Prevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina.

INTRODUCTION: As non-carious cervical lesions (NCCLs) may compromise aesthetics and function, knowledge of their aetiological covariables enhances management of clinical complaints and success of restorative treatments. AIMS: The primary aim of this study was to assess the presence of NCCLs among the general population of the Republic of Srpska, Bosnia and Herzegovina and the potential association with patient-related risk factors. METHODS: A prevalence study of NCCLs included 738 respondents from eight towns/municipalities. Two dental practitioners examined all respondents. NCCLs were diagnosed according to the Smith and Knight tooth wear index, measured using a Williams periodontal probe. Data regarding risk factors were obtained through a structured questionnaire. Multivariate logistic regression was used to analyse the association of risk factors and the occurrence of NCCLs. RESULTS: Non-carious cervical lesions were diagnosed in 384 (52%) respondents. Multivariate regression analysis showed that several variables were independently associated with the risk of developing NCCLs, including frequent consumption of acid food (P = 0.001), frequent consumption of acid drinks (P = 0.001), retaining drink in the mouth (P = 0.001), alcohol consumption (P = 0.030), bruxism (P = 0.018) and gastro-oesophageal reflux (P = 0.023). First mandibular premolars were the most affected teeth (left: 46.0%; right: 44.0%), followed by the second right maxillary premolars (37.3%), second left maxillary premolars (33.6%) and finally by the first right maxillary premolars (34.0%). CONCLUSION: The results of the current study suggest that NCCLs occur frequently and have a multifactorial aetiology. The lowest prevalence was recorded among individuals younger than 20 years of age. As the majority of risk factors are modifiable, regular dental care could lead to the early detection of NCCLs.

Accuracy of three electronic apex locators in determining the apical foramen in multi-rooted teeth: Randomised clinical and laboratory study.

This study aimed to compare the accuracy of three electronic apex locators (EALs), Raypex 5, Apex NRG and ProPex II, in locating the apical foramen (AF) in vivo. Thirty multi-rooted teeth were included in the study. Distances from the file tip to the radiographic apex from the buccal (R1) and mesial (R2) aspect were measured after extraction. The distance from the file tip to the AF (L) was measured microscopically. Raypex 5, Apex NRG and ProPex II were accurate to within ± 0.5 mm in 84.6%, 78.6% and 66.7% of cases, respectively. R1, R2 and L measurements between the EALs were not statistically different (P > 0.05). R1 and L correlated positively (r(2) = 0.817; P < 0.001). There were no significant differences in all measurements between vital and non-vital root canals (P > 0.05). There was no statistically significant difference between the EALs. There was a positive correlation between electronic and radiographic measurements when locating the AF.

Frequency and quality of root canal fillings in an adult Serbian population.

INTRODUCTION: Estimation of frequency and quality of root canal fillings is the way to evaluate endodontic treatment needs and success/failure rates of performed endodontic procedures. OBJECTIVE: The aim of this study was to determine the frequency and quality of root canal fillings and the frequency of apical periodontitis on endodontically treated teeth in a group of adult patients from Serbia. METHODS: In order to analyze the presence and quality of root canal fillings and the frequency of periapical radiolucencies on endodontically treated teeth, 3526 teeth were examined on orthopantomograms of 153 adult patients. RESULTS: Overall, 12.5% of examined teeth were root filled, and 51.8% of them had radiographic signs of apical periodontitis. The analysis of root fillings quality revealed the presence of more inadequate ones (55.9%). The frequency of apical periodontitis was significantly higher in teeth with inadequate than in those having adequate root canal obturation (72.2% and 25.9%, respectively). CONCLUSION: The frequency of apical periodontitis on root-filled teeth in this group of patients was high, indicating a low success rate of performed endodotic procedures and high endodontic retreatment needs.

Analysis of sealing ability of root canal sealers using scanning electronic microscopy technique.

INTRODUCTION: An ideal endodontic sealer should adhere firmly both to dentin and to gutta-percha. OBJECTIVE: The aim of this study was to evaluate the adhesion of the root canal filling to dentin and gutta-percha using scanning electronic microscopy (SEM). METHODS: The sealing ability of endodontic sealers to dentinal walls of the root canal was assessed in recently extracted human single canal premolars. Twenty teeth were prepared using the crown-down technique and irrigated with 3% NaOCl. A total of 20 samples were divided into two groups. The root canals were obturated using Ketac-Endo Aplicap and GutaFlow. The sealing ability and adhesion properties at the sealer-dentin interface were studied using SEM and the results were rated from 1 to 3; extremely good adhesion (rated 1), good adhesion (rated 2) and a relatively good adhesion (rated 3). RESULTS: The results showed extremely good adhesion on Ketac-Endo and GuttaFlow dentin interface. GuttaFlow has strong adhesion (rated 1) to gutta-percha in comparison with Ketac-Endo to gutta-percha interface (rated 2). CONCLUSION: New GuttaFlow filling material has a strong sealing ability and excellent adhesion to dentinal walls and gutta-percha cones. Ketac-Endo showed excellent bond to dentin with a slightly weaker adhesion capacity to the gutta-percha cones in comparison to GuttaFlow.

[Root canal treatment of mandibular second premolar tooth with taurodontism].

INTRODUCTION: Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE: The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION: Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.