Need For Endodontic Treatment Research Articles

Long-Term Outcome of Horizontal Root Fractures in Permanent Teeth: A Retrospective Cohort Study

IntroductionHorizontal root fracture (HRF) is a complex traumatic dental injury that affects the pulp, dentin, cementum, and periodontal ligament. This retrospective cohort study evaluated treatment outcomes in permanent teeth with HRF. MethodsWe analyzed clinical and radiographic data from a dental trauma center (2006–2022). Permanent teeth with HRF with a follow up of ≥12 weeks were considered for outcome assessment (defined as clinical normalcy and radiographic healing at the fracture line). Prognostic factors were identified through multivariable logistic regression analyses (P value ≤ .05). Results125 teeth from 103 patients were included. After a median follow-up of 79 weeks, the overall favorable outcome was 92%. This includes teeth that received emergency splinting/repositioning at baseline (62.2%) and those that received subsequent endodontic intervention for the coronal fragment (baseline: 85%; subsequent follow-ups: 91.8%). Being male and incomplete root development were both significantly associated with a better outcome of splinting/repositioning (OR = 2.58; 95% CI, 1.06-6.24 and OR = 4.37; 95% CI, 1.16-16.41, respectively) and a reduced likelihood of requiring endodontic treatment (OR = 0.44; 95% CI, 0.20-0.96 and OR = 0.24; 95% CI, 0.08-0.76, respectively). Treatment delays surpassing one week were significantly associated with an increased likelihood of requiring endodontic treatment compared to timely presentations within 24 hours (OR = 3.06; 95% CI, 1.07-8.77; P value < .05). ConclusionWith timely diagnosis and treatment, and close monitoring, HRF cases can achieve a 92% favorable outcome. Male sex and incomplete root development correlate with improved baseline outcomes and a reduced need for endodontic treatment. Conversely, delayed presentation increases the likelihood of requiring endodontic intervention.

Clinical-therapeutical management of exposed pulp and incomplet apexogenesis: Cases reports

The study of bioactive materials, such as MTA cement, and the availability of this material to clinical professionals are an important step towards conservative treatments, however the using technique of this material is still restricted to practitioners in the field of endodontics. Case reports with short, medium and long-term follow-up are significant data for a reproducible, low-cost technique that is well accepted among professionals. Here we present two case reports with the application of bioactive cements in a tooth with pulp exposure and in another one with deep carious lesion, pulp exposure and open apex. In both cases, definitive restoration was performed in the same visit with favorable prognosis and without the need of endodontic treatment. After one year follow-up, it is underlined the dentin bridge formation in the region of pulp exposure in both cases and complete maturation of the apex in the second case.

Clinical evaluation of zirconia crowns cemented with two different resin cements: A retrospective study.

Self-adhesive resin cement has been used extensively with zirconia crowns. Several in vitro studies showed that adhesive resin cementation may increase zirconia crowns' retention and their fatigue resistance. This retrospective study aimed to evaluate the clinical performance, survival and success rates and complications encountered with zirconia crowns cemented with two different self-adhesive resin cements. A total of 112 patients who received 176 monolithic zirconia crowns were evaluated. Crowns were cemented with RelyX Unicem 2 (n = 74) and Panavia SA (n = 102) self-adhesive resin cements. Clinical assessments of the crowns and supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Intraoral photographs and periapical and bitewing radiographs were obtained for further assessment by two evaluators. Descriptive statistics, McNemar, t-test, log rank (Mantel-Cox) tests and Kaplan-Meier survival analyses were performed (a = .05). The 5-year survival and success rates were 100% and 96.4%, respectively. The complications encountered were recurrent caries (2.2%) and the need for endodontic treatment (0.5%). No technical complications, such as fracture or loss of retention, were observed. The type of cement and patient-related factors did not influence the survival and success rates of the crowns. Survival rate of zirconia crowns cemented with two different self-adhesive resin cements was 100% after 5 years.

ASSESSMENT OF ORTHOPEDIC TREATMENT LATE RESULTS OF PATIENTS WITH FIXED PARTIAL DENTURES DUE TO THE FUNCTIONAL STATE OF ABUTMENT TEETH

The scientific work highlights the results of an index assessment of the periodontal condition of patients abutment teeth with dentition defects which were replaced with metal-ceramic fixed partial dentures due to partial teeth loss. Since during the preparation of abutment teeth there is sometimes a need for endodontic treatment of them due to medical indications, we investigated the state of the periodontium before, during and after treatment and compared index indicators of pulpless teeth with teeth in which the vascular-nerve bundle was preserved. It was established that the periodontium of the vital tooth recovers and functions much better in comparison with the surrounding dental tissues of a nonvital tooth. Where there are inflammatory changes, which are objectively caused by pronounced swelling and bleeding of the gingival papilla. It is caused due to rubber dam pressure, which in turn is confirmed by reliable data of index indicators determined in various the terms of the treatment.&#x0D; After conducting a detailed examination of patients with vital abutment teeth with defects in the hard tissues of the teeth, we found that in the age group of 30-39 years, the most common defect in the hard tissues of the teeth was caries damage, which was observed in 8 patients (72.7%), damage due to injuries was found in 2 patients (18.2%), enamel hypoplasia was found in 2 patients (18.2%).&#x0D; Treatment of partial adentia involves the preparation of abutment teeth followed by the manufacture of fixed bridge prostheses. However, the vitality of the abutment tooth should be taken into account and the reserve forces of the periodontium should be taken into account in order to prevent functional overload. It is also necessary to monitor the hygienic condition of the oral cavity during the treatment and at various times after its completion.&#x0D; The peculiarity of the proposed method of preparation of vital upper and lower abutment teeth consists in the creation of a champfer on the vestibular surface with the transition to an imitation of a champfer on the oral surface, under constant control of the thickness of the peripulpal dentin using a dentometer with the use of full water cooling and subsequent fixation of provisional crowns. The use of a complex of diagnostic techniques for full control of the effectiveness of treatment during and after prosthetics at different times is substantiated and proposed.&#x0D; The gnathodynamometric study was carried out using an advanced device, the VIZIR E1000 gnathodynamometer: the plates placed between the opposing teeth were bitten, as a result of which the load was digitized using a flexible connection through an analog-digital converter and displayed on the display of a computer program, displayed graphically in newtons (N), the time of the masticatory load was also recorded in seconds.&#x0D; Using data from clinical indices, it was determined that the preservation of vital teeth is a reliable criterion of the effectiveness of the use of partial fixed prostheses than the use of pulpless teeth. The absence of periapical trauma in vital teeth, which occurs in pulpless teeth due to extirpation of the neurovascular bundle, is demonstrated by the Russel index, and other indices also demonstrate mucosal irritation caused by the use of rubber dams due to the need for quality endodontic treatment.

Secondary caries in fixed dental prostheses: Long-term clinical evaluation.

Even with excellent fixed dental prostheses (FDPs), there will be a substantial risk of biological complications, such as caries, if proper oral hygiene is not maintained. This study aimed to evaluate the risks of developing secondary caries withFDPs in relation to the patient oral hygiene status. Clinical and radiographic examinations were performed for patients to collect data related to their FDPcomplications and oral hygiene status. The main clinical parameter analyzed was secondary caries. Complications such as a fracture, debonding, or the need for endodontic therapy were also analyzed. The interval survival rateand the cumulative survival rateof FDPs from the time of treatment to the time of follow-up were analyzed. A total of 423 patients (with a total of 1116 FDPs) were examined in this study, with a mean age of 43.7 years and a mean follow-up time of 7 years. Regarding complications, secondary caries was detected in 94 FDPs (8.4%), fracture (or chipping) in 85 (7.6%) cases, need for endodontic treatment in 42 cases (3.7%), and debonding in four(0.3%) cases. Secondary caries was found in nineout of 219 FDPs (4%) in patients with good oral hygiene, 35 out of 634 FDPs (5.5%) in patients with fair oral hygiene, and 50 out of 272 FDPs (18.4%) in patients with poor oral hygiene (p ≤ .001). Good oral hygiene has a great influence on reducing the risk of secondary caries in patients with FDPs. The occurrence of secondary caries is a common complication in patients with poor oral hygiene.

Comparison of curative effect between different retrograde filling materials in young permanent molar root canal therapy.

The first mandible and maxilla permanent molars are the first permanent teeth that grow next to the deciduous teeth and may decay due to carelessness. Their caries can spread to the pulpal tentacles and cause pulpal and periapical diseases. In the current study, we tried to compare the curative effect of different retrograde filling materials, i.e. white MTA, gray MTA, Portland cement, and IRM, in young permanent molar root canal therapy. Because IL-1β stimulates bone degradation by osteoclasts, IL-1β gene expression was also measured for further evaluation. For this purpose, 400 students (240 boys and 160 girls) aged 8 to 11 years referred to the Pediatric Dental Center for first permanent molar root canal therapy were selected during two years. After recording the demographic characteristics of each patient, the first permanent molar teeth were examined by a general dentist with Abslang and decayed teeth were considered to have both discolorations in their grooves and apparent opacity. The patients, who need root canal therapy, were divided into four groups. The first group was treated with gray MTA. The second group was treated with white MTA. The third group received Portland cement for root canal therapy. The fourth group was treated with IRM. Also, IL-1β gene expression was evaluated by the real-time PCR technique. Relative changes in gene expression in PBMC cells were performed using One Way ANOVA. SPSS 18 software was used to determine the correlation of gene expression in PBMCs. The results showed that there was no significant difference between the groups in terms of age (p = 0.12) and gender (p = 0.24). Also, the need for endodontic treatment in the mandible (n = 278) was higher than the maxilla (n = 85) and both jaws (n = 37). But there was no significant difference between the groups in terms of the need for endodontic treatment (p = 0.32). The results of Pearson correlation coefficients between studied groups in terms of IL-1β gene expression showed that gray MTA and white MTA were not statistically different, but MTAs were generally different from Portland cement and IRM, with higher IL-1β gene expression. In general, the results showed that the teeth in the vicinity of gray MTA and white MTA showed a more appropriate response than Portland cement and IRM, so the use of MTA and its preference over other materials is recommended. In the case of Portland cement, more studies are needed to reach a conclusion comparing this material with MTA.

Factors Associated with the Need for a Primary Endodontic Treatment after Single-Unit Crown Cementation: A Retrospective Case-Control Study

IntroductionThis case-control study aimed to identify factors associated with an increased risk for endodontic treatment after single-unit crown cementation and to describe the timeline of such events. MethodsAfter evaluating the electronic records of all single-unit crowns placed on nonendodontically treated teeth between 1999 and 2019 and excluding teeth with preexisting questionable or confirmed endodontic disease, “cases” were identified as teeth requiring primary endodontic treatment after crown cementation. This was not examined in the current study because the cases and controls were matched by tooth type. ResultsOverall, 69 teeth without any suspected or confirmed past endodontic disease required an endodontic intervention after crown cementation. The mean number ± standard deviation of restorations in a tooth before crown cementation was significantly higher among the cases than the matched controls (2.16 ± 0.99 vs 0.78 ± 0.78, P < .05). Teeth with ≥2 and ≥3 previous restorations had an almost 4 (odds ratio = 3.81; 95% confidence interval, 1.56–9.29; P < .05) and almost 6 (odds ratio = 5.97; 95% confidence interval, 1.230–28.95; P < .05) times higher risk, respectively, for endodontic treatment after crown cementation compared with teeth with ≤1 restoration present before crown cementation. The majority (65%, n = 45) of teeth in the cases group required endodontic treatment during the first 3 years after crown cementation. ConclusionsThe presence of multiple restorations at the time of crown cementation was identified as a significant predictive factor for the need for endodontic treatment after crown cementation in teeth with no preexisting questionable or confirmed endodontic disease. Therefore, clinicians should be aware and inform patients about the increased risk of primary endodontic treatment in teeth with a history of more than 1 restoration, especially during the first 3 years after permanent crown cementation.

Uncomplicated crown fracture management

Background: Trauma-related injuries of the maxillofacial region occur more often these days and dentists are facing this condition frequently in their regular practice life. Traumatic dental injuries affects the same region with different frequencies in different age groups. It should be noted that upper central incisors are mostly traumatized by injuries compare to the other incisors. The maxillary central incisors were about 72%, while premolars, canine, mandibular incisors, the upper lateral incisors injury rate is up to 8%. A strong impact most often affects the crown and a weak and dull impact on the root apical direction and may result in avulsion of tooth and root fracture. Dental injuries caused by trauma have been an emergency condition, treatment options depend on the severity of injuries and clinical condition of the tooth at that moment. Combination treatment for a traumatic fracture of the tooth includes fixation of the tooth, the performance of surgical manipulation, determination of the need for endodontic treatment, restoration, and orthodontic consultations.&#x0D; Problem: In our case patient has an uncomplicated crown fracture.&#x0D; Solution: Direct composite restoration.&#x0D; Update Dent. Coll. j: 2021; 11 (1): 20-22

Long-Term Survival and Complication Rates of Porcelain Laminate Veneers in Clinical Studies: A Systematic Review.

The presented study aimed to assess the survival rate of porcelain laminate veneers (PLV) based on a systematic review of the literature. An electronic search was last updated in February 2021. Eligibility criteria included clinical series of patients rehabilitated with PLVs published in the last 25 years, with a minimum follow-up of 3 years. Survival analysis methods were applied. Twenty-five studies were included, with 6500 PLVs. The 10-year estimated cumulative survival rate (CSR) of PLVs was 95.5%. The 10-year CSR of PLVs when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as isolated reasons for failure were 96.3%, 99.2%, 99.3%, and 99.0%, respectively. PLVs without incisal coverage had a higher failure rate than PLVs with incisal coverage. Non-feldspathic PLVs performed better than feldspathic PLVs. As a conclusion, the 10-year CSR of PLVs was 95.5%, when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as reasons for restoration failure. Fracture seems to be most common complication of PLVs, followed by debonding, with both more commonly happening within the first years after PLV cementation. PLVs with incisal coverage and non-feldspathic PLVs presented lower failure rates than PLVs without incisal coverage and feldspathic PLVs.

Etiological factors commonly related to the need of endodontic treatment in individuals with orofacial clefts.

BackgroundDental treatment is fundamental in the rehabilitation of individuals with orofacial clefts, due to their oral condition; when indicated, endodontic therapy allows elimination of infection of the root canal system. Aim: To analyze, by a retrospective study, the most prevalent type of orofacial cleft, the etiological factors most commonly related to the endodontic treatment need, as well as their success and failure rates. Material and MethodsThis study analyzed data from 136 records (76 females and 60 males) with mean age of 19 years and 7 months, who met the inclusion criteria. Data were collected including the type of cleft, etiological factors that led to the need of endodontic treatment, as well as their success and failure rates. The statistical analysis was performed by the chi-square, Kruskal-Wallis, Fisher’s Exact and Batista Pike tests. ResultsAmong the etiological factors, were pulp involvement due to caries, endodontic treatment for prosthetic rehabilitation, tooth resorptions, for orthodontic movement, dental trauma and indication of internal tooth bleaching; the most prevalent factor was pulp involvement due to caries. Among all data analyzed, cleft lip and palate presented the highest percentage, and there was predominance of treatment success compared to failure. ConclusionsThe well-conducted root canal treatment is necessary for dental rehabilitation, maintaining the masticatory function and esthetic harmony of these individuals. Key words:Cleft lip, Cleft palate, Endodontics.

Restabelecimento funcional e estético do sorriso através de restaurações cerâmicas – relato de caso

The demand of patients for an aesthetic and harmonious smile has been growing, which generates the need for knowledge of various techniques and materials to obtain satisfactory results. Thus, ceramic restorations are increasingly present in dentistry due to their excellent optical and mechanical properties. Thus, the objective of this work was to perform the functional and aesthetic restoration of the smile through ceramic restorations in the anterior teeth. Patient L.T., male, 47 years old, sought the dental clinic of the Universidade Paranaense, complaining about the aesthetics of his smile. On clinical examination, asymmetry was observed between the gingival zeniths of the elements, as well as short clinical crowns and extensive and unsatisfactory composite resin restorations. In the radiographic examination, it was observed the presence of satisfactory molten metal core in the element 21, and the need for endodontic treatment in the elements 12, 11 and 22, for placement of intraradicular retainer, being selected the Fiberglass Pin (FP). Given this case, the procedure of gingivectomy with osteotomy was also proposed. Total metal-free crowns were made of lithium disilicate for elements 13, 12 and 22 and zirconia for elements 11 and 21. The ceramic laminate on tooth 23 was also made of lithium disilicate. The final result obtained was approved by the patient and the professionals involved.

Fracture of upper incisors: a three-year follow-up of a multidisciplinary approach

ABSTRACT Multiple clinical specialties are usually needed for a successful long-term treatment in buccal cavity. The aim of this article is to report a clinical case of multi-disciplinary rehabilitation of fracture upper incisors without pulp exposure, concerning about endodontics, periodontics and restorative dentistry comments or procedures. A case of a patient reporting trauma that resulted in fracture and substantial loss of hard tissue, in mesial angle of both upper central incisors (11 and 21). In palatal side, fracture extended beyond cingulum up to subgingival region. Periodontal surgery was performed in order to reestablish biological space. Clinical and radiographic assessments demonstrated no need for endodontic treatment, since pulp was vital and non-altered. Preparations for restorative procedures were minimally invasive, followed by composite direct. A three-year follow-up was performed, consisting in re-assessment of clinical and radiographic aspects, re-polishing of the restorations and photographic documentation. No pulp tissue alteration was observed after the follow-up period. Restorative procedures, adjacent tissues and pulp vitality were considered adequate, and the patient was satisfied with the treatment.

Practice-based analysis of direct posterior dental restorations performed in a public health service: Retrospective long-term survival in Brazil.

The aim of this retrospective study was to evaluate the survival and associated factors for the longevity of direct posterior restorations and to verify whether the geographic location of public health units could influence the long-term survival of such restorations. Data were extracted from electronic patient files of the Brazilian public oral health services. The sample comprised 2,405 class I and II restorations performed 4 to 24 years ago (mean, 8.9 years) in 351 patients (6.8 teeth/patient) across 12 public health units located in different city regions (42 professionals—55 restorations). The restoration was considered successful if it had not been repaired or replaced at the time of evaluation; failure was defined as replacement of the restoration, the need for endodontic treatment, tooth/restoration fracture or tooth extraction. Data were analyzed using the Kaplan-Meier test for restoration survival and Cox regression to evaluate the factors associated with failure. The majority of the restorations involved the use of amalgam (85%), involved a single face (70%), and were without pulp/dentin capping (85%). The overall survival rate was 95%, and the mean observation time was 8.9 years. The restoration survival was 79% (95% CI: 60.6–89.5) over 24 years, and the mean survival time was 22.2 years (95% CI: 21.9–22.6 years). The annual failure rate up to 24 years was 0.9%. After the adjustment, only the number of restored faces and the geographic location where the restoration was performed remained associated with failure of the restoration. The direct posterior restorations performed at the evaluated public health service units presented high survival rates. The restorations of people with lower access to POHS had lower survival rates. Class I restorations presented higher survival rates than class II restorations with two or more faces, regardless of the restorative material used.

Contextual and individual determinants of the need for endodontic treatment in adults in Brazil: A multilevel analysis.

To examine the relationship between contextual and individual determinants with the need for endodontic treatment in Brazilian adults. Individual-level data from 6897 adults aged 35-44years living in the Brazilian state capitals who participated in the Brazilian Oral Health Survey (SBBrasil 2010 Project) were combined with city-level data. Individual- and city-level variables were selected to represent the structural and intermediate determinants of health according to the WHO model of social determinants of health. The association of independent variables with one or more teeth in need of endodontic treatment was evaluated using multilevel logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI). The prevalence of the need for endodontic treatment was 7.7%. Adults living in cities with better contextual socioeconomic conditions (OR 0.82; 95% CI=0.72-0.93) and better specialized dental services (OR 0.85; 95% CI=0.77-0.95) were less likely to need endodontic treatment. Younger age, greater schooling and use of private dental services reduced the odds of need for endodontic treatment. Number of people per room, type of dental service and reason for the last dental visit were also associated with need of endodontic treatment. Contextual and individual factors were relevant determinants of endodontic treatment needs in adults.

Management of Calcified Root Canal: A Case Report

Background: Calcification of root (calcific metamorphosis) is usually seen as defensive reaction of pulp totrauma. Intensity of trauma/hit, time span since trauma, pulp response to trauma are multiple factor decidingdegree of calcification. Calcification may be seen partially or entirely in root canal. Usually calcifiedtooth remain asymptomatic, but when tooth becomes symptomatic endodontic treatment need to be done.Treatment of calcified canal is challenge to dentist.Case report: A female patient reported to the department of conservative dentistry and endodontics at sharadpawar dental college with chief complain of pain in upper front region of jaw. On radiographic examinationcalcified root canal was associated with upper anterior teeth. Root canal treatment was planned for calcifiedtooth. Access opening was carried out using BR45. To achieve patency within canal file#8, 10 were used, butinitally patency could not be achieved due to calcified canal. With help of chelating agents 17% EDTA liquidand gel and small size K file #8,10 canal negotiation was carried out to achieve patency. Working lengh wasthen determined and canal was instrumented. Naocl, EDTA was used as intermittent irrigant. Final rinse wasdone using 2%CHX. Canal was obturated using cold lateral condensation technique followed by permanentrestoration. Entire procedure was carried out under magnification.Conclusion: Calcified canal treatment is bit tedious then routine endodontic procedure. But it can bemanaged if procedure is carried out under proper illumination, magnification, CBCT, understanding rootcanal anatomy, use of dye, modified access bur, files, chelating agent, irrigants and irrigation activationsystem.

Smokers may have a higher prevalence of apical periodontitis and root canal treatment than nonsmokers, but this is not evidence that smoking is a risk factor for these outcomes

Pinto KP, Ferreira CM, Maia LC, Sassone LM, Fidalgo TKS, Silva EJNL. Does tobacco smoking predispose to apical periodontitis and endodontic treatment need? A systematic review and meta-analysis [published online ahead of print April 28, 2020]. Int Endod J. https://doi.org/10.1111/iej.13316.

Does tobacco smoking predispose to apical periodontitis and endodontic treatment need? A systematic review and meta-analysis.

Controversial findings exist in the literature regarding the association between tobacco smoking and development of apical periodontitis or need for root canal treatment, with some studies reporting an increase in the prevalence of these outcomes in smokers, whilst others reporting no association. To evaluate if there is scientific evidence to support an association between tobacco smoking and a greater prevalence of apical periodontitis and/or root canal treatments. A systematic search was performed using MeSH terms and free terms in the PubMed, Scopus, Virtual Health Library (VHL), Cochrane library and Open Gray databases. Observational studies that evaluated the association between smoking and the development or healing of periapical lesion and/or the prevalence of root canal treatment in humans were included. A quality assessment of included studies was performed, and the relevant information and findings were evaluated. A meta-analysis using nine included studies was performed through RevMan software, and the certainty of evidence was evaluated through GRADE. Fifteen studies were included, of which 10 were classified as low risk of bias, 4 were considered as moderate risk of bias and 1 as high risk of bias. Ten studies reported that smoking was associated with a greater prevalence of periapical periodontitis and/or root canal treatment. Five studies reported no association. Nine studies were included in the pooledmeta-analysis, comprising two subgroups: apical periodontitis and root canal treatment. From these nine studies, eight studies were included in the apical periodontitis subgroup meta-analysis and demonstrated that this condition was significantly more prevalent in smokers when compared to the nonsmokers (odds ratio=2.78[CI: 1.60, 4.85], P<0.001; I2 =79%; no adjusted odds ratio). Three studies were included in the root canal treatment subgroup meta-analysis and demonstrated an increased prevalence in smokers when compared to the nonsmokers (odds ratio=2.73 [CI: 1.06, 2.83], P<0.001; I2 =72%; no adjusted odds ratio). The pooled meta-analysis demonstrated that smokers had twice the chance of having apical periodontitis and/or root canal treatment when compared to nonsmokers (odds ratio of 2.42 [CI: 1.59, 3.68], P<0.01; I2 =85%). The GRADE analysis demonstrated moderate certainty of evidence. Several confounding factors were identified such as misinformation regarding the period of time subjects had smoked, as well as the frequency of smoking and the number of cigarettes consumed. No adjustment in odds ratio data for confounding was performed. This systematic review and meta-analysis indicate that tobacco smokers have an increased prevalence of periapical periodontitis and root canal treatments with moderate certainty of evidence.

Cigarette smoking as an oral health risk behavior in adolescents: a cross-sectional study among Polish youths

The aim of this study was to evaluate the relationship between cigarette smoking and the condition of the teeth and periodontium and the oral health behavior of 18-year-olds. Cross-sectional studies on 1,611 18-year-olds from Poland were conducted in 2017. The questionnaire provided socio-economic data, information about health-related behavior (cigarette smoking and oral health behavior), and absence from school due to oral pain. The dentition status (DMFT and DMFS), periodontal status (gingival bleeding, depth of periodontal pockets, loss of attachment), and need for endodontic treatment or tooth extraction were clinically assessed. Cigarette smoking was reported by 25% of participants (15% reported every day smoking). Adolescents who smoked cigarettes regularly had a higher mean number of decayed teeth (2.40±3.21 vs. 1.95±2.66) and similar periodontal status. Cigarette smoking increased the risk of oral hygiene neglect (63% vs. 69%), dietary mistakes (25% vs. 13%), failure to make dental appointments (32% vs. 43%), occurrence of oral pain (28% vs. 27%), absence from school due to pain (13% vs. 6%), and the need for endodontic treatment or tooth extraction (11% vs. 5%). The socio-economic factors and sex of the subjects decreased the influence of smoking only on oral hygiene neglect. Cigarette smoking by adolescents seems to be an independent risk factor for serious dietary mistakes, failure to benefit from oral healthcare, and more dynamic damage of teeth, which lead to pain and even tooth loss. Therefore, these aspects should be included in the risk assessment of oral disease and incorporated into educational programs promoting a healthy lifestyle.

Factors associated with public dental service use by adults in the state of São Paulo, Brazil, 2016.

The aim of this study was to investigate the factors associated with public dental care use by adults in the State of São Paulo, Brazil. A cross-sectional study was conducted with a representative sample of adults aged 35 to 44 years using data from the 2015 Epidemiological Survey of the Oral Health Status of the Population of the State of São Paulo (SBSP-2015). Multivariate logistic regression was performed using variables based on a model proposed by Andersen for predicting access to public dental services. Results: 3,421 (59.9%) adults visited private services and 2,288 (40.1%) visited public services. Prevalence of the use of public dental services was greatest among women (41.8%) and adults with a lower education level (50.2%). Being non-white (OR = 1.32, 95% CI: 1.16, 1.50), lower household income (OR = 2.37, 95% CI: 2.11, 2.65), having had toothache (OR = 1.60, 95% CI: 1.39, 1.83), and need for endodontic treatment (OR = 1.44, 95% CI: 1.12, 1.85) were associated with public dental service use. Predisposing, enabling, and need factors were associated with public dental care use.

Diagnostic accuracy of three placement sites for the cold test in subjects amongst different age groups

BackgroundThe cold test is a specific test of pulp sensitivity and is part of the endodontic diagnosis. The aim of this study was to identify the diagnostic accuracy including sensitivity, specificity, accuracy, positive predictive value and negative predictive value in three sites for the cold test in teeth with a need for endodontic treatment within different age groups from both genders.MethodsA cross-sectional study was performed, evaluating 425 subjects. Two hundred and fifty-eight subjects from both genders from the ages of 17–27, 28–39, 40–50, and 51–65 years-old participated in the study. The cold test studied was 1, 1, 1, 2-tetrafluoroethane, and the gold standard was established through direct pulp inspection. The sites evaluated in the study were: The sites evaluated in the study were: a) the middle third of the buccal surface; b) the cervical third of the buccal surface, and c) the middle third of the lingual surface.ResultsThe highest diagnosted accuracy was observed on the middle third buccal surface with an accuracy of = 0.97, a sensitivity of = 1.00, a specificity of 0.95, a predictive value of = 0.95 and a negative predictive value of = 1.00. This was in the female group aged from 40 to 50 years old.ConclusionThe tables of this study can be used as an auxiliary for pulp sensitivity tests.