40-Year Outcome of Old-School, Non-Surgical Endodontic Treatment: Practice-Based Retrospective Evaluation.

(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different private dental practices treated 174 patients with 245 teeth from 1969 to 1993. After root canal obturation, either a new direct restoration (amalgam, resin composite, or glass-ionomer cement) or the re-cementation of a pre-existing prosthetic restoration or renewal of prosthetic restoration followed. Metal posts (operator A) or metal screws (operator B) were inserted when coronal substance loss was significant. The primary outcome (i.e., tooth survival) was achieved when the endodontically treated tooth was, in situ, painless and had full function at the end of the observation period. A secondary outcome, the impact of different prognostic factors on survival rate, was evaluated. (3) Results: The overall mean survival was 56.1% of all treated teeth after 40 years of clinical service, resulting in an annual failure rate of 1.1%. Most investigated clinical co-factors (jaw, tooth position, intracanal dressings, post/screw placement, and gender) showed no significant influence on survival. (4) Conclusions: Even with materials and techniques from the 1970s and 1980s, successful root canal treatment was achievable. Except for post-endodontic restorations, most of the evaluated factors had no significant influence on the clinical long-term survival of root canal-treated teeth.

The restoration of root filled teeth: a review of the clinical literature.

Clinicians often face dilemmas regarding the most appropriate way to restore a tooth following root canal treatment. Whilst there is established consensus on the importance of the ferrule effect on the predictable restoration of root filled teeth, other factors, such as residual tooth volume, tooth location, number of proximal contacts, timing of the definitive restoration and the presence of cracks, have been reported to influence restoration and tooth survival. The continued evolution of dental materials and techniques, combined with a trend towards more conservative endodontic-restorative procedures, prompts re-evaluation of the scientific literature. The aim of this literature review was to provide an updated overview of the existing clinical literature relating to the restoration of root filled teeth. An electronic literature search of the PubMed, Ovid (via EMBASE) and MEDLINE (via EMBASE) databases up to July 2020 was performed to identify articles that related the survival of root filled teeth and/or restoration type. The following and other terms were searched: restoration, crown, onlay, root canal, root filled, post, clinical, survival, success. Wherever possible, only clinical studies were selected for the literature review. Full texts of the identified articles were independently screened by two reviewers according to pre-defined criteria. This review identifies the main clinical factors influencing the survival of teeth and restorations following root canal treatment in vivo and discusses the data related to specific restoration type on clinical survival.

Progress in restorative treatments of primary incisor defects / 口腔疾病防治

@#Dental caries and trauma are the most common oral diseases in children, which could result in defects of the teeth or detention. Maintenance of the primary dentition in a nonpathologic condition is important for oral health, craniofacial development, and the overall well-being of the children. In contemporary dentistry, primary anterior teeth defects are mainly treated with drugs, restorative treatments, or both. Restorative treatment is the most preferred method and includes direct restoration, full coronal restoration, post-and-core crowns, etc. This article reviews the available information regarding a variety of restorative treatments for primary incisor defects, including their backgrounds, clinical indications, clinical pathways, and related studies. The literature review shows that intraconal direct restoration is widely used on single surfaces. There are many kinds of full coronal restorations, and each has its own advantages. Pediatric resin-bonded strip crowns and zirconia crowns are the most popular and have excellent aesthetics. The use of post-and-core crowns for primary incisors is controversial. The absorbable post may be the next research hotspot. Therefore, treatment of severely destroyed primary incisors poses a challenge for pediatric dentists, as three important considerations must be kept in mind: children′s behavioral management, preservation of the tooth structure and parental satisfaction.

Bond strengths of absorbable polylactic acid root canal post with three different adhe-sives / 北京大学学报(医学版)

Objective:To find absorbable adhesives with suitable bonding properties for the absorbable polylactic acid root canal post. To test and compare the bond strengths of absorbable polylactic acid root canal post with three different adhesives. Methods:The absorbable polylactic acid root canal posts were used to restore the extracted teeth, using 3 different adhesives: cyanoacrylates, fibrin sealant and glass ionomer cement. The teeth were prepared into slices for micro-push-out test. The bond strength was statistically analyzed using ANOVA. The specimens were examined using microscope and the failure mode was divided into four categories:cohesive failure between absorbable polylactic acid root canal posts and adhesives, cohesive failure between dentin and adhesives, failure within the adhesives and failure within the absorbable polylactic acid root canal posts. Results:The bond strength of cyanoacrylates [(16. 83 ± 6. 97) MPa] and glass ionomer cement [(12. 10 ± 5. 09) MPa] were significantly higher than fibrin sealant [ ( 1 . 17 ± 0 . 50 ) MPa ] , P <0 . 001 . There was no significant difference between cyanoacrylates and glass ionomer cement (P =0. 156). In the group of cyanoacrylates, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 25 . 0%, the cohe-sive failure between the dentin and the adhesives was 16. 7%, the failure within the adhesives was 33. 3%, and the failure within the absorbable polylactic acid root canal posts was 25 . 0%. In the group of fibrin sealant , the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 66 . 7%, the cohesive failure between the dentin and the adhesives was 22 . 2%, the failure within the ad-hesives was 11. 1%. In the group of glass ionomer cement, the cohesive failure between the absorbablepolylactic acid root canal posts and the adhesives was 87. 5%, the failure within the adhesives was 12. 5%. The major failure mode in fibrin sealant and glass ionomer cement was the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives. No major failure modes were found in the group of cyanoacrylates. Conclusion:The bond strength of fibrin sealant is low, which cannot meet the requirement of clinical use. The bond strengths of cyanoacrylates and glass ionomer cement are suitable for clinical use. The cyanoacrylates are a kind of absorbable adhesive which has suitable bonding proper-ties for the absorbable polylactic acid root canal post.

Effect of cementation technique of individually formed fiber-reinforced composite post on bond strength and microleakage.

OBJECTIVES: The aim of this study was to evaluate the effect of two different cementation techniques of individually formed E-glass fiber-reinforced composite (FRC) post on bond strength and microleakage. METHODS: The crowns of extracted third molars were removed and post preparation was carried out with parapost drills (diameter 1.5 mm). After application of bonding agents individually formed FRC posts (everStick POST, diameter 1.5 mm) were cemented into the post spaces with either ParaCem®Universal or self-adhesive RelyX™Unicem, using two different cementation techniques: 1) an "indirect (traditional) technique" where the post was prepolymerized prior application of luting cement and insertion into the post space or 2) a "direct technique" where the uncured post was inserted to the post space with luting cement and light-polymerized in situ at the same time. After water storage of 48 hours, the roots (n = 10/group) were cut into discs of thickness of 2 mm. A push-out force was applied until specimen fracture or loosening of the post. A microleakage test was carried out on roots which were not subjected to the loading test (n= 32) to evaluate the sealing capacity of the post-canal interface. The microleakage was measured using dye penetration depth under a stereomicroscope. RESULTS: Higher bond strength values (p<0.05) and less microleakage (p<0.05) were obtained with the "direct technique" compared to the "indirect technique". None of the FRC posts revealed any dye penetration between the post and the cement. CONCLUSIONS: The "direct technique" seems to be beneficial when cementing individually formed FRC posts.

Restoration of crown fractures with a fiber post, polyethylene fiber and composite resin / Restauração de fraturas coronárias com pinos de fibra, de polietileno e de resina composta: técnica restauradora combinada com dois relatos de caso

OBJECTIVE: To describe the treatment of two patients who had horizontal crown fractured maxillary incisors a few years after endodontic treatment. METHOD: The 23 and 19-year-old male patients presented to Atatürk University Dentistry Faculty with complex crown fractures. The treatment includeda glass fiber reinforced root canal post, a fiber ribbon core and restoration with a universal resin composite. RESULTS AND CONCLUSION: The one-year follow-up examinations showed thatthe restorations were still in place and successful.

OBJETIVO: Descrever o tratamento de dois pacientes com fraturas horizontais de coroas de incisivos superiores, alguns anos após tratamento endodôntico. MÉTODO: Os pacientes, ambos do sexo masculino, com 23 e 19 anos de idade, apresentaram-se na Faculdade de Odontologia da Universidade Ataturk com fraturas coronárias complexas de incisivos superiores. O tratamento consistiu de utilização de pinos intracanais reforçados com fibra de vidro, tiras de fibra de vidro e restauração com uma resina composta universal. RESULTADOS E CONCLUSÃO: Oacompanhamento do paciente por um ano mostrou o sucesso do tratamento.