The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population.

Purpose: Our study investigated the association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus (DM) among the elderly population, representing the first study of its kind in Iran. Methods: This was a cross-sectional community-based study as a part of the second wave of the Birjand longitudinal aging study (BLAS, 2021-2022) for people older than 60. We used the Comprehensive Geriatric Oral Health Assessment Tool (CGOHAT) for the oral health evaluation. Participants were initially categorized into diabetic and non-diabetic groups. Those patients with DM were further categorised into uncontrolled and controlled diabetes based on their HbA1c level. The association between periodontitis, gingivitis, and edentulism with type II diabetes mellitus and uncontrolled diabetes was assessed using logistic regression. Results: Among the 1,011 participants, 324 (32.04%) had DM. The mean ± SD DMFT was 27.06 ± 7.71 and 27.07 ± 7.72 among those with and without DM, respectively (p = 0.976). The M index comprised 85.46% of the total DMFT among those without DM and 84.51% among those with DM. The prevalence of periodontitis was higher among those without DM (110, 32.84%, p = 0.390). The prevalence of gingivitis was higher among those with DM (73, 45.06%, p = 0.617). Among the diabetic group, 137 (42.28%) had controlled DM. Based on the adjusted matched multivariate logistic model, decayed teeth (1.24, 95%CI: 1.06 - 1.46, p-value = 0.006), periodontitis (2.78, 95%CI: 1.02 - 7.56, p-value = 0.044), and moderate tooth loss (5.73, 95%CI: 1.13 - 28.88, p-value = 0.034) were significantly associated with increased odds of uncontrolled DM. Conclusions: Based on the findings of this study, tooth loss was highly prevalent among the elderly Iranians regardless of their diabetes status. Also, periodontitis, tooth loss, and decayed teeth were significantly associated with increased odds of poor glycemic control among those with DM. Thus, it can be concluded that improving the oral health of the geriatric population may be a crucial part of improving the glycemic control among those with diabetes which has been frequently neglected. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01434-2.

Scanning electron microscopic evaluation of the effect of different root-end resection methods in the crack formation in root canals filled with mineral trioxide aggregate or calcium-enriched mixture cement.

Background: There is some concern that root resection may alter the surface features and crack formation of the previously set orthograde material. The aim of this in vitro study was to evaluate the crack formation in orthograde mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) plugs after root resection. Materials and Methods: This in vitro study was conducted on 170 extracted human maxillary anterior teeth. The teeth were randomly divided three experimental (n = 50) and control (n = 20) groups. In Group 1, after root canal treatment, half of the roots were cut with a bur, and the other half with an ultrasonic cutter. In Groups 2 and 3, after the 4-mm CEM and MTA plugs were placed and set, the root ends of half of the samples were cut with a bur and the other half by an ultrasonic cutter. The prevalence of cracks in the dentin and orthograde apical plugs of MTA and CEM was then assessed by scanning electron microscopy. Data were analyzed using the McNemar's, Chi-square, and Fisher's exact tests at P ≤ 0.05 level of significance. Results: In general, the prevalence of crack in dentin in Groups 2 and 3 was significantly higher than in the plug (P < 0.05). There was no significant difference in the prevalence of dentin crack in the studied groups (P > 0.05). The prevalence of crack in dentin was lower when the bur was used to cut off the end of the root, although the difference was not significant. The prevalence of crack in the plug was similar in CEM and MTA. Conclusion: Based on the results of this study, the prevalence of crack in dentin is always significantly higher than its prevalence in the plug, and the prevalence of crack in the plug was similar in CEM and MTA; then, when there is an orthograde access to the root canal and surgery is likely in future, MTA and CEM can be placed in an orthograde technique and it just resects the root during surgery.

Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial.

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.

Endodontic Treatment of a Maxillary Lateral Incisor with Two Canals: A Case Report.

Variations in the number of roots and canals have been extensively reported in endodontic literature. One rare variation is presence of two separate root canals in maxillary lateral incisors. This study reports a maxillary lateral incisor with two canals. Although rare, knowledge about this anatomical variation can help in successful endodontic treatment of such teeth.

Comparative Evaluation of Root Canal Transportation by Three NiTi Single-File Systems in Curved Canals: A Cone Beam Computed Tomography Study.

INTRODUCTION: This study is aimed at evaluating root canal transportation in the mesiobuccal canal of mandibular first molars prepared with One Shape, Reciproc, and M-One nickel titanium (NiTi) single-file rotary systems using cone beam computed tomography (CBCT). MATERIALS AND METHODS: In this ex vivo study, CBCT scans of 45 extracted human mandibular first molars with 20-40° curvature were obtained. The teeth were randomly divided into three groups (n=15) for preparation of the mesiobuccal canal with One Shape, Reciproc, and M-One rotary systems according to the manufacturers' instructions. CBCT scans were obtained again after canal preparation. Changes caused by preparation in the coronal, middle, and apical thirds were determined on CBCT scans and analyzed using the Kruskal-Wallis test at P ≤ 0.05 level of significance. RESULTS: No significant difference was noted in the amount of canal transportation among the three groups (P > 0.05). M-One caused greater transportation in the apical third compared with Reciproc and One Shape, and One Shape caused greater transportation in the coronal third compared with other groups, although its magnitude was less than 0.3 mm. CONCLUSION: Reciproc, One Shape, and M-One are not significantly different in terms of canal transportation.