The association between smoking and smokeless tobacco use with dental caries among Pakistani patients.

BACKGROUND: Tobacco use is widely recognised as a significant risk factor for oral cancer and periodontal diseases. However, the relationship between various types of tobacco use and dental caries has been inconsistent. This study aimed to determine the association between smoking and smokeless tobacco and dental caries among patients in a tertiary care hospital in Quetta, Pakistan. METHODS: This cross-sectional study was conducted from November 2020 to March 2021 among patients in a tertiary care hospital in Quetta, Pakistan. Oral examinations and interviews were performed according to the WHO Oral Health Survey basic methods (5th edition) to determine dental caries status, tobacco use, and oral health behaviours. The odds ratio and binary logistic regression were analysed to assess the association between the types (smoking tobacco, smokeless tobacco, and use of both types), duration, and frequency of tobacco use and high caries level (DMFT ≥ 5). RESULTS: Four hundred participants aged 18-65 were included, and 67.8% were tobacco users. Use of both smoking and smokeless tobacco (aOR = 14.7, 95%CI = 1.87-115.96, p = 0.011), smokeless tobacco only (aOR = 5.90, 95%CI = 1.89-18.37, p = 0.002), and smoking only (aOR = 2.18, 95%CI = 1.23-3.88, p = 0.008) were associated with significantly increased risk of high caries. Using tobacco for longer periods and more frequently daily also significantly increases the risk of high caries. CONCLUSION: Smoking and smokeless tobacco are significantly associated with high dental caries after adjusting for other factors. Due to the high severity of dental caries and the high prevalence of tobacco use among Pakistani patients in this study, it is highly recommended to strengthen policies aimed at reducing tobacco usage, including smokeless forms.

Influence of Different Post-endodontic Restorations on the Survival Rate Against Fracture of Endodontically Treated Anterior Teeth Affected by Cervical Lesions with Pulpal Involvement: A Retrospective Clinical Study.

OBJECTIVE: To compare the survival rate against fracture of endodontically treated anterior teeth (ETT) affected by cervical (class V) lesions with pulpal involvement restored with resin composite or a post/core and crown, and to identify the prognostic factors for fracture. METHODS: Dental records and radiographs of ETT affected by cervical lesions with pulpal involvement restored with resin composite or a post/core and crown during a recall period from 2009-2022 were selected according to the inclusion and exclusion criteria. The number of tooth fracture, the restorability after fracture and any possible risk factors were identified. The survival rate against ETT fracture were analyzed and com- pared between the two restoration groups by Kaplan-Meier survival analysis and the Tarone-Ware test. Non- proportional hazard models were used to identify the prognostic factors. The sub-analysis in each restoration group was also performed. RESULTS: The study comprised 175 ETT restored with resin composite (n=125) or a crown (n=50). With a mean recall period of 32.9+-15.8 months, the survival rate against ETT fracture with resin composite (85.6%) was not significantly different from those with a crown (88%) (p≥0.05). The most frequent mode of fracture was crown-root fracture, which accounted for 78% and 83.30% of the fractures in the resin composite and crown groups, respectively. A significant prognostic factor for ETT fracture affected by cervical lesions with pulpal involve- ment was additional tooth structure loss from a class III, class IV or another class V lesion on the opposite side (p<0.05). The ETT affected by cervical lesions with pulpal involvement combined with additional tooth structure loss had a 7.25-fold higher risk of fracture than those with single-surface affected by cervical lesions with pulpal involvement (hazard ratio [HR] = 7.25; 95% confidence interval [CI], 1.68-31.30). The sub-analysis in the crown and resin composite groups revealed that the survival rates of ETT with single-surface affected by cervical lesions with pulpal involvement was 100% and 96.15%, respectively, which were significantly higher than those of ETT with additional tooth loss at 80.65% and 78.08%, respectively (p<0.05). CONCLUSION: With a mean 33-month recall period, the survival rate against ETT fracture affected by cervical lesions with pulpal involvement restored with resin composite or crown were not significantly different. Additional tooth structure loss was a significant prognostic factor for fracture.

Outcomes and Predisposing Factors of Two Prophylactic Treatments in Dens Evaginatus Premolars: A Retrospective Study.

INTRODUCTION: Dens evaginatus (DE) in premolars may contain a pulpal extension inside the occlusal tubercle. DE prophylaxis should be performed to prevent pulpal exposure due to tubercle fracture. The aim of this study was to compare the outcomes of 2 prophylactic treatments, that is, prep and fill (PF) and reinforcement (RF), in DE premolars based on clinical and radiographic data, and to identify the predisposing factors. Furthermore, DE prevalence was reported. METHODS: The DE premolar data were collected from dental and radiographic records at the Faculty of Dentistry, Mahidol University, and Bangkok Hospital, Thailand during 2000-2020. Their prevalence and characteristics were determined. Only DE teeth treated with PF or RF prophylaxis were included. Outcomes and possible predisposing factors of the 2 prophylactic groups were evaluated and statistically analyzed. RESULTS: Initially, 303 DE premolars from 110 patients were identified, with the highest prevalence observed in second mandibular premolars (37.21%). The prevalence of contralateral, same quadrant, and opposite arch DE premolars was 50.91%, 39.09%, and 34.55%, respectively. A total of 216 DE teeth met the criteria with an ∼82% recall rate, with 190 and 26 premolars treated by PF and RF, respectively. With mean recall periods of ∼31 and 23 months, the outcomes in the PF and RF group were 95.79% and 80.77% success, respectively, which were significantly different (P = .01). No significant predisposing factor was found. CONCLUSION: Prophylactic treatment in DE premolars with PF provided a significantly higher success rate than those treated with RF.

Comparison of the Survival Rate Against Fracture of Endodontically Treated Premolars with Exposed Cervical Lesions Restored with Crowns and Resin Composites: A Retrospective Study.

OBJECTIVE: The purpose of this study was to evaluate the effect of coronal restorations on the survival rates against fracture of endodontically treated premolars with exposed cervical lesions and to identify the prognostic factors for fracture. METHODS: Data of the endodontically treated premolars with exposed cervical lesions restored with resin composites or crowns between 2011 and 2020 were collected. The presence of a fracture was recorded, and the possible prognostic factors were recorded. Statistical analyses were performed, with a significance level of P<0.05, using a Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazard models were used to identify the prognostic factors. RESULTS: The survival rates against fracture were not significantly different between the teeth restored with crowns (93.3%) or resin composites (86%) (P≥0.05). A high frequency of non-restorable fractures was observed in both groups. Crestal bone reduction to the middle-third of the root was identified as the significant prognostic factor (P<0.05). CONCLUSION: For endodontically treated premolars with exposed cervical lesions, resin composite restorations provided a high comparable survival rate that was comparable to that of crowns. A higher risk of fracture was found in endodontically treated premolars with crestal bone loss to the middle-third of the root.

Survival Rates of Unrestorable Fracture of Endodontically Treated Anterior Teeth Restored with Resin Composites or Crowns: A Retrospective Cohort Study.

Introduction: Current guidelines for the restoration of endodontically treated anterior teeth (ETT) are based on laboratory results and insufficient clinical findings. This retrospective cohort study aimed to compare the survival rates of ETT with unrestorable fracture restored with direct resin composite (DRC) or full coverage crown (FCC), and identify predisposing factors. Methods and Materials: Dental records and radiographs of ETT restored with DRC or FCC were collected from the dental charts of patients who received endodontic treatments and attended recall(s) from 2007 to 2019. Clinical/radiographic data and incidence of unrestorable fracture were recorded. Survival rates of ETT with unrestorable fracture treated with DRC and FCC were analyzed using Kaplan-Meier survival analysis and log-rank test, whereas predisposing factors were identified using Cox proportional-hazard model. Moreover, the survival rates of maxillary ETT with different sites of remaining cervical tooth structure were analyzed. Results: A total of 263 ETT with 157 DRC and 106 FCC were recruited. At an average recall period of 38 months, the survival rate of ETT restored with FCC was significantly higher (99.1%) than DRC (90.4%) (P<0.05). The predisposing factors of ETT with FCC were not identified; however, the identified predisposing factors of ETT with DRC were: (i) considered less than three walls of remaining cervical tooth structure, (ii) the ratio between root dentin thickness and root canal width at the cervical region was less than 1:1:1, (iii) loss of posterior-teeth support, and (iv) parafunctional habits. Maxillary ETT with complete or palatal structure had a significantly higher survival rate than those without the palatal structure (P<0.05). Conclusion: Based on the findings of the current cohort study, the survival rate of ETT with unrestorable fracture restored with FCC was significantly higher than DRC. However, ETT without predisposing factors were not susceptible to fracture and could be successfully restored with DRC.

Comparison of the Effects of Intraradicular Materials on the Incidence of Fatal Root Fracture in Immature Teeth Treated with Mineral Trioxide Aggregate Apexification: A Retrospective Study.

INTRODUCTION: This study aimed to compare the incidence of root fractures that led to extraction in immature teeth endodontically treated by mineral trioxide aggregate (MTA) apexification and were restored with either reinforced (resin composite or fiber post) or nonreinforced (gutta percha or MTA) intraradicular materials. METHODS: Necrotic immature teeth treated with MTA apexification from 1996 to 2017 were selected according to the inclusion and exclusion criteria. Intraradicular materials and preoperative and treatment factors were obtained from dental charts and radiographs. The incidence of fatal root facture was identified. Kaplan-Meier survival analysis and the Cox proportional hazard model were used to show the survival rate and predisposing factors at a significance level of .05. RESULTS: The average recall period was 30 months. The incidence of root fracture in the teeth restored with the reinforced materials was 5.5%, which was not significantly different from the nonreinforced materials (8.3%). Furthermore, the fracture rates between the fiber post and resin composite groups were not significantly different. Two significant predisposing factors influencing the incidence of root fracture were detected: preoperative external inflammatory root resorption (hazard ratio = 26.86; P < .05) and patient age > 15 years (hazard ratio = 8.60, P < .05). CONCLUSIONS: Immature teeth treated with MTA apexification and restored with the reinforced or nonreinforced intraradicular materials exhibited a similar rate of root fracture. Preoperative external inflammatory root resorption and patient age > 15 years were found to be the predisposing factors that significantly increased the incidence of root fracture.

Endodontically treated posterior teeth restored with or without crown restorations: A 5-year retrospective study of survival rates from fracture.

AIM: The aim of the present study was to investigate survival rates from fracture of endodontically treated posterior teeth (ETT) restored with or without crowns with recall periods of up to 5 years. METHODS: ETT with single-unit crown or resin composite restorations were studied based on the inclusion criteria. Restoration, tooth structure loss, adjacent teeth, fracture, and restorability were recorded. Survival rates from fracture were calculated, and risk factors were identified. RESULTS: Overall, survival rate of ETT with crowns (92.2%) was significantly higher than resin composites (77.4%) (P < 0.05). ETT with one or two surface loss/es and two adjacent teeth had a high survival rate of 86.9%, which was not significantly different to ETT with crowns (P ≥ 0.05). Restoration and adjacent teeth were identified as significant factors. The majority of fractured ETT with resin composites were restorable, whereas those with crowns were unrestorable. Survival rates from unrestorable fracture were not significantly different between the crown (93.1%) and resin composite (96%) (P ≥ 0.05). CONCLUSIONS: The survival rate from the fracture of ETT restored with crowns was significantly higher than ETT restored with resin composites, but was not significantly different to ETT with one or two ETT with one or two surface loss/es and two adjacent teeth. ETT restored with resin composites had mostly restorable fracture, whereas ETT with unrestorable fracture were similar between the two restorations.

Survival Rates from Fracture of Endodontically Treated Premolars Restored with Full-coverage Crowns or Direct Resin Composite Restorations: A Retrospective Study.

INTRODUCTION: The aim of the present study was to compare the survival rates against fracture of premolar endodontically treated teeth (ETT) restored with resin composite or crowns and to identify risk factors associated with the fracture. METHODS: Data from dental records and radiographs of premolar ETT with postendodontic restorations (ie, resin composite or crowns) were collected between 2012 and 2016 and selected following selected inclusion and exclusion criteria. Tooth location, type of restoration, number of proximal contacts, and amount of tooth surface loss were recorded. The incidence and restorability of postendodontic fractures were identified. Survival rates against fracture of the 2 restoration types were calculated using Kaplan-Meier survival analysis. Any potential factors associated with fractures were identified using Cox proportional hazards models. RESULTS: The survival rate against fracture of ETT restored with crowns (95.1%) was higher than resin composite (77.0%). ETT restored with resin composite with 1 or 2 tooth surface losses and 2 proximal contacts had a high survival rate of 88.5% that was not significantly different from ETT with crowns. A higher incidence of restorability after fracture was observed in teeth restored with resin composite than crowns. The type of restoration and number of proximal contacts were identified as potential risk factors associated with fracture incidence. CONCLUSIONS: The survival rate against fracture of ETT restored with crowns was higher than resin composite. However, ETT with 1 or 2 tooth surface losses and 2 proximal contacts and restored with resin composite showed a high survival rate that was comparable with ETT restored with crowns.

Survival rates against fracture of endodontically treated posterior teeth restored with full-coverage crowns or resin composite restorations: a systematic review.

This systematic review aims to summarize the current clinical studies that investigated survival rates against fracture of endodontically treated posterior teeth restored with crowns or resin composite restorations. Literature search were performed using keywords. Publications from 1980 to 2016 were searched in PubMed, ScienceDirect, Web of Science, MEDLINE, and SCOPUS. Included studies were selected based on inclusion and exclusion criteria. Three clinical studies were included: 1 randomized controlled trial and 1 prospective and 1 retrospective cohort studies. Pooled survival rates ranged from 94%-100% and 91.9%-100% for crowns and resin composite, respectively. The majority of teeth had no more than 3 surface loss of tooth structure. The studies included were heterogeneous, and were not appropriate for further meta-analysis. Current evidence suggested that the survival rates against the fracture of endodontically treated posterior teeth restored with crowns or resin composites were not significantly different in the teeth with minimum to moderate loss of tooth structure.

Dental status and its impact on the quality of life of elderly in Phon Sawan, Nakhon Phanom Province.

The number of elderly people in Thailand is increasing. Oral health is an important part of overall wellbeing. We studied the impact of oral health on the quality of life among elderly attending Phonsawan Hospital, Nakhon Phanom Province, Thailand, in 2010. We studied 107 males and 278 females, aged 60-93 years. We studied the impact of oral health on the quality of life using the Oral Health Impact Profile-49 (OHIP-49) questionnaire. The OHIP-49 questionnaire is divided into seven areas: functional limitations, physical pain, physical disability, psychological discomfort, psychological disability, social disability and handicaps. The data were analyzed using descriptive, bivariate and multivariable logistic regression analyses. Seventy-one point nine percent of subjects had untreated dental caries, with the mean number of decayed, missing and filled teeth of 10.77. Eighty-nine point one percent of subjects had lost at least 1 tooth and the mean number of missing teeth was 8.22. Sixty-three point six percent of people had tooth attrition and 16.1% of people had a pocket depth of > or = 6 mm. The mean OHIP-49 was 54.25. Multivariable logistic regression analysis showed a OHIP-49 score greater than the median of 56 was directly associated with tooth attrition, tooth sensitivity, gingival swelling, oral ulcers, poor oral hygiene and never having received oral hygiene instructions. Community oral health education programs need to be developed and implemented.

Effects of dental caries on nutritional status among first-grade primary school children.

The aim of this study was to explore association between caries prevalence and nutritional status among first-grade primary school children. A cross-sectional study of 212 students was conducted. All students were weighed and measured and then the body mass index (BMI) was calculated. Each student underwent dental examination and was interviewed. Overall, caries prevalence was 80.2% and the average decayed, missing, and filled surfaces (dmfs) were 12.4 +/- 12.3. Although none of the students was in the underweight category, 45.8% were in low percentile (5th < BMI-for-age < 15th). Multiple logistic regression showed that each extra carious surface (dmfs) increased the odds of being at risk for underweight (5th < BMI-for-age < 15th) by 3.1% after adjusting for gender and dental visits. Our findings stressed that caries has significant implications on overall child health and health personnel should increase awareness of negative impacts and promote healthy nutritional choices for children.