Use of contemporary technologies and new materials in undergraduate Endodontics teaching.

BACKGROUND: This study aims to analyze the use of contemporary technologies and materials in undergraduate endodontic teaching in Spain. MATERIAL AND METHODS: The survey was sent to the undergraduate endodontic programme leads in the 23 Spanish dental schools. The survey asked about the use of magnification, ultrasonic devices, electronic apex locator, rotary instruments, root-filling techniques, and bioceramic cements in the teaching of endodontics. RESULTS: The response rate was 91%, and the final number of schools included in the study was twenty. Only two schools (10%) used magnification (loupes or operative microscope). Five schools (25%) used ultrasonic devices to prepare the access cavity, and four (20%) to activate the irrigation solution. In 14 dental schools (70%) no type of ultrasonic instrument was used. Electronic apex locators in working length determination was used in 19 schools (95%). All schools used rotary instrumentation in the teaching of endodontics, and 45% of schools used reciprocating instruments. Five schools (25%) used warm vertical compaction technique, four (20%) single cone gutta-percha technique, and four (20%) thermoplastic injection techniques. No school used carrier-based gutta-percha. Bioceramic cements were used in 19 of the schools (95%). CONCLUSIONS: Spanish dental schools have incorporated some of the new endodontic technologies and materials, including the electronic apex locator, rotary instruments, and the new bioceramic cements; however, the modern root filling techniques, magnification, and ultrasonic instruments are not yet used in most dental schools. Key words:Bioceramic materials, dental schools, endodontic curriculum, magnification, online survey, rotary instrumentation, ultrasonic devices.

Prevalence of endodontic infection in patients with Crohn´s disease and ulcerative colitis / Prevalencia de infección endodóntica en pacientes con enfermedad de Crohn y colitis ulcerosa

Background: Previous studies have linked apical periodontitis (AP) to inflammatory bowel disease (IBD). Theaim of this study was to compare the prevalence of AP and root canal treatment (RCT) in patients with ulcerativecolitis (UC) and Crohn´s disease (CD).Material and methods: A cross-sectional study, including 28 patients with Crohn´s disease and 26 with ulcerativecolitis, was conducted. AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical indexscore (PAI). Student’s t test, χ2 test and multivariate logistic regression were used in the statistical analysis.Results: Multivariate logistic regression run with age, gender, number of teeth, number of RFT, periodontal dis -ease and the type of IBD as covariates, taking as dependent variable and outcome “periapical status” (0 = notooth with RPL; 1 = at least one tooth with RPL), showed that both UC and CD patients had the prevalence api-cal periodontitis (OR = 1.03; C.I. 95% = 0.25 – 4.31; p = 0.97). The multivariate analysis, including all the abovecovariates, shows that both in UC and CD patients the prevalence of RCT was similar (OR = 0.76; C.I. 95% =0.17 – 7.31; p = 0.73). Periapical status was significantly associated with endodontic status (OR = 42.72; C.I. 95%= 3.87 – 472.15; p = 0.002), regardless of IBD type. Conclusions: The results of the present study show similar frequency of AP and RFT in both UC and CD patients.The type of IBD does not appear to affect the prevalence of radiographically detectable periapical lesions or theprevalence of root canal treatment.(AU)

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study.

AIM: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. MATERIALS AND METHODS: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. RESULTS: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3-4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2-1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5-49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1-1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6-1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8-1.7; p = 0.49) were associated with MetS. CONCLUSIONS: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.

Correction: Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment?

[This corrects the article on p. 751 in vol. 10, PMID: 30305872.].

Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment?

BACKGROUND: The aim of this study was to investigate the diagnostic criteria and treatment decisions in the management of deep caries lesions (DCLs). The null hypothesis tested was that DCLs are managed according to the current scientific evidence. MATERIAL AND METHODS: A total of 288 dentists were contacted directly or by mail, and 125 (43%) were included in the study. Dentists were requested to answer a questionnaire about the routine approach to the diagnosis and treatment of DCLs. Logistic regression analyses were carried out to calculate odds ratios (OR). RESULTS: Pulp sensitivity tests were used by 65% of dentists when assessing pulpal health in cases of DCLs, particularly those who had followed courses in cariology (OR = 3.8; p = 0.005). Dentine hardness was the most frequent criterion used during DCLs excavation (98%). Two thirds of the respondents (65%) removed carious tissue until they felt hard dentine, and feeling hard dentine correlated with caries removal even at the risk of pulpal exposure (OR = 15.8; p = 0.0000). Acute transient pain or sensitivity to cold or heat (reversible pulpitis) were considered by 58% of respondents as a reason to provide endodontic therapy. CONCLUSIONS: The null hypothesis tested is rejected. The evidence-based more conservative approach on the management of DCLs is not being translated to clinical dentistry. Root canal treatment is being indicated in cases of DCLs in which the diagnosis is reversible pulpitis. Likewise, it can be concluded that non-conservative management of DCLs, with endodontic overtreatment, could be occurring. Key words:Deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, pulpal diagnosis, reversible pulpitis, treatment decisions.