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A case is presented of external cervical resorption detected on routine 6-monthly examination. Following root canal therapy orthodontic extrusion and pericision, the tooth was restored using a radicular retained post and core supporting a porcelain bonded to gold full coverage crown.
A family is reported with dentinal dysplasia type I affecting both dentitions. Presenting features included unusual mobility of the teeth, followed by early exfoliation; normal clinical shape of the crowns of the teeth, but with an amber color without any sign of attrition or abnormal loss of enamel. Radiographic findings showed pulp-chamber and root-canal obliteration, poor root formation, radiolucent linear appearance of the pulp chamber parallel to the cementoenamel junction and frequent periapical radiolucencies. Histological studies have reported large masses of calcified tubular dentin, atypical osteodentin, and also true denticle.
In the present study the periodontal condition of a group of adopted 6-17 year-old children of Asian origin living in Sweden was compared with that of age- and sex matched Sweden children. Thirty-one Asian children and 31 Swedish children participated. Data on general health for all the children and on age at arrival for the Asian children was collected by interview. A clinical examination included recording of presence of plaque, supragingival calculus, bleeding on probing, probing depth, and caries. Radiographs were used to determine marginal bone loss (distance between the cemento-enamel junction and the marginal bone level > 2 mm), proximal calculus, and proximal caries. In addition, previously taken and filed radiographs of the primary dentition of the older children and current radiographs of the younger children with primary teeth were analysed to determine the prevalence of bone loss and calculus. The children of Asian origin showed a significantly higher number of surfaces with plaque and bleeding on probing. No significant differences were noted in the number of individuals with probing depths > or = 4 mm, supragingival calculus, or radiographic calculus. Three of the Asian and none of the Swedish children displayed radiographic bone loss. The retrospective analysis of all available radiographs from the primary dentition showed that 9 of 29 (31%) Asian children and 2 of 29 (7%) Swedish children had experienced bone loss in primary teeth.
The aim of this study was to register the root canal number, root canal position, and root canal cross-section in human two-rooted, permanent maxillary second molars. One hundred and fifty-nine such teeth extracted in Denmark were cross-sectioned at the mid-root level and apically in accordance with precise guidelines. The observations were made in a stereomicroscope, corresponding to the above-mentioned section levels. At mid-root there were two canals present in 11% of the teeth examined; the canals were located mesially and distofacially, mesiofacially and distally, or facially and lingually. Three canals positioned mesiofacially, distofacially, and lingually were observed in 89% of the teeth. At the same level 62% of the canal cross-sections were noncircular, some being, for instance, C-shaped, whereas 38% of the cross-sections were circular. Apically, two canals were found, representing 19% of the teeth, with the canal position as at mid-root; 81% of the teeth were three-canaled with the same canal position as at mid-root. At the apical level 60% of the canal cross-sections were noncircular, whereas 40% of the cross-sections were circular.
Erosion lesions are probably caused by a number of factors in combination. Symptomatic treatment is most indicated for lesions too shallow to restore. For the restoration of erosion, glass ionomer materials, because they eliminate the risk of secondary caries, remain the material of choice, although dentin-adhesive resins have been continuously improved. Recent light-cured glass ionomer restorative materials can be placed without most of the inconvenience inherent in earlier chemically cured materials, and like their chemically cured predecessors, can be veneered with composite resin to improve the esthetics of highly visible restorations.
Clinicians must be very careful when making clinical evaluations of the need for crown lengthening procedures and margin placement and subsequent determinations about the dento-gingival junction and biologic width. Clinicians have tried to standardize a biologic phenomenon and assign the same standard to all patients regardless of the circumstances.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
This study examined furcation dimensions and morphology in first and second mandibular molar teeth. One hundred thirty-four extracted human mandibular molars with divergent roots were selected. Teeth were viewed at 7X magnification on a dissecting microscope interfaced with a computer equipped with a state-of-the-art histomorphometry software program. Various aspects of furcation anatomy were measured and recorded. Data were examined by using analysis of variance for all paired comparisons. For nonparametric data, the Kruskal Wallis test was used. Results indicated that 61.94% of buccal and 50.75% of lingual molar surfaces presented with cervical enamel projections (CEPs), with the highest frequency noted in second molars. CEPs ranged from 0.98 mm to 1.33 mm, whereas root trunk heights varied between 2.23 mm and 2.93 mm. Generally, lingual molar surfaces had longer root trunks when compared to buccal surfaces. Root separation increased by approximately 0.5 mm at each 1-mm increment apical to the furcal roof. This study provides new information regarding the furcal anatomy of mandibular molar teeth and supplements previous reports that suggest the CEP is a common problem which must be addressed by clinicians when treating molar teeth.
AIM: To: (i) study coronal pulp dimensions in human first molar teeth; (ii) investigate the effects of restorations on pulp size; (iii) determine differences in dimensions between teeth of Mongoloid patients and teeth of other ethnic groups; and (iv) record the presence of pulp stones. METHODOLOGY: Bitewing radiographs of 121 subjects (mean age, 20.9 years) were taken under standardized conditions. The films were digitally scanned and nine measurements were made from the image of each first molar. The data were analysed in terms of presence or absence of restorations and in terms of racial group. Differences were examined using Student's t-test, Pearson correlations and Levene's test. RESULTS: A total of 445 teeth were analysed. Large crowns were correlated to large pulps. Teeth restored with occlusal and proximal restorations had significantly smaller pulps (P = 0.044 and 0.004, respectively), but no difference was found in pulp area in the clinical crown between the restoration types. Mongoloid crowns were shorter and more bulbous. Pulp areas of maxillary molars and pulp widths at the cervix of mandibular molars were significantly larger in Mongoloids. The pulp area in the clinical crown correlated to pulp horn height for Mongoloids and others and for maxillary and mandibular teeth. No differences were found between the heights of pulp horns in the Mongoloid and other teeth. Four of the pulp measurements demonstrated sexual dimorphism. Stones were present in almost 10% of the subjects, representing 4% of the tooth pulps examined. CONCLUSION: Even teeth with shallow occlusal restorations had reduced pulp spaces. There were significant differences in pulp and crown dimensions between the teeth of Mongoloid patients and those of other patients.
Chlorpromazine (CPZ), a phenothiazine derivative, possesses anti-inflammatory properties, inhibition of tumor neurosis factor-alpha (TNF-alpha) synthesis and bone resorption. TNF-alpha promotes inflammatory changes and bone resorption in periodontitis. We have studied the effect of CPZ in experimental periodontitis. Wistar rats were subjected to a ligature placement around the cervix of the right second upper molars. Alveolar bone loss was evaluated by the sum of the distances between the cusp tip and the alveolar bone along the axis of each molar root, which was subtracted from the contralateral side. Histopathological analysis of the periodontium was based on cell influx, osteoclast number, and alveolar bone and cementum integrity. Animals were weighed daily and total and differential peripheral white blood cell counts were performed 6 h and 1, 7 and 11 d after periodontitis induction. Groups were treated with CPZ 1 h before and daily up to the 11th d of periodontitis. Alveolar bone loss was inhibited 46%, 55.4%, and 76.5% by CPZ at 1, 3 and 9 mg/kg, respectively. Histological analysis showed a significant reduction of cell influx and osteoclast number, as well as preservation of the alveolar process and cementum. CPZ reversed leukocytosis but not weight loss. In conclusion, CPZ reduces bone loss in experimental periodontitis, probably via TNF-alpha blockade.
BACKGROUND: Composite resins are widely used as the material of choice for definitive restorations due to their ability to integrate functional and aesthetic aspects in dental rehabilitation. Recently, one-shade composite resins have been introduced to simplify the clinical workflow. OBJECTIVES: This study aimed to compare the clinical performance of a "chameleon effect" composite resin with that of a multi-shade composite resin in non-carious cervical lesions after 36 months of follow-up. METHODS: This study was a randomized, controlled, double-blind clinical trial with an equivalence design using a split-mouth approach. The sample consisted of 60 patients presenting at least two non-carious cervical lesions, totaling 120 restorations. Restorations were performed using two materials from the same commercial brand: Vittra Unique (one-shade group) and Vittra APS (multi-shade group). The clinical performance of the restorations was longitudinally evaluated according to the FDI criteria. Survival analysis was performed using Kaplan-Meier curves and the log-rank test, while other clinical parameters were compared using the chi-square test (α = 0.05). RESULTS: At baseline, no statistically significant differences were observed between the groups regarding the evaluated biological, functional, and aesthetic parameters (p > 0.05). Both materials demonstrated clinically acceptable performance according to the FDI criteria, with no significant differences between them. CONCLUSIONS: After 36 months, no significant differences were observed between the one-shade and the multi-shade composite resins in the restoration of non-carious cervical lesions. CLINICAL SIGNIFICANCE: This 36-month randomized clinical trial demonstrates that single-shade composite resins achieve structural durability and aesthetic integration equivalent to traditional multi-shade layering when restoring non-carious cervical lesions. This evidence validates a simplified, single-shade restorative workflow, significantly reducing chairside time and operator-dependent variables without compromising the clinical longevity.
AIM: To assess the influence of different variables on the survival of class II glass ionomer restorations a clinical study was carried out among 6-7 year old schoolchildren in and around Dar es Salaam, Tanzania. METHODS: 217 children were randomly divided into three groups. In the conventional group, Class-II cavities were excavated with burs, in the ART group they were excavated with hand instruments and in the Carisolv group excavation took place with a chemical solution and special blunt hand instruments. The preparations in all groups were restored with hand mixed glass ionomer cement (Fuji IX). Four operators were involved in the treatment phase. After restoration, residual caries and cervical gaps were assessed on bite-wings. The quality of the restorations was established and the survival rate determined in two subsequent evaluations. RESULTS: 195 children (90%) were present at the first evaluation which took place after 7 months and 194 (89%) were present at the second evaluation, after one year. At the first evaluation the survival rate of the ART-restorations was 38%, of the conventional restorations 50%, and of the Carisolv restorations 35%. Survival rates at the time of the second evaluation were 30%, 42% and 28% respectively. The differences between the three treatment groups were, however, not significant (p = 0.200 at t = 1 and p = 0.247 at t = 2). In the first evaluation 161 bitewings were available of the 195 restorations, while for the second evaluation 130 cases were available. There was no significant relation between residual caries and the success/failure rate (p = 0.140 at t = 1 and p = 0,201 at t = 2). Also cervical gaps appeared to have no relation with the failure rate (p = 0.057 at t = 1 and p = 0.833 at t = 2) However, together those variables have a significant influence on the survival rate (p = 0.025). CONCLUSION: The combination of two variables (residual caries and cervical gaps) has considerable influence on the survival rate of class II glass ionomer restorations compared to each variable alone.
Microleakage at the cervical tooth/restoration interface of class II restorations was evaluated, either on multiple sections or on teeth rendered transparent, in order to determine whether a modified clearing protocol could be established as a routine method for microleakage evaluation in class II restorations. Forty-eight class II cavities were restored with a composite/bonding agent (Tetric Universal/Heliobond, Vivadent, Schaan, Liechtenstein) in bulk technique (BT) (n=24) and with a composite/dentin adhesive system (Tetric Universal/Heliobond/Syntac Classic) in increments (IT) (n=24). The 24 specimens were assigned to two groups. Group I: dye penetration (India ink), multiple sectioning (conventional method). Group II: dye penetration (India ink) and modified clearing protocol. Linear microleakage (% dye/section) along the cervical tooth/restoration interface on multiple sections, and microleakage patterns (% dye/surface) at the cervical surface on transparent teeth were evaluated with an image analyzing system. The data were statistically analyzed with the Mann Whitney U-test, Wilcoxon's rank sum test, and the error rates method. The application of the modified clearing protocol allowed for distinct evaluation of microleakage patterns. Either protocol revealed lower penetration values for IT than for BT. With the conventional protocol, the median (25-75% percentiles) percentage of dye penetration was 2% (1-46%) for IT and 40% (23-85%) for BT. The clearing protocol revealed dye penetration of 5% (1-22%) for IT and 16% (4-24%) for BT. The clearing protocol together with the use of India ink as tracer allows for evaluation and visualization of the continuous distribution of microleakage at the cervical tooth/restoration interface without loss of information due to sectioning, although this method seems to be less discriminative than the conventional sectioning technique.
The aim of this study was to compare the clinical performance over 1 year of a microhybrid composite resin for class V restorations both lined and not lined with a flowable composite resin. Nineteen patients having at least two pairs of cervical noncarious lesions under occlusion were enrolled in this study. A total of 38 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250, and Single-Bond + Filtek Z250). Two calibrated operators placed all restorations according to the manufacturers' instructions. Two other independent examiners evaluated the restorations at baseline and after a 12-month period according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test and McNemar's test (P=0.05). One restoration was lost after 12 months for each group (retention rate 95% for each group). After 12 months, 18 restorations showed a trend towards dark yellowing (color match A2). The use of Filtek Flow as a liner under Filtek Z250 restorations did not improve the clinical performance of class V restorations after 6 and 12 months of evaluation.