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BMC Oral Health Aug 2021Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore...
BACKGROUND
Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries.
METHODS
In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4-16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC).
RESULTS
At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24-3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries.
CONCLUSIONS
No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable.
Topics: Adolescent; Arthritis, Juvenile; Child; Cross-Sectional Studies; Dental Caries; Dentition, Permanent; Humans; Multilevel Analysis; Tooth, Deciduous
PubMed: 34433437
DOI: 10.1186/s12903-021-01758-y -
The International Journal of Oral &... 2017To test whether a Maryland bridge-type splint provides adequate stability for a custom root-shaped implant to osseointegrate in a manner substantially equivalent to that...
OBJECTIVE
To test whether a Maryland bridge-type splint provides adequate stability for a custom root-shaped implant to osseointegrate in a manner substantially equivalent to that of a threaded implant.
METHODS
Six beagle dogs were subjected to intraoral impressions and cone beam scans that were used to fabricate custom root-shaped implants (RTIs) and crowns. Premolars in the mandible (P4) and in the maxilla (P3) were extracted, and 24 RTIs were immediately placed in extraction sockets. Splint extensions of the crowns were bonded to mesial and distal teeth. Twelve mandibular molars (M2) were extracted, and threaded implants (DXI), serving as controls, were placed immediately. Animals were placed on a soft diet after surgery. Weekly intraoral photographs and radiographs were taken, and animals were sacrificed at 4 months. Fluorescent labels were injected 35, 21, and 7 days before sacrifice. Clinical implant stability and vertical pullout forces were tested, and loss of vertical bone height was measured on radiographs. Histomorphometric measurements of percent bone-to-implant contact (BIC) and mineral apposition rates were made from undecalcified sections.
RESULTS
Three RTI splints broke or debonded, and the implants were removed. No loss of DXI implants was noted. All remaining implants were clinically stable. Mean pullout forces were 366.7 ± 182.8 N for RTI (no pullout data for the threaded DXI). Mean vertical bone loss was 0.4 ± 0.6 mm mesially and 0.2 ± 0.7 mm distally for RTI and 0.8 ± 1.1 mm mesially and 0.8 ± 1.0 mm distally for DXI, with no significant differences between groups. BIC values were 70.8% ± 12.7% for mandibular RTI, 68.3% ± 11.6% for maxillary RTI, and 78.8% ± 5.5% for DXI. Mineral apposition rates within local osteons were 1.9 ± 0.5 μm for RTI and 1.7 ± 0.3 μm for DXI; at the implant surface, they were 2.5 ± 1.2 μm for RTI and 3.3 ± 1.8 μm for DXI, with no significant differences between groups.
CONCLUSION
All RTIs with intact splints exhibited clinically successful integration, similar to that of control threaded implants. The RTI may be a viable option for single-tooth replacement.
PubMed: 28518183
DOI: 10.11607/jomi.5416 -
Journal of Microscopy and Ultrastructure 2018Enamel is one of the most important structures of the tooth, both functionally and aesthetically. Because of the highly mineralized nature of enamel, its structure is...
INTRODUCTION
Enamel is one of the most important structures of the tooth, both functionally and aesthetically. Because of the highly mineralized nature of enamel, its structure is difficult to study under routine light microscopy. Since scanning electron microscopy (SEM) offers the possibility of studying structures under very high magnification without altering the gross specimen, it is one of the best methods to study the enamel surface.
AIMS AND OBJECTIVES
To study and compare the surface morphology and morphometry of enamel on various surfaces of permanent dentition.
MATERIALS AND METHODS
A total of 20 permanent teeth were analyzed under the SEM. In both anterior and posterior teeth, four surfaces - mesial, distal, labial, and lingual - in three thirds - cervical, middle, and incisal - were studied. In addition, the occlusal surface was also studied for the posterior teeth. The different prism morphology and prism dimensions were recorded.
RESULTS
Based on our observations, we could definitely identify striae of retzius, debris, and cracks under ×50 magnification. Three morphological patterns of prism arrangement were identified: Type 1 - shallow prisms, Type 2 - well-defined prisms, Type 3 - microporosities, on analyzing the mesial, distal, labial, lingual, and occlusal surfaces of the permanent teeth, at ×3000 magnification. The prisms were measured under ×6000 magnification and the results showed larger prisms in posterior than in anterior teeth.
CONCLUSION
The study aided us in categorizing the enamel prism structure based on morphology and morphometry in anterior and posterior teeth of the permanent dentition.
PubMed: 30221142
DOI: 10.4103/JMAU.JMAU_27_18 -
PloS One 2023Fractal dimension (FD) analysis has been proposed and validated in osseointegration-related research. The aim of this study was to evaluate the feasibility of FD...
BACKGROUND
Fractal dimension (FD) analysis has been proposed and validated in osseointegration-related research. The aim of this study was to evaluate the feasibility of FD analysis in the osteogenesis detection of bone substitute materials (BSMs) of Bio-Oss in maxillary lateral sinus augmentation.
METHODS
Patients who received lateral maxillary sinus augmentation and underwent grafting with BSMs (Bio-Oss) were included in the study. The cross sections of the BSMs under cone-beam computed tomography (CBCT) at mesial, distal, and sagittal directions were obtained immediately after the graft (T0) and 6 months later (T1), and the obtained images were cropped to include only the BSMs. The FD analysis was performed, and the FD value was obtained by the method of box-counting. Paired t-tests and analysis of variance (ANOVA) were used, and p-values <0.05 was considered statistically significant.
RESULTS
Twelve participants with 22 implants, which were inserted simultaneously after sinus augmentation, were included in this study. A total of 22 mesial, 22 distal, and 14 sagittal images were obtained after FD analysis. The mean FD value and standard deviation at T0 was 1.2860 ± 0.0896, while at T1, it was 1.2508±0.1023; thus, significant differences were detected (p = 0.022). However, the increasing or decreasing trend of FD value was not stable, and no significant difference was detected for FD values of mesial, distal, and sagittal images between T0 and T1. ANOVA indicated that no significant difference was detected among the FD values of mesial, distal, and sagittal images at any timepoint. Differences in FD values between the sexes were not significant either.
CONCLUSIONS
Since the FD analysis for the osteogenesis detection of BSMs in maxillary sinus augmentation indicated unstable trends of change, its feasibility is not reliable. The initially rough surface, self-degradation, and volume change of the BSMs during osteogenesis may be the reason for the variation in FD values.
Topics: Humans; Bone Substitutes; Osteogenesis; Pilot Projects; Sinus Floor Augmentation; Fractals; Transverse Sinuses; Minerals; Bone Transplantation; Maxillary Sinus
PubMed: 38157335
DOI: 10.1371/journal.pone.0296248 -
Journal of the Mechanical Behavior of... Apr 2023To compare the biomechanical properties of different endocrown designs on endodontically treated teeth with an extensive defect in the mesial wall using a...
OBJECTIVE
To compare the biomechanical properties of different endocrown designs on endodontically treated teeth with an extensive defect in the mesial wall using a three-dimensional finite element method (3D FEM).
METHODS
Four finite element analysis models were designed and built up based on different endocrown configurations in a mandibular molar. One model was designed as a butt joint preparation with 2 mm occlusal thickness(control), the other three models were butt joint designs with different distances between the bottom of the mesial wall preparation and the cemento-enamel junction (CEJ): 2 mm, 1 mm and 0 mm respectively. A vertical load parallel with the longitudinal axis of the tooth and an oblique load with a 45°angle to the longitudinal axis were applied to the occlusal surfaces. The maximum Von Misses (VM) stresses and stress distribution patterns were calculated and compared. Weibull risk-of-rupture analysis was used to analyze the survival probability of the restorations and tooth in the different models.
RESULTS
For the restoration, the model with a mesial wall destruction at the level of CEJ showed much higher risk of failure than other models. Overall, none of the four models showed failure. Under oblique loading, VM stress in the cement layer of the models with a mesial wall defect was higher than in the control model. In the dentin, the highest VM stresses were found in the peri-cervical dentin. Under the oblique loading, the model with the mesial wall destruction at the level of CEJ restored by endocrown showed the highest risk of failure.
CONCLUSION
Under the oblique loading, with the increase of the simulated defect in the mesial wall, the peak VM stress values in the cement layer increased accordingly. In the model with a mesial wall defect up to the level of CEJ risk of failure was highest in the cervical dentin.
Topics: Humans; Tooth, Nonvital; Molar; Finite Element Analysis; Dental Stress Analysis
PubMed: 36739827
DOI: 10.1016/j.jmbbm.2023.105691 -
Journal of Oral Biology (Northborough,... 2016An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form...
BACKGROUND
An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms.
MATERIALS AND METHODS
A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification.
RESULTS
Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin.
CONCLUSIONS
These observations further document the potential protective effects of dental calculus mineralization against dental caries.
PubMed: 27446993
DOI: 10.13188/2377-987x.1000017 -
Cureus Apr 2023Background Total treatment time in implant placement can be significantly reduced by placing immediate implants into the freshly extracted sockets. Also, immediate...
Background Total treatment time in implant placement can be significantly reduced by placing immediate implants into the freshly extracted sockets. Also, immediate implant placement can act as a guide for proper and accurate implant placement. Additionally, in immediate implant placement, the resorption of bone associated with the healing of the extraction socket is also reduced. This clinical study aimed to clinically and radiographically assess the healing of endosseous implants having different surface characteristics in nongrafted and grafted bone. Methodology In 68 subjects, 198 implants were placed, including 102 oxidized (TiUnite, Göteborg, Sweden) and 96 turned surface implants (Nobel Biocare Mark III, Göteborg) were placed. Survival was considered with clinical stability and acceptable function with no discomfort and no radiographic or clinical signs of pathology/infection. Rest cases that showed no healing and implant no osseointegration were considered failures. Clinical and radiographic examination was done by two experts after two years of loading based on bleeding on probing (BOP) mesially and distally, radiographic marginal bone levels, and probing depth (mesial and distal). Results Five implants failed in total where four implants were with the turned surface (Nobel Biocare Mark III) and one was from the oxidized surface (TiUnite). The one oxidized implant was in a 62-year-old female and was placed in the region of mandibular premolar (44) of length 13 mm and was lost within five months of placement before functional loading. Mean probing depth had a nonsignificant difference between oxidized and turned surfaces with the mean values of 1.6 ± 1.2 and 1.5 ± 1.0 mm, respectively, with = 0.5984; mean BOP in oxidized and turned surfaces was 0.3 ± 0.7 and 0.4 ± 0.6, respectively (= 0.3727). Marginal bone levels, respectively, were 2.0 ± 0.8 and 1.8 ± 0.7 mm (= 0.1231). In marginal bone levels related to implant loading, a nonsignificant difference was seen in early loading and one-stage loading with -values of 0.06 and 0.09, respectively. However, in two-stage placement, significantly higher values were seen for oxidized surfaces (2.4 ± 0.8 mm) compared to turned surfaces (1.9 ± 0.8 mm), with = 0.0004. Conclusions This study concludes that nonsignificantly higher survival rates are associated with oxidized surfaces compared to turned surfaces after two years of follow-up. Higher marginal bone levels were seen in oxidized surfaces for single implants and implants placed in two stages.
PubMed: 37139027
DOI: 10.7759/cureus.36990 -
Investigative Radiology Mar 2022Accurate visualization of dental root canals is vital for the correct diagnosis and subsequent treatment. This work assesses the improvement of a dedicated new coil for...
OBJECTIVES
Accurate visualization of dental root canals is vital for the correct diagnosis and subsequent treatment. This work assesses the improvement of a dedicated new coil for dental magnetic resonance imaging (MRI) in comparison to conventional ones in terms of signal-to-noise ratio (SNR) and visibility.
MATERIALS AND METHODS
A newly developed intraoral flexible coil was used to display dental roots with MRI, and it provides improved sensitivity with a loop design and size adjusted to a single tooth anatomy. Ex vivo and in vivo measurements were performed on a 3 T clinical MR system, and results were compared with conventional head and surface coil images. Additional comparison was performed with a modified fast spin echo sequence and a constructive interference in steady-state sequence.
RESULTS
Ex vivo, an SNR gain of 6.3 could be achieved with the intraoral flexible coil setup, and higher visibility down to 200 μm was possible, whereas the external loop coil is limited to 400 μm. In vivo measurements in a volunteer resulted in an SNR gain of up to 4.5 with an improved delineation of the root canals, especially for the branch tissue splitting of the mesial root canal into mesial-buccal and mesial-lingual.
CONCLUSIONS
In summary, we showed the feasibility of implementing a wireless coil approach with readily available dental practice materials for sealing and placement. Highly improved MRI scans can be acquired within clinically feasible scan times, and this might provide additional medical findings to supplement available x-ray images.
Topics: Dental Pulp Cavity; Equipment Design; Humans; Magnetic Resonance Imaging; Phantoms, Imaging; Signal-To-Noise Ratio
PubMed: 34510099
DOI: 10.1097/RLI.0000000000000826 -
International Journal of Clinical... Sep 2023To evaluate the thickness of the root canal dentin wall in the cervical, middle, and apical third of primary first molars.
AIM
To evaluate the thickness of the root canal dentin wall in the cervical, middle, and apical third of primary first molars.
MATERIALS AND METHODS
Cross-sectional study consisting of 30 cone-beam computed tomography (CBCT) images of primary maxillary and mandibular first molars, with crown, and root integrity. The wall dentin thickness of each canal was measured in three axial views, divided into distal (D), mesial, lingual/palatine, and buccal surfaces.
RESULTS
The smallest dentin wall thickness of the maxillary molar was located on the mesial surface of the mesiobuccal (MB) canal apical third (mean 0.55 ± 0.04 mm). The buccal and palatal (P) surfaces of the distobuccal (DB) and P canals showed the smallest dentin thickness on the cervical third (0.62 ± 0.02 mm). On the mandibular molar, we found the smallest dentin thickness on the apical third [lingual surface of the MB canal and buccal surface of the mesiolingual (ML) canal] with a mean of 0.41 ± 0.07 mm. Additionally, the dentin thickness is average of the D canal was about 0.67 ± 0.11 mm.
CONCLUSION
It is essential to understand the primary first molar's anatomy to reduce possible complications in pediatric patients from instrumentation during root canal treatments.
CLINICAL SIGNIFICANCE
Pulpectomy is among the most challenging procedures in pediatric dentistry and the knowledge of the root anatomy of primary teeth allows the professional to make better clinical decisions and reduce possible risks during root canal treatment.
HOW TO CITE THIS ARTICLE
Justiniano-Navarro C, Caballero-García S, López-Rodriguez G, Evaluating the Thickness of the Root Canal Dentin Wall in Primary First Molars using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2023;16(S-2):S122-S127.
PubMed: 38078037
DOI: 10.5005/jp-journals-10005-2660 -
Journal of Dentistry Oct 2023To compare direct visual analysis (DVA) and intraoral scanning (IOS) for the assessment of developmental defects of the enamel (DDE).
OBJECTIVE
To compare direct visual analysis (DVA) and intraoral scanning (IOS) for the assessment of developmental defects of the enamel (DDE).
METHODS
Thirty-nine extracted permanent human teeth with DDE were selected by an experienced examiner and digitised using IOS. The scanning was recorded using the OBS Studio software parallel to the IOS software to obtain a coloured high-definition MP4 file of the process. Two other experienced, blinded, and calibrated examiners randomly analysed the same teeth through DVA and IOS. A third examiner resolved any disagreements between the two examiners. Descriptive statistics were used to analyse the frequencies of the scores. Cohen's kappa test was used to determine whether the DVA scores were different from those assigned using IOS. Spearman's test was used to verify non-random examiner errors. The Chi-square test was used to compare score frequencies. Statistical significance was set at p <0.05.
RESULTS
Scores indicating more severe and extended DDE (p <0.05) were more frequently assigned with IOS than with DVA (IOS: 25.64%, 25.64%, 38.46%, and 35.90% between one-third to two-third of the lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 10.26%, 7.69%, 15.38%, and 10.26% for the respective aforementioned tooth surfaces). Contrarily, 'no visible enamel defect' was significantly less assigned for IOS than for DVA (IOS: 15.38%, 43.59%, 35.90%, 15.38%, and 17.95% for buccal, lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 38.46%, 66.67%, 56.41%, 51.28%, and 43.59% for the respective aforementioned tooth surfaces). Kappa agreement ranged from fair to moderate when comparing DVA and IOS; the correlation between both methods was positive, indicating that the examiners assigned the scores properly and the differences arose from employing different methods.
CONCLUSION
The assessment of DDE differed depending on the method used. IOS scores indicated more severe and extended DDE than DVA scores. Clinical investigation is the next step in validating the use of IOS for DDE diagnosis.
CLINICAL SIGNIFICANCE
This study showed that DDE can be assessed differently using IOS. It is clinically relevant as it directly affects the determination of the severity of the defect and dental treatment planning.
Topics: Humans; Developmental Defects of Enamel; Software; Tongue
PubMed: 37604397
DOI: 10.1016/j.jdent.2023.104677