Retrospective Cohort Study on Potential Risk Factors for Repeated Need of Dental Rehabilitation under General Anesthesia in a Private Pediatric Dental Practice.

The need for dental rehabilitations under general anesthesia (DRGAs) is continuously increasing, particularly for dental treatment of children. The present retrospective cohort study aimed to investigate potential risk factors for repeated need of DRGA in a cohort of patients from a private pediatric dental practice. Demographic and anamnestic data, dental status, and treatments performed during DRGA were retrospectively analyzed from the electronic dental charts of 1155 children that received at least one DRGA between October 2016 and December 2021. The median age of all children was 5 years at time of their first DRGA. The rate of repeated DRGAs was 9%. Patients with repeated need of DRGA were significantly younger at time of their first DRGA and revealed significantly more often a history of preterm birth and current use of a baby bottle as compared to patients with only one DRGA. There were significantly fewer treatments (regardless of type) in the second DRGA than at the first. Within the limitations of this study, young age at first DRGA, a history of preterm birth, and current use of a baby bottle may be risk factors for repeated need of DRGA. The search for effective strategies to minimize the repeated need for DRGA in children remains critical.

Antimicrobial photodynamic therapy vs. local minocycline in addition to non-surgical therapy of deep periodontal pockets: a controlled randomized clinical trial.

OBJECTIVES: To investigate the additional influence of either antimicrobial photodynamic therapy (aPDT; Helbo® Photodynamic Systems) or local application of minocycline microspheres (MC; Arestin, OraPharma) on clinical and microbiological healing results in deep periodontal pockets (PPD ≥6 mm) following non-surgical periodontal therapy (SRP). MATERIALS AND METHODS: Forty-five patients with chronic periodontitis were evaluated: test group aPDT + SRP (n = 15), positive control group MC + SRP (n = 15), and negative control group SRP-alone (n = 15). Clinical and microbiological healing parameters were recorded in every patient for four experimental teeth at baseline, 6 weeks, and 3, 6, and 12 months. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis (α = 0.05). RESULTS: Significant improvements in clinical and microbiological parameters were found for all groups after 6 weeks and 3, 6, and 12 months. Differences between groups were not statistically significant. Changes after 12 months [median (25/75%)] are as follows: reduction in PPD [mm]: aPDT + SRP 2 (1/3), MC + SRP 3 (1/4), SRP-alone 2 (1/3); percentage of residual BOP positive teeth [%]: aPDT + SRP 75 (25/100), MC + SRP 33.3 (0/50), SRP-alone 66.7 (25/75). CONCLUSIONS: Within the limitations of this study, neither the applied aPDT system nor MC showed a significant additional influence on clinical and microbiological healing outcomes in deep periodontal pockets compared to SRP alone. CLINICAL RELEVANCE: In deep periodontal defects, the efficacy of non-surgical periodontal treatment seems not to be improved by adjunctive use of antimicrobial photodynamic therapy or minocycline microspheres.

Controlled, prospective, randomized, clinical evaluation of partial ceramic crowns inserted with RelyX Unicem with or without selective enamel etching. Results after 2 years.

Among the materials used for luting indirect restorations, growing interest has been directed towards the use of self-adhesive resin cements. The aim of this prospective randomized controlled clinical trial was to evaluate the clinical performance of the self-adhesive resin cement RelyX Unicem (RXU) for luting partial ceramic crowns (PCCs). In addition, the influence of selective enamel etching prior to luting (RXU+E) was assessed. Two-year results are reported. Thirty-four patients (68 PCCs) had originally received the intended treatment at baseline (BL). Twenty-nine patients (14 male, 15 female) with a total of 58 PCCs participated in the 2-year recall. In each patient, one PCC had been placed with RXU, one PCC with RXU+E. Restorations were evaluated at BL and 24 months after placement using modified United States Public Health Service criteria for postoperative hypersensitivity, anatomic form, marginal adaptation, marginal discoloration, surface texture and recurrent caries. Additionally, the "percentage failure" within the 2-year recall period for all restorations (n = 68) was calculated according to ADA Program Guidelines. Target value for acceptability of each procedure was <5% failure within 24 m. For statistical analysis of the data, the chi-square test was applied (α = 0.05). The median patient age was 41 years (24-59 years). Median PBI was 8% (5-10%). Twenty-two RXU PCCs were placed in molars, seven in premolars. Twenty-one RXU+E PCCs were placed in molars, eight in premolars. Statistically significant changes were observed for marginal adaptation (MA) and marginal discoloration (MD) between BL and 2 years but not between the two groups (RXU, RXU+E). Percentage of alfa values at BL for MA (RXU, 97% and RXU+E, 100%) and for MD (RXU, 97% and RXU+E, 97%) decreased to RXU, 14% and RXU+E, 28% for MA and to RXU, 50% and RXU+E, 59% for MD after 24 months. Within the observation period, three failures were recorded with RXU (5.1% failure), one failure was recorded for RXU+E (1.7% failure), but a significant influence of selective enamel etching on failure could not be verified. Although the results of the present study reveal a slight tendency for more favourable results if selective enamel etching is applied prior to insertion of ceramic PCCs with a self-adhesive luting material, longer-term evaluation is needed to confirm this. Additional selective enamel etching with a self-adhesive luting material does not considerably improve clinical performance of the restorations within the observation period reported, neither does it impose a hazard with respect to postoperative hypersensitivity.

Controlled, prospective, randomized, clinical evaluation of partial ceramic crowns inserted with RelyX Unicem with or without selective enamel etching. 1-year results.

PURPOSE: To compare the performance of partial ceramic crowns (PCCs) inserted with RelyX Unicem (RXU) either with (RXU+E) or without (RXU) selective enamel etching. METHODS: 34 patients (15 male, 19 female) participated in the investigation, with a total of 68 PCC restorations. In each patient, one PCC was randomly assigned to insertion with RXU, the second PCC was assigned to insertion with RXU+E. The PCCs were CAD/CAM fabricated using the Cerec 3 system. RXU: 25 PCCs were placed in molars, nine in premolars. RXU+E: 26 PCCs were placed in molars, eight in premolars. The restorations were clinically rated using modified United States Public Health Service (USPHS) criteria at baseline, 6 and 12 months after placement. The median patient age was 41 years (24-59 years). The median (25-75%) PBI was 6% (3-9%). RESULTS: All patients were available for the three recall appointments. One PCC (RXU) debonded after 11 months in situ, one PCC (RXU+E) fractured after 12 months in situ. Both restorations had to be replaced. At the 12 months recall, 66 of 68 controlled restorations were functional without need of replacement. The evaluation using USHPS criteria revealed a significant decrease of alfa ratings over time with respect to criteria marginal adaptation and marginal discoloration. No statistically significant differences between the two luting techniques, RXU and RXU+E, we reobserved during the observation period of 1 year. Within the limitations of the present study, adhesive luting with RXU with or without selective enamel etching can be recommended.

Marginal integrity of partial ceramic crowns within dentin with different luting techniques and materials.

This in vitro study evaluated the marginal integrity of partial ceramic crowns (PCCs) luted with or without a resin-coating and compared the results with the marginal sealing of a recently introduced self-adhesive universal resin cement. PCC preparations were performed on 84 extracted human molars, with proximal margins placed 1 mm below the cemento-enamel junction. The PCCs were fabricated from Vita Mark II ceramic (Vita) using the Cerec-3 Unit (Sirona). The prepared teeth were assigned to three groups: (1) conventional luting technique (n=36), (2) resin-coating luting technique (n=36) or (3) recently introduced self-adhesive universal resin cement (n=12). Within these three groups, the following materials were applied: (1) Excite/Variolink II (EVC), ED-Primer/Panavia-F2.0 (PAC), Syntac Classic/ Variolink II (SYC); (2) Excite/Variolink II with Excite/Tetric Flow resin-coating (EVR), ED-Primer/Panavia-F2.0 with Clearfil SE-Bond/ Protect-Liner F resin-coating (PAR), Excite/ Variolink II with Syntac Classic/Tetric Flow resin-coating (SYR); (3) RelyX Unicem (REX). After thermocycling and mechanical loading (TC: 5000 cycles at 5 degrees C/55 degrees C; 30 seconds/cycle; ML:500000 cycles at 72.5 N, 1.6 Hz), microleakage was assessed by evaluating silver staining (%) on multiple tooth sections. Ceramic/composite-, resin-coating/composite- (where applicable) and dentin/composite-interfaces were evaluated separately. The data were statistically analyzed with the Mann-Whitney-U-test and the Error Rates Method. In Groups 1 and 2, the evaluation of microleakage at dentin showed better marginal integrity when the resin-coating technique was applied (EVR, PAR, SYR: 18-53%) than within the conventional luting technique group (EVC, PAC, SYC: 58-67%). However, the lowest microleakage values were found for RelyX Unicem (REX: 15%). In conclusion, resin-coating may improve the marginal sealing within dentin, depending on the materials used. Luting with a self-adhesive universal resin cement showed the best marginal sealing of all groups.