Oral surgery, oral medicine, oral pathology, oral radiology and endodontics

Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth.

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International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth

In vitro tests continue to be an indispensable method for the initial screening of dental materials. Thermal cycling is one of the most widely used procedures to simulate the physiological aging experienced by biomaterials in clinical practice. Consequently it is routinely employed in experimental studies to evaluate materials' performance. A literature review aimed to elucidate test parameters for in vitro aging of adhesive restorations was performed. This study aims to assess whether or not a standardized protocol of thermal cycling has been acknowledged from a review of the literature. An exhaustive literature search, examining the effect of thermal cycling on restorative dental materials, was performed with electronic database and by hand. The search was restricted to studies published from 1998 to August 2013. No language restrictions were applied. The search identified 193 relevant experimental studies. Only twenty-three studies had faithfully applied ISO standard. The majority of studies used their own procedures, showing only a certain consistency within the temperature parameter (5-55°C) and a great variability in the number of cycles and dwell time chosen. A wide variation in thermal cycling parameters applied in experimental studies has been identified. The parameters selected amongst these studies seem to be done on the basis of convenience for the authors in most cases. A comparison of results between studies would appear to be impossible. The available data suggest that further investigations will be required to ultimately develop a standardized thermal cycling protocol.

Thermal cycling for restorative materials: does a standardized protocol exist in laboratory testing? A literature review.

For restoring cavitated dental lesions, whether carious or not, a large number of material combinations are available. We aimed to systematically review and synthesize data of comparative dental restorative trials. A systematic review was performed. Randomized controlled trials published between 2005 and 2015 were included that compared the survival of ≥2 restorative and/or adhesive materials (i.e., no need for restorative reintervention). Pairwise and Bayesian network meta-analyses were performed, with separate evaluations for cervical cavitated lesions and load-bearing posterior cavitated lesions in permanent and primary teeth. A total of 11,070 restorations (5,330 cervical, 5,740 load bearing) had been placed in 3,633 patients in the included trials. Thirty-six trials investigated restoration of cervical lesions (all in permanent teeth) and 36 of load-bearing lesions (8 in primary and 28 in permanent teeth). Resin-modified glass ionomer cements had the highest chance of survival in cervical cavitated lesions; composites or compomers placed via 2-step self-etch and 3-step etch-and-rinse adhesives were ranked next. Restorations placed with 2-step etch-and-rinse or 1-step self-etch adhesives performed worst. For load-bearing restorations, conventional composites had the highest probability of survival, while siloranes were found least suitable. Ambiguity remains regarding which adhesive strategy to use in load-bearing cavitated lesions. Most studies showed high risk of bias, and several comparisons were prone for publication bias. If prioritized for survival, resin-modified glass ionomer cements might be recommended to restore cervical lesions. For load-bearing ones, conventional or bulk fill composites seem most suitable. The available evidence is quantitatively and qualitatively insufficient for further recommendations, especially with regard to adhesive strategies in posterior load-bearing situations. Moreover, different material classifications might yield different findings on the same materials. Future trials should aim for sufficient power, longer follow-up times, and high internal validity to prove or refute differences between certain material combinations. An agreed material classification for future syntheses is desirable.

Directly Placed Restorative Materials Review and Network Meta-analysis

Essentials of complete denture prosthodontics

Objective
To evaluate the position of the root apices of posterior teeth of mandible with inferior alveolar nerve canal and the cortical bone on cone beam computed tomography.


METHODS
The retrospective study was conducted from September to October 2021 at the Aga Khan University Hospital, and comprised cone beam computed tomography scans between November 2017 and October 2021 scans of healthy individuals of either gender aged 18-71 years with healthy, untreated, mandibular posterior teeth bilaterally. Shortest distance from apices of the mandibular posterior teeth to the border of inferior alveolar nerve canal, and to the mandibular buccal cortex were measured on the scans. Data was analysed using SPSS 23.


RESULTS
Of the 106 scans, 55(52%) were males and 51(48%) were females. Of the 746 33teeth in the scans, 385(51.6%) were present in the scans of males and 361(48.4%) in those of the females. For all mandibular posterior teeth, the distances in females were shorter than males, but for the distance from root apices to the IAN canal, the difference between genders was significant for the roots of second premolar and second molar only on the left side (p≤0.05). Regarding the distance from the root apices to the buccal cortex, no significant difference was found between the genders, for each type of tooth, (p>0.05). Correlations between the distance from apex to inferior alveolar nerve (r<0.30) and between age and apex to buccal cortex distance (r<0.28) were weak.


Conclusion
Procedures planned apical to second premolar and second molar teeth can potentially damage the inferior alveolar nerve.

Evaluation of bone morphology in posterior mandible: A cone-beam computed tomography based study.

Context: Literature has no consensus over the utility of enameloplasty before fissure sealant placement. Aim: The objective of the study was to explore the effect of enameloplasty using a scanned electron microscope on the adaptability of resin-modified glass ionomer versus flowable resin-based sealants. Settings and Design: An in vitro, experimental study was done from July to November 2017 at the NED University and Dow University of Health Sciences, Karachi, Pakistan. Materials and Methods: An in vitro experimental study was done, for which twenty extracted human molars and premolars were selected. They were divided into two groups on the basis of sealant type (resin-modified glass ionomer versus flowable resin-based sealant). The groups were further subdivided on the basis whether these were subjected to enameloplasty or not. All specimens were thermocycled, sectioned, dried, and gold sputtered before inspection under a scanning electron microscope (×50). Statistical Analysis Used: The adaptability of the sealant material in the tooth fissures was assessed on an ordinal scale. SPSS version 23.0 was used for data analysis. Mann–Whitney U-test and ordinal regression were applied at 0.05 level of significance. Results: There were no statistically significant differences between adaptability scores achieved with resin-modified glass ionomer-based sealant and flowable resin-based sealant (P = 0.96). Moreover, enameloplasty resulted in inferior adaptability of the two sealant materials (P = 0.02). Conclusions: Enameloplasty has shown to exert a negative influence over adaptation of the sealant material into the tooth fissure irrespective of the sealant chemistry.

Evaluation of In situ Adaptability of two types of fissure sealants placed with or without enameloplasty

Background: With root canal treatment, the organic debris and micro-organisms from pulp space is removed and an ideal canal preparation is achieved that is conducive of hermetic obturation. The purpose of this study was to correlate the pre-operative canal curvature with the post-operative curvature in human extracted teeth prepared with K-3 rotary systems. M ethods: The root canal preparation was carried out on extracted human molars and premolars using K-3 endodontic rotary files. A pre and post-operative image of the teeth using digital radiograph were taken in order to compare pre and post-operative canal curvature. The images were saved in an images retrieval system (Gendex software, USA). Change in the canal curvature was measured using the software measuring tool (Vixwin software, USA). Student paired t test and Pearson correlation test was applied at 0.05 level of significance. Results: There is a statistically significant difference between pre-operative and post-operative canal curvature ( p value <0.001) and a strong positive correlation (91% correlation) between pre-operative and post-operative canal curvature in teeth prepared with the K-3 rotary files. Conclusions: A significant difference between pre and post instrumentation curvature was found. Degree of canal curvature was not correlated with time taken for canal preparation. Keywords:  Endodontic treatment; K-3 files; Canal curvature

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Comparison of pre-operative curvature with post-operative curvature in root canals treated with k-3 rotary systems

Immediate implants have gained a wide popularity in the recent times as patients benefit from reduced time interval between the implant placement and delivery of the final restoration.Careful treatment planning and execution of the procedure can prevent the need to undergo second stage surgery for prosthesis and thus improves the patients' compliance. An immediate placement and loading protocol has been followed in this case report.

https://www.peertechzpublications.com/articles/JDPS-2-107.pdf

Replacement of A Hopeless Mandibular Tooth With an Immediately Placed and Loaded Dental Implant : A Case Report

Dental implants offer a predictable solution for the replacement of missing dentition. This report describes the case of a patient who underwent dental implant surgery several years ago but due to negligence on the part of previous dentist, her implant pushed into the maxillary sinus. The patient presented with vague pain and swelling in the right maxillary region. Orthopantomogram (OPG) showed that the implant was lying in the right maxillary sinus which the patient had no clue of. It was decided to retrieve the implant and later restore the missing teeth for definitive function and aesthetics. However, at the time of surgery, the implant in question was missing from the anticipated position as it had migrated to the most posterior-superior compartment of the antrum making its retrieval difficult in the first attempt. Later, a maxillofacial surgeon carried out the retrieval. Fortunately, the implant moved back to a more favourable position at the time of second surgery.

Farhan Raza Khan

Papers

Evaluation of bone morphology in posterior mandible: A cone-beam computed tomography based study.

Evaluation of In situ Adaptability of two types of fissure sealants placed with or without enameloplasty

Comparison of pre-operative curvature with post-operative curvature in root canals treated with k-3 rotary systems

Replacement of A Hopeless Mandibular Tooth With an Immediately Placed and Loaded Dental Implant : A Case Report

Migratory dental implant in the maxillary antrum: a case report.