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1.

Introduction

This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) instrument systems in the mesial canals of mandibular molars using micro–computed tomographic (micro-CT) imaging.

Methods

A total of 17 type IV mesial roots of extracted first mandibular molars were scanned using micro-CT imaging before and after root canal preparation with the 2 instrument systems. Both systems were used in the same root but alternating the mesial canals from root to root. The following parameters were analyzed: root canal volume, surface area, unprepared surface areas, transportation, canal/root width ratio, and preparation time.

Results

There were no statistically significant differences between the 2 systems for all evaluated parameters (P > .05). The unprepared surface areas for the full canal length and the apical 5-mm segment were 33% and 14% for BT-RaCe and 31% and 14% for ProTaper Next, respectively. After preparation, all root canals had a diameter that was not larger than 35% of the root diameter at the coronal and middle segments.

Conclusions

The 2 systems showed no differences in any of the evaluated shaping parameters. None of the tested systems put the roots at risk of fracture because of excessive dentin removal.  相似文献   

2.

Introduction

The aim of this study was to investigate the sequelae of direct pulp capping (DPC) using mineral trioxide aggregate (MTA) and Biodentine in mature permanent teeth with carious exposure.

Methods

Clinical records of 30 patients (15 each with MTA and Biodentine) treated with DPC technique from January 2015 to June 2015 were retrieved. Success rates (based on symptoms, sensibility tests, and radiographic analysis) and adverse events were analyzed.

Results

The patients were reviewed at 1, 3, 6, 12, and 18 months after treatment. Four cases (2 each of MTA and Biodentine) were lost to follow-up. MTA and Biodentine groups showed success rates of 84.6% and 92.3%, respectively, with overall success rate of 88.5%. Radiographically visible dentin bridge formation was observed in 69.2% (9/13) and 61.5% (8/13) of cases done with MTA and Biodentine, respectively. The cases done with MTA showed coronal discoloration on review. Diffuse calcifications of the pulp chamber were observed in 1 (7.7%) case done with MTA and 3 (23.1%) cases done with Biodentine.

Conclusions

The advent of bioceramic materials with better biocompatibility and sealing properties can make the outcome of DPC technique in mature permanent teeth with carious exposure more predictable. The success rate observed in this study should be confirmed through randomized controlled trials with long follow-up periods. Effects of adverse events like coronal discoloration and calcifications of the pulp chamber also need to be evaluated.  相似文献   

3.

Introduction

The present study evaluated the cleaning and shaping ability of 3 instrumentation systems in oval canals of extracted vital teeth using a correlative analytic approach.

Methods

Oval distal canals from 33 freshly extracted mandibular molars with pulp vitality were scanned by micro–computed tomographic (micro-CT) imaging for sample selection. Specimens matched by anatomic similarities were distributed into 3 experimental groups according to the instrument system to be evaluated: the Self-Adjusting File (SAF; ReDentNOVA, Ra'anana, Israel), TRUShape (Dentsply Sirona, Tulsa, OK), and XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The irrigant was 5.25% sodium hypochlorite heated at 37°C. After rescanning with micro-CT imaging, the unprepared surface areas were identified, measured, and then histologically evaluated for the amount of pulp remnants in each root third.

Results

When the apical 4-mm canal segment was evaluated, the SAF exhibited significantly less unprepared areas than the XP-endo Shaper (P < .05), and there were no significant differences for the other comparisons (P > .05). Analysis of the full canal length showed no statistically significant differences between the 3 tested systems (P > .05). Likewise, the tested systems did not differ significantly in cleaning the unprepared walls (P > .05).

Conclusions

There was no significant difference in the amount of unprepared surface areas between the 3 instrument systems, except for the comparison between the SAF and XP-endo Shaper in the apical 4-mm segment. None of them prepared 100% of the root canal walls. The cleaning ability of the 3 systems was similar.  相似文献   

4.

Introduction

This study compared the effects of different mixing and placement techniques on sealing of ProRoot MTA (Dentsply Maillefer, Ballaigues, Switzerland) and MTA Angelus (Soluçoes Odontologicas, Londrina, Brazil) apical plugs using micro–computed tomographic (micro-CT) imaging.

Methods

Standardized divergent open apex models were created using 120 extracted maxillary incisors and divided into 8 groups (n = 15). ProRoot MTA and MTA Angelus were mixed manually or mechanically and introduced to form apical plugs by hand condensation or indirect ultrasonic activation for 10 seconds. The samples were scanned using micro-CT imaging, and volumetric analysis of the voids between the dentin walls and the apical plugs and the porosity inside MTA was performed.

Results

Irrespective of the mixing and placement techniques used, the voids between the dentin walls and the apical plugs in the MTA Angelus groups were greater than those in the ProRoot MTA groups (P < .05). The mechanically mixed groups were significantly less porous than the manually mixed groups (P < .05). Combined mechanical mixing and indirect ultrasonic activation yielded a less porous structure for both types of MTA than combined manual mixing and hand condensation (P < .05). Marginal adaptation for ProRoot MTA, both mixed and placed manually, was greater than for MTA Angelus (P < .05), but no difference was found when indirect ultrasonic activation was performed (P > .05).

Conclusions

ProRoot MTA showed better marginal adaptation than MTA Angelus. Mechanically mixed products had better handling characteristics than the manually mixed product. Indirect ultrasonic activation did improve the adaptation of manually mixed MTA Angelus to the dentin walls.  相似文献   

5.

Introduction

This prospective randomized controlled study evaluated the clinical and radiographic outcome of endodontic microsurgery when using iRoot BP Plus Root Repair Material (BP-RRM; Innovative BioCeramix Inc, Vancouver, BC, Canada) or mineral trioxide aggregate (MTA) as the retrograde filling material and analyzed the relationship between some potential prognostic factors and the outcome of the surgery.

Methods

By using strict inclusion and exclusion criteria, 240 teeth were successfully enrolled and randomly and equally allocated to either the MTA or BP-RRM treatment group. A standardized surgical procedure was performed by a single operator. The patients were followed up at 1 week, 3 months, 6 months, and 12 months; follow-up included clinical and radiographic examination. Clinical and radiographic evaluations acquired at the 12-month follow-up were taken as the primary outcome. For the identification of prognostic factors, the dichotomous outcome (success vs failure) was taken as the dependent variable.

Results

A total of 158 teeth were analyzed at the 12-month follow-up, including 87 teeth in the MTA group and 71 teeth in the BP-RRM group. The success rate in the MTA and BP-RRM groups was 93.1% (81/87 teeth) and 94.4% (67/71 teeth), respectively (P > .05). Three significant outcome predictors were identified: quality of root filling (P < .05), tooth type (P < .05), and size of the lesion (P < .05)

Conclusions

These results suggest that BP-RRM is comparable with MTA in clinical outcome when used as root-end filling materials in endodontic microsurgery.  相似文献   

6.

Introduction

Questions exist regarding the efficacy of resin-containing materials such as TheraCal directly applied on the pulp. This study sought to investigate the clinical efficacy of TheraCal as compared with Biodentine and ProRoot mineral trioxide aggregate (MTA) for partial pulpotomy.

Methods

In this clinical trial, partial pulpotomy was performed for 27 sound human maxillary and mandibular third molars scheduled for extraction. The teeth were randomly divided into 3 groups (n = 9) and underwent partial pulpotomy with TheraCal, Biodentine, and ProRoot MTA. The teeth were then restored with glass ionomer cement. Clinical and electric pulp tests were performed after 1 and 8 weeks. The teeth were radiographed and extracted at 8 weeks. Histologic sections were prepared and analyzed for pulp inflammation and dentinal bridge formation. Data were analyzed by using one-way analysis of variance.

Results

Clinical examination showed no sensitivity to heat, cold, or palpation in ProRoot MTA and Biodentine groups. Two patients in TheraCal group (20%) reported significant pain at 1 week. Periapical radiographs showed no periapical pathology, and electric pulp test revealed a normal pulp response with no hypersensitivity. Inflammation was absent with all materials at 8 weeks. Normal pulp organization was seen in 33.33% of the teeth in ProRoot MTA, 11.11% in TheraCal, and 66.67% in Biodentine group (P = .06). Biodentine group showed complete dentinal bridge formation in all teeth, whereas this rate was 11% and 56% in TheraCal and ProRoot MTA groups, respectively (P = .001).

Conclusions

Overall, Biodentine and MTA performed better than TheraCal when used as partial pulpotomy agent and presented the best clinical outcomes.  相似文献   

7.

Introduction

The purpose of this study was to compare different high-resolution cone-beam computed tomographic (CBCT) imaging protocols in the diagnosis of incomplete root fractures of endodontically treated teeth.

Methods

Twenty single-rooted human teeth were endodontically treated, and an incomplete root fracture was induced. The teeth were scanned with the CBCT unit PreXion 3D (Teracom, San Mateo, CA) operating at 2 different protocols: high resolution/standard (HI-STD) (19 seconds and 512 basis images) and high resolution/high density (HI-HI) (37 seconds and 1024 basis images). Three oral radiologists evaluated all images using multiplanar reconstructions. The diagnostic tests and the receiver operating characteristic (ROC) curve were calculated.

Results

The HI-STD and HI-HI protocols presented an accuracy of 0.90 and 0.93, respectively, and both protocols had a sensitivity of 0.97. The HI-HI protocol showed a higher positive predictive value and slightly higher areas under the ROC curve.

Conclusions

Both high-resolution imaging protocols presented high accuracy in the detection of incomplete root fracture of endodontically teeth. Thus, the HI-STD protocol should be indicated this reduces the radiation dose.  相似文献   

8.

Statement of problem

The clinical challenge of adhering cement to intracanal dentin is transmitting light to the most apical parts of root canals to allow more efficient polymerization of the cement.

Purpose

The purpose of this in vitro study was to compare the cement-polymerizing ability, microstructure, and radiopacity of a new fiber optic post (iLumi fiber optic Post) with a clinically successful fiber post (DT Light Post).

Material and methods

Polymerizing ability was compared using a modified depth-of-polymerization protocol. A split aluminum mold with a 12-mm cylindrical hole (diameter=4.7 mm) was filled with light-polymerized resin cement (Variolink Esthetic LC). Each fiber post (n=12) was positioned and light-polymerized on the coronal end for 60 seconds with a light-emitting diode polymerization light. Unpolymerized resin was dissolved with an organic solvent, and the weight and length of the polymerized resin cement were measured. Scanning electron microscopy was used to examine vertical and horizontal cross-sections. The radiopacity values of both the posts and 5 additional reference posts were evaluated using an aluminum step wedge.

Results

The weight and length of the polymerized resin cement were significantly greater (P<.05) with the fiber optic post, which scanning electron microscopy showed to have a higher density of parallel fibers. The iLumi post demonstrated greater radiopacity among the tested fiber posts and a titanium alloy post.

Conclusions

The iLumi fiber optic posts have a unique structural fiber composition and excellent radiopacity and light-transmitting ability that produce more complete polymerization of the resin cement than the DT Light posts.  相似文献   

9.

Introduction

This study aimed to analyze the chemical-physical properties, including pH, volumetric change, radiopacity, and apatite-forming ability in simulated body fluid, of a new tricalcium silicate material (MTA Flow; Ultradent Products Inc, South Jordan, UT).

Methods

MTA Flow was tested in comparison with MTA Angelus (Angelus, Londrina, PR, Brazil). The pH of soaking water was tested up to 168 hours in deionized water. In the solubility test, the root-end fillings of 20 acrylic teeth were scanned twice by micro–computed tomographic imaging before and after immersion in ultrapure water for 168 hours. In addition, using an aluminum step wedge, the radiopacity of each material was evaluated as recommended by international standards. The mean gray values of the test materials were measured using ImageJ software (National Institutes of Health, Bethesda, MD). The morphologic and chemical analyses of the material surface were performed using scanning electron microscopic energy-dispersive X-ray spectroscopic analysis after 28 days in Hank’s balanced salt solution (HBSS). The data were analyzed using 2-way analysis of variance with the Student-Newman-Keuls test (P < .05).

Results

MTA Flow showed similar alkalizing activity to that of MTA Angelus. In the solubility test, both materials presented lower values without statistical differences. Both materials showed a marked alkalinizing activity within 3 hours, which continued for 168 hours. MTA Angelus showed statistically higher radiopacity values (P < .05). All materials showed the ability to nucleate calcium phosphate on their surface after 28 days in HBSS.

Conclusions

MTA Flow showed remarkable alkalinizing capability, low solubility, good radiopacity, and the ability to form calcium phosphate deposits after being soaked in simulated body fluid, showing values similar to those of MTA Angelus.  相似文献   

10.

Introduction

Recently, different rotary glide path systems have been introduced. The aim of this study was to compare the centering ability of different rotary pathfinding systems and their effect on the final preparation by Hyflex CM files.

Methods

Sixty endodontic training blocks with J-shaped canals were divided into 3 groups according to the pathfinding system used. Instrumentation was done with G-File + Hyflex CM (G-File group), PathFile + Hyflex CM (PathFile group), and Hyflex GPF + Hyflex CM (GPF group). Three images were taken: initial, after glide path preparation, and after final instrumentation. Pre-instrumentation and post-instrumentation images were superimposed, and centering ratio along the J-shaped canal was measured to evaluate the occurrence of deviation. Statistical analysis of the data was performed by using one-way analysis of variance, followed by Tukey test (α = 0.05).

Results

The ability of instruments to remain centered in canals at 0-mm level (apex) was significantly lower in PathFile group (P < .05). No significant difference was found at other levels. After final preparation by Hyflex CM no significant difference was found at any level.

Conclusions

The centering abilities of Hyflex GPF and G-Files are better than that of PathFile at apex, but it has no significant effect on final preparation by Hyflex CM.  相似文献   

11.

Introduction

This study evaluated how exposing the novel calcium silicate nanoparticulate bioceramic iRoot BP Plus (Innovative Bioceramix, Vancouver, Canada) to an acidic environment affects ion release from this material and alters MC3T3-E1 preosteoblast viability on and attachment to this material. These factors were compared against those of ProRoot MTA under similar conditions.

Methods

Each material was exposed to phosphate-buffered saline (pH = 7.4) or butyric acid (pH = 5.4) for 5 days. Trace metal elements within the 2 materials and released ions were identified using inductively coupled plasma optical emission spectroscopy. The microstructures and elemental compositions of MTA and iRoot BP Plus after treatment with butyric acid were determined using scanning electron microscopy with an energy-dispersive X-ray spectrometer. Furthermore, the viability of MC3T3-E1 cells on and their levels of attachment to the materials after the butyric acid treatment were compared.

Results

iRoot BP Plus contained fewer toxic metal elements than MTA. Under acidic conditions, both materials displayed similar ion release abilities, with increased release of Si and Ca ions. Substantial changes in microstructure, including reduced apatite formation, were observed for both materials after exposure to acidic pH. Furthermore, exposing iRoot BP Plus and MTA to an acidic environment increased and decreased MC3T3-E1 cell viability on these materials, respectively. MC3T3-E1 cell attachment to both materials was not significantly affected by acidic pH.

Conclusions

iRoot BP Plus seems more biologically appropriate for application in an inflamed acidic environment than ProRoot MTA.  相似文献   

12.

Statement of problem

How tooth preparation and material type affect the stress distribution of endodontically treated teeth restored with endocrowns remains unclear.

Purpose

The purpose of this finite element (FE) study was to determine the influence of the quantity of remaining dental tissues and material type on stress distribution in endodontically treated maxillary premolars using 3-dimensional FE analysis.

Material and methods

Five 3-dimensional FE models were constructed on the basis of the restorative methods used and the quantity of preserved tooth tissues: a sound maxillary premolar, an endodontically treated maxillary premolar restored with composite resin, and endodontically treated maxillary premolars restored with endocrowns with thicknesses of 1.0 mm, 2.0 mm, and 3.0 mm. The following endocrown materials were used: Paradigm MZ100, IPS Empress, IPS e.max CAD, and In-Ceram Zirconia. Stress distributions were analyzed under vertical and oblique loads.

Results

As the quantity of preserved dental tissues increased, the von Mises stress in dentin decreased, and the peak von Mises strain value of the cement layer increased. When the elastic modulus of the endocrown material increased, the von Mises stress in endocrown and dentin increased, and the peak von Mises strain value of the cement layer decreased.

Conclusions

Although the conservative preparation of teeth for endocrowns is likely to protect the residual tooth structure, it may cause future cohesive bonding failure. An increase in the elastic modulus of the material may benefit the durability of bonding between the endocrown and the abutment tooth; however, it may cause fracture of the residual tooth structure.  相似文献   

13.

Statement of problem

Reproducing the characteristics of natural teeth in ceramic crowns remains a complex and difficult process.

Purpose

The purpose of this in vitro study was to evaluate the effect of the substrate, cement, type, and thickness of the ceramic on the resulting color of a lithium disilicate ceramic.

Material and methods

Forty ceramic disks were prepared from IPS e.max Press LT (low translucency) and HO (high opacity) in 2 different thicknesses (1.5 and 2 mm). The LT groups were composed of monolithic ceramic disks, and the HO groups were composed of disks fabricated with a 0.5-mm thickness combined with a 1- or 1.5-mm veneering ceramic thickness. Disks made of composite resin (R) and alloy (A) were used as substrate structures. The resin cement used was Variolink II. Color was measured with a spectrophotometer and expressed in CIELAB coordinates. Color differences (ΔE) were calculated. The data were analyzed with ANOVA and the Tukey HSD test (α=.05).

Results

When the ΔE of ceramic disks with both substrates, with and without cement, were compared, the lowest value (3) was obtained for ceramic HO with a 2-mm thickness/alloy substrate/without cement; the highest value (10) was obtained for ceramic LT with a1.5-mm thickness/alloy substrate/with cement. This difference was statistically significant. When the effect of cement on the ΔE of ceramics in both substrates was compared, the lowest value (1.1) occurred with ceramic HO with a 1.5-mm thickness/resin substrate, and the highest was observed for ceramic LT with a 1.5-mm thickness/alloy substrate (6.4). This difference was statistically significant.

Conclusions

The substrate color, type and thickness of ceramic, and presence of the cement significantly influenced the resulting optical color. The ΔE values of cemented HO ceramics were lower than that of the LT ceramic.  相似文献   

14.

Introduction

The aim of the present study was to evaluate the frequency of dentinal microcracks observed after root canal preparation with HyFlex CM (Coltène/Whaledent, Altstätten, Switzerland), HyFlex EDM (Coltène/Whaledent), Vortex Blue (Dentsply Tulsa Dental Specialties, Tulsa, OK), and TRUShape (Dentsply Tulsa Dental Specialties) systems using micro–computed tomographic (micro-CT) analysis.

Methods

Forty human mandibular incisors with 1 and straight root canals were randomly assigned to 4 experimental groups (n = 10) and 1 control group for root canal preparation: group 1, HyFlex CM; group 2, HyFlex EDM; group 3, Vortex Blue; and group 4, TRUShape. The specimens were scanned using high-resolution micro-CT imaging before and after root canal preparation. Afterward, preoperative and postoperative cross-sectional images of the teeth were screened to identify the presence of dentinal defects. The number of microcracks was determined as a percentage for each group.

Results

Before and after canal preparation, 36,152 cross-sectional images were examined. Four thousand four hundred fifty-two (12.31%) dentinal defects were observed. No new microcracks were observed after root canal instrumentation with the tested systems.

Conclusions

Root canal preparation with the HyFlex CM, HyFlex EDM, Vortex Blue, and TRUShape systems did not induce the formation of new dentinal microcracks on straight root canals of mandibular incisors.  相似文献   

15.

Introduction

The purpose of the present study was to compare 2 modes of reciprocal movement (torque-sensitive and time-dependent reciprocal rotation) with continuous rotation in terms of torque and apical force generation during nickel-titanium rotary root canal instrumentation.

Methods

A custom-made automated root canal instrumentation and torque/force analyzing device was used to prepare simulated canals in resin blocks and monitor the torque and apical force generated in the blocks during preparation. Experimental groups (n = 7, each) consisted of (1) torque-sensitive reciprocal rotation with torque-sensitive vertical movement (group TqR), (2) time-dependent reciprocal rotation with time-dependent vertical movement (group TmR), and (3) continuous rotation with time-dependent vertical movement (group CR). The canals were instrumented with TF Adaptive SM1 and SM2 rotary files (SybronEndo, Orange, CA), and the torque and apical force were measured during instrumentation with SM2. The mean and maximum torque and apical force values were statistically analyzed using 1-way analysis of variance and the Tukey test (α = 0.05).

Results

The recordings showed intermittent increases of upward apical force and clockwise torque, indicating the generation and release of screw-in forces. The maximum upward apical force values in group TmR were significantly smaller than those in group CR (P < .05). The maximum torque values in clockwise and counterclockwise directions in groups TqR and TmR were significantly smaller than those in group CR (P < .05).

Conclusions

Under the present experimental conditions using TF Adaptive instruments, both torque-sensitive and time-dependent reciprocal rotation generated significantly lower maximum torque and may have advantages in reducing stress generation caused by screw-in forces when compared with continuous rotation.  相似文献   

16.

Background

The effectiveness of stainless steel crowns (SSCs) versus direct restorations when placed in primary mandibular molars (teeth nos. L and S) is uncertain. The authors evaluated effectiveness by gauging longevity of treatment.

Methods

The authors obtained private dental insurance claims (2004-2016) from a national dental data warehouse. Paid insurance claims records (n = 1,323,489) included type of treating dentist, treatment placed, and patient age.

Results

Dentist specialty, type of treatment, and patient age were significant in predicting failure after the first restoration. The authors found high survival rates for all treatments (> 90%) after 5 years; however, as soon as within 3 years after treatment, SCCs had approximately 6% better survival.

Conclusions

Teeth nos. L and S first treated with SSCs lasted longer without new treatment compared with teeth first treated with direct restorations; the difference was small. Teeth treated by pediatric dentists had better survival rates.

Practical Implications

Primary mandibular first molars initially treated with SSCs lasted longer without new treatment compared with direct restorations. Overall dental care costs of the former were considerably higher.  相似文献   

17.

Introduction

The aim of this study was to evaluate the effect of supplementary use of XP-endo Finisher file, passive ultrasonic activation (PUI), EndoActivator (EA), and CanalBrush (CB) on the removal of calcium hydroxide (CH) paste from simulated internal resorption cavities.

Methods

The root canals of 110 extracted single-rooted teeth with straight canals were prepared up to size 50. The specimens were split longitudinally, and standardized internal resorption cavities were prepared with burs. The cavities and root canals were filled with CH paste. The specimens were divided into 5 groups as follows: XP-endo Finisher, EA, PUI, CB, and syringe irrigation (SI). The root canals were irrigated with 5.25% NaOCl and 17% EDTA for 2 minutes, respectively. Apart from the SI group, both solutions were activated by using tested techniques for 1 minute. The quantity of CH remnants on resorption cavities was scored. Data were analyzed by using Kruskal-Wallis H and Mann-Whitney U tests.

Results

XP-endo Finisher and PUI removed significantly more CH than SI, EA, and CB (P < .05), showing no significant difference between them (P > .05). Differences among SI, EA, and CB were also non-significant (P > .05).

Conclusions

None of the tested techniques render the simulated internal resorption cavities free of CH debris. XP-endo Finisher and PUI were superior to SI, CB, and EA.  相似文献   

18.

Introduction

This is the first long-term randomized controlled trial to evaluate dentin-like glass fiber posts (GFPs) compared with rather rigid titanium posts (TPs) for post-endodontic restoration of severely damaged endodontically treated teeth with 2 or fewer remaining cavity walls.

Methods

Ninety-one subjects in need of post-endodontic restorations were randomly assigned to receive either a tapered GFP (n = 45) or TP (n = 46). Posts were adhesively luted by using self-adhesive resin cement, followed by composite core build-up and preparation of 2-mm ferrule design. Primary end point was loss of restoration for any reason. Kaplan-Meier curves were constructed, and log-rank test was calculated (P < .05).

Results

After a follow-up of 132 months, 17 GFP and 20 TP restorations survived, and 19 failed (12 GFP, 7 TP). Failure modes for GFP were root fracture (n = 4), core fracture (n = 1), secondary caries (n = 1), endodontic failure (n = 2), extraction because of tooth mobility grade III associated with insufficient design of removable partial denture (n = 1), tooth fracture (n = 1), and changes in treatment plan (n = 2); failure modes for TP were endodontic failure (n = 5), root fracture (n = 1), and 1 extraction for other reasons. Cumulative survival probability was 58.7% for GFP and 74.2% for TP.

Conclusions

When using self-adhesively luted prefabricated posts, resin composite core build-up, and 2-mm ferrule to reconstruct severely damaged endodontically treated teeth, tooth survival is not influenced by post rigidity. Survival decreased rapidly after 8 years of observation in both groups.  相似文献   

19.

Introduction

The aim of the study was to compare the outcomes of regenerative endodontic treatment (RET) and apexification on immature permanent teeth with pulp necrosis and apical periodontitis.

Methods

A total of 118 patients (118 teeth) were recruited and randomly assigned to either RET or apexification treatment. Each treatment group was divided into 2 subgroups according to the etiology: dens evaginatus or trauma. Clinical symptoms and complications were recorded, and cone-beam computed tomographic imaging with a limited field of view was used to measure the change of root length, root thickness, and apical foramen size at the 12-month follow-up. The t test/rank sum test and Fisher exact test were applied to compare the change of root morphology between RET and apexification.

Results

One hundred three of 118 cases were completed at the 12-month follow-up. The survival rate was 100% for both treatment groups. All cases were asymptomatic with apical healing. The RET group showed a significant increase in root length and root thickness compared with the apexification group (P < .05). In the RET group, the cases caused by dens evaginatus achieved increased root length and root thickness compared with those caused by trauma (P < .05).

Conclusions

RET and apexification achieved a comparable outcome in regard to the resolution of symptoms and apical healing. RET showed a better outcome than apexification regarding increased root thickness and root length. The etiology had an impact on the outcome of RET. Dens evaginatus cases showed better prognoses than trauma cases after RET.  相似文献   

20.

Background

Awake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations.

Methods

The authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment.

Results

The authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism.

Conclusions

Literature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism.

Practical Implications

Clinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities.  相似文献   

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