A novel LED-based device for occlusal caries detection

The aim of this in-vitro study was to compare the performance of laser-based (DIAGNOdent, KaVo, Biberach, Germany) and LED-based (Midwest Caries I.D., DENTSPLY Professional, New York, USA) caries detectors in the detection of occlusal caries in permanent molars. The study consisted of 129 visually sound or non-cavitated pits or fissures in 82 extracted permanent human molar teeth. Two trained examiners used the laser-based and LED-based caries detectors to examine the fissures for caries. The teeth were then sectioned at the surfaces suspected of containing occlusal caries and histologically evaluated using stereomicroscopy as a gold standard. Inter-examiner reliability of the caries detector examination was assessed using Cohen's Kappa statistics. The sensitivity, specificity, and accuracy in diagnosing occlusal caries using the two devices were calculated according to appropriate cut-off scores. Receiver operating characteristic (ROC) curves were also determined to compare the diagnostic performance of the devices in occlusal caries diagnosis. The cut-off level of significance was taken as p?=?0.005. Cohen's Kappa showed substantial agreement for the laser-based caries detector (0.74), and almost perfect agreement for the LED-based (0.89) caries detector. The specificity of the laser-based device varied from 0.49 to 0.97 at T1 and T2. Its sensitivity varied from 0.33 to 0.65 at T1 and T2. The specificity of the LED-based device varied from 0.48 to 0.56 at T1 and T2. Its sensitivity varied from 0.65 to 0.84 at T1 and from 0.80 to 0.84 at T2. Taking the limitations of the current study into consideration, the DIAGNOdent laser pen was more accurate in determining when teeth were free of occlusal caries than was the Midwest Caries I.D. LED-based device, although the Midwest Caries I.D. device more often revealed the presence of occlusal caries than did the DIAGNOdent pen.     

The influence of suture material on the strength of horizontal mattress suture configuration for meniscus repair

PurposeComparison of the mechanical characteristics of meniscal repair fixation using horizontal sutures and six different sutures under submaximal cyclic and load to failure test conditions may aid physicians in selecting a suture type.MethodsA 2-cm long anteroposterior vertical longitudinal incision was created in six groups of bovine medial menisci. Lesions were repaired using a No. 2 suture either composed of polyester or polyester and ultra high-molecular weight polyethylene (UHMWPE), or UHMWPE and polydioxanone or pure UHMWPE. Endpoints included ultimate failure load (N), pull-out stiffness (N/mm), pull-out displacement (mm), cyclic displacement (mm) after 100 cycles, after 500 cycles, and mode of failure.ResultsPolyester suture had lower ultimate load than all groups except the suture composed of polyester and UHMWPE (P < .05). Pure UHMWPE suture had higher ultimate failure load than sutures composed of either polyester or polyester plus UHMWPE (P < .05).Predominant failure mode was suture cutting through the meniscus for the groups except for polyester suture which failed by suture rupture.ConclusionUnder cyclic loading conditions in bovine meniscus, braided polyester suture fixation provided lower initial fixation strength than fixation with various high strength sutures composed of pure UHMWPE or a combination of absorbable monofilament polydioxanone and UHMWPE, except for combination of polyester and UHMWPE sutures.Clinical relevancePresent study does not support the usage of the braided polyester sutures instead of high strength sutures composed either partially or totally of ultra-high molecular weight polyethylene for the horizontal suture configuration of meniscus repair.     

In Vitro Fracture Resistance of Roots Obturated with Epoxy Resin–based,Mineral Trioxide Aggregate–based,and Bioceramic Root Canal Sealers

Introduction

The aim of this study was to evaluate the fracture resistance of teeth filled with 3 different endodontic sealers.

Methods

Seventy-five single-rooted extracted mandibular premolars were decoronated to a length of 13 mm. The teeth were randomly divided into 5 groups (n = 15 for each group). In group 1, the teeth were left unprepared and unfilled (negative control), and in group 2, the teeth were left unobturated (positive control). The rest of the roots were prepared by using the ProTaper System up to a master apical file size of F3: group 3, bioceramic sealer (Endosequence BC sealer) + gutta-percha; group 4, mineral trioxide aggregate–based sealer (Tech Biosealer Endo) + gutta-percha; and group 5, epoxy resin–based sealer (AH Plus Jet) + gutta-percha. All root specimens were stored for 2 weeks at 100% humidity to allow the complete setting of the sealers. Each specimen was then subjected to fracture testing by using a universal testing machine at a crosshead speed of 1.0 mm/min⁻¹ until the root fractured. The force required to fracture each specimen was recorded, and the data were analyzed statistically.

Results

The fracture values of groups 3 and 5 were significantly higher than those of group 4 (P < .05). There was no significant difference between groups 3 and 5 (P > .05).

Conclusions

In contrast to Tech Biosealer Endo, Endosequence BC and AH Plus Jet sealer increased the force to fracture in root-filled single-rooted premolar teeth.     

Late self-extraction of a traumatically displaced molar tooth from the maxillary sinus

An unusual case of late self-extraction of an impacted left maxillary third molar that was displaced into the left maxillary sinus after a traffic accident is described. The patient had been operated on for a maxillofacial trauma after a traffic accident in a plastic and reconstructive surgery department 18 years ago. He was admitted to our clinic 1? years ago for obstruction and periodically purulent drainage from the left side of the nose. A displaced tooth in the middle meatus was diagnosed, and the patient refused a surgical procedure to remove the tooth. The tooth was self-extracted from the nasal cavity 1 year later. One week after the extraction, the patient was mostly healed and had no complaints.     

The Comparison of the Effects of Ellagic Acid and Diclofenac Sodium on Intra-Abdominal Adhesion: An In Vivo Study in the Rat Model

Peritoneal adhesions are seen frequently after abdominal surgery and can cause serious complications. We aimed to evaluate the effects of the oral use of diclofenac sodium and ellagic acid on formation of postoperative adhesions in rats Studies have shown that agents with anti-inflammatory properties and antioxidant substances can prevent adhesion by decreasing oxidative stress. We compared and evaluated the effects of ellagic acid that has strong antioxidant and anti-inflammatory properties and the nonsteroidal anti-inflammatory diclofenac sodium on peritoneal adhesion development in our experimental study. Laparotomy was performed with a midline incision under general anesthesia and an adhesion model was created on the antimesenteric side of the cecum in Groups I, II, and III. Group I received 85 mg/kg ellagic acid and Group II, 50 mg/kg diclofenac sodium through the nasogastric catheter while Group III received no medication. Only laparotomy was performed in Group IV. The rats were sacrificed at the end of the 14th day. Following macroscopic scoring, tissue samples were removed and subjected to biochemical and histopathologic evaluation. The degree of adhesion and the malondialdehyde level were decreased (P < 0.05), and glutathione level increased (P < 0.05) in Group I compared to Group II and Group III. The effects of ellagic acid on the prevention of peritoneal adhesion were found to be stronger than diclofenac sodium. This can be explained by the fact that ellagic acid is a strong antioxidant and decreases oxidative stress with anti-inflammatory and anti-angiogenic effects.Key words: Ellagic acid, Diclofenac sodium, Intraabdominal adhesion, RatPeritoneal adhesions are fibrotic adhesions that are formed intra-abdominally on the visceral or peritoneal surface during the healing of peritoneal injury.^1,2 Adhesions often occur after laparotomy and are also a significant cause of postoperative morbidity.^3,4 Adhesions can be asymptomatic but can also lead to serious complications such as intestinal obstruction, perforation and fistula.^3–6Adhesion formation begins with mesothelial cell injury on the peritoneal membrane surface. An inflammatory process consisting of cellular elements of small venules and fibrin exudation, edema, and hyperemia begins in this region and a serous exudates develops.^5,7–9 Fibrous bands develop between fibrinous exudate and serosal surfaces, leading to formation of fibrinous bridges. Mesothelial cells produce plasminogen activator that dissolves fibrin clots, and the fibrinolytic system is engaged causing the fibrinous exudates to be rapidly resorbed. Adhesions are formed otherwise.^10–12DS (diclofenac sodium) is a nonsteroidal anti-inflammatory agent often used in clinical practice for postoperative analgesia and is known to have a fibrinolytic effect.^13,14 EA (ellagic acid) is a natural antioxidant reported to be present in walnuts, carrots, tomatoes, pomegranate, grape juice, grape wine, blueberries, blackberries, and strawberries in significant quantities.^15–18 EA is a phenolic acid derivative that inhibits lipid peroxidation in addition to its anti-inflammatory, antiproliferative, anti-angiogenic and anticarcinogenic effects.^16,17We aimed to evaluate the effects of the oral use of DS that has an anti-inflammatory effect and EA that has an antioxidant effect in addition to its anti-inflammatory effect on intra-abdominal adhesion development in comparison in the present study.     

The Effects of Mtwo,R-Endo,and D-RaCe Retreatment Instruments on the Incidence of Dentinal Defects during the Removal of Root Canal Filling Material

Introduction

The aim of this study was to compare the incidence of dentinal defects after retreatment procedures with different nickel-titanium rotary retreatment files.

Methods

One hundred-eighty mandibular premolars were randomly assigned to 6 groups (n = 30 teeth per group). One group was left unprepared, and the remaining 5 groups were prepared with K-files (Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and AH plus sealer (Dentsply Maillefer, Ballaigues, Switzerland). Of these 5 groups, 1 group was left filled and received no further treatments; in the other groups, removal of the filling material was performed with Mtwo R (VDW, Munich, Germany), D-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland), R-Endo instruments (Micro-Mega, Besançon, France), or Hedström files (Dentsply Maillefer). Roots were then sectioned 3, 6, and 9 mm from the apex and observed under a microscope. The presence of dentinal defects was noted. Chi-square tests were performed to compare the incidence of dentinal defects between the groups. A Pearson correlation test was performed to check the correlation between defects and root level or remaining dentin thickness.

Results

No defects were observed in the unprepared group. Dentinal defects were detected in all retreatment groups. Retreatment groups showed significantly more defects than the filled but no retreatment group (P < .05). There was no significant difference in the occurrence of defects between retreatment groups (P > .05). There was no correlation between the appearance of defects and level of the root or remaining dentin thickness.

Conclusions

Under the experimental conditions, all retreatment techniques used in this study created defects in the root dentin.     

Effect of intracanal medicaments on matrix metalloproteinase-9 and vasoactive intestinal peptide secretion in periapical lesions of re-treated canals: a randomized controlled clinical study

Clinical Oral Investigations - The aim of this study was to evaluate the effect of calcium hydroxide (Ca[OH]2) and chlorhexidine (CHX) gel on matrix metalloproteinase-9 (MMP-9) and vasoactive...