Effect of endodontic sealer in young molars treated by undergraduate students - a randomized clinical trial

Abstract The progression of caries in permanent molar teeth of young patients, frequently result in endodontic treatment. This randomized blinded clinical trial assessed the effect of two endodontic sealers (Sealer 26 and AH Plus) on the incidence of pain and apical repair after endodontic treatment of young molar teeth, and secondly identify factors associated with the outcomes. Endodontic treatment was performed by undergraduate students in molar teeth (n=69) of young patients (n=54) at the Endodontic and Restorative Public Extension Clinic Service. Protaper Next was used and the endodontic sealers were allocated which were restored with direct composite resin. Two primary clinical outcomes - apical repair and postoperative pain, were assessed after 12 and 24 months for blinded operators. Description of incidence rates and mixed-model regression using Generalized Estimation Equations (GEE). After 2 years 69 molar teeth of 54 patients were evaluated. No effect of the endodontic sealer was observed irrespective of period of evaluation. Apical repair incidences and asymptomatic teeth were, respectively, 90.5 and 89.3, 96.8 and 90.0% during 1 and 2 years of follow-up. Failed apical repair was associated with unsatisfactory pulpectomy (p=0.003) and periapical conditions (p=0.007) as well as their interaction (p=0.016). None of these independent variables was able to predict the occurrence of pain in both periods. Prognosis of apical repair is dependent on the initial conditions. Endodontic treatment of young molars associated with composite resin restorations performed by undergraduate students have satisfactory results after 2 years and was effective to prevent the risk of permanent teeth loss.

Resumo A rápida progressão das lesões de cárie nos dentes molares permanentes de pacientes jovens, frequentemente resulta no tratamento endodôntico. Este ensaio clinico randomizado cego avaliou o efeito de dois cimentos endodônticos (Sealer 26 e AH Plus) na incidência de dor e reparo apical após tratamento endodôntico de dentes molares jovens e identificar fatores associados aos desfechos do tratamento. O tratamento endodôntico foi realizado por estudantes de graduação em dentes molares permanentes (n=69) de pacientes jovens (n=54) na Clínica de Extensão Endodôntica e Restauradora da Universidade Federal de Uberlândia, Brasil. Protaper Next foi usado e os dois cimentos foram distribuídos aleatoriamente nas amostras, as quais foram restauradas com resina composta direta. Dois desfechos clínicos primários - reparo apical e dor pós-operatória foram avaliados após 12 e 24 meses por operadores de forma cega. Análise longitudinal dos dados incluiu a descrição das taxas de incidência e modelo de regressão misto usando Equações de Estimativa Generalizadas (GEE). As incidências (%) do reparo apical e dos dentes assintomáticos foram respectivamente 90,5/89,3 e 96,8/90,0 nos períodos de 1 e 2 anos de acompanhamento. Ausência de reparo apical foi associada com pulpectomia insatisfatória (p=0,003) e condições periapicais (p=0,007), bem como sua interação (p=0,016). Nenhuma dessas variáveis independentes foi capaz de prever a ocorrência de dor nos períodos de acompanhamento. O tratamento endodôntico mostrou resultados satisfatórios após 2 anos. O prognóstico do reparo apical depende das condições iniciais. Nenhum efeito do cimento endodôntico foi observado. O tratamento endodôntico de molares jovens associado com restaurações em resina composta realizado por estudantes de graduação tem um papel relevante na redução do risco de perda do dente permanente.

A Morphometric Analysis Of The Shape, Position, Number And Size Of Mental Foramen In Dry Human Mandibles

Aim: To provide morphometrical information on the shape, position, number and size of mental foramen in dryhuman mandibles. The knowledge on the anatomy of mental foramen is very important in clinical dentistry,surgical procedures and nerve blocks, to avoid injuries to the neurovascular bundle in the mental foramen.Material and Methods: This study was conducted on 45 dry adult human mandibles in the Department ofAnatomy, College of Dentistry, Ajman University, Ajman, U.A.E. The shape and number of mental foramen werestudied by visual examination. The size and position of the mental foramen were measured using Vernier caliper.The excel software was used for the statistical analysis.Results: In our study, bilateral mental foramen were present in all the mandibles.The majority of mandibles wereoval in shape with 71.12% on left side and 66.67% on the right side. The most common position for mentalforamen was found to be along the longitudinal axis passing between the 2nd premolar and 1st molar teeth with44.45% on the left side and 46.66% on the right side respectively. The mean vertical diameter of mental foramenwas found to be 3.23 mm on left side and 3.33 mm on the right , whereas the horizontal diameter was found to be4.05 mm on the left side and 4.21 mm on the right side. We also found the higher incidence of postero-superiorlydirected mental foramen on both sides with 55.33% on left and 44.45% on right side. Their was no incidence ofaccessory mental foramen in any mandibles studied.Conclusion: Our study will be a helpful supplement to the data collected previously on the variation in theincidence, position, shape and size of mental foramen. It will provide useful information to dental surgeons,anesthetics and neurosurgeons to carry out nerve block and surgical procedures like apical curettage ofmandibular premolars and periodontal surgery. We did not come across any accessory mental foramen in any45 mandibles studied

Identification of the Most Appropriate Site for the Cold Test in Molar Teeth / Identificación del sitio más apropiado para la prueba de frío en dientes molares

Abstract A test frequently used to complement endodontic diagnoses is the cold test; however, in the last 20 years, authors have reported incorrect results within pulp sensitivity tests. Specifically, a high frequency of false results in posterior teeth, were found. The aim of this study was to identify the most appropriate site for the cold test in molar teeth with a need for endodontic treatment, calculating predictive values, accuracy and reproducibility. A cross-sectional study was performed, evaluating 390 subjects. A total of 152 subjects of both genders from the ages of 15-65 years old participated. The ideal standard was established by direct pulp inspection, and the cold test agent used was 1,1,1,2-tetrafluoroethane. The patients were divided into four groups in relation to the molar tooth: (1) mandibular first molar, (2) mandibular second molar, (3) maxillary first molar, and (4) maxillary second molar. 169 teeth and 676 sites were studied. (a) The most appropriate sites for cold test were the middle third of the buccal surface and cervical third of the buccal surface in the mandibular molars with the following results: Middle third of the first molar: Accuracy 0.93, positive predictive value 0.90 and negative predictive value 0.96. Middle third of the second molar: Accuracy 0.93, positive predictive value 1.00 and negative predictive value 0.90. In relation to third cervical the results were: First molar: Accuracy 0.93, positive predictive value 0.89 and negative predictive value 0.97 y second molar: Accuracy 0.93, positive predictive value 1.00 and negative predictive value 0.90. (b) The highest reproducibility was observed in the middle third of the buccal surface with cervical third of the buccal surface in the mandibular second molar (1.00). The most appropriate site and reproducibility of the sites are auxiliary to complement endodontic diagnose with the cold test.

Resumen Una prueba frecuentemente utilizada para complementar los diagnósticos endodónticos es la prueba de frío. Sin embargo, en los últimos 20 años, los autores han reportado resultados incorrectos con las pruebas de sensibilidad pulpar. Específicamente, se ha observado una alta frecuencia de resultados falsos en dientes posteriores. El objetivo del estudio fue identificar el sitio más adecuado para la prueba de frío en dientes molares con necesidad de tratamiento endodóntico, calculando valores predictivos, exactitud y reproducibilidad. Se realizó un estudio transversal donde se evaluaron a 390 sujetos. 152 sujetos de ambos sexos de 15 a 65 años cumplieron con los criterios de inclusión. El estándar ideal que se utilizó en el estudio fue la inspección directa de pulpa en la cámara pulpar y la prueba de frío utilizada fue el 1,1,1,2-tetrafluoroetano. Los pacientes fueron divididos en cuatro grupos en relación al diente molar: (1) primer molar mandibular, (2) segundo molar mandibular, (3) primer molar maxilar, y (4) segundo molar maxilar. En el estudio se evaluaron 169 dientes con 676 sitios. (a) Los sitios más adecuados para la prueba de frío fueron el tercio medio y el tercio cervical de la superficie bucal en los molares mandibulares con los siguientes resultados: Tercio medio del primer molar: Exactitud 0.93, valor predictivo positivo 0.90 y valor predictivo negativo 0.96. Tercio medio del segundo molar: Exactitud 0.93, valor predictivo positivo 1.00 y valor predictivo negativo 0.90. En relación al tercio cervical los resultados fueron: Primer molar: Exactitud 0.93, valor predictivo positivo 0.89 y valor predictivo negativo 0,97 y segundo molar: Exactitud 0.93, valor predictivo positivo 1.00 y valor predictivo negativo 0.90. (b) La más alta reproducibilidad (1.00) se observó entre el tercio medio con el tercio cervical de la superficie bucal en el segundo molar inferior. El sitio más apropiado y la reproducibilidad de los sitios son auxiliares para complementar el diagnóstico endodóntico con la prueba de frío.

Frecuencia y variabilidad de la morfología dental de molares temporales y permanentes en un grupo de mestizos caucasoides de Popayán (Cauca, Colombia) / Frequency and variability of dental morphology of temporal and permanent molars in a group of Caucasoid mestizos from Popayán (Cauca, Colombia)

Objetivo: Determinar la frecuencia y variabilidad de la morfología dental en molares temporales y permanentes de un grupo de mestizos caucasoides de Popayán (Cauca, Colombia), con el fin de generar nuevos marcadores grupales que permitan comparar las diferentes poblaciones colombianas y mundiales a partir de nueve rasgos morfológicos dentales coronales (RMDC). Materiales y métodos: Estudio descriptivo transversal cuantitativo que determinó la frecuencia y variabilidad de nueve RMDC (cúspide de Carabelli, reducción del hipocono, metaconulo, patrón cuspídeo, número de cúspides, pliegue acodado, protostílido, cúspide 6 y cúspide 7) mediante la metodología ASUDAS en 101 individuos autoreconocidos como mestizos caucasoides (59 femeninos y 42 masculinos), con edades comprendidas entre los 10 y los 17 años. Resultados: Se identificaron frecuencias significativas de reducción del hipocono (89,9%), Patrón cuspídeo en Y (81,6%) y número de cúspides (92,7%); y bajas frecuencias de metacónulo (0,2%), protostílido (0,6%) y cúspide 6 (0,2%). No se encontró dimorfismo sexual y asimetría bilateral en los RMDC estudiados. Conclusiones: La muestra estudiada se caracteriza por presentar una morfología dental propia de poblaciones mestizas colombianas que se incluyen en el complejo dental caucasoide (cúspide Carabelli, reducción del hipocono y número de cúspides); sin embargo, debido a los procesos etnohistóricos de la región geográfica donde se ubican, presentan influencia de grupos indígenas (patrón cuspídeo) incluidos en el complejo dental mongoloide. Palabras clave: Antropología dental, morfología dental, dientes molares, rasgos morfológicos dentales coronales, mestizos caucasoides

Objective: To determine the frequency and variability of dental morphology in temporary and permanent molars of a group of Caucasoid mestizos from Popayán (Cauca, Colombia), in order to generate new group markers that allow comparing the different Colombian and world populations from nine coronal dental morphological features (NMDT). Materials and methods: quantitative, descriptive, cross-sectional study that determined the frequency and variability of nine NMDT (Carabelli trait, hypocone reduction, metaconule, cusp pattern, cusp number, defleckting wrinkle, protostilyd, cusp 6 and cusp 7) using the ASUDAS methodology In 101 self-described individuals as Caucasoid mestizos (59 females and 42 males), aged between 10 and 17 years. Results: Significant reduction frequencies of the hypoconus (89.9%), cusp pattern in Y (81.6%) and number of cusps (92.7%) were identified; And low frequencies of metacele (0.2%), protostilyd (0.6%) and cusp 6 (0.2%). No sexual dimorphism and bilateral asymmetry were found in the NMDT studied. Conclusions: The sample studied is characterized by a dental morphology characteristic of Colombian mestizo populations that are included in the Caucasoid dental complex (Carabelli cusp, reduction of the hipocono and number of cusps). However, due to the ethnohistorical processes of the geographic region where they are located, they are influenced by indigenous groups (cuspid expression) included in the mongoloid dental complex

Prevalence of Dental Caries among adolescence of Dhanusha District, Nepal

Background  and  Objectives:  In  developing  countries  like  Nepal,  the  oral  health  system  is currently  in  transition  phase  facing  a  high  prevalence  of  dental  caries.  It  has  significant  social impact in important life activities which hinders the achievement and ma intenance of good oral health  due  to  lack  of  dental  awareness  in  all  age  groups.  Streptococcus  mutans  is  the  most predominant  organism  to  cause  dental  caries.  Therefore, the  present  study  was  designed  to determine the prevalence of dental caries and to identify its etiology among adolescence.Material and Methods: This cross-sectional study was carried by following Standard protocols of Bergey’s  Manual  of  Systematic  Bacteriology  to  isolate  and  identify  the  organism.  The  data  was analyzed  using  SPPS  17.0  and  Microsoft  excels  2007  which  was  considered  as  statistically significant at p-value < 0.05.Results: The prevalence of dental caries in adolescent was found to be 33%.  The highest numbers of  patients  having  dental  caries  were  in  the  age  group  of  15-19  in  female  (66.32%)  than  male (39.70%).  Bacterial  growth  was  observed  more  in  female  (75.60%)  than  male  (24.39%)  which was found to be statistically significant (p=0.0001).  S. mutans  was found as the most important cause  of  dental  caries.  Maxillary  region  of  tooth  were  more  vulnerable  to  dental  caries  than mandibular  region  of  tooth.  Most  of  the  respondents  had  once  per  day  brushing  habit  without fluoridated dentrifice containing tooth paste.Conclusion:  The prevalence of dental caries was found one third of total.  S.mutans  was the main causes of dental caries and molars tooth are more affected than others.

Clinical application of the intrapulpal injection with STATM anesthetic delivery system in pulpectomy of primary molars / 实用口腔医学杂志

Objective:To observe the effect of intrapulpal injection in the pulpectomy of primary molars.Methods:22 petients with 44 diseased primary molars were divided into 2 groups(n =22 teeth).The intrapulpal injection with a computer-controlled local anesthetic delivery system STATM was performed in the experimental Group,and traditional infiltration anesthesia technique was conducted in the control group.Results:During the anesthesia process,the VAS value of the experimental group was lower than the control group(P ＜ 0.05).The pain control in the experimental group was better during pulp removal within 1 min.There was no occurrence of postoperative soft tissue numbness and factitial ulcer in the experinental group.Conclusion:The intrapulpal injection,administered with STATM,is more effective than traditional infiltration anesthesia in pulpectomy of primary molar teeth.

Pérdida del primer molar permanente en niños de 8, 10 y 12 años. Área Sur. 2013 / Loss of the first permanent molar in children of 8, 10 and 12 years. South Area. 2013

Fundamento: Los primeros molares permanentes son las estructuras dentarias más susceptibles a la caries dental y a su pérdida prematura. Objetivo: Identificar la pérdida de este molar en niños de ocho, 10 y 12 años. Metodología: Se realizó un estudio observacional, descriptivo, transversal en el período comprendido de enero a junio 2013. El universo estuvo conformado por 125 niños y niñas del área Sur de Sancti Spíritus atendidos en consulta lo que constituyó la muestra de estudio. Las variables estudiadas en la investigación fueron: edad, sexo y afecciones bucales causadas por esta pérdida dentaria. Resultados: El sexo masculino fue el más afectado con la pérdida del primer molar permanente y fue aumentando con la edad. La ausencia del primer molar inferior derecho fue la que se presentó en mayor porcentaje, siendo la giroversión y la masticación unilateral las afecciones bucales más comunes Conclusiones: La pérdida del primer molar permanente predominó en el sexo masculino y en el grupo de 12 años de edad. El primer molar inferior derecho fue el diente con mayor porcentaje de ausencia, siendo la giroversión y la masticación unilateral las afecciones bucales más comunes provocadas por la pérdida de este.

Background: The first permanent molars are the most susceptible dental structure to dental caries and their early loss. Objective: To identify the loss of this molar in children from 8, 10, and 12 years old. Methodology: It was carried out a descriptive, transversal and an observational study from January to June 2013. The universe was composed by 125 children from the south area in Sancti Spiritus, assisted in consultation what constituted the study sample Results: Male sex was the most affected by the loss of the first permanent molar and it increased with age. The absence of the first inferior right molar reached the highest percent being the rotation of the teeth and unilateral mastication the most common buccal affections caused by the loss of the molar already mentioned. Conclusion: Male sex and 12 year old children were the most affected by the loss of the first permanent molar.The first inferior right molar reached the highest percent of loss being the rotation of the teeth and the unilateral mastication the most common buccal affections.

Problem of protect 6th permanent molar / Шинэ санаа Шинэ нээлт

The age of 12 permanent molars 6 source formation, teeth grow footnote rows of teeth to catch various dental routine dental transferred under the grip. Operations and development perspective 6th gear teeth with dental row a key role to ensure a balance between teeth. This is the dental caries and other reasons deviations in adjacent teeth, jaw bones flaw, merge lengthen teeth, chewing on a toothpick footnote central line switch the arc fault is the key basic conditions.We study in MNUMS Dental school 2013-2014 customers in 1:1 ratio unfolded taken x-ray studied biological life in a sample of pictures of children over the age of 12 . Picture Image J 1.49b measurement statistics into the application development with SPSS 17.0.Biological age of 12 years old 6th gear teeth grow reach during our study involved 56 children , 18 ( 32.14 %) were taken in 6th gear teeth .Therefore, the 6th gear to be controlled from the start grow regular dental caries prevention laces jaw bone and teeth abnormalities shows the importance of the development.

Modified gavage methods for guinea pigs / 复旦学报（医学版）

Objective To modify the method of gavage administration in guinea pigs. Methods Fourty awake guinea pigs were kept rearing on the hind legs and leaning on a vertical fixture to avoid their escaping forward. A 1 mL injector was inserted into the mouth to the depth when the molar teeth were passed. Another fourty guinea pigs under general anesthesia were reversed at trendelenburg position and a children suction tube with an outer diameter of 2 mm was inserted into the stomach. Results All of the 80 guinea pigs were administered by modified gavage smoothly for seven consecutive days by one operator each time. None endured much pain or digestive tract injury, or died from air way perfusion by mistake. Conclusions We successfully modified the gavage method in guinea pigs, which would definitely take guinea pigs involved in intragastical pharmacal experiments besides the routine of rats and mice.

Multiple abnormal unerupted mandibular permanent molar teeth: a case report / Molares mandibulares anormales no-erupcionados múltiples: reporte de un caso

Abnormal multiply unerupted permanent molars have long received the attention of anatomists and maxillofacial surgeons besides the other developmental teeth anomalies. This paper presents a clinical case of a 23-year-old male patient who was admitted to the department of maxillofacial surgery in faculty of dentistry in Gulhane Medical School with a six month history of pain at the rest position and during chewing and also tender on his right corpus of mandible. The impaction which resulted in eruption failure and anatomical dislocation of the normally developed three mandibular molar teeth was found. It was defined facial asymmetry on his right side in extra-oral examination. Diagnosis of multiple abnormal unerupted mandibular molar teeth was confirmed by panoramic and 3D CT images. The unerupted inverted tooth was the third molar which is positioned to basis of the mandible on the right side. In the other side, the first molar was placed on basis of mandible and located distoangulary. The second molar was located on middle of the left corpus mandible vertically. And also, the third molar was erupted mesioangulary. The arch-length was evaluated by the oral surgeon. Mesio-distal distance between the teeth was to be sufficient. Causes of impacted permanent teeth might have been influenced by local factors such as prolonged deciduous tooth retention, malposed tooth germs, but not causing arch-length deficiency and supernumerary teeth. Abnormalities such as those reported in the present case are significant during maxillofacial surgery.

Los molares permanentes anormales no erupcionados múltiples, además de otras anomalías del desarrollo de los dientes, desde hace tiempo han recibido atención de anatomistas y cirujanos maxilofaciales. Este artículo presenta un caso clínico de un paciente masculino de 23 años de edad, que fue admitido en el Departamento de Cirugía Maxilofacial de la Facultad de Odontología de la Escuela de Medicina Gulhane, con una historia de seis meses de dolor, en la posición de descanso y durante la masticación, así como dolor en su cuerpo mandibular derecho. Fue encontrada la impactación que resulta de la falla en la erupción y la dislocación de la anatomía normal del desarrollo en tres molares mandibulares. En el examen extraoral fue definida asimetría facial del lado derecho. El diagnóstico de molares mandibulares anormales no erupcionados múltiples fue confirmado por radiografía panorámica e imágenes de tomografía 3D. El diente invertido no erupcionado fue el tercer molar que se encontró en la base de la mandíbula en el lado derecho. En el otro lado, el primer molar se posicionó sobre la base de la mandíbula distoangularmente. El segundo molar se encontró verticalmente en medio del cuerpo mandibular izquierdo. También, el tercer molar erupcionó mesioangularmente. La longitud del arco fue evaluada por el cirujano oral. La distancia mesio-distal entre los dientes fue suficiente. Las causas de impactación de los dientes permanentes podrían haber sido influenciadas por los factores locales, tales como la retención prolongada de dientes deciduos o gérmenes dentales malposicionados, pero no fueron provocados por deficiencia de longitud del arco y dientes supernumerarios. Anomalías tales como las reportadas en el presente caso, son importantes en la cirugía maxilofacial.