The era of minimally invasive dentistry has led to the development of new access cavity designs. The impact of various access cavity designs on the fracture resistance of teeth has been extensively studied. The primary aim of this systematic review and meta-analysis is to evaluate and compare the effects of recent modifications in endodontic access cavity design- specifically, conventional, conservative, and truss designs on tooth fracture resistance. Three independent reviewers searched studies across six different databases (PubMed, Scopus, EBSCOhost, BVS, Wiley, and Google Scholar) from January 2000 to July 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were then screened using strict inclusion and exclusion criteria. A quality assessment was performed using a modified version of the quality assessment of in-vitro studies according to the QUIN (Quality Assessment Tool For In Vitro Studies) tool, categorizing the selected articles into low, moderate, and high risk of bias. Quantitative data synthesis was conducted to combine equivalent results using STATA. Forest plots were created with the level of significance set at 0.05 (p = 0.05). Out of 243 articles, 14 met the strict inclusion criteria. Among the selected articles, 11 showed a low risk of bias and three showed a moderate risk. The meta-analysis revealed that fracture resistance of conservative and truss access designs is significantly higher than that of conventional endodontic access, with a standardized mean difference (SMD) of 2.61 (95% 1.47 to 3.74; p-values <0.001) and SMD = -1.26 (95% confidence interval (CI): -1.81 to 0-0.71; p<0.001). The heterogeneity (I²) values for these comparisons were 92% and 65.6%, respectively. The extent of the access cavity has a substantial impact on tooth fracture resistance. Newer conservative and truss endodontic access designs offer better fracture resistance compared to conventional endodontic access.
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http://dx.doi.org/10.7759/cureus.68796 | DOI Listing |
J Conserv Dent Endod
November 2024
Department of Prosthodontics, D. Y. Patil Dental School, Lohegaon, Pune, Maharashtra, India.
Aim: To evaluate the effect of applying a matrix metalloproteinase (MMP) inhibitor on the fracture resistance of root-filled teeth restored with Everstick fiber-reinforced composite resin.
Subjects And Methods: After the selection of 60 freshly extracted human mandibular first molar, root canal access and standard uniformly sized mesio-occluso-distal (MOD) cavities were made and the teeth were randomly assigned into three groups ( = 20 each): Group I, the MOD cavity was first lined with flowable composite resin and then restored with composite resin. In Group II, Everstick fiber was placed into the bed of flowable composite in buccal-pulpal-lingual direction before the composite restoration was placed.
Cureus
January 2025
Dental Public Health, University College London, London, GBR.
Minimally invasive dentistry (MID) has revolutionized pediatric dental care by emphasizing the preservation of healthy tooth structures, reducing treatment-related trauma, and improving patient compliance. This narrative review explores advancements in MID techniques, including silver diamine fluoride (SDF), resin infiltration, atraumatic restorative treatment (ART), bioactive materials, laser-assisted therapies, and three-dimensional (3D) printing technologies. These approaches prioritize early diagnosis, prevention, and conservative management, aligning with patient-centered and sustainable practices.
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December 2024
General and Family Medicine, Câmara de Lobos Health Center, Serviço de Saúde da Região Autónoma da Madeira, Entidade Pública Empresarial da Região Autónoma da Madeira (SESARAM, EPERAM), Câmara de Lobos, PRT.
Immune thrombocytopenic purpura (ITP) is an autoimmune condition characterized by a reduced platelet count due to enhanced peripheral destruction and impaired platelet production. While thrombocytopenia is a well-documented complication of various viral infections, cytomegalovirus (CMV), a member of the Herpesviridae family, is primarily associated with infections in immunocompromised patients and is rarely implicated in causing severe thrombocytopenia in immunocompetent patients. This article aims to highlight the importance of considering CMV as a significant etiological factor in ITP, particularly in cases of asymptomatic thrombocytopenia.
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December 2024
Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, JPN.
Objectives This study aimed to identify the etiology and the direction of dislocation of the natural crystalline lens or intraocular lens (IOL) in IOL intrascleral fixation surgery and to determine the change in intraocular pressure (IOP) after surgery. Methods We retrospectively investigated the diagnosis, direction of lens and IOL dislocation, and IOP before and after surgery (preoperatively and one day, one week, and one month postoperatively) in 236 eyes from 228 patients who underwent IOL intrascleral fixation at Chiba University Hospital between February 2015 and September 2020. Results IOL intrascleral fixation was performed in 48 (20.
View Article and Find Full Text PDFCancer Causes Control
January 2025
Office of Biostatistics & Data Science, University of Texas Medical Branch, Galveston, TX, 77555, USA.
Purpose: Oral cavity (OC) and oropharyngeal (OP) cancer rates have increased annually rising in the U.S. and Texas.
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