A Cross-Sectional Survey on Reasons for Initial Placement and Replacement of Single Crowns.

This cross-sectional survey investigated the reasons for placement and replacement of single crowns, the type of materials selected for initial placement and evaluated their longevity. Information was collected over 19 months period using a questionnaire focusing on the principal reasons for the placement and replacement of crowns, selected material type and the age of the crowns at the time of replacement. A total of 842 single crowns were evaluated in 476 patients. Of the 842 crowns, 472 (56%) were initial placements and 370 (44%) replacements. The main reason for placement of first single crowns was related to endodontic problems (26.5%). Metal-ceramic was indicated significantly more frequent (88.9%; p⟨0.01) than other materials for the placement and replacement of single crowns. The median age of the replaced crowns was 6 years.

Analysis of Endodontic Complications Following Fixed Prosthodontic Rehabilitation.

PURPOSE: The aim of this study was to determine endodontic treatment needs and types of endodontic disease following fixed prosthodontic treatment 24 hours after tooth preparation, 1 week after tooth preparation, 1 month after placement, and 6 months after placement. MATERIALS AND METHODS: Study groups consisted of patients who attended a university dental hospital department of prosthodontics for fixed prosthodontic treatment from January 2011 to December 2013. All teeth were clinically and radiographically evaluated according to American Association of Endodontists evaluation criteria before preparation. Metal-ceramic fixed partial dentures were placed for all patients. A total of 1,633 abutment teeth were prepared with 1,100 pontics in 524 patients (214 female and 310 male). Participant age, sex, and tooth number were recorded. Endodontic treatment follow-up was scheduled for 24 hours after tooth preparation, 1 week after preparation, 1 month after placement, and 6 months after placement, and all teeth were evaluated after placement of FPDs according to a modified criteria. RESULTS: 2,733 retainers were placed with 624 FPDs. Of the FPDs, 332 (53%) were placed in the posterior and 196 (31.5%) in the anterior region. The remaining 96 FPDs (15.5%) were placed anteroposterior. The abutment/pontic ratio was 1.44:1. The number of retainers per FPD was 4.37. Of 1,633 abutment teeth, 103 were endodontically treated after placement of FPDs. Most observed endodontic disease was symptomatic irreversible pulpitis. There were statistically significant differences in terms of teeth regions (P < .001). When follow-up times of 24 hours, 1 week, 1 month, and 6 months were evaluated, there was no statistically significant difference among all teeth groups (P > .05). CONCLUSION: A total of 2,733 retainers on 624 FPDs were evaluated over 6 months, and the mean endodontic treatment need ratio was 6.3%.

Bond strength of self-adhesive resin cement to root dentin. Comparison of photon-initiated photoacoustic streaming technique with needle and ultrasonic irrigation.

OBJECTIVE: The aim of this study was to investigate the effects of photon-initiated photoacoustic streaming (PIPS) with various irrigating solutions on the bond strength of a self-adhesive resin cement to root dentin. MATERIALS AND METHODS: Seventy-two mandibular premolar roots were divided into six groups after post space preparation and treated with a needle irrigation with distilled water and NaOCl, ultrasonic irrigation with NaOCl, PIPS with NaOCl, PIPS with EDTA and PIPS with distilled water at 0.3 W, 15 Hz and 20 mJ per pulse for 60 s. Fiber posts were cemented with a newly marketed, self-adhesive resin cement. The data obtained from the push-out tests were analyzed using analysis of variance (ANOVA) and LSD post-hoc tests (p = 0.05). RESULTS: PIPS with distilled water resulted in higher push-out values than those of needle (with both distilled water and NaOCl) and ultrasonic irrigation (p < 0.05). CONCLUSIONS: The use of PIPS may provide higher bond strength of self-adhesive resin cement to root dentin than needle and ultrasonic irrigation techniques.

Comparison of bond strength of self-etch adhesive to pulp chamber dentin after placement of calcium hydroxide and various antibiotic pastes.

OBJECTIVE: The aim of this study was to evaluate the effect of calcium hydroxide, double antibiotic paste (DAP) and triple antibiotic paste (TAP) with minocycline, cefaclor and amoxicillin on the micro tensile bond strength (µTBS) of self-etch adhesive to pulp chamber dentin. MATERIALS AND METHODS: Sixty mandibular first molars were cut horizontally and randomly divided into a control group and five experimental groups, which received an intra-canal dressing, as follows: calcium hydroxide, DAP, TAP with minocycline, TAP with cefaclor and TAP with amoxicillin. After storing the specimens for 4 weeks, the medicaments were removed by irrigation with 10 mL each of the following solution: 2.5% NaOCl, 17% EDTA and distilled water. A self-etch adhesive (Clearfil S3 Bond, Okayama, Japan) was applied and composite resin (Clearfil Majesty Posterior, Kuraray Medical Inc., Japan) was placed into the cavity. A µTBS test was performed on each specimen using a universal test machine. RESULTS: The DAP reduced the µTBS of self-etch adhesive compared to the control group, calcium hydroxide and TAP with minocycline and with cefaclor (p < 0.05). However, the other medicaments did not result in a decreased µTBS of self-etch adhesive to pulp chamber dentin as compared to the control group (p > 0.05). CONCLUSIONS: The use of DAP resulted in a reduced µTBS of self-etch adhesive to pulp chamber dentin.

Early childhood caries update: A review of causes, diagnoses, and treatments.

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Minimal intervention concept: a new paradigm for operative dentistry.

The current treatment philosophy is to prevent and detect dental disease at the earliest stage in order to avoid invasive treatment. With the current understanding of the nature of dental disease and its process, the treatment philosophy is now changing to a more conservative approach and the concept of minimal intervention is gaining popularity in modern dentistry throughout the world. It is now established that demineralized but non-cavitated enamel and dentine can be healed and traditional surgical approach of drilling and filling may no longer be necessary as this only treats the symptoms of the disease and not the cause. However, when surgical intervention is indicated, the least invasive techniques such as preventive resin restoration and minimal cavity preparation are utilized. The aim of this article is to give dental professionals an overview of the concepts of minimal intervention dentistry and recent innovations in dental technology in both the diagnosis and treatment of dental caries.

Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp.

OBJECTIVES: To assess the incidence of postoperative pain after single- and multi-visit endodontic treatment of teeth with vital and non-vital pulp. METHODS: In total, 306 patients with teeth requiring endodontic treatment were identified and were included in this study. Two experienced clinicians treated the patients, who were randomly assigned to two groups. While the teeth of patients in group 1 were obturated, group 2 were temporarily sealed and obturated after one week. Three days after the root canal instrumentation of each tooth, the patients were asked whether they experienced any postoperative pain and to rate the level of discomfort as no, mild, moderate, or severe pain. Data were analyzed statistically using the chi-square test. RESULTS: No significant difference in postoperative pain was found between vital and non-vital teeth (P>.01). Mild, moderate, and severe pain occurred in 31.4, 13.7, and 4.6% of vital teeth, respectively. Postoperative pain occurred in 107 (69.9%) and 106 (69.3%) teeth in the single- and multi-visit treatment groups, respectively. There was no significant difference in postoperative pain between the two groups (P>.01). CONCLUSIONS: The prevalence of postoperative pain did not differ between vital and non-vital teeth. The majority of patients in either groups reported no or only mild pain.

Effect of different cavity disinfectants on shear bond strength of composite resin to dentin.

PURPOSE: The aim of this study was to evaluate the effect of different cavity disinfectants on dentin bond strengths of composite resin applied with two different adhesive systems. MATERIALS AND METHODS: One hundred mandibular third molars were sectioned parallel to the occlusal surface to expose midcoronal dentin. The dentin surfaces were polished with waterproof-polishing papers. The specimens were randomly divided into 5 groups of 20 each. In group 1, the specimens were not treated with any cavity disinfectants and served as control. From groups 2 to 5, dentin surfaces were treated with the following cavity disinfectants, respectively; 2% chlorhexidine solution, 2.5% NaOCl, 1% chlorhexidine gel, 3% H2O2. The specimens were then randomly divided into 2 subgroups including ten teeth each to evaluate the effect of different bonding systems. Dentin bonding systems were applied to the dentin surfaces and the composite buildups were created. After the specimens were stored in an incubator for 24 h, the shear bond strength was measured at a crosshead speed of 1 mm/min. The bond strength data were analyzed with one way analysis of variance and Tukey-HSD tests. RESULTS: There was no significant difference between chlorhexidine gel and control groups regardless of the type of the bonding agent (p > 0.05). On the other hand, pretreatment with NaOCl, H2O2 or chlorhexidine solutions had a negative effect on the shear bond strength of self-etching bonding systems. CONCLUSION: The findings of this study suggest that when NaOCl, H2O2 or chlorhexidine solution are used as a cavity disinfectant, an etch-and-rinse bonding system should be preferred.

A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results.

OBJECTIVE: The purpose of this study was to investigate the clinical performance of high-strength glass ionomer cement (HSGIC) and resin-modified glass ionomer (RMGIC) in single and multiple surface carious cavities in the field conditions. MATERIAL AND METHODS: A split-mouth design, including ninety-one fillings placed on contra lateral molar pairs of 37 children, was used in permanent dentition. As filling materials, a HSGIC (Ketac Molar/3M ESPE) and a RMGIC (Vitremer/ 3M ESPE) were used with the Atraumatic Restorative Treatment (ART). Baseline and 6, 12 and 24-month evaluations of the fillings were made with standard-ART and USPHS criteria by two examiners with kappa values of 0.92 and 0.87 for both criteria. RESULTS: According to the USPHS criteria, the retention rates of RMGIC and HSGIC restorations were 100% and 80.9% for single surface, and 100% and 41.2% for multiple surface restorations after 24 months, respectively. Irrespective of surface number, RMGIC was significantly superior to HSGIC (p= 0.004), according to both standard-ART and USPHS criteria. CONCLUSION: The results indicate that RMGIC may be an alternative restorative technique in comparison to high-strength GIC applications in ART-field-trials. However, further clinical and field trials are needed to support this conclusion.

A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results

OBJECTIVE: The purpose of this study was to investigate the clinical performance of high-strength glass ionomer cement (HSGIC) and resin-modified glass ionomer (RMGIC) in single and multiple surface carious cavities in the field conditions. MATERIAL AND METHODS: A split-mouth design, including ninety-one fillings placed on contra lateral molar pairs of 37 children, was used in permanent dentition. As filling materials, a HSGIC (Ketac Molar/3M ESPE) and a RMGIC (Vitremer/ 3M ESPE) were used with the Atraumatic Restorative Treatment (ART). Baseline and 6, 12 and 24-month evaluations of the fillings were made with standard-ART and USPHS criteria by two examiners with kappa values of 0.92 and 0.87 for both criteria. RESULTS: According to the USPHS criteria, the retention rates of RMGIC and HSGIC restorations were 100 percent and 80.9 percent for single surface, and 100 percent and 41.2 percent for multiple surface restorations after 24 months, respectively. Irrespective of surface number, RMGIC was significantly superior to HSGIC (p= 0.004), according to both standard-ART and USPHS criteria. CONCLUSION: The results indicate that RMGIC may be an alternative restorative technique in comparison to high-strength GIC applications in ART-field-trials. However, further clinical and field trials are needed to support this conclusion.

Effect of intracanal medication with calcium hydroxide and 1% chlorhexidine in endodontic retreatment cases with periapical lesions: an in vivo study.

BACKGROUND/PURPOSE: Calcium hydroxide (Ca(OH)(2)) has been widely used as an intracanal medicament for endodontic retreatment, but very few studies used both Ca(OH)(2) and 1% chlorhexidine (CHX) as intracanal medicaments. The purpose of this study was to assess the in vivo effectiveness of a combination of Ca(OH)(2) and 1% CHX as intracanal medicaments in endodontic retreatment cases with periapical lesions. METHODS: Previous cases of endodontically treated teeth with periapical pathosis in 70 patients (36 men and 34 women, age range 18-60 years) were included. Of these teeth, 59 had received root canal treatment and 11 had been subjected to previous apical surgery, indicating endodontic failure. Following the routine procedures, including canal reshaping and irrigation with 2% CHX, a canal medication material containing Ca(OH)(2) powder and a 1% CHX solution was placed into the root canals. Over a 6-week period, the intracanal medication was periodically changed until the teeth became asymptomatic. Patients were recalled at 3-month intervals for radiographic and clinical examination. RESULTS: Our clinical and radiographic assessment of retreatment cases showed complete healing in 41 (64%) teeth, incomplete healing in 9 (14%) teeth, and failure in 14 (22%) teeth. For complete healing teeth, the healing time varied from 6 to 36 months. The size of the periapical lesions and previous surgical treatment had no influence on the prognosis. CONCLUSION: Our results suggest that a combination of Ca(OH)(2) and 1% CHX can be successfully used as intracanal medicament for disinfection in endodontic retreatment cases with periapical lesions.

Prevention of maternal bacterial transmission on children's dental-caries-development: 4-year results of a pilot study in a rural-child population.

AIM: Dental caries with its bacterial agent is an infectious disease, and shows a vertical transmission. The control of bacterial transmission of Mutans streptococci (MS) from mother to child has been studied, and its results on their children's caries development, and on their siblings' bacterial levels, have been analysed in a field-trial (for 4 years) in rural area. MATERIAL AND METHODS: In the same tribe, 8 mothers and their 11 children (test children [TC]), and then (following years) their 9 siblings (test sibling [TSb]), were followed for 4 years. The study started when the TC group had just started to erupt. Test mothers were subjected to a preventive regime. Examination of caries development as well as determination of plaque levels of MS in TC and TSb were carried out annually and at 6-month intervals. At the end of 4 years, two control groups (control children [CC] and control siblings [CSb]) resembling TC and TSb were selected from the other tribe living in the same village, and bacterial data and caries status were compared to both test groups. RESULTS: Microbial data demonstrated that the test children (p<0.01) and test siblings (p<0.05) had significantly low bacterial level in plaque samples. Accordingly, TC had significantly low dmf-t and -s number compared to corresponding control group (p<0.001 for dmf-t, p<0.0001 for dmf-s). CONCLUSION: The preventive regimen was applicable in rural southeastern Anatolia, where an introverted life style with a great tribal system is prevailing, any other preventive measures may have been practical or available, and babies are basically cared by mothers.

In vitro assessment of the effectiveness of chlorhexidine gel and calcium hydroxide paste with chlorhexidine against Enterococcus faecalis and Candida albicans.

OBJECTIVE: The purpose of this study was to compare the effectiveness of various medicaments, including Ca(OH)2/2% chlorhexidine, 2% chlorhexidine gel, and Ca(OH)2 alone, against Enterococcus faecalis and Candid albicans in vitro. STUDY DESIGN: Eighty extracted single-rooted human maxillary teeth were used. After removing the crown, each root was instrumented up to size 50 by using a conventional technique. The root canal was irrigated with ethylenediamine tetra-acetic acid (EDTA) solution to remove smear layer. Then, roots were infected with E faecalis and C albicans. Subsequently, the roots were divided into 4 treatment groups: group 1 was treated with calcium powder hydroxide in distilled water, group 2 was treated with calcium hydroxide powder in 2% chlorhexidine, group 3 was treated with 2% chlorhexidine gel, and group 4 was treated with 0.9% sterile saline serving as negative control. Microbial samples were taken after 7, 15, and 30 days. After incubation, dentine chips were obtained form each root canal and examined microbiologically. The microbiological samples were plated to count colony-forming units in per milligram of dentin. RESULTS: The results showed that the 2% chlorhexidine gel was significantly more effective than calcium hydroxide with 2% chlorhexidine, calcium hydroxide, and control saline solution (P < .05). CONCLUSION: Under the conditions of this study, 2% chlorhexidine gel is effective in the elimination of E faecalis and C albicans from the root canal system. However, to support this in vitro observation, further in vivo studies are needed.