Accuracy of three electronic apex locators in anterior and posterior teeth: an ex vivo study

Introduction

The aim of this study was to determine in anterior teeth, bicuspids, and molars (1) the accuracy of 3 different electronic apex locators (EALs) in detecting the apical foramen and (2) the accuracy of digital radiography in determining the working length (WL), compared with visible control under a microscope.

Methods

By using radiovideography (RVG), we measured the lengths of 120 root canals with 3 different EALs (Endex, ProPex II, and Root ZX) and compared them with the actual lengths. The accuracy of EALs and RVG was related to each dental category. An endodontic training kit (Pro-Train) was used during experimental procedures.

Results

Statistical analysis showed that the 3 EALs and RVG were less accurate in anterior teeth and molars than in bicuspids. The paired-sample t test showed no statistically significant difference between mesiodistal plane and buccolingual plane digital radiography in all groups.

Conclusions

The 3 EALs tested were more accurate in detecting the apical foramen in bicuspids than in both molars and anterior teeth. Radiographic measurements were not reliable for determining WL in all dental groups in both radiographic planes.     

Effect of curing modes of dual-curing luting systems and root regions on retention of translucent fiber posts in root canals

PURPOSE: To evaluate the effect of different curing modes of dual-curing luting systems and root regions on the push-out strength of fiber posts to intraradicular dentin. MATERIALS AND METHODS: Forty-two extracted premolars with a single root canal were sectioned at the cementoenamel junction and the roots were endodontically treated. The roots were divided into two groups according to two dual-curing luting systems: (1) XP BOND-Dual Cure/Calibra resin cement; (2) XP BOND-Dual Cure/FluoroCore 2. For each luting system, three different curing modes were applied to the dentin adhesive and resin cement: "Self-cure and Self-cure (SC&SC)", "Self-cure and Dual-cure (SC&DC)", and "Dual-cure and Dual-cure (DC&DC)". Translucent Easy fiber posts (Dentsply Maillefer) were luted in the roots. A thin-slice push-out test was performed, and the data of push-out strength were analyzed using three-way ANOVA with luting system, curing mode, and root region (apical, middle and coronal) as factors. Tukey's test was used for post-hoc comparisons. RESULTS: The push-out strength of XP BOND-Dual Cure/Calibra was significantly lower when Calibra resin cement was self-cured than when it was dual-cured (SC&SC: 6.04 +/- 2.65 MPa; SC&DC: 10.69 +/- 3.01 MPa; DC&DC: 10.72 +/- 3.63 MPa; p < 0.05). The curing modes did not affect the push-out strength of XP BOND-Dual Cure/FluoroCore 2 (SC&SC: 7.90 +/- 3.94 MPa; SC&DC: 8.32 +/- 2.73 MPa; DC&DC: 9.27 +/- 4.12 MPa; p > 0.05). The coronal push-out strength was significantly higher than the apical push-out strength (p < 0.05). CONCLUSION: Retention of fiber posts in root canals was affected by the curing modes of dual-curing luting system and root regions.     

Placement of fiber prefabricated or custom made posts affects the 3-year survival of endodontically treated premolars

PURPOSE: To assess whether the amount of residual coronal dentin and the placement of a prefabricated (DT Light Post) (LP) or a customized fiber post (Ever Stick Post) (ES) have a significant influence on the 3-year survival of endodontically treated premolars. METHODS: A sample of 345 patients provided six groups of 60 premolars in need of endodontic treatment. Groups were defined based on the amount of dentin left at the coronal level after endodontic treatment and before abutment build-up. Within each group teeth were randomly divided into three subgroups (n = 20). In Subgroup A, no root canal retention was provided for the coronal restoration. In Subgroups B and C, LP and ES, respectively, were placed inside the root canal. All the teeth were finally restored with a single unit metal-ceramic crown. RESULTS: Data were not affected by any loss to follow-up. The overall 36-month survival rate of crowned endodontically treated premolars was 76.7%. The lowest survival rate was recorded for teeth restored without any root canal retention (62.5%). Teeth restored with LP had a survival rate higher (90.9%) than those restored with ES (76.7%). The Cox regression analysis showed that the presence of root canal retention was a significant factor for survival (P < 0.05). The decrease in failure risk was higher in teeth restored with LP (HR = 0.1; 95% CI for HR = 0.09 to 0.34; P < 0.001) than when using ES (HR = 0.5; 95% CI for HR = 0.3 to 0.7; P = 0.003). Teeth retaining one (HR = 0.3; 95% CI for HR = 0.2 to 0.7; P = 0.003), two (HR = 0.2; 95% CI for HR = 0.1 to 0.5; P < 0.001), or three coronal walls (HR = 0.1; 95% CI for HR = 0.05 to 0.3; P < 0.001) had a significantly lower failure risk than teeth deprived even of the ferrule effect. Similar failure risks existed for teeth missing all the coronal walls regardless of the presence or absence of a ferrule effect (P > 0.05). Interaction terms were not significant (P > 0.05). Post placement and the amount of residual coronal dentin affected the 3-year survival of endodontically treated premolars.     

Myoepithelial carcinoma of the submandibular gland: report of a case with multiple cutaneous metastases

Myoepithelial carcinoma is a rare and aggressive neoplasm of the salivary glands. One-third of the patients may develop regional distant metastases, and lungs and kidneys have been regarded as the most usual sites for implantation. There is, however, little information on the metastatic behavior of this malignancy. We report the first case of patient with multiple cutaneous metastases from a myoepithelial carcinoma of the submandibular gland, which depicted a very aggressive clinical course.     

Short-term bone response to titanium implants coated with thin radiofrequent magnetron-sputtered hydroxyapatite in rabbits

Background: It has been suggested that calcium phosphate (CaP) coatings initiate faster bone growth around implants. A major concern about the viable use of these coatings has been their biologic performance related to the coating characteristics. Purpose: The purpose of this study was to investigate the early bone response to micron‐ and submicron‐thick hydroxya‐patite (HA) coatings in cortical and trabecular bone. Materials and Methods: CaP coatings were manufactured by magnetron sputtering. Heat treatment was subsequently used to increase the crystallinity of the coatings. Coatings were characterized by x‐ray diffraction, Fourier transform infrared spectroscopy, inductively coupled plasma optical emission spectroscopy (ICP‐OES), and stylus profilometry. Four types of CaP‐coated implants were used (0.1 urn and 2.0 μm amorphous; 0.1 um and 2.0 μn crystalline); uncoated machined commercially pure titanium implants served as controls. Four hundred eighty implants were randomly placed in 60 rabbits. Ten animals were followed up for 1 week, 10 for 3 weeks, and 40 for 6 weeks. The bone response was histomorphometrically evaluated. Results: Coatings with a CaP ratio very close to that of HA were produced. Crystalline coatings significantly improved the early bone‐implant contact whereas the amorphous‐coated implants behaved similarly to uncoated titanium. Conclusions: Crystalline CaP coatings 100 nm thick on titanium implants elicited an improved early bone response compared with that of uncoated titanium implants. No further improvement in the bone response was observed with 2 μm coatings.     

Biofeedback fixation training method for improving eccentric vision in patients with loss of foveal function secondary to different maculopathies

International Ophthalmology - Fixation stability (FS) of the preferred retinal locus (PRL) may be improved by biofeedback fixation training (BFT) with microperimetry. Such training can be done on...     

Cognitive correlates of under-ambiguity and under-risk decision making in high-functioning patients with relapsing remitting multiple sclerosis

Introduction: Impairment of decision making in relapsing remitting multiple sclerosis is still controversial, and its neuropsychological correlates have never been explored thoroughly, especially in patients with minimal physical and cognitive deficits. In the present study we investigated the cognitive underpinnings of decision making under ambiguous and explicit conditions in patients with very mild relapsing remitting multiple sclerosis, using a dice and a card gambling game. Method: The study sample included 60 patients and 35 healthy subjects. In the Game of Dice Task, winning and losing probabilities are obvious to the subject, while in the Iowa Gambling Task they are initially ambiguous and have to be gradually identified. Performance at the two tasks was correlated with scores obtained at tests investigating cognitive processing speed, memory, language and executive functions. Results: Patients’ performance did not differ from that of controls at either gambling task. There was only a trend for them to be significantly slower than healthy subjects in progressively recognizing advantageous decks in the Iowa Gambling Task. While the Game of Dice was unrelated to neuropsychological tests, predictors of performance at the Iowa task were Letter Fluency and the Symbol Digit Modalities Test for the initial, under-ambiguity, trials and the Wisconsin Card Sorting Test for the last, purely under-risk, trials. Conclusions: Our results suggest that high-functioning patients with relapsing remitting multiple sclerosis are substantially capable of making advantageous decisions, even if they may be slower in processing options and shifting strategy when selection criteria are not explicit.     

Prevalence of patent foramen ovale in ischemic stroke in Italy: the SISIFO study

Patent foramen ovale (PFO) is a common congenital anatomical defect in the general population with a mean prevalence of 20 %. Transcranial Doppler sonography and echocardiography, both with infusion of agitated saline as an echo contrast, have been introduced for the diagnosis of PFO. Transesophageal echocardiography is considered the gold standard. Several studies have suggested an association between cryptogenetic stroke and PFO, but the role of this condition as a risk factor for stroke is still debated. The aims of this prospective multicentre study are the evaluation of PFO prevalence in the whole ischemic stroke population and the identification of a stroke recurrence profile risk in patients with PFO. All consecutive patients admitted for acute ischemic stroke and with a confirmed diagnosis at discharge are eligible cases for the study. Demographic and vascular risk factors are registered. Clinical severity is summarized by the National Institute of Health stroke scale. Echocardiographic and transcranial studies are performed in each patient to detect the presence of PFO. Prevalence of PFO will be calculated with 95 % CIs. Univariate analysis will be performed to detect the correlation of PFO with different registered factors and multivariable analysis with PFO as independent variable. The present study should contribute to better identify the role of PFO in ischemic stroke risk and recurrence-related events. Qualifying findings of the study are represented by the high number of enrolled patients, the prospective methodology of the study and the presence of secondary instrumental endpoints.