Treatment Option For Teeth Research Articles

Restoration of fractured anterior tooth with monochrome composite resin in pediatric dental patient

Direct restoration with monochromatic composite resin is a treatment option for teeth with coronal fracture after dentoalveolar trauma. This restorative material, in principle, is capable of mimicking the color of the dental substrate. This study aimed to report and discuss the technique of direct restoration with monochromatic composite resin, in a child patient. An 8-year-old male patient attended the Emergency Room of the Baby Clinic of the State University of Londrina for immediate treatment after dentoalveolar trauma that resulted in enamel and dentin fracture, without pulp involvement. As a procedure, restoration was performed with glass ionomer cement and referral to the institution's Dental Residency program. In this service, after case planning, the restoration of the coronal fracture of the substrates was performed with the insertion of multiple increments of the Vittra APS Unique (FGM) composite, with the aid of a silicone guide prepared based on a waxing model to facilitate the reestablishment of the palatal surface form and anatomy. In the clinical follow-up evaluation, the aesthetic and functional results obtained were considered highly satisfactory by patients, relatives and dental clinicians. Thus, it can be concluded that the option for monochromatic composite resin is a viable alternative to make it easier for the dental clinicians to perform the procedure and reduce the clinical time, a relevant fact because it is a case of caring for a pediatric dentistry patient.

The Outcome of Decoronation in Severe Cases of External Cervical Root Resorption in Young Patients.

This study examines decoronation as a treatment option for teeth with progressive external cervical root resorption (ECR). Six young patients aged 9.5-13, with a total of nine incisor teeth affected by ECR due to previous dental trauma, were treated by decoronation. Six teeth were classified as class 4 and two as class 3, according to Heithersay's classification. Another tooth with class 2 resorption also had a perforation. After decoronation, all cases showed favorable outcomes during a follow-up period of 2.5-8 years. The procedure halted the progression of ECR and promoted vertical and horizontal ridge development above the submerged root. Decoronation can be considered for the successful treatment of advanced cases of ECR in young patients.

Factors Associated with Hypersensitivity, Management, and Treatment Options for Teeth with Molar Incisor Hypomineralisation.

Tooth hypersensitivity is a common symptom in molar incisor hypomineralisation (MIH) patients and can affect children's quality of life. During daily routine, children with MIH often report sensitivity to various thermal and mechanical stimuli, and difficulty in achieving effective analgesia is a common issue becoming a challenge for dentists. Research has focused on the possible pathophysiological mechanisms behind this phenomenon, which, in turn, have not been determined. Even with the apparently intact enamel of MIH-teeth, the porosity of the hypomineralised enamel acts as an open door for the invasion of oral microorganisms, which reach the dentinal tubules, and stimulate subclinical inflammatory reactions in the pulp. Tissue inflammation may, in turn, lead to morphological and cytochemical changes within sensory neurons, resulting in sensitization of these nerve fibers. This phenomenon is complex, and the treatment modalities focus on inflammation management followed by tubule obliteration by using different materials and technologies. In conclusion, this chapter reviews the concept and etiology of hypersensitivity in teeth with MIH and summarizes the clinical management according to the best evidence available.

The Ability of Dental Interns and Freshly Graduated Dentists to Assess Tooth Restorability. A Multicenter, Cross-Sectional Study.

Treatment planning should be integrated to gain and apply essential data to decide. It is necessary to evaluate theendodonticand periodontal conditionof the tooth, in addition to its restorability. Treatment planning is emphasized as a crucial clinical skill for a certified dental practitioner in the General Dental Council learning outcomes. The role of dental schools is to guarantee that dental graduates have the knowledge, skills, and competence to choose appropriate treatment options for teeth. The primary objective of our study was to assess the ability ofdental interns and recently graduated dentists from different dental schoolsfortooth restorability. This was a multicentral, cross-sectional study. Participant recruitment was achieved by sending an online questionnaire to the interns and graduate units at the assigned universities. The questionnaire consisted two parts. The first part record general information about participants and opinions regarding their training of restorability assessment. The second part include five hypothetical clinical case scenarios, where the participants were asked to choose the restorability decisions, rationales for the options, and prognosis of the tooth/teeth. The data was analyzed by using SPSS software version 26. 104 respondents participated in this survey. The decision and prognosis of all clinical scenarios were not significantly associated with gender, experience, place of work and place of study. Only the decision and prognosis of scenario 1 showed significant relationship with place of graduation. Developing universities graduates showed significantly higher percentage for restorability as against developed universities graduates (p=0.001) and developing universities and recently established institutions graduates showed significantly higher percentage for the questionable prognosis as against developed universities graduates (p=0.018). The inability of dental interns and freshly graduate dentalpractitioners to make decisions highlighted questions regarding the conditionof learning outcomes and graduate attributes.

Effectiveness of Oral Health Education in Improving Oral Health Related Knowledge in Pregnant Mothers Attending the Ante-natal Clinic at the Divisional Hospital, Kotaligoda

Objective of this study were to assess effectiveness of oral health education in improving oral health related knowledge in pregnant mothers attending ante-natal clinic. A questionnaire was used to assess oral health related knowledge before and following education programs. Post education answers were compared with previous ones. Minitab 18 was utilized for statistical analysis. Following education, knowledge on treatment options for teeth with infected pulp other than extraction, features of gingival diseases, association of diabetes mellitus and periodontal diseases and the change of oral health with ageing process was increased. More participants identified that oral hygiene maintenance is necessary for optimum periodontal health. The results indicated that mean post knowledge was significantly higher than mean pre knowledge (p< 0.001). There was a statistically significant association between pre knowledge and monthly income. Education programs significantly improve the knowledge on oral health of the pregnant mothers. However, the increase of knowledge does not vary according to the age, monthly income and education level of them. It is recommended that pregnant mothers should be educated regularly on oral health and oral health practices as the knowledge will be beneficial for long term oral health behavior. Keywords: Pregnant mother, Effectiveness, Oral health education

Attachment of human periodontal ligament fibroblasts to root dentin conditioned with different endodontic irrigants: An experimental study.

Background. Periradicular surgery is the last treatment option for teeth with persistent periradicular endodontic lesions. This study aimed to assess the adhesion of fibroblasts to root dentin conditioned with ethylenediaminetetraacetic acid (EDTA), MTAD, and QMix.Methods. Twelve dentin discs were fabricated of 6 human single-rooted teeth. Fibroblasts were isolated from the periodontal ligament (PDL) of a premolar tooth. The teeth were healthy and freshly extracted from the socket. The samples were divided into four groups for surface conditioning with (I) EDTA, (II) MTAD, (III) QMix, and the control group. Fibroblasts were cultured on conditioned dentin discs at 37°C, 95% air, and 5% CO2 for 4 hours and then rinsed with PBS three times to eliminate unattached cells from the surface. The mean counts of attached cells were calculated using a Neubauer chamber. Also, the attachment of fibroblasts was evaluated using scanning electron microscopy (SEM).Results. The mean counts of fibroblasts attached to root dentin in EDTA, QMix, MTAD, and control groups were 303±46, 243±41, 213±33, and 347±38, respectively. No significant difference was noted in the number of fibroblasts attached between MTAD, EDTA, and QMix and the control group (P>0.05). Under SEM, the fibroblasts were flat and spindle-shaped, with cytoplasmic processes covering the untreated dentin surface. In the experimental groups, the cells were rounder with fewer processes. All the three groups showed weaker adhesion to dentin compared to the control (untreated dentin) group.Conclusion. Under the limitations of this study, it was concluded that treating the dentin surface with EDTA, MTAD, or QMIX might not be an effective way to improve the adhesion of human PDL fibroblasts.

Diagnosis and Management of Furcation Lesions in Dogs - A Review.

The furcation is the anatomic area where the roots divide on a multirooted tooth. Periodontal disease causing alveolar bone loss can lead to furcation lesions of various stages. Once furcation involvement has occurred, the area can be more difficult to clean or treat due to the complex anatomy and morphology of furcations. Teeth with short root trunks, longer tooth roots, and roots with wide furcation entrance areas/degrees of separation and wide root divergence are considered better candidates for long term maintenance. Dog teeth possess many of these advantageous anatomic features compared to human teeth. Treatment options for teeth with furcation lesions include: closed debridement, open debridement, furcation plasty, tunneling, partial tooth or root resection, root separation (hemisection or trisection), regenerative therapies, or exodontia. There are many factors to consider in determining treatment options. The favorable and unfavorable characteristics for maintenance of teeth with furcation lesions are summarized. Home care and ongoing professional care are important aspects of periodontal disease control for any patient. Studies of systemic and local antibiotic therapies in human patients have not demonstrated reduction of furcation stages, and probiotic effects at furcation sites have not been specifically examined. Human review studies show that most molar teeth once deemed "hopeless" due to stage 3 furcation lesions can be maintained for at least 5 to 15 years with supportive periodontal therapy. Similar long term studies in dogs are needed to improve the evidence-based management of canine patients with furcation lesions.

Surgical Repositioning of an Inverted Developing Incisor Assisted by 3D Technology

Permanent central incisor impaction is very rare, and causes of impaction include adjacent supernumerary teeth, odontoma, and trauma. Surgical repositioning is a treatment option for teeth with ectopic eruption pathways. In this case report, an inverted developing maxillary central incisor was surgically repositioned at the initial stage of root development. Three dimensional (3D) virtual images were acquired using computed tomography, and a replica was produced by LCD-based masked stereolithography 3D printing. A resin for 3D printing was approved as a medical device and used as a 3D printing replica. Further, 3D technology has been found to be useful for successful tooth repositioning surgery.

An update on the diagnosis and treatment of dens invaginatus

Dens invaginatus is a malformation with varying anatomical features, posing challenges to treatment. Early and accurate diagnosis plays a significant role in selecting the appropriate treatment. The diagnosis of teeth with a complex root canal system including dens invaginatus has made progress with the application of three-dimensional imaging techniques in endodontics. Advanced treatment options provide hope for teeth that could not be saved before. This review discusses diagnostic methods and treatment options for teeth with dens invaginatus, and provides guidelines for the management of dens invaginatus cases in clinic. Current as well as traditional diagnostic techniques are summarized. Treatment options including state-of-the-art alternatives are presented for coronal dens invaginatus and radicular dens invaginatus.

Clinical and radiographic assessment of periapical pathology in single versus multivisit root canal treatment: An in vivo study.

Objective:The objective of the study was to compare and evaluate the clinical and radiographic outcome of single- versus multivisit endodontic treatment in teeth with periapical pathology at the end of 1, 3, and 6 months.Materials and Methods:Sixty single- and multi-rooted teeth indicated for root canal treatment with periapical pathology were included in the study. The teeth were assigned randomly into two groups Group I and Group II (n = 30 each), which were further subdivided into subgroup IA, subgroup IB and subgroup IIA, subgroup IIB (n = 15 each), respectively. Group I was medicated with ApexCal paste and obturated using the standardized protocol in second visit 7–10 days later, whereas Group II was obturated at the first visit. In subgroup IA and subgroup IIA, obturation was done using Apexit Plus sealer, whereas, in subgroup IB and subgroup IIB, AH Plus sealer was used. Patients were recalled at intervals of 1, 3, and 6 months to evaluate teeth for periapical healing.Results:Kruskal–Wallis and one-way ANOVA test showed no significant difference between Groups I and II, whereas Wilcoxon signed-rank test showed improvement in all the subgroups with highly significant P value (≤0.001).Conclusion:Single-visit root canal treatment can be considered as a viable option for treatment of teeth with periapical pathology.

Root canals-from concretion to patency

Teeth with calcification provide an endodontic treatment challenge; traumatized teeth usually develop partial or total pulpal obliteration which is characterized by apparent loss of the pulp space radiographically and a yellow discoloration of the clinical crown. Since only 7-27% of such teeth develop pulp necrosis with radiographic signs of apical periodontitis, it is difficult to decide whether to treat these teeth immediately upon detection of the pulpal obliteration or to wait until signs and symptoms of pulp and/or apical periodontitis occur. This article reviews the etiology, prevalence, classification, mechanism, diagnosis as well as treatment options for teeth with pulp obliteration and the various management approaches and treatment strategies for overcoming potential complications. A search of articles from PubMed and Medline from 1965 to present was done with the keywords dental trauma, discoloration, pathfinding instruments, pulp canal obliteration, and root canal treatment was conducted. A total of 94 abstracts were collected, of which 70 relevant articles were read and 31 most relevant articles were included in this article.

Prognostic Factors for Clinical Outcomes According to Time after Direct Pulp Capping

IntroductionDirect pulp capping is a treatment option for teeth with carious-exposed pulp. Because pulp capping studies have exhibited fluctuations in success rates according to different follow-up times, investigating the clinical pulpal survival rate and the potential factors contributing to the survival with respect to time is necessary. MethodsA total of 175 patients treated between November 2007 and August 2010 met the inclusion criteria. During the follow-up, we investigated 7 clinical variables with respect to the survival of the pulp capping treatment: sex, age, maxilla versus mandible, tooth position, capping materials, temporary filling materials, and exposure site. Survival analysis was performed using the Kaplan-Meier method and the Cox proportional hazard regression model. ResultsThe Kaplan-Meier survival curves and log-rank tests revealed that only age, exposure site, and capping material had significant effects on the pulpal survival rate (P < .05). A Cox regression model showed that mineral trioxide aggregate was the sole factor affecting the survival of the treated pulps (P < .05). In the analyses performed separately according to time, there was no conspicuous factor that affected the survival rate before 100 days. However, after 100 days, the type of pulp capping material was the single most important factor influencing the survival rate (P < .05). ConclusionsThe results of this study indicated that careful patient selection and the type of pulp capping material should be taken into consideration when performing a pulp capping treatment.

Treatment of a crown‐root fracture with intentional replantation – case report with 16‐year follow‐up

To report the intentional replantation of a maxillary central incisor with a crown-root fracture. An 11-year-old girl was referred to a paediatric clinic with an extensive crown-root fracture of the maxillary right central incisor (tooth 11) with pulp exposure. Radiographs revealed that tooth 11 had a periapical radiolucent lesion, which suggested pulpal necrosis. The treatment option chosen was planned extraction and immediate intentional replantation of tooth 11 in a more coronal position. Sixteen years after treatment, tooth 11 was aesthetically and functionally sound, suggesting that the treatment was successful. Intentional replantation may be considered as a treatment option for teeth with crown-root fractures.

The effect of thermocycling on the bonding of different restorative materials to access opening through porcelain fused to metal restorations

PURPOSEPorcelain fused to metal (PFM) crowns provide the best treatment option for teeth that have a large or defective restoration. More than 20% of teeth with PFM crowns or bridges require non-surgical root canal treatment (NSRCT). This may be due to the effect of restorative procedures and the possible leakage of bacteria and or their by-products, which leads to the demise of the tooth pulp. Thus, this study was planned to compare the ability of the restorative materials to seal perforated PFM specimens.MATERIALS AND METHODSThe study evaluates the ability of amalgam, composite or compomer restorative materials to close perforated PFM specimen's in-vitro. Ninety PFM specimens were constructed using Ni-Cr alloys and feldspathic porcelain, and then they were divided into 3 groups: amalgam (A), composite + Exite adhesive bond (B) and compomer + Syntac adhesive bond (C). All the PFM samples were embedded in an acrylic block to provide complete sealing of the hole from the bottom side. After the aging period, each group was further divided into 3 equal subgroups according to the thermocycling period (one week for 70 cycles, one month for 300 cycles and three months for 900 cycles). Each subgroup was put into containers containing dye (Pelikan INK), one maintained at 5℃ and the other at 55℃, each cycle for 30 sec time. The data obtained was analyzed by SPSS, 2006 using one way ANOVA test and student t-test and significant difference level at (P<.01).RESULTSThe depth of dye penetration was measured at the interfaces of PFM and filling materials using Co-ordinate Vernier Microscope. The lowest levels of the dye penetration for the three groups, as well as subgroups were during the first week. The values of dye leakage had significantly increased by time intervals in subgroups A and C.CONCLUSIONIt was seen that amalgam showed higher leakage than composite while compomer showed the lowest level of leakage.