The Evaluation of the Cervical Marginal Sealing of Direct vs. Indirect Composite Resin Restorations in MOD Cavities.

INTRODUCTION: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. MATERIAL AND METHOD: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. RESULTS: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). CONCLUSIONS: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

Influence of Diabetes Mellitus and Smoking on Pro- and Anti-Inflammatory Cytokine Profiles in Gingival Crevicular Fluid.

Smoking and diabetes mellitus have been recognized as significant modifying factors of the evolution of periodontitis, being considered at the moment as descriptive factors in the periodontitis grading system. The purpose of this study was to assess the consequence of smoking, type 2 diabetes, and the combination of these two factors on clinical periodontal parameters, on the levels of gingival crevicular fluid (GCF), and also on ratios of pro-inflammatory and anti-inflammatory cytokines by using a commercially available kit-based multiplex fluorescent immunoassay. The study was carried out on 124 volunteers (control (C) group = 29, diabetes mellitus (DM) group = 32, smoking (S) group = 31, and S + DM group = 32). Total mean bleeding on probing was significantly lower in the S and S + DM groups, compared to that of the other groups (p < 0.05). Total amounts of TGF-ß, MIP-1α, IL-6, IL-2, and IL-17 were significantly increased in the periodontally healthy sites of diabetes patients (p < 0.05), compared to those of the controls. Systemically healthy smoking patients had higher values of GM-CSF, TGF-ß, IL-4, TNF-α, IL-5, and IL-7, while diabetic smoking patients showed higher values of IL-4, TGF-ß, and MIP-1α. In smoking and systemically healthy patients, IL-23, IL-7, and IL-12 showed increased concentrations, while concentrations of TGF-ß, MIP-1α, IL-2, IL-7, IL-12, IL-17, IL-21, and IL-23 were higher in smoking DM patients. In conclusion, in our study, diabetes mellitus induced a general pro-inflammatory state, while smoking mainly stimulated immunosuppression in the periodontal tissues of periodontitis subjects.

Clinical-radiological study on the role of biostimulating materials in iatrogenic furcation lesions.

UNLABELLED: Root perforation is an unwanted incident which may occur at any stage of endodontic treatment and can adversely affect tooth prognosis. AIM: To compare the recovery rate after treatment of root perforations in the interradicular area of the molars, using two different materials: MTA and ceramic nanoparticles mineral cement DiaRoot BioAggregate, by a clinical-radiological and statistical analysis over a period of up to 24 months. MATERIAL AND METHODS: The study was conducted on 28 molars from patients of both sexes, mean age 33.29 +/- 6.2DS, with iatrogenic perforation of pulp chamber floor. The teeth were divided into 2 groups according to the applied material: group 1--gray MTA (ProRoot MTA, Dentsply, Tulsa Dental), and group 2--BioAggregate (Diadent Group International, Vancouver). Patients included in the study were monitored and assessed by radiological examinations at 6, 12 and 18 months. RESULTS: Pulp chamber floor perforations are significantly associated with tooth location (chi2 = 35.60, r = 0.67, p = 0.00359, 95% CI). Both when the perforation was repaired with MTA and BioAggregate, the clinical improvement was significant (chi2 = 17.608, r = 0.58, p = 0.0035, 95% CI). CONCLUSIONS: Based on the results of this study, both MTA and BioAggregate are excellent materials for root perforation repair.

[Epidemiological study regarding prevalence, distribution and severity of periodontal disorders in a study group aged between 15-65 years]. / Studiu epidemiologic privind prevalenta, distributia si severitatea afectiunilor parodontale in cadrul unui lot de pacienti cu vârsta 15-65 ani.

UNLABELLED: The study aimed to assess the prevalence and severity of periodontal disorders as well as possible correlations between periodontal status and parameters as follows: sex, age, dental group. MATERIAL AND METHOD: Study group included 143 subjects (58-males, 84-females) aged between 15-65 years. The assessment of periodontal status was performed using CPITN indices (gingival inflammation, periodontal pockets depth) and Rateitschak indices (alveolar resorption degree visible on ortopantomographs). The correlations between age group, sex, dental group and CPITN indices, alveolar resorption degree and periodontal status were performed. Data were processed and submitted to statistical analysis. RESULTS: The results regarding CPITN indices distribution were as follows: CPITN 0-6%, CPITN 1-8%, CPITN 2-22%, CPITN 3-47%, CPITN 4-17%. The results regarding alveolar resorption degree were as follows: absent-37%, small-28%, moderate-24%, severe-11%. The prevalence of chronic periodontitis was 60% and rapid progressive periodontitis were associated with 4.2% patients. CONCLUSION: The investigation of CPITN indices and alveolar resorption degree represent efficient tools for the assessment of periodontal status and treatments needs in epidemiological studies.

[Longitudinal study of the efficacy of conservative endodontic treatment for chronic periapical lesions]. / Studiu longitudinal privind eficienta tratamentelor endodontice conservatoare pe un lot de dinti cu leziuni periapicale cronice.

UNLABELLED: Our study aimed to assess the possibilities of healing in periapical lesions following endodontic therapy, using a standardised technique. MATERIAL AND METHODS: Study group included 34 patients with 15-45 age. 40 teeth with periapical granuloma and periapical difuse osteitis were endodontically treated. All teeth presented radicular obturations with adequate length and density consisting of gutaperca points and antiseptic sealer (Endoflas, Sanlor). Optimum coronal sealing was provided through prosthetic restorations or composite resins associated with glassionomer cements. All treated teeth were radiographically monitorised on a 24 months time interval. Periapical Index (PAI) were used for assessment of periapical healing processes. Recorded data were used for statistical analysis in SPSS 16 trial. RESULTS: The assessment of periapical status after 24 months showed a complete periapical healing for 42.5% teeth (PAI 1-2), partial periapical healing for 52.5% teeth and 5% endodontic failures. Median values for PAI indices decreased from an initial 4.75 value to 4.30 after 3 months, 3.33 after 12 months and 2.60 after 24 months. Wilcoxon tests confirm significant statistical differences between PAI indices at different time intervals. CONCLUSIONS: Adequate radicular obturation associated with optimum coronal sealing provide a favourable environment for periapical healing processes, providing success in endodontic therapy of chronic apical periodontitis. Time interval represents a major factor that influences periapical remineralisation degree.