Impact of pecking amplitude on cyclic fatigue of new nickel-titanium files.

OBJECTIVES: The aim of this study is to determine the cyclic fatigue resistance of Mtwo Minimal in static and dynamic tests, with different amplitudes of pecking movements, at intracanal temperature. MATERIALS AND METHODS: Two hundred new 25-mm Mtwo Minimal rotary files (#10/0.035, #17.5/0.045, #25/0.05, #40/0.03, #45/0.03) were tested in static and dynamic cyclic fatigue tests at 35°C (±1°C). An artificial stainless-steel canal was used. In the dynamic mode, axial movements were set at 1 and 3 mm. The number of cycles to fracture (NCF) was recorded and statistically analyzed by one-way analysis of variance (p < 0.05). RESULTS: The 3-mm dynamic test showed significantly increased NCF than the other tests for the #10/0.035, #17.5/0.045, and #25/0.05 files (p < 0.05). The #40/0.03 and #45/0.03 files showed no significant differences in all the tests (p > 0.05). CONCLUSION: Mtwo Minimal showed higher cyclic fatigue resistance in the dynamic test than the static test, except for the larger instruments. The 3-mm pecking amplitude increased the cyclic fatigue resistance of the smaller instruments.

THE IMPACT OF THE DIABETES ON ORAL HEALTH - AN OBSERVATIONAL STUDY.

OBJECTIVE: The aim: To evaluate the impact of diabetes mellitus on the oral health. PATIENTS AND METHODS: Materials and methods: This is an observational study. In the present research were taken into consideration 300 patients. The study sample consisted of 191 males, respectively (63.7%) of them and 109 females (36.3%) of the participants. RESULTS: Results: In the current study, we analyzed the oral health of diabetic patients within the age class of 11-80 years. We divided them into seven age groups: 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, and 71-80 years. Based on the results of the current study it was observed that 83.7% of patients were affected by gingivitis. The results of our study show that dental caries prevalence was 68.7 % and the prevalence of missing teeth among patients with diabetes mellitus was 78.7%. According to the ANOVA test, high blood sugar values had a direct impact on the manifestation of gingivitis and there it was a strong correlation between them P-value = .000. Males with diabetes mellitus were more affected by dental caries and this was indicated by the P-value= .02, in comparison to females who recorded a P-value = .03. The relation between gender males and missing teeth was highly significant P-value = .001. CONCLUSION: Conclusions: The present study proved that diabetes mellitus is risk factor for oral health. The authors studied this group of patients exposed to high blood glucose levels and found out that oral diseases were high in these patients.

Effectiveness of Sealants Treatment in Permanent Molars: A Longitudinal Study.

BACKGROUND: Our study gives a clear result about sealants treatment in preventing dental caries manifestation and reducing its prevalence in children aged 6-11 years old. AIM AND OBJECTIVE: This study aims to compare and evaluate the progress of dental caries in the first and second permanent molars and also to evaluate, within a period of 24 months, the clinical effects of dental sealants, used in the treatment of occlusive cavities, among children 6-11 years old. MATERIALS AND METHODS: Participants: The overall sample was composed of 120 children, to whom we randomly chose 480 posterior teeth, which were divided into two groups. Intervention: The first group was the control group with 240 untreated teeth, while the second group had an equal number of teeth, which underwent the sealant treatment. The study participants were evaluated within the periods 0, 6, 12, 18, and 24 months. The study participants were checked every 6 months. Basic design: This observational, analytical, and descriptive research was designed as a longitudinal study. The study started in January 2019 and ended in January 2020. The study was conducted in five dental clinics in the city of Vlore, Albania. RESULTS: After 24 months of observation, we noticed that the number of dental caries in the untreated group is three times higher than the number of dental caries in the treated group. In the group of teeth treated with sealant, 189 (78.8%) teeth remained unaffected by dental caries. The present study showed that there is a significant correlation between period and caries manifestation (p < 0.05). It also proved that sealant treatment is an important measure and it is highly significant in the caries reduction (p = 0.000). CONCLUSION: This study proved that sealant treatment is highly successful in reducing dental caries. In the future, it is worthwhile to go further in this research. CLINICAL SIGNIFICANCE: Dental caries is a problem in children aged 6-11 years old and not only. That is why this study recommends that sealants treatment should be used to prevent and reduce the prevalence of dental caries. HOW TO CITE THIS ARTICLE: Canga M, Malagnino G, Malagnino VA, et al. Effectiveness of Sealants Treatment in Permanent Molars: A Longitudinal Study. Int J Clin Pediatr Dent 2021;14(1):41-45.

The fate of overfilling in root canal treatments with long-term follow-up: a case series.

This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

Influence of Rotation Speed of Mtwo Files on Root Canal Instrumentation Time with Different Canal Curvatures.

Introduction: The aim of this study was to analyze the effect of rotation speed on the instrumentation time of root canals with different curvatures using Mtwo NiTi rotary instruments. Methods and Materials: Forty root canals were selected and divided into 2 groups, according to the angle of curvature (group A>30°, group B<30°). Both groups were divided into 2 subgroups (n=10), according to the rotational speed used for root canal instrumentation (150 rpm: group A1 and B1; 250 rpm: group A2 and B2). The total instrumentation time and the total number of instrumentation cycles (NCI) required to complete root canal preparation were registered for each canal. The mean and standard deviation were then calculated. Data were then statistically analyzed using two-way ANOVA and interaction effect P-values (P<0.05). Results: During root canal instrumentation, there were no file fractures. Total instrumentation time of the low speed groups A1 (150 rpm) and B1 (150 rpm) were significantly higher (P<0.05) than that of the high speed groups, A2 (250 rpm) and B2 (250 rpm); however, there was no statistically significant difference in terms of NCI between the different groups (P>0.05). Statistical difference was not found between the different angles of curvature, group A1 vs B1 and A2 vs B2 in terms of total instrumentation time (P>0.05) and NCI (P>0.05). Conclusions: This ex-vivo study showed that canal preparation with Mtwo rotary files could be completed safely with an increase of the instrumentation time at low rotational speed independently of the root canal curvature.

A Comparison of Mtwo and RaCe Rotary Instruments in the Preparation of Curved Canals.

AIM: The aim of this study was to compare the effectiveness of Mtwo and RaCe rotary instruments in cleaning and shaping root canals curvature. MATERIALS AND METHODS: The present study was conducted on 160 simulated canals in resin blocks with an angle curvature of 15°-30°. These 160 simulated canals were divided into two groups, where each group consisted of 80 blocks. In the first group, the canals were prepared using Mtwo rotary system (VDW, Munich, Germany). In the second group, the canals were prepared using RaCe instruments (La Chaux-De-Fonds, Switzerland). The data were recorded using SPSS version 23 software (Microsoft, IL, USA). RESULTS: The results obtained by using the Mtwo rotary instruments showed that these instruments were able to clean and shape in the right-to-left motion curved canals, at different levels, without any deviation and in perfect symmetry, with a p value = 0.000. The data showed that greater the depth of the root canal, greater the deviations of the RaCe rotary instruments. These deviations occurred in three levels, which are the following: S2 (p = 0.004), S3 (p = 0.007), and S4 (p = 0.009). The Mtwo files can go deeper and create a greater angle in S4 level (21°-28°) compared to RaCe instruments with an angle equal to 19°-24°. CONCLUSION: The present study noted a clinical significant difference between Mtwo rotary instruments and RaCe rotary files used for the canal preparation and indicated that Mtwo instruments are a better choice for the curved canals. CLINICAL SIGNIFICANCE: There are a large number of procedures and instruments used in the preparation of the root canal. Mtwo and RaCe rotary files were the instruments taken under comparison, in order to determine which of them would perform better.

Evaluating different stressors among parents with hospitalized children.

BACKGROUND: The pediatric hospital is an environment with a high level of stress for most parents. Parents experience high levels of stress if their children are hospitalized due to the fear for the loss of their child's life. OBJECTIVE: The objective of this study was to evaluate stress factors in parents of hospitalized children. MATERIALS AND METHODS: This study was conducted from January to July 2019 at the General Pediatrics Department of Fieri Regional Hospital. The study sample was composed of 200 parents, of which 86 (43.3%) were males and 114 (56.7%) were females. The parents chosen as our sample had their children hospitalized for at least 5 days. RESULTS: Our results showed that 80% of the sample was stressed out by waiting at the hospital, whereas 42% of them felt stressed also by their child's oral problems. Parents of hospitalized children (83%) felt stressed about the painful techniques applied to their children. Nearly 65% of them were stressed out by the hospital environment; child's sleep bruxism was considered another stressor by 39% of the sample. CONCLUSION: This study claims that parents of hospitalized children experience stress from different stressors such as dental visits, waiting for the diagnosis, and sleep bruxism. There are other factors which do not influence parental stress including residence, divorced parents, and hospital conditions.

Maintenance Evaluation of the Original Anatomy of the Root Canal Diameters Instrumented with Mtwo and BioRace Systems.

Objective:The aim of the present study was to evaluate maintenance of the original anatomy of the root canal diameters instrumented with the Mtwo rotary instruments and BioRace file systems. Material and method:Acrylic resin blocks with 160 simulated root canals with an angle curvature 15°-30° were taken into consideration in the present comparative study. The 160 simulated root canals were divided into two groups, each of them containing 80 acrylic resin blocks. Each group was divided into two subgroups (n=40 canals each). The simulated root canals subgroups were prepared with Mtwo and BioRace rotary nickel-titanium instruments. The results were scrutinized using analysis of variance (ANOVA)-test and Tukey's test. The significance level was set at P < 0.05. Results:No significant difference was noted between the Mtwo rotary instruments and BioRace files as they both had equal value in the coronal section (P=.000) in S1 (D1) and S1 (Dpi). The results of Tukey's test revealed a significant difference between the Mtwo rotary instruments and BioRace files in middle and apical section with the value (P=.003) in S3 (Dpi) and S4 (Dpi). The results of Tukey's test found out a significant difference between the Mtwo rotary instruments and BioRace files in the middle and apical section with the respective values (P=.003) in S3 (Ai) and (P=.006) in S4 (Ai). Conclusion:Ccording to the findings of the present study, enlargement of the root canal diameters resulted to be better on the middle and apical section of the canal prepared with Mtwo instruments in comparison with BioRace instruments. Thus, Mtwo instruments will increase the rate of success of endodontic therapy.

Effectiveness of Fluoridation Depending on Periodicity in 6-10-year-old Children.

BACKGROUND: The cost-effectiveness of this study was achieved in the group that was treated every three months with periodic intervals, which had a reduction of caries with 62%. The relative effectiveness of our study is the application of fluoride treatment every 3 months compared with treatments done every 4 and 6 months, respectively. OBJECTIVE: To evaluate the reduction of caries disease depending on the time period of fluoride gel application. The sample was chosen randomly. MAIN HYPOTHESIS: The frequency of fluoride gel application every 3 months has positive impacts on reducing dental caries. BASIC DESIGN: This is a cross-sectional study with a controlled sample for a period of 24 months. Durashield fluoride fluid (5% sodium fluoride) was used for the treatment of permanent dentition of the 6-10-year-old children. CLINICAL SETTING: This study proves that fuoride application every 3 months significantly reduces caries morbidity. PARTICIPANTS: Our study included 400 children, who were divided into 4 groups, 100 children in each group. INTERVENTION: The first group did not undergo any treatment and it is called the control group. The second group was under fluoride treatment every 4 months. The third group was treated with fluoride every 3 months, and the fourth group was treated every 6 months. RESULTS: The data collected from the control group showed that there is an increase in 24% of the caries incidence. In the group treated with fluoride every 4 months, caries incidence decreased to 30%. The group treated every 3 months with periodic intervals had a reduction of caries with 62%, while the group treated every 6 months had a reduction of 40%. Based on the analysis of variance (ANOVA) test, the fluoridation application every 3 months is significant for p = 0.000. CONCLUSION: The best results were achieved in the treatment with fluoride in a 3-month periodic interval. HOW TO CITE THIS ARTICLE: Canga M, Malagnino VA et al. Effectiveness of Fluoridation Depending on Periodicity in 6-10-year-old Children. Int J Clin Pediatr Dent 2019;12(4):280-282.

Evaluating Therapy Treatments in Patients with Mental Disorders in Relation to Oral Health.

AIM: The purpose of this study was to find the correlation between dental caries and teeth loss in relation to gender, age, treatments with different therapies, time period being hospitalized, sugar consumption, smoking, and oral hygiene in mental disordered patients. OBJECTIVE: Evaluating therapeutic treatments in patients with mental illnesses, focusing on the effects on oral health. MATERIALS AND METHODS: This is a longitudinal cohort study conducted on patients who have been hospitalized from 5 years to 30 years. Patients were observed for 7 months (January 2019-July 2019) in the psychiatric hospital "Ali Mihali", in Vlora, Albania. In our study, 200 patients participated, of which 103 were females (51.5%) and 97 were males (48.5%). RESULTS: In the present study, we analyzed the oral health of patients within the age class of 30-70 years. We divided them into four age groups: 30-40, 41-50, 51-60, and 61-70 years. According to the ANOVA test, a strongest influence on caries manifestation and missing teeth was noticed during the time the patient was being hospitalized, with p values = 0.000 in both cases. The treatments done with different therapies also had a strong influence on the teeth loss with a p value = 0.001, while in carious teeth the p value was 0.004. This study showed that there is a strong statistically significant correlation between sugar consumption and smoking, in relation to caries manifestation and teeth loss, with p values = 0.000, respectively. CONCLUSION: These patients are a vulnerable group, if we consider their oral health. The present study proved that the most important reasons for their poor dental health are: bad oral hygiene, smoking, sugar consumption, adverse effects of medications, and the time period that these patients have been hospitalized. CLINICAL SIGNIFICANCE: By knowing the factors that have worsened the oral health of mental disordered patients, we can try to raise the awareness about caries reduction and to avoid teeth loss. How to cite this article: Canga M, Malagnino I, Malagnino G, et al. Evaluating Therapy Treatments in Patients with Mental Disorders in Relation to Oral Health. J Contemp Dent Pract 2019;20(10):1179-1183.

Could early rheumatoid arthritis resolve after periodontitis treatment only?: case report and review of the literature.

Rheumatoid arthritis (RA) is an immune-mediated polyarthritis; currently no pathogenic agent has been identified as a disease trigger. A patient with RA, presumably caused by periodontal infection, whose remission has been observed after periodontitis treatment in absence of specific RA therapy, is reported here for the first time, to our knowledge. A 61-year-old male patient presented migrant arthritis associated with antibodies against citrullinated protein antigens positivity. The clinical features allowed to make RA diagnosis according to the 2010 European League against Rheumatism/American College of Rheumatology RA classification criteria. X-ray of the second upper molar showed chronic apical periodontitis. After its treatment, arthritis remission has been observed in the absence of specific RA therapy. It has been suggested that periodontitis may have a trigger role in RA pathogenesis. This could be explained by the enzymatic action of Porphyromonas gingivalis, probably leading to break tolerance to collagen. The identification and subsequent treatment of periodontitis should therefore be considered pivotal in RA prophylaxis and management.

'Simultaneous technique' and a hybrid Microseal/PacMac obturation.

UNLABELLED: In these endodontic case reports we present a root canal preparation protocol using the Mtwo Ni-Ti rotary files according to the 'simultaneous technique' which is a'crown-down' approach, where every instrument in the sequence is used to the full working length. A hybrid Microseal/PacMac obturation (consisting of three stages: master cone compaction, backfill with pre-plasticized guttapercha and vertical compaction) is proposed in order to: maintain the obturation length control associated with the Microseal system; use preheated gutta-percha to backfill the canal rapidly with the PacMac condensor; and to reduce potential voids in the obturation material with the final vertical compaction. CLINICAL RELEVANCE: The'simultaneous technique'followed by apical preparation using Mtwo apical files allows obturation using the proposed hybrid Microseal/Pacmac method, aiming to overcome some of the shortcomings of the Microseal and Pacmac obturation methods, such as length control difficulty and sealer pooling.

Vertical ridge augmentation around implants by e-PTFE titanium-reinforced membrane and bovine bone matrix: a 24- to 54-month study of 10 consecutive cases.

PURPOSE: The objective of the present study was to clinically and histologically evaluate the effectiveness of deproteinized bovine bone as the augmentation material in vertical ridge augmentation of the inserted implants. MATERIALS AND METHODS: This retrospective study was performed on 10 vertically augmented ridges in which 24 dental implants were inserted. Deproteinized bovine bone (Bio-Oss) was used as the only augmentation material and was covered with a titanium-reinforced expanded polytetrafluoroethylene (e-PTFE) membrane (Gore-Tex). For 3 augmented areas, bone samples were retrieved for histologic and histomorphometric examination. RESULTS: Clinical evaluations showed bone defects around the implants of 2 to 9 mm (average -5.1 mm; SD = 2.1). Bone height gain at 6 to 8 months after augmentation was 3 to 9 mm (average 5.3 mm; SD = 1.7). Differences between pre- and postaugmentation were statistically significant, for a mean value of > 4 mm (P < .005). The obtained bone biopsy specimens showed significant new bone formation and remodeling of the deproteinized bovine bone material. The radiographic data and the clinical stability showed that all implants were successfully osseointegrated. The radiographic and clinical follow-up indicated that the generated bone crest levels were stable. CONCLUSION: This clinical study suggests that vertical ridge augmentation with an e-PTFE membrane and deproteinized bovine bone is predictable and can lead to long-term success.

Capacity of coronal dentin to increase fiberglass post retention: a pull-out test.

PURPOSE: To evaluate the capacity of residual dentin in the coronal part of the root canal to increase the retention of serrated fiberglass posts (Extra-glass P-6%). METHODS: 40 freshly-extracted maxillary central incisors were randomly and evenly divided into four test groups (TGs) with no (TG0), one (TG1), two (TG2) and three (TG3) coronal walls, respectively. After shaping, the canals were filled with gutta-percha and prepared to receive fiberglass posts. Coronal wall dentin was etched with 38% phosphoric acid for 60 seconds, rinsed, and dried. Dentin bonding agent (Prime & Bond NT) was applied, and fiberglass posts were luted for 8 mm into the post space using a self-cure composite (ResiLute). All samples were then subjected to tensile forces in a universal testing machine. Data were analyzed with ANOVA and Student t-tests (P< 0.01). RESULTS: The samples with residual coronal dentin showed higher bond strength than the samples without residual crown walls (TG0=100.30N; TG1=201.83N; TG2=263.54N; TG3=278.86N). The differences between the groups were all statistically significant at P< 0.01, except for the difference in tensile strength between TG2 and TG3, which was not statistically significant. Residual crown walls significantly increased the tensile load required to displace the posts.