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Acta Odontologica Scandinavica May 2024Health complaints attributed to dental amalgam fillings comprise both intraoral and general health complaints. There are data suggesting that patients with medically...
OBJECTIVE
Health complaints attributed to dental amalgam fillings comprise both intraoral and general health complaints. There are data suggesting that patients with medically unexplained physical symptoms (MUPS) attributed to amalgam fillings show improvement in symptoms after removal of all amalgam fillings. However, data indicating changes of specific health complaints are limited. This study evaluated the changes of health complaints after removal of amalgam restorations in patients with health complaints attributed to dental amalgam fillings.
METHOD
Patients with MUPS attributed to dental amalgam (Amalgam cohort) had all their amalgam fillings removed. The participants indicated an intensity of 11 local and 12 general health complaints on numeric rating scales before the treatment and at follow-up after 1 and 5 years. The comparison groups comprising a group of healthy individuals and a group of patients with MUPS without symptom attribution to dental amalgam did not have their amalgam restorations removed.
RESULTS
In the Amalgam cohort, mean symptom intensity was lower for all 23 health complaints at follow-up at 1 year compared to baseline. Statistically significant changes were observed for specific health complaints with effect sizes between 0.36 and 0.68. At the 5-year follow-up, the intensity of symptoms remained consistently lower compared to before the amalgam removal. In the comparison groups, no significant changes of intensity of symptoms of health complaints were observed.
CONCLUSION
After removal of all amalgam restorations, both local and general health complaints were reduced. Since blinding of the treatment was not possible, specific and non-specific treatment effects cannot be separated.
Topics: Humans; Dental Amalgam; Norway; Female; Male; Prospective Studies; Middle Aged; Adult; Dental Restoration, Permanent; Cohort Studies
PubMed: 38699922
DOI: 10.2340/aos.v83.40260 -
Dentistry Journal Apr 2024(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based...
(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different private dental practices treated 174 patients with 245 teeth from 1969 to 1993. After root canal obturation, either a new direct restoration (amalgam, resin composite, or glass-ionomer cement) or the re-cementation of a pre-existing prosthetic restoration or renewal of prosthetic restoration followed. Metal posts (operator A) or metal screws (operator B) were inserted when coronal substance loss was significant. The primary outcome (i.e., tooth survival) was achieved when the endodontically treated tooth was, in situ, painless and had full function at the end of the observation period. A secondary outcome, the impact of different prognostic factors on survival rate, was evaluated. (3) Results: The overall mean survival was 56.1% of all treated teeth after 40 years of clinical service, resulting in an annual failure rate of 1.1%. Most investigated clinical co-factors (jaw, tooth position, intracanal dressings, post/screw placement, and gender) showed no significant influence on survival. (4) Conclusions: Even with materials and techniques from the 1970s and 1980s, successful root canal treatment was achievable. Except for post-endodontic restorations, most of the evaluated factors had no significant influence on the clinical long-term survival of root canal-treated teeth.
PubMed: 38668002
DOI: 10.3390/dj12040090 -
Journal of Dental Sciences Apr 2024Computer aided implant surgery has been widely adopted in modern implant dentistry. However, absence of reliable anatomic landmarks for superimposing digital data sets...
ABSTRACT BACKGROUND/PURPOSE
Computer aided implant surgery has been widely adopted in modern implant dentistry. However, absence of reliable anatomic landmarks for superimposing digital data sets for patients with terminal dentition or complete edentulism remained challenging. Utilization of additional fiducial markers intraorally as the reference points for the improvement of accuracy became crucial in implant digital workflow. Nevertheless, the choice of the material for fiducial markers should present the least radiographic artifacts under cone beam computed tomography (CBCT) for better accuracy. The aim of this in vitro study was to investigate the volume of radiographic artifacts generated through different materials under the image of CBCT.
MATERIALS AND METHODS
Fifteen dental materials were selected and configured into cubic shape. All the materials were scanned initially with the laboratory scanner as the control groups. The samples were scanned by CBCT machine as test groups and the volume of artifact generated under CBCT images were compared and analyzed using 3D modeling software.
RESULTS
Eleven out of fifteen materials could be recognized under CBCT images. Volumetric analysis reported that statistically significant differences among the materials could be noted, and the flowable composite resin presented the least volumetric difference. Lithium disilicate glass-ceramic, flowable composite resin, and gutta-percha presented the least deformation and maintained their cubic shapes.
CONCLUSION
The results of the present study may imply that flowable composite resin compared to all ceramic materials, amalgam and gutta-percha may be a preferable choice when utilized as fiducial markers under CBCT images.
PubMed: 38618050
DOI: 10.1016/j.jds.2023.07.001 -
Materials (Basel, Switzerland) Apr 2024Dental amalgams have been used by dentists for the restoration of posterior human teeth. However, there have been concerns about the release of mercury from amalgams...
Dental amalgams have been used by dentists for the restoration of posterior human teeth. However, there have been concerns about the release of mercury from amalgams into the oral cavity. The objective of the present research is to study the effect of titanium (Ti) nanoparticles on the microstructural mechanism of the release of mercury vapor in two commonly used brands of dental amalgam (the Dispersalloy: 11.8% Cu; the Sybralloy: 33% Cu). Ti powder was added to both the Dispersalloy and the Sybralloy in increments of 10 mg up to 80 mg. The addition of Ti powder to both brands of dental amalgam has been found to result in a considerable decrease in Hg vapor release. The decrease in the Hg vapor release due to Ti addition has been explained by the formation of strong Hg-Ti covalent bonds, which reduce the availability of Hg atoms for evaporation. The Ti atoms in excess of the solubility limit of Ti in Hg reside in the grain boundaries, which also reduces the evaporation of Hg from the amalgam. The binding of Hg with Ti via a strong covalent bond also results in a significant improvement in mechanical properties such as Vickers hardness.
PubMed: 38612175
DOI: 10.3390/ma17071662 -
Journal of Pharmacy & Bioallied Sciences Feb 2024This study intends to evaluate the frequency and causes of replacement for failed amalgam and composite dental restorations.
AIM
This study intends to evaluate the frequency and causes of replacement for failed amalgam and composite dental restorations.
METHODOLOGY
A cross-sectional study comprising female patients with failed permanent composite and amalgam restorations aged 15-60 years old was carried out at the dental clinics of Qassim University. Using a self-structured proforma, demographic data and causes for restoration failure were recorded. The effectiveness of the restorations was assessed by using the Ryge criteria after performing clinical and radiographic examinations. The Statistical Package for Social Science was used for the statistical analysis.
RESULTS
It is found that 84.6% of the 299 unsuccessful restorations examined were composite, and 15.4% were amalgam. The main reason for dental failure for both amalgam (95.6%) and composite (93.28%) restorations was secondary caries. Failure of amalgam restoration was largely caused by poor marginal adaptation. With varied incidences between amalgam and composite restorations, typical complaints included discomfort, sensitivity, pain, and food impaction with soreness. The main justification for replacement in amalgam restorations was sensitivity. Repair and replacement rates were similar for amalgam, composite, and mandibular/maxillary restorations. Moreover, 21.1% of individuals overall reported no symptoms, with 8.7% in the amalgam group and 23.3% in the composite group with significant differences ( = 34.28, = 0.001).
CONCLUSION
According to the current study, secondary caries was found to be the main reason for both amalgam and composite restoration failure. The main problems reported were sensitivity, discomfort, and pain with amalgam showing more sensitivity-related failures.
PubMed: 38595355
DOI: 10.4103/jpbs.jpbs_945_23 -
International Journal of Paediatric... Apr 2024The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching...
BACKGROUND
The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools.
AIM
To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools.
DESIGN
Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively.
RESULTS
Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy.
CONCLUSION
There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.
PubMed: 38590044
DOI: 10.1111/ipd.13181 -
Cureus Mar 2024Foreign body sinusitis is a rare but important condition that should be taken into account when considering differential diagnoses. In this case report, we present a...
Foreign body sinusitis is a rare but important condition that should be taken into account when considering differential diagnoses. In this case report, we present a unique case of sinusitis caused by a foreign body originating from a dental procedure. Additionally, the complexity of the case was compounded by the patient's occupation as a flight attendant. A 49-year-old female flight attendant presented with a two-month history of facial pressure exacerbated by flying. A computed tomography (CT) of her paranasal sinuses confirmed the presence of a radiopaque foreign body near the left maxillary infundibulum, with minimal left ethmoid sinus mucosal thickening. Initially, she elected for non-operative management due to schedule conflicts. Upon follow-up over the next year, she complains of recurring severe facial swelling and congestion. A repeat CT scan shows that she has a dental amalgam that migrated from her left maxilla to the ethmoid infundibulum, lodged between her uncinate process and ethmoid bulla. The patient subsequently underwent foreign body removal. The patient recovered well, and a follow-up CT confirmed the complete removal of the foreign body. This case provides excellent insight into the mechanism of foreign body migration and sinusitis complicated by the unique circumstances of barotrauma associated with regular air travel.
PubMed: 38586646
DOI: 10.7759/cureus.55639 -
Brazilian Dental Journal 2024This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and...
This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and light-cured (CN-LC), Equia Forte Fill (EQUI); conventional resin composite Filtek Z350 XT (Z350); resin glass ionomer cement Riva light Cure (RIVA) and flowable resin composite Filtek Bulk Fill Flow (BULK-F) were evaluated. Sixty specimens (n=10) were prepared for sorption (SR), solubility (SL), flexural strength (FS), shrinkage stress (SS), conversion degree (CD), microhardness (MI), and surface roughness (SR) tests. Non-cured and light-cured materials were assessed on FTIR. 30 human molar teeth were used in the bond strength test (BS). Data were subjected to ANOVA and post-hoc Tukey's test (5% of significance). EQUI showed more sorption in SR and no statistical difference from RIVA and CN-LC. CN group showed more solubility and EQUI presented less (p<0.05). BULK-F showed higher FS (MPa), without differences from CN and Z350, whereas EQUI presented the lowest FS not differing from RIVA. BULK-F and CN-LC showed more shrinkage stress differing from EQUI. CN-LC and CN showed higher CD differing from the other which showed no differences (p>0.05) between them. EQUI showed the highest hardness (p<0.05) in MI. There were no differences (p>0.05) in SR (µm). Z350 and BULK-F presented higher BS, whereas CN-LC showed the lowest, although not differing from EQUI and RIVA. Equia Forte's solubility and microhardness make it a good alternative as a restorative material. Cention N degree of conversion and flexural strength making it an esthetic option to amalgam.
Topics: Humans; Glass Ionomer Cements; Materials Testing; Composite Resins; Dental Materials; Flexural Strength; Hardness
PubMed: 38537023
DOI: 10.1590/0103-6440202405728 -
Dental Research Journal 2024The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and...
BACKGROUND
The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and restoration with reinforced zinc oxide-eugenol.
MATERIALS AND METHODS
In this experimental study, a total of 12 immature mandibular central incisors from six adult male sheep, weighing 30-40 kg and with the age of 1 year old with Merino race were examined. After anesthesia, the pulps of the teeth in the case group were mechanically exposed and then were restored with reinforced zinc oxide-eugenol and amalgam. In the control group, the teeth remained intact. The animals were sacrificed at intervals of 2, 4, 6, and 8 weeks (E2, E4, E6, and E8) in the case and 2 and 8 weeks (C2 and C8) in the control groups. Then, their teeth were removed with the surrounding supporting tissues and alveolar bones. Tissue processing and staining were done, and the sections were examined under a light microscope. The Kruskal-Wallis and Mann-Whitney tests were used to analyze the data and compare the changes between the two groups. < 0.05 was considered statistically significant.
RESULTS
In response to mechanical exposure, reparative or tertiary dentin was formed, and its thickness increased during the time of the study. The thickness of the odontoblastic layer in the E4 group was the highest amount. The pulp chamber diameter in the C2 group was significantly larger than the other groups, and the diameter of the apical foramen in the E8 was decreased significantly compared to the controls ( < 0.05).
CONCLUSION
In response to mechanical exposure and restoration with reinforced zinc oxide-eugenol, some morphometric parameters of the dental pulp changed significantly in the sheep model compared to the controls.
PubMed: 38476710
DOI: No ID Found -
BMC Oral Health Mar 2024This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs....
BACKGROUND
This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA).
METHODS
This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent.
RESULTS
The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320).
CONCLUSION
MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.
Topics: Animals; Dogs; Female; Bicuspid; Dental Pulp; Dental Pulp Capping; Dentin, Secondary; Drug Combinations; Edema; Gutta-Percha; Hydroxyapatites; Inflammation; Oxides; Tooth, Deciduous
PubMed: 38468251
DOI: 10.1186/s12903-024-04098-9