Comparison of Immediate Implantation into the Socket with and without Periapical Pathology: Systematic Review and Meta-Analysis.

Background and Objectives: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets with and without periapical pathology. Materials and Methods: After the search and review of the literature in the electronic databases, 109 publications were achieved. The titles and abstracts of 66 publications were screened. After the evaluation of the full text of 22 publications, based on the inclusion criteria, six controlled clinical studies were included in this systematic review and meta-analysis. Results: The statistical calculation showed no heterogeneity among the studies included. The implant survival was 99.6% in the test (socket with periapical pathology) and control (socket without periapical pathology) groups of all the clinical trials. The results of the meta-analysis showed no statistically significant difference between test and control groups regarding the marginal bone level and the width of keratinized mucosa in all the studies. Other parameters indicating plaque level, bleeding on probing, and gingival recession also did not differ between test and control groups at the final follow-up in nearly all studies. Conclusions: Within the limitation of this systemic review and meta-analysis, the obtained data suggest that implants immediately placed into the extraction sockets of teeth exhibiting periapical pathology can be successfully osseointegrated for an extended period.

Evaluation of Outcomes in Immature Teeth After Revitalization or Apexification Procedures: A Systematic Review and Meta-Analysis.

There are two main treatment options for immature teeth with necrotic pulp and apical periodontitis. Apexification creates a mineralized tissue barrier, while revitalization aims to regenerate vital tissue in the canal space. There is no conclusive evidence to determine the most effective procedure regarding root length and dentin wall thickness. The objective of this systematic review was to compare the outcomes of revitalization and apexification procedures in immature non-vital teeth in terms of root length and dentin wall thickness. A literature search was conducted using the PubMed, ScienceDirect, Google Scholar, and Embase databases. Articles relevant to the study topic were gathered according to the selection criteria, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The included studies had to be published in English, conducted over a six-year period, and compared the outcomes of revitalization and apexification procedures in immature non-vital teeth. Data were collected using appropriate keywords from the eligible studies. Six articles were included for qualitative and quantitative analysis. The eligible studies showed a low risk of bias. In all revitalization cases, the root length increased significantly (mean difference (MD) (%) = 5.91; 95% confidence interval (CI) = 2.39-9.43; p = 0.0010; MD (mm) = 2.43; 95% CI = 2.05-2.80; p < 0.00001). The dentin wall thickness was statistically significant in most cases (MD (%) = 10.94; 95% CI = 7.01-14.88; p < 0.00001), MD (mm) = 0.16; 95% CI = 0.07-0.25; p = 0.0007). The systematic review and meta-analysis showed both procedures to be credible treatment options for necrotic immature teeth. Apexification had a positive impact, to some extent, on the development of root length. Revitalization yielded a significantly greater increase in root length and root dentin wall thickness and appeared to be superior in promoting root development.

Self-Reported Oral Health, Oral Hygiene and Associated Factors in Lithuanian Adult Population, 1994-2014.

This study aimed to examine 20-year trends (1994-2014) in self-reported oral health and oral hygiene and to assess the associated factors in a Lithuanian population aged 20-64 years. Nationally representative cross-sectional data on 8612 men and 11,719 women were obtained from 11 biennial postal surveys of Lithuanian health behavior monitoring. Dentate status was assessed by asking about the number of missing teeth. Over the study period, the proportion of men with all teeth increased from 17.5% to 23.0% and the same proportion increased in women-from 12.5% to 19.6%. The prevalence of edentulousness was 2.8% in 2014. The proportion of individuals brushing teeth at least twice a day increased from 14.6% to 31.9% in men and from 33.0% to 58.8% in women. Multivariate logistic regression analysis revealed that older age, lower education, living in rural areas, daily smoking, confectionary consumption (only in women), obesity, no visits to a dentist during the past year, toothache and brushing teeth less than twice a day increased the odds of missing six or more teeth. Efforts should be made to promote good oral hygiene habits, prevent and control behavioral risk factors and increase access to dental care among risk groups.

An in vitro evaluation of microleakage of class V composite restorations using universal adhesive under different level of cavity moisture conditions.

Objective of this study was to evaluate microleakage using self-etching universal adhesive on direct class V composite resin restorations under different cavity moisture conditions. MATERIALS AND METHODS: 30 extracted human molars were divided into three groups (n=10) to compare the adhesive "Prime&BondActive"under optimal, overly dry, and overly wet cavity moisture conditions. Class V cavities were filled with nanocomposite and polished. All teeth were thermocycled for 3000 cycles, sealed and immersed in 1% methylene blue solution for 24 hours. Consequently, teeth were sectioned and analyzed under a microscope. Dye penetration lengths were scored in millimetres and permeation degrees. RESULTS: The results showed that self-etching universal adhesive was least permeable (lower dye penetration depths) under optimal working field conditions. During overly wet cavity moisture conditions performans decreased insignificantly. CONCLUSIONS: According to the present study there is no significant difference of microleakage using universal adhesive in class V composite restorations with different moisture level. However, too wet working field conditions tend to increase microleakage formation. In clinical performance, it could be suggested to keep an appropriate cavity moisture level.

Long-term effect of periodontal surgery on oral health and metabolic control of diabetics.

OBJECTIVE: The objective of this study was to evaluate impact of periodontal surgery on periodontal health and on glycaemia control of type 1 and type 2 (T1DM; T2DM) diabetics with severe periodontitis, during 12 months follow-up, in comparison with non-diabetic controls. MATERIALS AND METHODS: A total of 23 T1DM and 10 T2DM patients with respective number of matched non-diabetics were examined prior to, and 3, 6 and 12 months after periodontal surgery. Glycosylated haemoglobin (HbA1c) reflected control of DM. Periodontal parameters were oral debris (DI-S), probing pocket depth (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP). RESULTS: Periodontal status in all diabetics improved after 3 months and remained so during follow-up: mean (SD) DI-S > 1 (T1DM 1.1(0.5)/0.9(0.7); T2DM 1.2(0.4)/0.8(0.4)), PPD >5 mm (T1DM 35.1(32.2)/5.1(7.8); T2DM 46.3(24.2)/13.0(10.9)), CAL ≥6 mm (T1DM 44.4(37.0)/24.52(27.2)); mean % BOP >50 % (T1DM 57.1(25.1)/22.8(20.8)), T2DM 59.4(20.8)/18.9(15.7)), p < 0.05. Mean HbA1c values decreased in T2DM patients after 3 months and remained stable during follow-up. No improvement of glycaemia control was observed in T1DM patients. Positive correlation between mean HbA1c and CAL changes was observed (r = 0.842, p < 0.05). Mean changes of periodontal parameters did not differ between diabetics and controls. CONCLUSION: Periodontal surgery improved significantly periodontal status of all patients and metabolic control of T2DM patients. CLINICAL RELEVANCE: Research findings concerning long-term effect of periodontal surgery among patients with diabetes mellitus are scarce. We found that surgical periodontal treatment positively affects periodontal health of all diabetics and improves metabolic control of type 2 DM. There is a positive correlation between clinical attachment loss and glycosylated haemoglobin levels.

Self-reported oral health behavior and attitudes of dental and technology students in Lithuania.

The aim of the present study was to assess self-reported oral health habits, attitudes, lifestyle between the sample groups of preclinical and clinical dental and technology students in Lithuania using the Hiroshima University Dental Behavioral Inventory (HU-DBI), and to evaluate the impact of education on their behavior and self-reported oral health. A sample of 183 dental and 75 technology students at the Lithuanian University of Health Sciences, Medical Academy, Faculty of Odontology, and Kaunas University of Technology completed the Lithuanian version the HU-DBI questionnaire with 11 additional items. The data were analyzed using the "SPSS 19.0 for Windows" software package. The mean HU-DBI score of clinical final-year dentistry students was significantly higher (p=0.001) than the score of the preclinical group (6.81 (1.2) and 5.96 (1.5), respectively). The mean scores of both groups of dental students were significantly (p<0.05) higher than that of the technology group (5.37 (1.8)). Oral health behaviors and knowledge were superior in dental students. Dental education had a significant positive impact on the oral health and behavior improvement. The attitudes of the Lithuanian dental students should be further improved by initiating a comprehensive program that would emphasize the importance of oral hygiene before the clinical program starts.

Severity of periodontal disease in adult patients with diabetes mellitus in relation to the type of diabetes.

BACKGROUND: The purpose of this study was to evaluate associations between diabetes mellitus - related factors and periodontal parameters among adult patients with diabetes mellitus, with respect to type of diabetes. METHODS: Study participants were 179 randomly selected 18-62-year-aged patients with type 1 diabetes mellitus and 87 randomly selected 32-70-year-aged patients with type 2 diabetes. Metabolic control of diabetes was determined by the values of glycosylated haemoglobin (HbA1c). The periodontal status of all patients was evaluated by simplifying oral debris index (DI-S), probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and bleeding on probing (BOP). Data analysis was performed with respect to patients' age, diabetes duration, metabolic control level, and diabetes type. Binary regression was used to test relationship of various parameters with CAL. RESULTS: All periodontal estimates were significantly higher among patients with type 2 diabetes. The periodontal disease was more severe in >45-year-aged participants and with DI-S>1. In patients with type 1 diabetes, the disease duration >12 years was negatively related to most periodontal parameters. No significant correlation between the periodontal estimates and HbA1c was observed in either group. The significant predictors of severe periodontal disease were type 2 diabetes mellitus (OR = 2.356), duration of disease (OR = 1.827), high BOP (OR = 3.343) and DI-S (OR = 2.958). CONCLUSIONS: Severity of periodontal disease is related to diabetes type, being more pronounced in patients with type 2 diabetes patients than in patients with type 1 diabetes. Dental plaque seems to be the major contributing factor for all patients with progressive periodontitis.

Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease.

The aim of this study was to investigate the relationship among type 1 diabetes mellitus, dental caries, and salivary status in children. The study comprised 68, 10-15-yr-old diabetics, and 68, age- and gender-matched non-diabetic controls. Diabetics were categorized into well-to-moderately controlled (HbA1c < 9.0%) and poorly controlled (HbA1c >or= 9.0%) groups. Caries was recorded by assessing lesion activity at non-cavitated and cavity levels. Teeth were examined visually for the presence of dental plaque. Saliva was analyzed for unstimulated and stimulated flow rates, buffer effect, mutans streptococci, lactobacilli, and yeasts. Diabetics had fewer caries and plaque, lower salivary flow rates and buffer effect, and more frequent growth of yeasts than their non-diabetic controls. Well-to-moderately controlled diabetics had fewer decayed surfaces and lower counts of mutans streptococci and yeasts than poorly controlled diabetics, but the level of metabolic control of diabetes had no influence on salivary flow rates and buffer effect. High caries levels in diabetics were significantly associated with age, plaque score, and decreased unstimulated salivary flow rate, but were not associated with the level of metabolic control of diabetes. High caries experience in this study population could be related to plaque accumulation and/or to changes in saliva induced by diabetes mellitus.

Dietary and oral hygiene habits in children with type I diabetes mellitus related to dental caries.

UNLABELLED: The aims of the study were to evaluate differences in dietary, oral hygiene habits and social class in children with Type I diabetes mellitus (DM), compared to non-diabetics, and to investigate relationship between selected caries-risk factors and caries experience in diabetics. MATERIAL AND METHODS: 70 children with Type I DM and 70 age- and sex-matched non-diabetic controls were included in the study. Metabolic control of diabetes was categorized into well- to- moderately-controlled and poorly-controlled groups based on glycosylated haemoglobin HbA1c. The study was based on the data obtained from the questionnaire including information about dietary and oral hygiene habits, pattern of dental visits and social class. Results showed that the diabetic children had more frequent main meals and less snacking than their controls: the mean number of main meals/day was 4.33 (SD = 0.93) in the diabetics, and 2.53 (SD = 0.85) in the controls. Significantly less diabetics (43%) used sweet drinks than their controls (79%). There were no differences according to the frequency of toothbrushing as well as frequency of dental visits between the diabetics and controls, however, significantly more diabetics reported that they never used dental floss than non-diabetics. There were no significant differences in the diet, toothbrushing frequency between the diabetics with different metabolic control. Multiple logistic regression analysis showed that among caries risk associated variables only age of children (OR = 1.98; CI = 1.23-3.19) and level of metabolic control of diabetes (OR = 4.65; CI = 1.28-16.89) were statistically significantly associated with high caries experience in the diabetics. CONCLUSIONS: Frequent consumption of sweet drinks and snacks can influence caries development in children. Amongst the diabetics, the differences in caries prevalence can be explained by combination of biological and behavioral factors rather than single dietary or oral hygiene elements.

Oral hygiene in children with type I diabetes mellitus.

UNLABELLED: Oral hygiene is an important etiological factor related to oral health status in children. The aim of the study was to evaluate the oral hygiene status in children with type I diabetes mellitus (DM) and in their non-diabetic controls, and to correlate it with the health condition of the gingival tissues. MATERIALS AND METHODS: Seventy 10-15 year-old children (mean age 13.6, SD=1.6) with type I DM and 70 their age and sex-matched non-diabetic controls were included in the study. The metabolic control of DM was categorized into well- to- moderately controlled and poorly-controlled diabetes groups based on glycosylated haemoglobin HbA1c. The oral hygiene and gingival status were assessed using the Simplified Oral hygiene index OHI-S (Greene-Vermillion) and gingival index GI (Löe-Silness), respectively. Student's t, Mann-Whitney U or chi-square tests and linear regression were used in the statistical analyses. RESULTS: There were no statistically significant differences in the mean values of OHI-S between the diabetics and non-diabetics, however the mean calculus index (CI-S) was significantly higher and the mean plaque index (DI-S) was significantly lower in diabetic subjects than non-diabetics (p<0.05). The children with type I DM had significantly higher mean values of GI compared with the non-diabetic subjects (0.15, SD=0.37 and 0.05, SD=0.19 respectively) (p<0.05). Healthy gingiva was recorded in 73% diabetics, and 87% of the non-diabetics (p<0.05). The poorly controlled diabetics had higher mean gingival, plaque, calculus indices than well-moderately controlled subjects, although the differences were not statistically significant. Statistically significantly higher mean OHI-S index was found in children with poor control of diabetes compared with the well-moderately-controlled diabetics (1.39, SD=0.75 and 1.07, SD=0.53, respectively) (p<0.05). The level of gingivitis statistically significantly correlated with the levels of calculus in both study groups (p<0.001). No difference in toothbrushing habits was revealed between the study subjects. CONCLUSION: Despite similar oral hygiene habits, the children with type I DM were more prone to calculus accumulation which seemed to be a predisposing factor in development of gingivitis in these individuals.