Effect of a circumferential ferrule on the survival and success of endodontically treated teeth restored with fiber posts: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: The success of endodontically treated teeth (ETT) is influenced by factors that include the use of prefabricated glass fiber posts. A consideration for success is the presence of a circumferential ferrule, but systematic reviews and meta-analyses are lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the impact of the presence or absence of a circumferential ferrule on the survival and success rates of ETT restored with prefabricated fiber posts. MATERIAL AND METHODS: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the major scientific literature databases was conducted. Eligible studies included randomized clinical trials and prospective cohort studies with a minimum 6-month follow-up, focusing on ETT restored with fiber posts either with or without a uniform circumferential ferrule. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to compare outcomes. The degree of variability among studies was assessed using the chi-squared test (α=.05). RESULTS: Of 3731 identified records, 8 were eligible for inclusion. Direct analysis of success rates (2 studies, 123 teeth) showed a significant increase in success when a uniform circumferential ferrule was present (RR=1.28, 95% CI: 1.06, 1.54, P<.05). However, indirect analysis of survival and success rates (8 studies, 407 teeth) indicated no significant differences in outcomes between the ferrule and no ferrule groups (P>.05). CONCLUSIONS: The results of this systematic review and meta-analysis determined that a uniform circumferential ferrule had a positive effect on the success rates of ETT restored with prefabricated fiber posts. However, further high-quality studies are required to provide more robust evidence and to allow potential confounding factors to be considered.

Human papillomavirus and head and neck squamous cell carcinoma in a UK population: Is there an association?

Background: Human papillomavirus (HPV) is an evolving important risk factor for head and neck cancer (HNC), especially for individuals who do not smoke and drink alcohol. The aim of this study was to establish the prevalence of HPV infection and elucidate its association with head and neck squamous cell carcinoma (HNSCC) patients in UK population. Methods: The presence and association of HPV was investigated in HNSCC patients in this retrospective clinical study. Samples were obtained from archived biopsies and resections. HPV screening was performed by the use of polymerase chain reaction (PCR) using the GP5+/GP6+ and the SPF1/2 consensus as primers and by immunohistochemistry (IHC). Samples of viral warts that were IHC positive for HPV and fibroepethelial polyps (FEP) were used, as positive and negative controls, respectively. Results: The cohort included 124 patients with HNSCC with an age range of 27-97 years (median, 60 years) and a male to female ratio of 2:1. Among the 124 HNSCC, 43/124 (34.7%) were from the tongue, 74/124 (60%) presented with advanced stage III or IV disease, 112/124 (90%) had a conventional phenotype, 84/124 (68%) were moderately differentiated, and 89/124 (72%) had bands or cords at the invasive front. Of the 124 patients with HNSCC, 84/124 (68%) demonstrated the presence of HPV, 0/124 (0%) was for oral squamous cell carcinomas (OSCC). HPV16 was the associated virus type in all positive samples. However, no significant association was observed between HPV positivity and other clinico-pathological variables including age and gender of the patients, stage, and malignancy differentiation. Conclusion: The results we provide suggest that HPV infection is low in HNSCC, in general, and absent in OSCC, specifically, in this UK population during this time period. This implies that HPV infection may not play an important role in HNSCC carcinogenesis compared to other risk factors in UK population. This information can aid in more effective treatment approaches for treating UK cases of HNSCC.

Self-confidence as a predictor of senior dental student academic success.

PURPOSE: Noncognitive indicators, such as personality type and self-confidence, have been used as predictors of achievement. Accordingly, we investigated whether self-confidence in clinical skills predicts academic success among predoctoral senior dental students. METHODS: Two consecutive cohorts (N = 336) of predoctoral senior dental students were invited to rate their self-confidence in clinical procedures twice: at the beginning and at the end of the academic year. Academic performance in clinical assessments was retrieved from scholastic records. Multiple linear regression models were constructed to predict clinical assessment grades using self-confidence scores as a predictor after controlling for possible confounders. RESULTS: Self-confidence scores in clinical procedures were positively correlated with clinical and academic performance. Self-confidence in clinical procedures and grade point averages were consistent predictors of student performance. Additionally, self-confidence had improved at the end of the senior year (p = 0.003). CONCLUSIONS: Self-confidence in clinical procedures was a predictor of future clinical success. Therefore, fostering and nurturing the confidence of students and integrating self-confidence assessment into the curricula at relevant timepoints should be a goal in dental education. Moreover, self-assessment of confidence in clinical skills could be used to guide students and graduates in developing their own personal development plan.

Survival and success of endocrowns: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Endocrowns are a monoblock type of restoration that use the pulp chamber and remaining coronal tooth structure as a means of retention. However, data on their long-term survival and success rates as compared with conventional crowns are lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to collate published work on endocrowns to assist clinicians in making decisions on when and whether they are an appropriate restorative option with a predictable outcome for extensively damaged endodontically treated teeth. MATERIAL AND METHODS: Databases such as PubMed (MEDLINE), Scopus, EMBASE, Cochrane library, and Google Scholar were searched up to June 2019 for clinical and in vitro studies on endocrown survival and success rates. For the meta-analysis, endocrown and conventional crown survival and success rates were compared, and the pooled effects were presented as relative risks and 95% confidence intervals using a random effects model. RESULTS: Ten studies fulfilled the inclusion criteria (3 clinical and 7 in vitro) and were included in the systematic review. The meta-analysis of the clinical studies showed an estimated overall 5-year survival rate of 91.4% for endocrowns and 98.3% for conventional crowns. The estimated overall 5-year success rates were 77.7% for endocrowns and 94% for conventional crowns. There were no significant differences in overall survival or success estimates between the assessed restorations (P>.05). CONCLUSIONS: Additional well-designed clinical studies with long-term assessment are needed; however, endocrowns appear to be a promising conservative restorative option with acceptable long-term survival for endodontically treated posterior teeth in selected patients.

Glass Ionomer Subgingival Matrix Technique to Restore a Tooth with Severe Root Resorption for Implant Site Development.

Here, we present the multidisciplinary, patient-specific management of a patient with severe external root resorption and bone loss in a maxillary anterior tooth. The tooth was provisionally noninvasively restored with glass ionomer subgingival matrix in preparation for forced orthodontic extrusion, papillary preservation, and implant placement. This approach enables clinicians to control infection within and around the resorbed tooth and then to use it as an anchor for slow forced tooth eruption to correct bone and mucogingival deformities. Aesthetic and functional outcomes were clinically and radiographically satisfactory. The advantages and disadvantages of this technique are discussed.

Angled Abutment Transfer Jig: A Technical Report.

AIM: To introduce an angled abutment transfer jig that splints abutments securely together to facilitate easy and quick orientation. BACKGROUND: Transferring angled abutments from cast to patients' mouth could be tasking and time-consuming. Transfer jigs are often used to facilitate orientation of abutments into implant fixtures. However, with the available jigs, abutments could move out of place and thus pose a hassle in repositioning. TECHNIQUE: This technical report introduces an angled abutment transfer jig that consists of two impression copings screwed onto angled abutments which are splinted together with red acrylic resin. Access to abutment screws is feasible through slots created in the impression copings. CONCLUSION: The introduced jig is rigid and thus ensures very accurate and easy transfer of abutments into implants followed by accurate prosthesis seating. CLINICAL SIGNIFICANCE: This transfer jig design allows clinicians to transfer the orientation of angled abutments from cast to patients' mouth with optimal speed and precision.

Quality of Fixed Dental Prostheses and Associated Biological Complications in a Saudi Population.

AIM: The interrelationships between dental prostheses, abutments, and supporting periodontal tissue are dynamic. Clinical studies assessing the quality and associated complications of fixed dental prostheses (FDPs) in the Saudi population are scarce. The aims of this project were to assess the location and accuracy of marginal adaptation and proximal contact quality of FDPs provided by dentists in the Kingdom of Saudi Arabia and to assess the impact of these factors on the health of the periodontium and caries susceptibility. MATERIALS AND METHODS: This retrospective cohort study collected demographic, dental, and social history data from patients with FDPs. Fixed dental prostheses quality was assessed using the United States Public Health Service Criteria, and periodontal health indices were measured. Descriptive and inferential statistics were used for data analysis. Logistic and multiple linear regression analyses were performed to assess predictors of caries risk and periodontal disease, respectively. RESULTS: Sixty-two patients with 62 FDPs were assessed. The mean patient age was 32.45 ± 9.0 (19-61) years with a male-to-female ratio of 3:1. On the assessment, 74.2% had marginal discrepancy, 54.8% had subgingival margins, 22.6% had open or tight proximal contacts, and 8.1% had marginal caries. Well-adapted margins promoted periodontal health, and inadequate proximal contact increased the risk of marginal caries. CONCLUSION: This study suggests that 26% of FDPs provided by dental practitioners in the Western province, Kingdom of Saudi Arabia, were of high marginal fit and proximal contact quality. CLINICAL SIGNIFICANCE: Constructing FDPs with high-quality marginal fit and proximal contact promotes periodontal health and reduces caries risk, thereby improving FDP outcome.

DNA replication licensing factor MCM2, geminin, and Ki67 define proliferative state and are linked with survival in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is still an unabated global killer with little advancement in its survival rate. DNA replication licensing proteins and Aurora kinase A are biomarkers that play important roles in genomic stability. The expression profile of minichromosomal maintenance protein 2 (MCM2), Ki67, geminin, and Aurora-A were linked to clinicopathological and outcome parameters, survival, and DNA content in 125 cases of OSCC. Oral fibroepithelial polyps (OFEP) were controls. The OSCC tumour cells were in a rapidly proliferating state, as assessed by the increased expression profile of MCM2, Ki67, geminin, and Aurora-A and of the geminin/Ki67 ratio, and the decrease of the MCM2/Ki67 ratio, in OSCC compared with OFEP (P < 0.000). There was an association between expression of MCM2, Ki67, and geminin and tumour histologic and invasive front grade (P < 0.05). A total of 82% of the OSCC assessed had aneuploid DNA content, which was associated with increased expression intensity of Aurora-A (P = 0.01). Geminin and the geminin/Ki67 ratio were associated with TNM staging (P < 0.05), and weak expression of MCM2, Ki67, geminin, and Aurora-A were predictive of OSCC survival (P < 0.05). Dysregulation of the origin licensing pathway and the mitotic pathway are important events in OSCC, and the combined analysis of these proteins may contribute to improved treatment decisions.