The efficacy of 2780 nm Er,Cr;YSGG and 940 nm Diode Laser in root canal disinfection: A randomized clinical trial.

OBJECTIVES: Effective disinfection of the root canals is the cornerstone of successful endodontic treatment. Diminishing the microbial load within the root canal system is crucial for healing in endodontically treated teeth. The aim of this study was to evaluate the effect of 2780 nm Er,Cr:YSGG and 940 nm diode lasers on the eradication of microorganisms from single-rooted teeth with asymptomatic apical periodontitis. MATERIALS AND METHODS: Thirty participants conforming to the inclusion criteria were randomly divided into 3 groups according to the disinfection protocol used; Conventional group: 2.5% Sodium Hypochlorite (NaOCl) and 17% EDTA solution NaOCl/EDTA, Dual laser group: 2780 nm Erbium, chromium: yttrium scandium-gallium-garnet (Er,Cr:YSGG) laser and 940 nm diode laser Er,CrYSGG/Diode, and Combined group: 17% EDTA and 940 nm diode laser EDTA/Diode. Bacterial samples were collected before and after intervention. The collected data were statistically analyzed using Friedman's test and Kruskal-Wallis test (P ≤ 0.05). RESULTS: The results of the study showed that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups showed significantly less mean Log10 CFU/ml of aerobic and anaerobic bacterial counts than the conventional NaOCl/EDTA group. CONCLUSIONS: In this study we evaluated in vivo the bactericidal efficacy of three disinfection protocols for endodontic treatment of single-rooted teeth with apical periodontitis. The results indicated that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups provide superior bactericidal effect compared to the conventional NaOCl/EDTA group. CLINICAL RELEVANCE: The integration of lasers into root canal disinfection protocols has demonstrated significant bacterial reduction which might promote healing and long-term success.

Effects of natural antimicrobial compounds propolis and copaiba on periodontal ligament fibroblasts, molecular docking, and in vivo study in Galleria mellonella.

Root canal treatment addresses infectious processes that require control. Occasionally, the radicular pulp is vital and inflamed, presenting a superficial infection. To preserve pulpal remnants, conservative procedures have gained favor, employing anti-inflammatory medications. This study investigated the effects of propolis (PRO), and copaiba oil-resin (COR) associated with hydrocortisone (H) and compared their impact to that of Otosporin® concerning cytotoxic and genotoxic activity, cytokine detection, and toxicity in the Galleria mellonella model. Human periodontal ligament fibroblasts (PDLFs) were exposed to drug concentrations and evaluated by the MTT assay. Associations were tested from concentrations that did not compromise cell density. Genotoxicity was evaluated through micronucleus counting, while cytokines IL-6 and TGF-ß1 were detected in the cell supernatant using ELISA. Molecular docking simulations were conducted, considering the major compounds identified in PRO, COR, and H. Increasing concentrations of PRO and COR were assessed for acute toxicity in Galleria mellonella model. Cellular assays were analyzed using one-way ANOVA followed by Tukey tests, while larval survivals were evaluated using the Log-rank (Mantel-Cox) test (α = 0.05). PRO and COR promoted PDLFs proliferation, even in conjunction with H. No changes in cell metabolism were observed concerning cytokine levels. The tested materials induce the release of AT1R, proliferating the PDFLs through interactions. PRO and COR had low toxicity in larvae, suggesting safety at tested levels. These findings endorse the potential of PRO and COR in endodontics and present promising applications across medical domains, such as preventive strategies in inflammation, shedding light on their potential development into commercially available drugs.

Comparison of the anesthetic effect of alkalized lidocaine versus non-alkalized lidocaine administered at a slow rate in mandibular primary molars.

Background: There are several invasive dental procedures that require local anesthetics. However, its infiltration is usually associated with anxiety and fear, increasing the perception of pain in pediatric patients. For this reason, it is important to evaluate different strategies for its application. We compared the anesthetic effect of the administration of 2% lidocaine with epinephrine 1:80000 non-alkalized at slow speed and alkalized at fast speed to block the inferior alveolar nerve in deciduous molars. Methods: A crossover clinical trial was carried out whose sample consisted of 38 patients between 6-10 years who required bilateral pulp treatment in their first mandibular primary molars. At the first appointment, they received 2% lidocaine with 1:80000 alkalinized epinephrine administered at a fast rate, and at the second appointment, 2% lidocaine with 1:80000 non-alkalized epinephrine administered at a low speed. We evaluated the onset of action, duration of the anesthetic effect, and intensity of pain during its infiltration. Results: We found that non-alkalized lidocaine at slow speed had a shorter onset time of action (57.21±22.21 seconds) and longer duration of effect (170.82±43.75 minutes) compared to administration of alkalinized lidocaine at fast speed (74.03±22.09 seconds, 148.24±36.24 minutes, respectively). There was no difference in the level of pain intensity. Conclusion: In this study, the slow administration of the non-alkalized local anesthetic showed a shorter onset time of action and a longer duration of the anesthetic effect in comparison with the alkalized local anesthetic administered at a rapid rate in the blockade of the inferior alveolar nerve in deciduous molars.

Accuracy of the American Association of Endodontists diagnostic criteria for assessing pulp health in primary teeth.

OBJECTIVES: There is a lack of studies evaluating the accuracy of the 2009 American Association of Endodontists (AAE) diagnostic criteria for diagnosing pulpal health in primary teeth. This study aimed to estimate and correlate the diagnostic accuracy of clinical diagnosis of reversible and irreversible pulpitis using the 2009 AAE criteria with histological findings in primary teeth. METHODS: Eighty primary teeth that were clinically diagnosed with normal pulp (n = 10), reversible pulpitis (n = 30), irreversible pulpitis (n = 30) and pulp necrosis (n = 10) were collected. The teeth were histo-processed, and pulp tissues were diagnosed histologically as uninflamed pulp, reversible or irreversibly inflamed and necrosis based on previously proposed criteria. RESULTS: The clinical diagnosis of pulp necrosis (sensitivity 70%, specificity 96%) and normal pulp (sensitivity 91%, specificity 100%) matched the histological diagnosis of necrosis and uninflamed pulp in 70% and 100%, respectively. The clinical diagnosis of irreversible pulpitis (sensitivity 64%, specificity 72%) matched the histological diagnosis of irreversible pulp inflammation for 47% of teeth evaluated. For the clinical diagnosis of reversible pulpitis (sensitivity: 65%, specificity: 86%), 80% matched the histological diagnosis of reversible pulp inflammation. Teeth with histologically diagnosed irreversible pulp inflammation were more likely to have lingering (OR 5.08; 95% CI 1.48-17.46, P = 0.010) and nocturnal tooth pain (OR 15.86; 95% CI 1.57-160.47, P = 0.019) when compared to teeth with reversible pulp inflammation. Using the classification and regression tree model, the presence of widened periodontal ligament space and nocturnal tooth pain were useful predictors of irreversible pulp inflammation with an accuracy of 78%. CONCLUSION: The 2009 AAE criteria was acceptable for primary teeth with pulp necrosis and normal pulp but poor for reversible pulpitis and irreversible pulpitis.

The financial and quality of life impact of urgent dental presentations: A cross-sectional study.

AIM: This study aimed to: (i) calculate personal financial costs associated with urgent dental attendance; and (ii) investigate the pain-related disability and quality of life impact of dental conditions which result in urgent dental attendance. METHODOLOGY: Data were collected from those presenting with urgent dental conditions to an out-of-hours dental service, a dental emergency clinic (DEC) and five primary care general dental practices across North-East England. A pre-operative questionnaire explored the impact of urgent dental conditions on oral health-related quality of life (OHRQoL) using Oral Health Impact Profile-14 (OHIP-14) and a modified Graded Chronic Pain Scale (GCPS). OHIP-14 yields a maximum score of 56, with a higher score indicating a lower OHRQoL. Personal financial costs were summed to provide a total. These included travel, appointment fees, childcare costs, medication use and time away from work. Data were analysed using one-way anova and multivariable modelling. RESULTS: In total, 714 participants were recruited. The mean OHIP-14 score was 25.73; 95% CI [24.67, 26.79], GCPS CPI was 71.69; 95% CI [70.09, 73.28] and GCPS interference was 49.56; 95% CI [47.24, 51.87]. Symptomatic irreversible pulpitis was the most frequently managed dental emergency and was associated with the highest mean OHIP-14 score (31.67; 95% CI [30.20, 33.15]). The mean personal financial cost of urgent dental care (UDC) was £85.81; 95% CI [73.29, 98.33]. Differences in travel time (F[2, 691] = 10.24, p < .001), transport costs (F[2, 698] = 4.92, p = .004), and appointment time (F[2, 74] = 9.40, p < .001) were significant between patients attending an out-of-hours dental service, DEC and dental practices for emergency care, with a DEC being associated with the highest costs and dental practices the lowest. CONCLUSIONS: Diseases of the pulp and associated periapical disease were the most common reason for patients to present for UDC and were the most impactful in terms of OHRQoL and pain in the present sample. Personal financial costs are significant from urgent dental conditions, with centralized services increasing the burden to patients of attending appointments.

What ultimately matters in root canal treatment success and tooth preservation: A 25-year cohort study.

AIM: There are currently no prospective studies evaluating the long-term outcomes of non-surgical root canal treatments beyond 5 years, both in terms of treatment success and tooth preservation, and identifying factors predictive of treatment outcome. The aim of the present work was therefore to fill this gap by assessing these outcomes over time and identifying predictive variables based on systematic data collection over a 25-year period. METHODOLOGY: Data concerning the treatments (N = 2500) were systematically collected since 1990. Information was recorded among clinical, technical, radiographic and patient-related characteristics, i.e., approximately 150 variables for each treatment. The data were analysed regarding both treatment success and tooth preservation by multivariable Cox proportional hazards model, and survival curves were generated. The statistical significance level was set at 0.0125. RESULTS: In total, 56.4% of the treatments could be followed over time (0-25 years, mean = 6.5 years, median = 5 years). Survival probability decreased almost linearly for treatment success, with about 85% after 5 years and 60% after 20 years, and for tooth preservation, with about 90% at 5 years and 50% at 20 years. The variables significantly associated with treatment failure were: pre-operative pain (Hazard Ratio-HR = 1.56 [95% CI 1.23-1.97]), persistent pain (HR = 2.63 [95% CI 1.44-4.80]), good operator rating of treatment prognosis (HR = 0.46 [95% CI 0.36-0.58]), size of periapical bone radiolucency (HR = 1.88 [95% CI 1.67-2.11]), and tooth type (p = .0006). For tooth extraction, they were: combined endodontic-periodontal lesion (HR = 3.37 [95% CI 1.88-6.05]), pre-existing complication before treatment (HR = 1.67 [95% CI 1.26-2.21]), good operator rating of treatment prognosis (HR = 0.45 [95% CI 0.33-0.60]), clinical failure of root canal treatment (HR = 2.78 [95% CI 1.98-3.89]) and tooth type (p = .0012). CONCLUSION: Root canal treatment success and tooth preservation on the arch are not static outcomes, but evolve with time. Among a substantial set of potential predictors, only a small proportion was significantly predictive of treatment success and tooth preservation, most of them being disease and patient characteristics, and not technical aspects, except pre-existing complications. These observations challenge the importance frequently given to byzantine considerations related to the numerous technical details of endodontic procedures, as opposed to general concepts of good clinical practice.

Hospitalisations due to pulp and periapical conditions in Australian children from 1998-99 to 2017-18.

OBJECTIVE: To assess the demographic and time trends in hospitalisation rate for Pulp and Periapical Diseases (P&PDs) over 20-years (1998-99 to 2017-18), amongst children and adolescents (under age 19 years) in all states and territories of Australia. P&PDs are considered potentially preventable, with the possibility of them resulting in emergency presentations if timely treatment is not provided. They can result in treatment under general anaesthesia, which is costly. DESIGN: Retrospective analysis of hospitalisation for pulp and periapical diseases. SETTING: Public and private hospitals across Australia. MAIN OUTCOME MEASURES: The number of hospitalisations (measured using the number of separations or cases of hospital admission) for all pulp and periapical diseases by age-group. RESULTS: There were about 40,000 hospitalisations regarding P&PDs over the 20 years among Australian children under 19 years old. The rate of admissions ranged from means of 28.5 to 44.1 per 100,000 population. The number of admissions increased over 20 years for all children, except those younger than 4 years. Children aged 5-9 years had the highest rate of admissions and, more days in hospital per admission than other age groups. Most children only had one-day admissions. CONCLUSION: Pulp and periapical diseases hospitalisation rates have increased over two decades. Additional approaches to improve child dental health in Australia need to be considered.

Research progress on in vivo models for stem cell-based pulp regeneration / 口腔疾病防治

@#Basic research on pulp regeneration requires in vivo experiments. The PubMed database was searched for in vivo models of stem cell-based pulp regeneration using the following keywords: "pulp regeneration", "stem cell" and "animal model". The retrieved models were classified into ectopic, semiorthotopic and orthotopic regeneration models and their characteristics and clinical values were reviewed. This literature review indicated that the ectopic regeneration model is the most widely used model for the simple steps. However, this model does not accurately capture clinical situations. The semiorthotopic regeneration model, which is an improvement of the ectopic regeneration model, can create a more realistic regeneration environment. The orthotopic regeneration model can simulate clinical procedures that more closely resemble application, but it is less commonly used for difficult operations and long experimental periods. The applicability of the above three animal models depend on the stage of the animal experiment: the ectopic regeneration model is suitable to test the regenerative effect and biocompatibility of the implant complex; the semiorthotopic regeneration model is suitable to more persuasively evaluate the regeneration effect of the implant complex; and the orthotopic regeneration model is suitable to confirm the regeneration effect and practicability of the regenerative implant complex prior to clinical study.

The Potential Clinical Applications of a Microfluidic Lab-on-a-Chip for the Identification and Antibiotic Susceptibility Testing of Enterococcus faecalis-Associated Endodontic Infections: A Systematic Review.

This systematic review evaluated the potential clinical use of microfluidic lab-on-a-chip (LOC) technology in the identification and antibiotic susceptibility testing of E. faecalis in endodontic infections. The search methodology employed in this review adhered to the PRISMA guidelines. Multiple scientific databases, including PubMed/MEDLINE, SCOPUS, and SCIELO, were utilized, along with exploration of grey literature sources. Up to September 2023, these resources were searched using specific keywords and MeSH terms. An initial comprehensive search yielded 202 articles. Ultimately, this systematic review incorporated 12 studies. Out of these, seven aimed to identify E. faecalis, while the remaining five evaluated its susceptibility to different antibiotics. All studies observed that the newly developed microfluidic chip significantly reduces detection time compared to traditional methods. This enhanced speed is accompanied by a high degree of accuracy, efficiency, and sensitivity. Most research findings indicated that the entire process took anywhere from less than an hour to five hours. It is important to note that this approach bypasses the need for minimum inhibitory concentration measurements, as it does not rely on traditional methodologies. Microfluidic devices enable the rapid identification and accurate antimicrobial susceptibility testing of E. faecalis, which are crucial for timely diagnosis and treatment in endodontic infections.

Relationship of NLRP3 inflammasome with periodontal, endodontic and related systemic diseases.

NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) is an inflammasome associated with oral and general health. There is a bidirectional relationship between the oral cavity and systemic health. The primary reason for this situation is the similarity in pathways for chronic inflammatory diseases both in the oral cavity and systemically. Periodontal and periapical diseases are some of the most common inflammatory conditions in adults and are associated with bacterial infection and host inflammation. The pathogenesis of periodontal and periapical lesions is complex and multifactorial, and the host inflammatory response determines the progression and pattern of the diseases. Inflammasomes, innate immune system receptors and sensors, are the key components in the pathogenesis of the inflammatory conditions. They are reported to be responsible for the initiation of the inflammatory reaction, maturation of proinflammatory cytokines and pyroptosis. The NLRP3 inflammasome is a multi-protein complex that contributes to immune responses during infection or injury. NLRP3 is implicated in several diseases such as diabetes, rheumatoid arthritis, cardiovascular diseases, inflammatory bowel diseases, multiple sclerosis, and Alzheimer's disease. There have been many recent advances in our knowledge concerning the essential role of NLRP3 inflammasome in periodontal and periapical inflammation. Therefore, the NLRP3 inflammasome may be a promising target for anti-inflammatory therapies. This paper will provide an overview of the role of NLRP3 inflammasome on periodontal and endodontic diseases with their links between systemic conditions, and presents a future perspective for the treatment of these inflammatory conditions.

A Scoping Review of Four Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies: Part 3-A Proposed Framework for Standardized Data Collection and Reporting of Endodontic Outcome Studies.

INTRODUCTION: Despite initiatives to standardize and improve reporting of rapidly growing endodontic outcome research studies, issues related to missing and ambiguous information are still of great concern. In this article, we propose a framework for standardized data collection and a compiled checklist for reporting of various study designs on endodontic outcome. METHODS: A comprehensive search was carried out to locate randomized controlled trials, cohorts, case-control studies, or case series of >100 patients that reported on endodontic outcomes. We reviewed these articles to develop a Data Collection Template and compiled a checklist for reporting of future endodontic outcome research. RESULTS: Out of 354 eligible articles previously reported in our scoping review on endodontic outcome studies, 109 articles were selected and screened for study variables or levels of categorization. Our complied Data Collection Template was developed in 19 domains to highlight important demographic, preoperative, intraoperative, and postoperative variables. Because of the specific needs for endodontic outcome literature, we also proposed a compiled checklist (consisting of 4 main domains) to facilitate the reporting of various study designs on endodontic outcome studies. This checklist included simple descriptions of the required items and examples on reporting from published endodontic studies. CONCLUSIONS: By facilitating the collection and reporting of relevant research data by investigators in private practice and academia, we hope that the proposed Data Collection Template and reporting guideline can highlight the importance of standardization among clinicians and researchers while producing valid scientific information that will support evidence-based treatment decisions.

A Scoping Review of 4 Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies-Part 2: Outcome Measures.

INTRODUCTION: Inconsistencies in the definitions of endodontic outcome terminology jeopardize evaluations of proposed interventions and patient care quality. This scoping review aimed to provide groundwork to develop a set of basic outcomes in endodontics. METHODS: We performed a comprehensive literature search for randomized controlled trials, cohort studies, case-control studies, and case series (≥10 patients) published after 1980 with patients ≥10 years of age with any preoperative pulpal and periapical diagnosis in permanent teeth requiring nonsurgical root canal treatment, retreatment, or apexification. Abstracted data on outcome assessment methods, assessors, and domains were reported after univariate and bivariate analyses. RESULTS: Treatment outcomes were evaluated radiographically (88%) or clinically (73%). Although 2-dimensional radiography exceeded 3-dimensional radiography, the use of the latter has increased since 2010, mostly for nonsurgical retreatments. Of 19 identified outcomes, 5 were most frequent: success (168 studies, 40%), radiographic healing (128 studies, 30%), survival (of an asymptomatic tooth [48 studies, 12%] or of a procedure code in administrative databases [31 studies, 7%]), pain assessment (14 studies, 3%), and quality of life (11 studies, 3%). Clinician-centered outcomes have been most frequently studied since the 1980s (71%), in academic settings (76%), and using a prospective design (45%). Patient-centered outcomes were reported in 19% of studies before 2010 and 30% since 2010. They were more common among retrospective studies (49%). CONCLUSIONS: Patient-centered outcome measures are lacking in endodontic studies. The state of available research can provide a baseline for the development of a core outcome set in endodontics, which should represent the important patient-centered outcomes in conjunction with well-validated clinician-centered outcomes.

A Scoping Review of 4 Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies-Part 1: Process and General Results.

INTRODUCTION: Despite initiatives to standardize reports, variances in study design, outcomes assessed, and tools used are persistent in the literature. This review scoped the existing literature on endodontic outcome studies for future development of core outcome sets. METHODS: A comprehensive literature search of randomized controlled trials, cohort studies, case-control studies, and case series (≥10 patients) published after 1980 including patients ≥10 years of age with any preoperative pulpal and periapical diagnosis in permanent teeth requiring nonsurgical root canal treatment (NS-RCT), retreatment (NS-ReTx), or apexification was performed. Abstracted data were reported through descriptive statistics. RESULTS: Of the 9957 studies screened, 354 were included. An increase in the quantity of endodontic outcome publications and levels of evidence in their study design was noted over the past 4 decades. Although 41% of the studies included participants 26-50 years of age, literature including participants >50 years old has increased since 2000. Apexification and NS-ReTx were mostly provided by specialists and postgraduate students. The most common follow-up period was 2-5 years (35%), and most randomized controlled trials (58%) reported follow-up times <1 year. Multiple-visit treatment was most common in apexification studies (85%). Deficiency, inconsistency, and ambiguity were observed across many reports. CONCLUSIONS: NS-ReTx and NS-RCT/NS-ReTx studies have increased over the past 2 decades, particularly those focusing on molars and patients >50 years old. Despite the progress in endodontic research, heterogeneity in reporting styles yields considerable limitations, particularly data standardization challenges and inconsistencies in methods and results reporting. This scoping review highlighted the state of available research and supported the development of standardized guidelines for future investigations.

Survival Rates of Implants That Have Compromised the Adjacent Teeth and the Associated Complications: An Opg Retrospective Study.

This retrospective study evaluated survival rates of implants compromising adjacent teeth and associated complications. Medical records and orthopantomographic images of 1132 patients and 1478 implants were retrospectively analyzed. Finally, 96 patients (52 females, 44 males) with 111 malpositioned implants were included in the study. The mean follow-up of the study was 32 ± 14 months. The patients were divided into 2 core groups: (1) adjacent teeth and dental implants were considerably close but tangent to each other (TAN), and (2) dental implant cutting the roots of the adjacent tooth (CUT). In addition, the CUT group was divided into 2 subcategories considering the possible cause of malangulation as angled implant (AI) or angled adjacent tooth (AT). Damage to adjacent teeth, future treatment requirements, and the survival rates of the implants were recorded. Among the 111 implants, 4 (3.6%) implants failed, all of which belonged to the CUT category and the AI subgroup. Among the 88 preoperatively vital adjacent teeth, root canal treatment was performed in 18 (20.5%) teeth, whereas 2 (2.3%) teeth were extracted due to malpositioned implanting in follow-ups. The placement of implants too close to the adjacent teeth and even cutting direction did not have a statistically significant effect on the survival rates of implants. However, this could cause adjacent teeth to undergo unnecessary root canal treatment or extraction. Patients with malpositioned adjacent teeth or dilacerated root(s) adjacent to the edentulous area are at a higher risk for malpositioned implant complications. Most implant malposition complications are observed in the first premolar region (37% cases). Therefore, more attention should be given while placing implants in the first premolar region.

Effects of different degrees of root canal filling therapy on pain severity, stress response and masticatory function in patients with dental diseases / 中国基层医药

Objective:To investigate the effects of different degrees of root canal filling therapy on pain severity, stress response and masticatory function in patients with dental diseases.Methods:A total of 120 patients with dental disease who received treatment in Department of Oral Surgery, Zhoushan Hospital between December 2019 and December 2020 were included in this study. They were randomly divided into study and control groups ( n = 60/group). Patients in the control group were given excessive root canal filling and those in the study group were given approximate root canal filling. Cortisol, adrenocorticotropic hormone, interleukin-1β and interleukin-10 levels, bite force, gingival index and masticatory efficiency were determined before and after treatment. Visual Analog Scale (VAS) was used to evaluate the severity of pain in each group. Clinical efficacy was compared between the two groups. Results:After treatment, interleukin-1β, cortisol and adrenocorticotropic hormone levels in the study group were (23.66 ± 6.94) μg/L, (129.61 ± 27.18) μg/L, (14.58 ± 4.11) ng/L, respectively, which were significantly lower than those in the control group [(31.31 ± 10.13) μg/L, (147.93 ± 30.26) μg/L, (17.16 ± 5.04) ng/L, t = 4.82, 3.45, 3.07, all P < 0.05]. Interleukin-10 level in the study group was significantly higher than that in the control group [(65.19 ± 16.06) ng/L vs. (56.61 ± 15.52) ng/L, t = 2.97, P < 0.05). Bite force and masticatory efficiency in the study group were (127.53 ± 33.20) 1bs and (84.73 ± 20.65)%, respectively, which were significantly higher than those in the control group [(115.25 ± 30.12) 1bs, (75.49 ± 18.14)%, t = 2.12, 2.60, both P < 0.05]. Gingival index and Visual Analog Scale score in the study group were (0.44 ± 0.12) and (2.73 ± 0.81) points, respectively, which were significantly lower than those in the control group [(0.44 ± 0.12), (2.73 ± 0.81) points, t = 7.92, 2.66, both P < 0.05]. Total response rate in the study group was significantly higher than that in the control group (96.67% vs. 81.67%, χ2 = 5.52, P < 0.05). Conclusion:Appropriate root canal filling therapy is highly effect on dental diseases. It can decrease stress response, inhibit inflammation, alleviate pain, and improve masticatory function.

[Progress in the diagnosis and treatment strategies of caries-derived dental pulp diseases].

Caries-derived dental pulp diseases are characterized with high incidence and serious endangerment. Considering the complexity of the pulpal infection and the limitation of the pulp self-repairing capability, it is still an urgent problem that how to eradicate infection and to promote tissue regeneration subsequently for dental clinicians. This review discusses and prospects on the pathogenesis, diagnosis and treatment strategies of caries-derived dental pulp diseases, so as to provid a reference on diagnosis and treatment of such diseases for the clinicians.

Estado de la enseñanza del diagnóstico de afecciones pulpares y periapicales centrada en el método clínico / Status of the pulp and periapical disorders diagnosis teaching focused on the clinical method

RESUMEN Fundamento: la enseñanza del diagnóstico de las afecciones pulpares y periapicales se enmarca como un contenido esencial del proceso de enseñanza-aprendizaje en la asignatura de Operatoria Clínica, para cumplir las funciones principales declaradas en el perfil profesional del modelo de formación del estomatólogo general en Cuba. Objetivo: determinar el estado actual de la enseñanza del diagnóstico de afecciones pulpares y periapicales en la asignatura de Operatoria Clínica de la carrera de Estomatología. Métodos: investigación observacional, descriptiva y de corte transversal realizada en la Universidad de Ciencias Médicas de Cienfuegos sobre una población conformada por 8 docentes y los 37 estudiantes de tercer año del curso 2017-2018. Se utilizó una guía para observar de forma directa cómo se realiza la enseñanza del diagnóstico de las afecciones pulpares y periapicales y se aplicó una encuesta a profesores y estudiantes con preguntas cerradas. Resultados: se evidenció como fortaleza que predomina la educación en el trabajo como forma organizativa y existen referencias de la enseñanza del método clínico en la carrera de medicina. Se constataron limitaciones en el claustro respecto a las categorías docentes, científicas y años de experiencia; limitado aprovechamiento de la caracterización de los estudiantes y sus resultados así como deficiente aplicación de las acciones esenciales correspondientes a la etapa diagnóstica del método clínico y prevalencia del papel autoritario del docente. Conclusiones: aún existen limitaciones en la enseñanza actual del diagnóstico de las afecciones pulpares y periapicales en la población objeto de estudio.

ABSTRACT Background: the teaching of the pulp and periapical diseases diagnosis is defined as an essential content of the teaching-learning process in the Clinical Operative subject, to fulfill the main functions declared in the professional profile of the general stomatologist training model in Cuba. Objective: to determine the current state of pulp and periapical disorders teaching diagnosis in the Stomatology career Clinical Operative subject. Methods: observational, descriptive and cross-sectional research carried out at the Cienfuegos University of Medical Sciences on a population of 8 teachers and 37 third-year students of the 2017-2018 academic year. A guide was used to directly observe how the teaching of the diagnosis of pulp and periapical diseases is carried out and a survey was applied to teachers and students with closed questions. Results: it was evidenced as a strength that education at work predominates as an organizational form and there are references to the clinical method teaching in the medical career. Limitations were found in the faculty with respect to the teaching and scientific categories and years of experience; limited use of the students characterization and their results as well as deficient application of the essential actions corresponding to the diagnostic stage of the clinical method and prevalence of the teacher authoritarian role. Conclusions: still limitations in the diagnosis of pulp and periapical diseases current teaching of the population under study.

Odontogenic causes complicating the chronic rhinosinusitis diagnosis.

OBJECTIVES: Chronic rhinosinusitis (CRS) frequently stems from a dental origin, although odontogenic sinusitis (OS) remains underdiagnosed amongst different professionals. This study aimed to explore how often odontogenic causes are considered when diagnosing CRS. MATERIALS AND METHODS: Patient records from 374 new CRS patients treated at a tertiary-level ear, nose, and throat (ENT) clinic were selected. Entries and radiological reports were assessed exploring how often dentition was mentioned and OS was suspected, how often radiologists reported maxillary teeth, and how commonly typical OS microbial findings and unilateral symptoms occurred. RESULTS: Although 10.1% of the CRS diagnoses were connected to possible dental issues, teeth were not mentioned for 73.8% of patients. Radiological reports were available from 267 computed or cone beam computed tomographies, of which 25.1% did not mention the maxillary teeth. The reported maxillary teeth pathology was not considered in 31/64 (48.4%) cases. Unilateral symptoms associated with apical periodontitis (OR = 2.49, 95% CI 1.27-4.89, p = 0.008). Microbial samples were available from 88 patients, for whom Staphylococcus aureus was the most common finding (17% of samples). CONCLUSIONS: Odontogenic causes are often overlooked when diagnosing CRS. To provide adequate treatment, routine assessment of patient's dental history and status, careful radiograph evaluation, and utilization of microbial findings should be performed. Close cooperation with dentists is mandatory. CLINICAL RELEVANCE: Dental professionals should be aware of difficulties medical professionals encounter when diagnosing possible OS. Thus, sufficient knowledge of OS pathology is essential to both medical and dental professionals.

The clinical application of ultrasonic root canal intermittent irrigation in endodontic vascular reconstruction / 中国医师杂志

Objective:To investigate the clinical effect of ultrasonic root canal intermittent irrigation in endodontic vascular reconstruction.Methods:32 young permanent teeth with pulp and periapical lesions were randomly divided into two groups ( n=32): experimental group was treated with ultrasonic root canal intermittent irrigation and the control group was rinsed with sodium hypochlorite root canal. The changes of periapical lesions and root development were evaluated by preoperative and postoperative clinical symptom observation and radiograph examination, and the clinical effect of endodontic vascular reconstruction was discussed. The time of inflammation control was discussed by analyzing the starting point from the first diagnosis to the date of mineral trioxide aggregate (MTA) coverage. Results:The clinical symptoms of the 16 affected teeth in the experimental group and the control group disappeared, the periapical lesions were eliminated, and the root continued to develop. In the experimental group, root formation was observed in 13 of the affected teeth, with a success rate of 81.25% and a reduction rate of 18.75%. In the control group, root formation was observed in 10 of the affected teeth, with a success rate of 62.5% and a reduction rate of 37.5%. There was no difference in the effective rate between the experimental group and the control group ( P>0.05). The control time of inflammation was (28.44±5.98)days in the experimental group and (34.13±7.17)days in the control group, with statistically significant differences ( P<0.05). Conclusions:Ultrasonic root canal intermittent swabbing applied to pulp revascularization can achieve good clinical effect and shorten the time of inflammation control.