Tooth avulsion with extra oral time in less than 60 minutes: two different therapeutic protocols with 13-year follow-up.

The aim of this study is to assess what needs to be the priority in tooth avulsion: replantation as quickly as possible and deferred endodontic treatment, or replantation and elimination of every irritating stimulus for the periodontal ligament.

Effect of self-adjusting file and WaveOne reciprocating file on the filling ability of oval-shaped canals with thermoplasticized gutta-percha.

The aim of the study was to compare the effect of Self-Adjusting Files (SAF) and WaveOne Primary file with syringe and needle irrigation on the filling ability of oval-shaped root canals obturated with thermoplasticized gutta-percha. Twenty-four single root teeth with single oval-shaped root canals were distributed into two experimental homogeneous groups. One group was instrumented and cleansed using the SAF system while in the other group the WaveOne system with syringe and needle irrigation was used. After instrumentation, the roots were filled by Thermafil Obturators and TopSeal sealer. Specimens were transversally sectioned at 2-, 5- and 7-mm levels from the apex and observed under light microscope. The percentage of gutta-percha filled area (PGFA), the percentage of sealer filled area (PSFA) and the percentage of voids area (PVA) were measured for each section, moreover the percentage of completely filled sections was evaluated. At all levels, no significant differences in terms of PGFA, PSFA, PVA and percentage of completely filled canals between groups were obtained (P > 0.05). On the contrary, when the data were pooled, the mean PGFA in the SAF group was 95.8%, whereas it was 93.2% in the WaveOne group (P less than 0.05). The percentage of sections completely filled was 77.8% in the SAF group, and 52.8% in the WaveOne group (P less than 0.05). Overall, the use of the SAF system in oval canals allows to obtain a significantly greater complete filling than the use of the WaveOne system.

"Superficial infiltration to treat white hypomineralized defects of enamel: clinical trial with 12-month follow-up.

Hypomineralization represents one of the most common defects in tooth crowns. Thanks to a wide understanding of aesthetics, patients request a treatment to resolve these defects. Different techniques are available, such as crowns/veneers, traditional restorative treatments, microabrasion, whitening, remineralizing agents and infiltration technique. The objective of this trial is to assess the effectiveness of superficial infiltration with Icon (DMG, Hamburg, Germany) on the attenuation of crown hypomineralized lesions of various etiological origins with a 12-month follow-up. Seventeen patients with white defects of enamel in the aesthetic sector were selected. The infiltration procedure was carried out following the manufacturer's instructions. Intraoral photographs were taken before and directly after treatment in order to document the immediate change in colour. Check-ups were performed 1 and 12 months later. All the defects which were treated showed a degree of attenuation. The teeth affected by molar incisor hypomineralization (MIH) showed partial attenuation in 8 cases, and only in one case the defect disappeared. Regarding the post-trauma cases, 6 were partially attenuated and 2 disappeared. The post orthodontic defects disappeared in 6 cases and were attenuated in 5. All incipient caries defects were completely hidden. Four out of 6 cases of fluorosis disappeared. Diagnosis plays a key role in guiding the dental clinical selection of treatment. While it has always been possible to achieve a high level of attenuation in cases of fluorosis and lesions of caries origin, cases of MIH should probably be treated using more invasive techniques. Post-trauma lesions should be infiltrated with caution, and only after having informed the patient of the possible ineffective outcome.

SDR® vs traditional composite in class II restorations in primary molars.

This study aims to compare the clinical characteristics of a new flowable resin-based composite with those of a traditional composite when applied to deciduous molars for class II restorations. Twentyeight children between 6-12 years of age, with paired minimal Class II cavities present on their primary molars, were chosen. The paired cavities were restored with either a microhybrid composite or a new flowable resin-based composite. The composites were assigned to cavities in either the right or left side of the mouth, using random allocation tables. Each pair of restorations were clinically assessed at sixmonth intervals following the United States Public Health Service criteria. The prevalence of carious lesions was higher in maxillar molars (53.6%) compared to the mandibular molars (46.4%). At 24 months, Charlie or Delta scores in the paired groups were not seen in any patient, thus demonstrating a clinical success. The statistical analysis using Pearson’s chi-squared test did not reveal significant p-values for any parameter except the proximal contact showing significant p-values for this parameter. SDR appears to be the material of choice for the restoration of deciduous teeth due to its clinical features shown at 24 months as well as its ease and speed of application.

Deep infiltration for the treatment of hypomineralized enamel lesions in a patient with molar incisor hypomineralization: a clinical case.

This case report presents the technique of deep infiltration for the treatment of hypomineralized enamel lesions in a patient affected by molar incisor hypomineralization (MIH) with the purpose of obtaining an aesthetic improvement in the affected vestibular enamel. Deep infiltration treatment involves a sequence of steps starting with an initial mechanical abrasion of the outside surface of the enamel, followed by a phase of chemical erosion using 15% hydrochloric acid, penetration through the porosity of the enamel by a very fluid resin, and finally the repair of the thin layer of lost enamel using a composite. The aesthetic improvement of the elements affected by hypomineralized lesions is discernible immediately following treatment and becomes more accentuated with time. At the expense of minimal damage to surface enamel, deep infiltration enables treatment of all types of white spot enamel lesions, regardless of aetiology, offering the possibility of restoring an aesthetically pleasing smile for patients.

Single tooth anaesthesia: a new approach to the paediatric patient. A clinical experimental study.

AIM: The objective of this study is to assess the efficacy of the STA Wand System with respect to pain and fear reduction in paediatric patients and by using the Single Tooth Anaesthesia (STA) technique. MATERIALS AND METHODS: Patients included children and teenagers between 6 and 17 years of age, who required the administration of local anaesthesia prior to expected treatments. Local anaesthesia was performed by means of the electronic STA Wand System (Milestone scientific., Inc.) adopting the Single Tooth Anaesthesia (STA) technique. Pre- and post-anaesthesia, the patients were asked to complete the Wong-Baker faces image scale and the provider filled in the Frankl Scale. RESULTS: All treatments were completed successfully and no collaboration issues were recorded. Frankl's assessment showed that 91% of patients regarded dental experience positively. The efficacy of the computer-assisted anaesthesia was at 100% when treating primary teeth, and 70% for procedures on permanent teeth. Almost the totality of treated patients (94%) gave a positive evaluation after having tried the device with STA technique. Only 6% of the patients assessed the procedure negatively. CONCLUSIONS: The STA technique allows for absence of anticipatory anxiety, absence of physical pain, no anaesthetic effects in the perioral tissues and a controllable, lower dosage of the anaesthetic liquid.