Characteristics of the molar surface after removal of cervical enamel projections: comparison of three different rotating instruments

Biometric analysis of furcation area of molar teeth and its relationship with instrumentation

The anatomy of furcation favours the bacterial retention and makes periodontal debridement as well as oral hygiene procedures difficult. Teeth that have lost attachment to a level of the furcation are said to have a furcal invasion or furcation involved.Involvement of furcation in a multi-rooted tooth poses a very different type of clinical situation in terms of establishment of diagnosis, determination of prognosis and of course planning the treatment modality.The present study was carried out on 200 selected extracted human first and second permanent molar teeth based on a predefined criteria. Teeth with prosthetic crowns, fused or fractured roots, those not fully developed, grossly carious or heavily restored at the cementoenamel junction (CEJ) were excluded from the study. The morphology of the root trunk was recorded by measuring various dimensions of the root trunk,including furcal angle and root trunk volume was calculated by using a custom made special apparatus. The furcation areas were debrided with different types of curettes in the market in order to see how best the instrument could be maneuvered in the furcation area. The data so obtained was statistically analysed using SPSS version 22. The highest root trunk volume and the longest root trunk length were found to be in the maxillary second molar. 48.60% furcations didn't allow instrument engagementof furcation area with standard area specific curettes. The proposal of inclusion of root trunk length (mm) is suggested in addition to classification of FI to have assess prognosis and appropriate treatment for of the involved tooth.

Cervical enamel projections from a periodontal perspective: A scoping review

Cervical enamel projections (CEPs) represent a unique developmental and anatomical anomaly wherein the enamel structure extends apically beyond the cemento-enamel junction of the tooth. In this scoping review, the existing literature on CEPs was evaluated to delineate their characteristics, prevalence, predilection for specific teeth and surfaces, clinical significance, and management approaches. Searches were conducted on MEDLINE (PubMed), Cochrane Library, and Embase databases using the keywords "enamel projection(s)" or "ectopic enamel." In total, 24 studies meeting inclusion criteria were included in the review. The prevalence of CEPs varied widely (8.3%-85.1%), predominantly manifesting as grade I or grade III. Mandibular first and second molars exhibited a higher incidence of CEPs, with a notable predilection for buccal surfaces. The consensus in most studies was that CEPs are associated with localized periodontal diseases. Recommendations inclined toward the removal of ectopic enamel during periodontal surgery to enhance periodontal attachment formation. However, decision-making should involve careful consideration of the benefits and drawbacks based on individual circumstances.

Cytotoxic Effects on Gingival Mesenchymal Stromal Cells and Root Surface Modifications Induced by Some Local Antimicrobial Products Used in Periodontitis Treatment

(1) Background: this study aims to test the cytotoxicity of three antimicrobial products used in periodontitis treatment on gingival mesenchymal stem cells (gMSCs) and their influence on root surfaces and gMSC adhesion. We tested the null hypothesis that the effects of the antimicrobials did not differ. (2) Methods: the commercial products based on sulphonic/sulphuric acids, sodium hypochlorite and silver nanoparticles, in five different concentrations, were added to culture medium for growing gMSCs. Cell proliferation capacity was tested using the Cell Counting Kit-8 (CCK8) and their viability was determined by succinate dehydrogenase activity (MTT) assay. Scanning electron microscopy evaluated the adhesion of gMSCs on root samples treated mechanically and with commercial products. (3) Results: the products induced a dose-dependent cytotoxicity in terms of reduced proliferation and viability of gMSCs, as well as cell shape modifications. Significant differences in CCK8 values between the different commercial products were observed. Based on proliferation tests, the null hypothesis was rejected. When MTT values of the three products were compared with each other, no significant differences were observed for any of the five concentrations (p = 0.065, p = 0.067, p = 0.172, p = 0.256, p = 0.060). (4) Conclusions: the three antimicrobials had a certain degree of cytotoxicity on gMSCs. gMSCs repopulated treated root surfaces.

Surface roughness of enamel and root surface after scaling, root planning and polishing procedures: An in-vitro study

Objectives

The aim of this study was to evaluate enamel and root surface roughness on exracted human teeth by using different tecniques (ultrasonic scaler, hand instruments, polishing paste, pumice and air powder system).

Materials and methods

A total of 200 samples were divided into two groups (enamel and root) randomly with 100 samples for each enamel and root groups. The groups were divided into 5 subgroups: Group I: ultrasonic scaler, group II: hand instruments, group III: polishing paste, group IV: pumice, group V: air-powder. Surface roughness (Ra) was assessed with Mitutoyo SJ-410 device. The one-way analysis of variance (ANOVA) test along with the Tukey test was used for statistical analysis. P values less than 0.05 were considered statistically significant.

Results

The use of ultrasonic scalers caused the highest roughness increase on the enamel surface (0.935 ​± ​0.010), whereas the use of pumice was the least (0.896 ​± ​0.018) (p ​< ​0.05). There was a significant difference between ultrasonic scalers and all the groups (hand instruments, polishing paste, pumice and air powder system) on enamel surface (p ​< ​0.05). Maximum surface roughness increase was observed in the ultrasonic scalers on root surface. There was a significant difference between ultrasonic scalers and polishing paste, pumice and air powder on root surface, respectively (p ​< ​0.05).

Conclusion

The use of ultrasonic scalers cause more rough enamel and root surfaces than hand instrumentation and polishing tecniques.

Clinical relevance

Uneven surfaces adversely affect the intended periodontal healing by creating a retention area of microbial dental plaque.