review was to assess the effects of using dental cavity liners in the placement of Class I and Class II resin-based composite posterior restorations in permanent teeth in children and adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 May 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4) in the Cochrane Library (searched 25 May 2016), MEDLINE Ovid (1946 to 25 May 2016), Embase Ovid (1980 to 25 May 2016) and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 25 May 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomized controlled trials assessing the effects of the use of liners under Class I and Class II posterior resin-based composite restorations in permanent teeth (in both adults and children). We included both parallel and split-mouth designs. DATA COLLECTION AND ANALYSIS We utilized standard methodological procedures prescribed by Cochrane for data collection and analysis. Two review authors screened the search results and assessed the eligibility of studies for inclusion against the review inclusion criteria. We conducted risk of bias assessments and data extraction independently and in duplicate. Where information was unclear we contacted study authors for clarification. MAIN RESULTS Eight studies, recruiting over 700 participants, compared the use of dental cavity liners to no liners for Class I and Class II resin-based composite restorations.Seven studies evaluated postoperative hypersensitivity measured by various methods. All studies were at unclear or high risk of bias. There was inconsistent evidence regarding postoperative hypersensitivity (either measured using cold response or patient-reported), with a benefit shown at some, but not all, time points (low-quality evidence).Four trials measured restoration longevity. Two of the studies were judged to be at high risk and two at unclear risk of bias. No difference in restoration failure rates were shown at one year follow-up, with no failures reported in either group for three of the four studies; the fourth study had a risk ratio (RR) 1.00 (95% confidence interval (CI) 0.07 to 15.00) (low-quality evidence). Three studies evaluated restoration longevity at two years follow-up and, again, no failures were shown in either group.No adverse events were reported in any of the included studies. AUTHORS' CONCLUSIONS There is inconsistent, low-quality evidence regarding the difference in postoperative hypersensitivity subsequent to placing a dental cavity liner under Class I and Class II posterior resin-based composite restorations in permanent posterior teeth in adults or children 15 years or older. Furthermore, no evidence was found to demonstrate a difference in the longevity of restorations placed with or without dental cavity liners.
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Affiliation(s)
- Andrew B Schenkel
- New York University College of DentistryCariology and Comprehensive Care345 East 24th StreetNew YorkUSA10010
| | - Ivy Peltz
- New York University College of DentistryCariology and Comprehensive Care345 East 24th StreetNew YorkUSA10010
| | - Analia Veitz‐Keenan
- New York University College of DentistryOral Maxillofacial Pathology, Radiology and Medicine345 East 24th Street NYC 1st floorNew YorkUSA10010
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