Perceptions of emergency department physicians regarding the management of traumatic dental injuries.

Background/aim: The purpose of this study was to investigate the self-reported confidence level and education of Atlantic Canada emergency department physicians in the management of traumatic dental injuries and to assess the need for further education surrounding the management of dental trauma.

Material And Methods: An 18-item survey was developed and distributed electronically to physicians by their respective provincial medical associations.

Results: Traumatic dental injuries were reported in the emergency department on a weekly basis (78%).

Effects of Intracanal Antimicrobials on Viability and Differentiation of Stem Cells From the Apical Papilla: An In Vitro Study.

Background: Recent studies have indicated that intracanal antimicrobials used to disinfect the root canal in regenerative endodontic therapies (RETs) may be cytotoxic to stem cells from the apical papilla (SCAP), leading to inconsistent treatment outcomes. However, the effects of intracanal antimicrobial agents on the odontogenic differentiation capacity of SCAP at sub-lethal concentrations have not been investigated. The aim of this study was to determine the effects of intracanal antimicrobials on SCAP viability and odontogenic differentiation capacity using a clinically relevant concentration range (0.

Fracture Resistance of Immature Teeth Submitted to Different Endodontic Procedures and Restorative Protocols.

Introduction: The purpose of this in vitro study was to determine whether the methods used to treat endodontically and restore anterior immature teeth with a necrotic pulp influence their resistance to fracture.

Methods: After access opening and cleaning and shaping, 80 specimen teeth were assigned into 5 groups according to the endodontic obturation method and coronal restoration as follows: A1, apexification with a composite restoration in the crown area; A2, apexification with a composite restoration in the crown and 3 mm into the root; IR, immediate revascularization with a composite restoration in the crown area; SR, successful revascularization with a composite in the crown area; and the control group, a mature tooth treated with gutta-percha and sealer with a composite restoration in the crown area. The teeth were mounted in acrylic blocks and brought to fracture under compressive forces in a universal testing machine.

Neuropathy Mimicking Dental Pain in a Patient Diagnosed with Lyme Disease.

This report documents the case of a patient who developed neuropathy that presented as dental pain and was later diagnosed with Lyme disease. A healthy female patient presented to the endodontist with toothache symptoms. Her symptoms included intense pain in the left mandible irradiating into the temporalis area and through her neck and tingling on the lower left lip and left side of her tongue.

Resistance to fracture of extracted teeth used for pre-clinical endodontic procedures: Influence of storage conditions.

Objectives: The purpose of this in vitro study was to determine whether different storage conditions used during endodontic procedures affect the fracture resistance of extracted teeth used for pre-clinical dental education.

Methods: Freshly extracted mandibular incisors and canines were sterilised in an autoclave for 40 minutes at 24°F under a pressure of 20 psi and then stored in distilled water at 4°C until use. Specimens were randomly assigned to two groups based on the storage method used whilst undergoing endodontic procedures.

Biomaterials and Scaffold Design Strategies for Regenerative Endodontic Therapy.

Challenges with traditional endodontic treatment for immature permanent teeth exhibiting pulp necrosis have prompted interest in tissue engineering approaches to regenerate the pulp-dentin complex and allow root development to continue. These procedures are known as regenerative endodontic therapies. A fundamental component of the regenerative endodontic process is the presence of a scaffold for stem cells from the apical papilla to adhere to, multiply and differentiate.

Effect of Different Disinfection/Sterilization Methods on Risk of Fracture of Teeth Used in Preclinical Dental Education.

The aim of this in vitro study was to determine whether different disinfection/sterilization methods affected the risk of fracture of extracted teeth used for preclinical dental education. Freshly extracted intact mandibular incisors were assigned to different groups according to the processing method used. In the autoclave group (n=20), teeth were autoclaved for 40 min at 240°F under a pressure of 20 psi; in the formalin group (n=20), teeth were immersed in 10% formalin for two weeks; and in the control group (n=10), teeth were not processed.

Effects of diode laser irradiation and fibroblast growth factor on periodontal healing of replanted teeth after extended extra-oral dry time.

Aim: The search for effective protocols to reduce the incidence of root resorption and allow periodontal ligament repair is still challenging, given the unpredictable outcome of late tooth replantation. The aim of this study was to assess the effects of both high-power diode laser irradiation (DL) and basic fibroblast growth factor (FGF) on the periodontal healing of replanted teeth after extended extra-oral dry time.

Methods: Maxillary incisors of 50 male rats were extracted and assigned to three experimental and two control groups (n = 10).

Assessing the Impact of Voice-Over Screen-Captured Presentations Delivered Online on Dental Students' Learning.

The traditional lecturing method is still one of the most common forms of delivering content to students in dental education, but innovative learning technologies have the potential to improve the effectiveness and quality of teaching dental students. What challenges instructors is the extent to which these learning tools have a direct impact on student learning outcomes. The aim of this study was to assess the impact of a voice-over screen-captured learning tool by identifying a positive, nil, or negative impact on student learning as well as student engagement (affective, behavioral, and cognitive) when compared to the traditional face-to-face lecture.

Glide Path Management with Single- and Multiple-instrument Rotary Systems in Curved Canals: A Micro-Computed Tomographic Study.

Introduction: Securing a reproducible glide path before instrumentation is recommended to maintain the original geometry of the root canal system and to prevent file separation. Mechanical glide path management systems have been introduced to expedite this step. The aim of this study was to compare apical transportation, canal volume increase, and working time during glide path management with ProGlider (PG; Dentsply Tulsa Dental Specialties, Tulsa, OK) and PathFiles (PF, Dentsply Tulsa Dental Specialties).

Use of electronic apex locators may improve determination of working length.

Data Sources: PubMed, LILACS, Science Direct, Cochrane Collaboration, NHS Evidence databases and in Evidence Based Dentistry and Journal of Evidence-Based Dental Practice.

Study Selection: Randomised controlled trials (RCTs), clinical trials (CTs), diagnostic comparative studies and evaluation studies undertaken in adults where working length determination by both electronic and radiographic methods were used were considered.

Data Extraction And Synthesis: Two reviewers independently assessed study quality.

Unilateral fusion of a supernumerary tooth to a maxillary permanent lateral incisor: a report of a rare case.

A supernumerary tooth is an additional entity to the normal series of teeth that may occur in isolation or may be fused to a normal counterpart. Diagnosis and delineation of an accurate treatment plan in cases involving supernumerary teeth are often a challenge. This report describes a case of unilateral fusion of a supernumerary tooth to a maxillary permanent lateral incisor in which a conservative approach was used to reach a favorable outcome.

Apical extrusion of debris in flat-oval root canals after using different instrumentation systems.

Introduction: The purpose of this study was to evaluate the amount of apically extruded debris in flat-oval root canal systems during cleaning and shaping with different instrumentation systems.

Methods: Seventy-two mandibular incisors were randomly assigned to 4 groups (n = 18) according to the instrumentation system to be used: the ProTaper Next rotary system (PTN; Dentsply Tulsa Dental, Tulsa, OK), the WaveOne reciprocating system (WO, Dentsply Tulsa Dental), the Twisted File Adaptive (TFA; SybronEndo, Orange, CA) rotary/reciprocating system, and the Self-Adjusting File (SAF) system (ReDent-Nova, Ra'anana, Israel). Debris extruded during the instrumentation was collected and dried in preweighed Eppendorf tubes.

Assessment of smear layer removal protocols in curved root canals.

This study sought to assess if the final rinse protocol interferes with the smear layer removal in the apical area of curved canals. Sixty-four extracted human mandibular molars with curved mesial roots were instrumented with rotary files and divided into six experimental groups for final rinse: 1EDTA (syringe irrigation with 1 mL of 17% ethylenediaminetetraacetic acid (EDTA) ), 5EDTA (syringe irrigation with 5 mL of 17% EDTA), 1EDTA-P (syringe irrigation with 1 mL of 17% EDTA + pumping with gutta-percha point), 5EDTA-P (syringe irrigation with 5 mL of 17% EDTA + pumping with gutta-percha point), 1EDTA-EA (syringe irrigation with 1 mL of 17% EDTA + EndoActivator) and 5EDTA-EA (syringe irrigation with 5 mL of 17% EDTA + EndoActivator). Final rinsing was carried out over 3 min.

Tooth discoloration induced by endodontic phenothiazine dyes in photodynamic therapy.

Objective: This study sought to assess if discoloration of tooth structures occurs after photodynamic therapy (PDT) and to determine the efficacy of a protocol to remove the photosensitizers.

Background Data: PDT has been used in root canal treatment to enhance cleaning and disinfection of the root canal system. PDT uses a low power laser in association with a dye as a photosensitizer.

Influence of single-file endodontics on apical transportation in curved root canals: an ex vivo micro-computed tomographic study.

Introduction: More information regarding the ability of single files to maintain the original canal position is required before adopting a single-file approach to cleaning and shaping. This study compares apical transportation in curved root canals when instrumenting with a single WaveOne (WO) file (Dentsply Tulsa Dental Specialties, Tulsa, OK) in a reciprocating motion with that incurred when using a sequence of Twisted Files (TFs; SybronEndo, Orange, CA) in a continuous rotating motion.

Methods: Forty mesial canals of mandibular molars were evenly allocated into 2 balanced groups (n = 20) with a 17-mm average canal length and 20° average curvature.

Effectiveness of photodynamic therapy against Enterococcus faecalis, with and without the use of an intracanal optical fiber: an in vitro study.

Background And Objective: Photodynamic therapy (PDT) is a new technique introduced in endodontics that combines the action of a photosensitizer (dye) and a low intensity light source. Currently, there are no PDT studies evaluating the microbial disinfection of root canals in order to compare the effects of light delivery systems in the photosensitizer activation. The aim of this study was to evaluate the PDT effectiveness in reducing Enterococcus faecalis, with and without the aid of an intracanal optical fiber.

Effect of chemical substances in removing methylene blue after photodynamic therapy in root canal treatment.

Background And Objective: The disadvantage of photodynamic therapy (PDT) is in the photosensitizing agents that may stain the tooth structure. There is no register of PDT studies evaluating protocols to minimize that concern. The present study evaluated the efficiency of chemical adjuncts in methylene blue dye (MB) removal after PDT.

Influence of final rinse technique on ability of ethylenediaminetetraacetic acid of removing smear layer.

Introduction: There is ongoing debate regarding the ideal sequence, volume, and concentration of irrigants, length of time for irrigation, and irrigation technique to achieve debridement of the root canal system. The aim of this study was to verify the impact of the final rinse technique on smear layer removal ability of 17% ethylenediaminetetraacetic acid (EDTA).

Methods: Sixteen single-rooted human teeth were instrumented and divided into 2 groups at the final rinse step according to the following final rinse techniques used: continuous rinse group, continuous rinse with EDTA during 3 minutes, and rinse and soaking group, rinse with 1 mL of EDTA, soaking of the canal for 2 minutes and 30 seconds, and rinse completion with the remaining 4 mL for 30 seconds.

Attachment of cultured fibroblasts and ultrastructural analysis of simulated cervical resorptions treated with high-power lasers and MTA.

Objective: The present study evaluated the fibroblast attachment and the morphologic changes of simulated cervical root resorptions after irradiation with high-power lasers and the use of mineral trioxide aggregate (MTA).

Study Design: Standardized cavities were done on the coronal third of 40 single-rooted teeth and assigned into 4 groups according to the treatment applied: (1) untreated control, (2) use of MTA, (3) irradiation with Er:YAG laser (42 mJ, 10 Hz, 10 s), and (4) irradiation with high-power diode laser (1 W, 10 s). Fragments were prepared for SEM analysis: 6 samples of each group were plated with human gingival fibroblasts and 4 samples were used for ultrastructural analysis.

Treatment options for teeth with open apices and apical periodontitis.

Three clinical cases involving teeth with open apices and apical periodontitis were treated using different protocols. The first case was managed with intracanal calcium hydroxide paste for 12 months before obturation with gutta-percha and sealer. In the second case, an apical plug of mineral trioxide aggregate (MTA) was used before obturation with gutta-percha and sealer and treatment was completed during 2 appointments.

Does a final rinse to remove smear layer interfere on dentin permeability of root canals?

Objective: The objective of this study was to assess the influence of different final irrigating solutions on dentin permeability and smear layer removal using the same specimens and relate the results obtained.

Study Design: Forty anterior human teeth were instrumented and divided into 4 groups (n = 10) at the final rinse step, according to the irrigant used: G I (control) - 1% NaOCl; G II - 17% EDTA; G III - 17% EDTAT; and G IV - Biopure MTAD. The canals were filled with 0.

Quasispecies of hepatitis C virus genotype 1 and treatment outcome with peginterferon and ribavirin.

The majority of patients with chronic hepatitis C fail to respond to antiviral therapy. The genetic basis of this resistance is unknown. The quasispecies nature of HCV may have an important implication concerning viral persistence and response to therapy.

Coronal and apical leakage analysis of two different root canal obturation systems.

This study compared the coronal and apical leakage of AH Plus with gutta-percha to that of Epiphany with Resilon. Twenty-four single rooted teeth were instrumented and divided into 2 groups according to the solutions for smear layer removal and the obturation materials employed: Group A - 17% EDTA-T and AH Plus with gutta-percha; Group B - primer and Epiphany with Resilon. The Group B specimens were light-cured in the coronal area for 20 s.

Influence of different volumes of EDTA for final rinse on smear layer removal.

Objective: The aim of this study was to analyze the influence of different volumes of 17% EDTA for final rinse on smear layer removal on the different areas of the root canal.

Study Design: Forty single-rooted teeth were instrumented using rotary instruments. The teeth were divided into 3 test groups according to the EDTA volume for final rinse (5 mL, 10 mL, 15 mL) and 1 control group (10 mL of 1% sodium hypochlorite).