Current Issue : January-March Volume : 2022 Issue Number : 1 Articles : 5 Articles
Double teeth refer to two teeth that are totally or partially joined by dentin and maybe their pulps. These developmental anomalies may be the result of either gemination or fusion. This is a case of a 15-year-old Indo-Trinidadian male who presented with the fusion of a mandibular third molar with a distomolar as an incidental finding. The patient had his general dental care provided by a paediatric dentist and was referred to an oral and maxillofacial radiologist, orthodontist, and oral surgeon for consultation. A Cone-beam CT was taken to supplement the plain film periapical and orthopantomogram radiographs. It showed the three-dimensional orientation of the double molar and the extent of joining. This is the first case of fusion of a mandibular third molar to a distomolar being reported in the Caribbean....
Discrepancy between the crown border and prepared tooth margin leads to a microleakage that eases the penetration of microorganisms and causes the dissolution of luting cement consequently. Several factors should be considered to achieve optimal fitness, including tooth preparation taper and type of cementing agent. The study aimed to determine the relation of tooth preparation taper and cement type on the microleakage of zirconia crowns. Materials and Methods. Fifty-six freshly extracted premolars without caries and restorations were selected as the study sample and divided into two groups of different tapering degrees (6 and 12 degrees). Zirconia copings were designed and fabricated by the CAD/CAM system. The samples were divided into four subgroups for cementation, and each subgroup was cemented with a different luting cement (n 7). After 5000 thermocycles at 5°C–55°C and dye penetration, the specimens were sectioned in the mid-buccolingual direction, and a digital photograph of each section was taken under a stereomicroscope. Data were analyzed by the Kruskal–Wallis and Mann–Whitney tests (α 0.05). Results. The results showed significant differences among the four types of luting cement in marginal permeability (PV< 0.001). Regardless of the type of cement, the 12-degree tapering resulted in a lower microleakage (46.4% without microleakage) with statistically significant differences from the 6-degree tapering (PV 0.042). Conclusion. Within the limitations of this study, increasing the tapering degree of the prepared tooth for CAD/CAM zirconia copings improved the marginal fit and decreased the microleakage score. In addition, total-etch resin cement indicated the least microleakage....
The need to rehabilitate severely compromised teeth is frequent in daily clinical practice. Tooth extraction and replacement with dental implant represents a common treatment choice. However, the survival rate for implants is inferior to teeth, even if severely damaged but properly treated. In order to reestablish a physiological supracrestal tissue attachment of damaged teeth and to arrange an efficient ferrule effect, three options can be considered: crown lengthening, orthodontic extrusion and surgical extrusion. Crown lengthening is considered an invasive technique that causes the removal of part of the bony support, while both orthodontic and surgical extrusion can avoid this inconvenience and can be used successfully in the treatment of severely damaged teeth. The aim of the present narrative review is to compare advantages, disadvantages, time of therapy required, contraindications and complications of both techniques....
Background: Diabetes increases periodontal disease risk and its complications, which are worsened with age or faulty restorations. Aim: Evaluate periodontal health among patients with diabetes treated with different dental restorations. Materials and Methods: This comparative cross-sectional study was conducted at the faculty of dentistry, Najran University, KSA, from March 2018 to February 2020. It included 260 diabetics, treated with different dental restorations, divided into four groups, each comprising 65 patients aged 45 - 60 years: Group 1 (G1), no restorations (control group); Group 2 (G2), Class II amalgam restorations; Group 3 (G3), Class II composite resin restorations; and Group 4 (G4), three-unit posterior metal ceramic prostheses. The Ages of all restorations ranged from 8 to 10 years. All groups were assessed for the Plaque Index (PI) and Gingival Index (GI), Overhangs Rate (OR), Alveolar Bone Loss (ABL) (the latter two using panoramic X-ray). HbA1c and duration of participants were also assessed and compared. Results: The mean HbA1c results of the groups ranged from 8.1% to 9.5%, and their mean diabetes durations ranged from 7.2 to 12 years. All the groups showed worse periodontal scores, ranging from 2.45 - 2.95 for PI and 2.25 - 2.8 for GI. G2 had higher scores than G1 and G3 (p < 0.001). G4 had the highest two recorded scores (p < 0.001). G2 had a higher rate of overhangs than G3 (p < 0.037). The mean ABL was 44% (SD 6.4) for G1, 56.0% (SD 6.7) for G2, 46.5% (SD 5.8) for G3, and 74.5% (SD 6.4) for G4. The lowest values were recorded in G1 and G3 (p = 0.987). The highest value was observed in G4, which was significantly high-er than other groups (p < 0.001). Conclusion: The worse periodontal parameters among subjects treated with either three-unit metal ceramic or Class II amalgam restorations indicated severe periodontal destruction. Untreated subjects and subjects treated with Class II composite resin had relatively better periodontal status....
This work aimed to investigate the use of Regenerative Endodontic Procedures (REP) on the treatment of pulp necrosis in mature teeth through systematic review and meta-analysis of evidence on clinical and radiographic parameters before and after REP. A search was performed in different databases on 9 September 2020, including seven clinical studies and randomized controlled trials (RCT). The methodological quality was assessed using Revised Cochrane risk-of-bias (RoB 2) and Before-and-After tools. Meta-analyses were performed to evaluate the success incidences regarding the reduction of periapical lesion and recovery of sensitivity. The certainty of the evidence was assessed using GRADE. Meta-analysis showed a high overall success of 0.95 (0.92, 0.98) I2 = 6%, with high periapical lesion reduction at 12 months (0.93 (0.86, 0.96) I2 = 37%) and by the end of follow-up (0.91 (0.83, 0.96) I2 = 13%). Lower incidences of positive sensitivity response were identified for the electrical (0.58 (0.46, 0.70) I2 = 51%) and cold tests (0.70 (0.54, 0.84) I2 = 68%). The calculated levels of REP success were similar to those reported for immature teeth. With a very low certainty of evidence, the meta-analysis showed a high incidence of REP’s success for mature teeth with necrotic pulp evidenced by periapical lesion reduction and moderate positive responses to sensitivity tests....
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