Longevity and Risk Factors of Post Restorations after up to 15 Years: A Practice-based Study

IntroductionThe aims of this multicenter, practice-based cohort study were to evaluate the success and survival of endodontically treated teeth with post restorations (ETT+Ps) and to analyze factors associated with the longevity of ETT+Ps.MethodsEight general dental practitioners each placed up to 27 ETT+Ps without any restriction to post materials or dimensions. Only incisors, canines, and premolars were included. At the last follow-up visit, ETT+Ps were considered as successful if the post and the initially placed definitive restoration were sufficient, whereas ETT+Ps were considered as survived if the post was still in function. Multilevel Cox proportional hazards models were used to evaluate the association between a range of predictors and time until no success and no survival.ResultsOverall, 195 endodontic posts in 195 patients were followed up for a mean (95% confidence interval) of 91 (81–101) months; the longest follow-up was 15 years. Of these, 122 ETT+Ps were considered successful (estimated success time = 110 [101–120] months), and 152 ETT+Ps survived [estimated survival time = 133 [124–141] months). Regarding the categories of success and survival, the annual failure rates were 6.0% and 3.3%, respectively. Recementation of old (telescopic) crowns after placing new posts was the only significant predictor for decreased time until failure for both success and survival analyses. By excluding recemented restorations, annual failure rates decreased to 3.5% and 2.1%, respectively.ConclusionsFor EET+Ps placed in a private practice setting, high success and survival rates were observed. If old (telescopic) crowns were recemented after new posts were placed, the high risk of subsequent failure should be considered and communicated with patients.     

Effects of dentifrices differing in fluoride compounds on artificial enamel caries lesions in vitro

The aim of this study was to compare the caries-preventive effect of a stabilized stannous fluoride/sodium fluoride dentifrice containing sodium hexametaphosphate with those of a regular, solely sodium fluoride-containing and amine fluoride-containing dentifrice on pre-demineralized bovine enamel specimens using a pH-cycling model. Bovine enamel specimens with two artificial lesions each were prepared. Baseline mineral loss of both lesions was analyzed using transversal microradiography (TMR). Eighty-five specimens with a mean (SD) baseline mineral loss of 3393 (683) vol% × µm were selected and randomly allocated to five groups (n = 13/15). Treatments during pH-cycling (28 days and 2 × 20 min demineralization/day) were: brushing twice daily with slurries of AmF (1400 ppm F^?), NaF (1450 ppm F^?), SnF₂/NaF (1100 ppm F^?/350 ppm F^?), and fluoride-free (FF) dentifrices or they were immersed in distilled water and remained unbrushed (NB). Subsequently, from each specimen one lesion was covered with acid-resistant varnish, while the remaining lesion was demineralized for another 14 days. Differences in integrated mineral loss (??Z) were calculated between values before and after pH-cycling (??Z _E1) as well as before pH-cycling and after second demineralization (??Z _E2) using TMR. Treatments AmF and NaF induced a significantly higher mineral gain (??Z _E1/??Z _E2) compared to treatments FF and NB (p < 0.05; ANOVA test). Except for treatments AmF and NaF no significant differences in mineral loss between before and after pH-cycling could be observed (p < 0.05; t test) [??Z _E1: AmF:1563 (767); NaF:1222 (1246); SnF₂/NaF:258 (1259); FF:?52 (1223); NB:?151 (834)]. Both dentifrices with either AmF or NaF promoted remineralization, whereas SnF₂/NaF dentifrice did not promote remineralization in a biofilm-free pH-cycling model.     

Efficacy of nano-hydroxyapatite on caries prevention—a systematic review and meta-analysis

Clinical Oral Investigations - The review systematically explored in vivo or in situ studies investigating the efficacy of nano-hydroxyapatite (nHA) to reduce initiation of or to remineralize...     

Caries-preventive effect of anti-erosive and nano-hydroxyapatite-containing toothpastes in vitro

Objectives

The aim of the study was to investigate the caries-preventive effect of newly developed fluoride and fluoride-free toothpastes specially designed for erosion prevention. The hypothesis was that these products might also show superior caries-inhibiting effect than regular fluoride toothpastes, since they were designed for stronger erosive acid challenges.

Materials and methods

Enamel specimens were obtained from bovine teeth and pre-demineralized (pH = 4.95/21 days) to create artificial caries lesions. Baseline mineral loss (ΔZ_B) and lesion depth (LD_B) were determined using transversal microradiography (TMR). Ninety specimens with a median ΔZ_B (SD) of 6027 ± 1546 vol% × μm were selected and randomly allocated to five groups (n = 18). Treatments during pH-cycling (14 days, 4 × 60 min demineralization/day) were brushing 2×/day with AmF (1400 ppm F⁻, anti-caries [AC]); AmF/NaF/SnCl₂/Chitosan (700 ppm F⁻/700 ppm F⁻/3500 ppm Sn²⁺, anti-erosion [AE1]); NaF/KNO₃ (1400 ppm F⁻, anti-erosion [AE2]); nano-hydroxyapatite-containing (0 ppm F⁻, [nHA]); and fluoride-free toothpastes (0 ppm F⁻, negative control [NC]). Toothpaste slurries were prepared with mineral salt solution (1:3 wt/wt). After pH-cycling specimens presenting lesion, surface loss (mainly by NC and nHA) were discarded. For the remaining 77 specimens, new TMR analyses (ΔZ_E/LD_E) were performed. Changes in mineral loss (ΔΔZ = ΔZ_B − ΔZ_E) and lesion depth (ΔLD = LD_B − LD_E) were calculated.

Results

All toothpastes caused significantly less demineralization (lower ΔΔZ) than NC (p < 0.05, ANOVA) except for nHA. The fluoride toothpastes did not differ significantly regarding ΔΔZ and ΔLD (p > 0.05, ANOVA).

Conclusion/clinical relevance

While both anti-erosive and anti-caries toothpastes reduced mineral loss to a similar extent, the fluoride-free nano-hydroxyapatite-containing toothpaste seemed not to be suitable for inhibition of caries demineralization in vitro.

     

Analysis of relative bacterial activity and lactate dehydrogenase gene expression of caries-associated bacteria in a site-specific natural biofilm: an ex vivo study

Clinical Oral Investigations - Detecting bacterial activity is considered a promising approach to monitor shifts from symbiosis to dysbiosis in oral microbiome. The present study aimed at...     

Longevity of composite build-ups without posts—10-year results of a practice-based study

Aim

The aim of this prospective, non-interventional, multi-center, practice-based study was, firstly, to evaluate the longevity of composite build-ups in endodontically treated teeth (ETT) without post placement and, secondly, to analyze factors influencing the success of these composite build-ups.

Methodology

Each of seven general dental practitioners placed up to 50 composite build-ups without additional posts in ETT. Teeth were restricted to incisors, canines, and premolars. Several clinical data were recorded for 192 coronal restorations on ETT in 192 patients. Cox proportional hazard models were applied to analyze associations between clinical factors and time until failure.

Results

Within a follow-up period of 10 years, 167 restorations were judged as successful [mean success time, 110 (105–115) months] and 180 teeth survived [mean survival time, 114 (110–119) months]. The main failure type was fracture of the restoration (n = 15). The annual failure rate was 2.4%. In bivariate Cox regression, both factors such as number of restored tooth surfaces and adhesive were significantly associated with the failure rate. In multivariate Cox proportional hazards regression, none of the investigated factors were significantly associated with the failure rate.

Conclusion

For composite build-ups in ETT without post placement, high success rates could be found after up to 10 years of observation time. Within the limitations of the present study, none of the analyzed factors such as “tooth type” or “number of restored tooth surfaces” was a significant predictor for the failure rate.

Clinical relevance

Endodontically treated teeth can be successfully directly restored with composite build-ups even when no additional post is inserted.

Trial registration

The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00012882).

     

Vanadate inhibition of the Ca++-ATPase of sarcoplasmic reticulum from pig heart

Summary Ca⁺⁺-ATPase of sarcoplasmic reticulum from pig heart can be inhibited by vanadate with half maximal inhibition at about 10^–5 M NH₄VO₃. At the same time vanadate lowers the [Mg⁺⁺] for maximal activity of the Ca⁺⁺-ATPase to half, from 8×10^–3 M to 4×10^–3 M Mg⁺⁺. At low vanadate concentrations around 5×10^–8 M the Ca⁺⁺-ATPase was activated.

---

Hemmung der Ca⁺⁺-ATPase aus dem sarkoplasmatischen Retikulum des Schweineherzens durch Vanadat

Zusammenfassung Die Ca⁺⁺-ATPase aus dem sarkoplasmatischen Retikulum des Schweineherzens kann durch 10^–5 M NH₄VO₃ halbmaximal gehemmt werden. Bei dieser Vanadatkonzentration wird gleichzeitig die Mg⁺⁺-Konzentration für maximale Aktivierung der Ca⁺⁺-ATPase um die Hälfte verringert, und zwar von 8×10^–3 M auf 4×10^–3 M Mg⁺⁺. Niedrige Konzentrationen von Vanadat, um 5×10^–8 M, aktivieren die Ca⁺⁺-ATPase.

---

---

The data have been presented at the Symposium Cardiac Effects of Vanadate. Munich, October 26–27, 1979.

---

With 1 figure