Prognostic factors of single‐visit endodontic and restorative treatment under general anaesthesia for special needs patients

The aim of this study was to evaluate the longevity of teeth with single‐visit endodontic and restorative treatment under general anaesthesia (GA) for special needs patients and to investigate factors associated with survival and success. Data were collected from 381 teeth in 203 patients [mean (s.d.) age = 27·0 (14·1)]. All endodontic and restorative procedures were performed during a single GA session except for cementation of crowns in the cases requiring crown restoration (38%). A total of 267 teeth (70·6%) were followed‐up for 6–81 months [mean (s.d.): 32·7 (20·0)]. Patients and teeth with and without follow‐up were compared. Kaplan–Meier analysis with generalised Wilcoxon test was used to compare the mean survival and success period. Cox proportion hazard regression model was applied for multivariate analysis. At the end of the observation period, 10 teeth had a crown fracture (5‐year survival rate = 89·8%), and an additional 10 teeth had primary or secondary caries (5‐year success rate = 86·4%). Risk factors associated with survival were age (>40), non‐parental caregiver, cooperation level and periodontal disease. A soft diet was an additional risk factor against the success of teeth. Single‐visit endodontic and restorative treatment under GA showed favourable outcomes, suggesting a promising treatment option for special needs patients. Patient‐ and dental‐specific circumstances need to be carefully considered to enhance the longevity of reconstructed teeth.     

Minimal intervention dentistry for managing dental caries – a review

This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non‐restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow‐up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing.     

乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察

目的乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察。方法 2013年7月至2015年12月于本院就医的乳磨牙龋的患儿78例,所有患儿均通过入院前确诊,满足乳磨牙龋诊断标准,然后按照随机数字表法分为观察组与对照组,各组均为39例,其中观察组采用预成冠方法进行修复,而对照组以复合树脂进行修复,两组患儿均为同一位医生完成治疗,统计各组的总体治疗成功率。结果本研究半年内两组患儿随访临床治疗评估(每月1次)显示,观察组患儿在治疗后3个月、6个月的总有效率分别为97.43%、94.87%,均高于对照组的89.74%、84.61%,以上组间差异显著,具有统计学意义(P0.05);对于乳牙功能的行使保存,预成冠成功率要远远高于树脂修复成功率,预成冠保存乳牙继续行使咀嚼功能疗效较树脂修复显著,以上两组的组间数据对比存在明显差异,具有统计学意义(P0.05)。结论对于乳磨牙龋修复而言,运用预成冠修复方法无论在成功率、咀嚼功能疗效均高于树脂修复效果,具有临床推广意义。     

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??The dentogingival complex damages of anterior teeth with biological width infringed by unfitting restorations set difficult problems for both the restorative dentists and the periodontal dentists. Periodontal treatment??crowns restored again??is not the right concept of restorative dentistry. Outcomes of periodontal surgery can be more predictable and effective based on esthetics. Meanwhile??a constant challenge for clinicians and technicians come out accordingly. In this study??therapeutic principle and operative procedure was summarized by combined scientific literature and the experience of our team.     

The relationship between various parameters of complete denture quality and patients’ satisfaction

BackgroundPatients’ appreciation of their conventional complete dentures might be affected by the quality of the dentures.MethodsA random sample of 33 edentulous patients who were rehabilitated by means of conventional complete dentures participated in the study. Three independent investigators who underwent technique calibration evaluated the dentures on the basis of seven clinical criteria by using a validated examination form. The patients filled out a validated denture satisfaction scale. The author used Pearson product-moment correlation and analysis of covariance to identify possible correlations.ResultsThe study results showed that most patients were between “reasonably satisfied” and “very satisfied” with their dentures. The author found nominally higher satisfaction among those receiving both mandibular and maxillary dentures and significant positive correlations between the overall denture satisfaction score and the stability of the mandibular denture (P = .039) and retention of the mandibular denture (P = .005). In contrast, esthetic lip support and lower lip line, occlusion, and maxillary stability and retention were not correlated with participants’ overall satisfaction level (P > .064).ConclusionsThe results of this study show that a clinically stable mandibular denture was the most important determinant of patients’ satisfaction.Practical ImplicationsThe study findings highlight the most important denture quality parameters that can aid clinicians in meeting their patients’ expectations.     

Complex endodontic and conservative treatment of a traumatized central incisor

ObjectivesThe functional recovery of a tooth with open-apex already endodontically treated is possible thanks to the materials, such as the MTA, able to produce an effective seal of the apex which can induce a restitutio-ad-integrum. A direct composite resin restoration may then provide a coronal seal immediate and effective in time, able to ensure a complete healing of the endodontic pathology.Materials and methodsThe hereby-clinical case describes a combined approach (endodontic and conservative) for the aesthetic-functional recovery of a severely fractured upper incisor of a child of 11 years.Results and conclusionsAt the control visit, after 12 months from the completion of the coronal restoration, a complete healing of periradicular bone tissue is observed through Rx. Clinical examination showed gingival tissue without inflammation and the probing depth is not increased, despite the presence of a cavity margin placed below the gingival margin.     

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??Root canal therapy is the general treatment for endodontic and periapical disease. However??the failure of the therapy still exists. Then root canal retreatment becomes an effective way to increase the conservation rate of those teeth. The aim of retreatment is to eliminate the infected site. The success rate of retreatment is related to many kinds of factors. With the development of implant technology and endodontic surgery??the indications of retreatment have changed. Besides??Niti instruments??ultrasonic and laser technology have improved the efficiency of the retreatment.