Dento-alveolar and maxillofacial injuries among different ethnic groups in Israel.

An evaluation of dental and maxillofacial trauma in a level 1 trauma center in Israel was carried out to assess the causes of trauma and the relationship between the injuries to the patient's age, gender and ethnicity. Analysis was based on data from the Israel Trauma Registry. Patients hospitalized in a level 1 trauma center from January 1, 2000 to December 31, 2005 were analyzed according to age, gender, time, place, ethnicity and cause of injury. Files of 22 558 trauma patients were reviewed. Maxillofacial and tooth injuries were separated and further analyzed according to the above parameters. Maxillofacial or dental injuries were observed in 1668 (7.4%) of the trauma patients, caused by motor vehicle accidents (39.2%), falls (30.9%), and intentional injuries (21.2%). Most occurred on the street/road (46.5%), at home (18.8%), and in public buildings (12.4%). Arab patients suffered more from vehicle accidents while Jewish patients presented more intentional injuries. Men were hospitalized three times more than women, and young people were at greater risk. The most frequent age of trauma was 19-28 years (27.6%). Ethnic differences were particularly noticeable for intentional injuries and vehicle accidents. This emphasizes that a larger percentage of the Arab population suffered from dental and maxillofacial injuries. Further dental health education and training for primary caregivers are warranted.

The in vitro antibacterial effect of iodine-potassium iodide and calcium hydroxide in infected dentinal tubules at different time intervals.

AIM: The aim of this study was to evaluate the antibacterial effect of iodine-potassium iodide (IKI) and calcium hydroxide (CH) on dentinal tubules infected with Enterococcus faecalis (E. faecalis) at different time intervals. METHODS AND MATERIALS: Hollow cylinders of bovine root dentin (n=45) were infected and divided into three equal groups filled with either IKI or CH and a positive control. After placing each medicament in the infected cylinders for time periods of 10 minutes, 48 hours and 7 days, microbiological samples were analyzed. At the end of each period, four 100 microm thick inner dentin layers (400 microm thick from each specimen) were removed using dental burs of increasing diameters. Dentin powder was cultured on agar plates to quantitatively assess their infection, expressed in colony forming units (cfu). RESULTS: In all layers of the positive control group, heavy bacterial infection was observed. After 10 minutes, IKI reduced the amount of viable bacteria more efficiently than CH, whereas at later time intervals CH showed the best results. CONCLUSION: For short periods of exposure, IKI has a more efficient antibacterial effect in the dentinal tubules than CH but CH performs better after longer durations of exposure. CLINICAL SIGNIFICANCE: This research indicates the use of IKI is a better choice for disinfecting the root canal than CH if only a short duration of exposure is used because of its more efficient antibacterial effect. However, if a longer exposure time is used, then CH is a better choice because of its better disinfecting effect over time.

Dento-alveolar and maxillofacial injuries: a 5-year multi-center study. Part 2: severity and location.

Maxillofacial and dental injuries are not uncommon. These injuries may cause morbidity and demand meticulously planned treatment. Part 1 of this study focused on the incidence of general trauma injuries, as well as facial or dental trauma. The aim of part 2 is to evaluate the severity and location of the dento-alveolar and maxillofacial injuries over 5 years. A retrospective cohort study was conducted based on data from the Israel National Trauma Registry. Patients admitted and hospitalized due to trauma injuries during the years 2000-2004, totaled 111,010 in which 5886 (5.3%) were maxillofacial or dental injuries. Most of these injuries were traffic-related (54.5%), followed by events at home (18.7%). Facial injuries combined with injuries to other organs involved occurred in 3721 (63.2%) of the patients. Most minor injuries were noted when no other organs were involved, while severe injuries were more common when multiple organs were involved. More than 25% of facial injuries required surgery. Meticulous epidemiologic studies are needed to support the leading role, extent, and severity of maxillofacial trauma.

Periopathogenic bacteria in persistent periapical lesions: an in vivo prospective study.

BACKGROUND: The aim of this in vivo prospective study was to detect the presence of periopathogenic bacteria in persistent periapical lesions and to compare the reliability of two different methods: anaerobic culture and the DNA hybridization technique. METHODS: Samples were obtained from 24 patients with persistent periapical lesions referred for surgical endodontic treatment. A sterile paper point was inserted into the periapical lesion for 10 seconds. The point was stored in sterile transfer tubes and analyzed by DNA hybridization. Tissue samples were transported in transfer medium and analyzed further using anaerobic culture. RESULTS: At least one periodontal pathogenic bacterium was found in seven of 24 cases. Bacterial species present were Treponema denticola (three cases), Porphyromonas gingivalis (three cases), Tannerella forsythensis (four cases), Prevotella intermedia (one case), and Actinobacillus actinomycetemcomitans (three cases). No particular signs or symptoms were associated with the presence of these bacterial species. Anaerobic culture failed to identify any of the periopathogenic bacteria. CONCLUSIONS: Periodontal pathogenic bacterial DNA can be detected in persistent periapical lesions. Anaerobic cultures failed to detect the periodontal pathogenic bacteria in positive hybridization assays, suggesting that standard culture methods lack sensitivity or that hybridization assays are flawed with low specificity. The clinical significance of the presence of bacterial DNA in persistent periapical lesions remains to be determined.

Interaction between sealers and gutta-percha cones.

Clinical observations seem to indicate that some gutta-percha cones are softened by contact with sealers. The purpose of the study was to verify whether an interaction existed between some sealers and different brands of gutta-percha cones. Because previous studies have indicated that the differences between brands of gutta-percha are magnified by heat, thermatic compaction was used in conjunction with a model of a root-canal preparation with lateral canals. Three brands of cones (Kerr, UDM, Beldent) were tested with three types of endodontic sealers (AH 26, Apexit, Roth's). A group without sealer served as a control. The length of flow into the lateral canals was measured for each combination and analyzed by two-way ANOVA. A highly significant difference was found, confirming the hypothesis that an interaction between sealer and cones is present in some combinations. It was not possible to ascribe a trend of greater effect to a certain sealer, but Roth's 811 had the least effect on flow.