Incidence of Postoperative Pain after Single- and Multi-Visit Endodontic Treatment in Teeth with Vital and Non-Vital Pulp

Objectives: To assess the incidence of postoperative pain after single- and multi-visit endodontic treatment of teeth with vital and non-vital pulp.

Methods: In total, 306 patients with teeth requiring endodontic treatment were identified and were included in this study. Two experienced clinicians treated the patients, who were randomly assigned to two groups. While the teeth of patients in group 1 were obturated, group 2 were temporarily sealed and obturated after one week. Three days after the root canal instrumentation of each tooth, the patients were asked whether they experienced any postoperative pain and to rate the level of discomfort as no, mild, moderate, or severe pain. Data were analyzed statistically using the chisquare test.

Results: No significant difference in postoperative pain was found between vital and non-vital teeth (P>.01). Mild, moderate, and severe pain occurred in 31.4, 13.7, and 4.6% of vital teeth, respectively. Postoperative pain occurred in 107 (69.9%) and 106 (69.3%) teeth in the single- and multi-visit treatment groups, respectively. There was no significant difference in postoperative pain between the two groups (P>.01).

Conclusions: The prevalence of postoperative pain did not differ between vital and non-vital teeth. The majority of patients in either groups reported no or only mild pain. (Eur J Dent 2009;3:273-279)

Micro-shear bond strength of universal adhesives used for amalgam repair with or without Alloy Primer

AIM

The aim of this study was to investigate the adhesive performance of three different universal adhesives to repair aged amalgam by composite resins with or without Alloy Primer.

MATERIALS AND METHODS

Sixty amalgam samples were prepared, aged, and randomly divided into 12 main groups according to adhesive procedures used. Composite buildups were placed on amalgam surfaces. After micro-shear bonding test, the fracture surfaces were examined under the scanning electron microscopy statistical analysis was performed using two-way analysis of variance and Tukey's post hoc tests.

RESULTS

Without use of Alloy Primer, all of the universal adhesives provided similar bond strength values with conventional adhesives (P > 0.05); however, an Alloy Primer significantly increased the bond strength values of universal adhesives (P < 0.05). No significant difference in bond strength values was noted for conventional adhesives with or without Alloy Primer (P > 0.05) except for Clearfil SE Bond (P < 0.05).

CONCLUSIONS

Within the limitations of this study, it can be concluded; using Alloy Primer before universal adhesives increased the bond strength significantly.

Erratum to: Effect of resin infiltration on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions

Authors would like to add ACKNOWLEGMENT in this article, page 30, between CONCLUSION and REFERENCES as below.

ACKNOWLEGMENT

This research was supported by Erciyes University Scientific Research Project Department.

Microshear bond strength of preheated silorane- and methacrylate-based composite resins to dentin

The aim of this study was to investigate the effect of preheating on microshear bond strength (MSBS) of silorane and methacrylate-based composite resins to human dentin. The teeth were randomly divided into three main groups: (1) composite resins were heated upto 68 °C; (2) cooled to 4 °C; and (3) control [room temperature (RT)]. Each group was then randomly subdivided into four subgroups according to adhesive system used [Solobond M (Voco), All Bond SE (Bisco), Clearfil SE Bond (CSE) (Kuraray), Silorane adhesive system (SAS) (3M ESPE)]. Resin composite cylinders were formed (0.9 mm diameter × 0.7 mm length) and MSBS of each specimen was tested. The preheated groups exhibited the highest MSBS (p < 0.001) and the groups cooled to 4 °C exhibited the lowest MSBS (p < 0.001). The CSE showed higher MSBS than the other adhesives (p < 0.001). This study concludes that preheating of composite resins may be an alternative way to increase the MSBS of composites on dentin.

Effect of resin infiltration on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions

The aim of this study was to evaluate and compare the effects of resin infiltration and sealant type on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Artificial enamel lesions were produced on the surfaces of 120 enamel specimens, which were divided into two groups: Group A and Group B (n=60 per group). Each group was further divided into four subgroups (n=15 per subgroup) according to sealant type: Group I-Demineralized enamel (control); Group II-Enamel Pro Varnish; Group III-ExciTE F; and Group IV-Icon. In Group A, hardness and surface roughness were evaluated; in Group B, bacterial adhesion was evaluated. Icon application resulted in significantly lower surface roughness and higher hardness than the other subgroups in Group A. In Group B, Enamel Pro Varnish resulted in lowest bacterial adhesion, followed by Icon. This study showed that resin infiltration of enamel lesions could arrest lesion progress.

Comparing the shear bond strength of direct and indirect composite inlays in relation to different surface conditioning and curing techniques

Objective:

The aim of this study was to test the null hypothesis that different surface conditioning (etch and rinse and self-etch) and curing techniques (light cure/dual cure) had no effect on the shear bond strength of direct and indirect composite inlays.

Materials and Methods:

A total of 112 extracted human molar teeth were horizontally sectioned and randomly divided into two groups according to restoration technique (direct and indirect restorations). Each group was further subdivided into seven subgroups (n = 8) according to bonding agent (etch and rinse adhesives Scotchbond multi-purpose plus, All-Bond 3, Adper Single Bond and Prime Bond NT; and self-etch adhesives Clearfil Liner Bond, Futurabond DC and G bond). Indirect composites were cemented to dentin surfaces using dual-curing luting cement. Shear bond strength of specimens was tested using a Universal Testing Machine. Two samples from each subgroup were evaluated under Scanning electron microscopy to see the failing modes. Data was analyzed using independent sample t-tests and Tukey's tests.

Results:

Surface conditioning and curing of bonding agents were all found to have significant effects on shear bond strength (P < 0.05) of both direct and indirect composite inlays. With direct restoration, etch and rinse systems and dual-cured bonding agents yielded higher bond strengths than indirect restoration, self-etch systems and light-cured bonding agents.

Conclusions:

The results of the present study indicated that direct restoration to be a more reliable method than indirect restoration. Although etch and rinse bonding systems showed higher shear bond strength to dentin than self-etch systems, both systems can be safely used for the adhesion of direct as well as indirect restorations.

Comparison of chemotherapy and hematopoietic stem cell transplantation pre and postterm DMFT scores: a preliminary study

AIMS

Chemotherapy is frequently used as a conditioning regimen to destroy malignant marrow cells before transplantation. Xerostomia, dysphagia, altered taste perception, mucositis, soft-tissue ulceration, and infection are common adverse oral effects of chemotherapy. The study was aimed to compare decayed, missing, filled teeth (DMFT) scores before and after hematopoietic stem cell transplantation (HSCT) and chemotherapy.

MATERIALS AND METHODS

Thirty-six patients undergoing HSCT were included in the study. A pre-HSCT dental treatment protocol was implemented that consisted of restoration of all active carious lesions, treatment of periodontal infections, and extraction of all teeth with advanced periodontal disease. Upon completion of dental treatment, the importance of rigorous and effective oral hygiene was reemphasized, and patients were recalled 6 months later. DMFT scores were calculated prior to the initiation of HSCT treatment and 6 months after transplantation.

STATISTICAL ANALYSIS USED

Regression analysis was used to evaluate the effects of HSCT and chemotherapy on DMFT scores.

RESULTS

Wilcoxon T test showed a statistically significant difference in DMFT scores before and after HSCT ( P < 0.001).

CONCLUSIONS

DMFT scores were found to increase after chemotherapy and HSCT, suggesting that the risk of infection is higher among HSCT patients when compared to other individuals. The results emphasize the need for dental examinations as an integral part of examination and treatment planning for patients undergoing HSCT and chemotherapy.

The effect of a new-generation flowable composite resin on microleakage in Class V composite restorations as an intermediate layer

Aim:

To evaluate the effect of application a new-generation bulk-fill flowable composite resin as an intermediate material between composite resin and dental substrates on micro-leakage in Class V composite restorations.

Materials and Methods:

A total of 144 Class V cavities were prepared in 72 human molars. Specimens were then randomly distributed among three groups according to adhesive system applied (Group 1: Clearfil SE Bond; Group 2: Adper Easy One; Group 3: Adhesive 200T), and each group was divided into three subgroups according to liner material used (Group A: No liner-control group; Group B: Aelite Flo LV, low viscosity microhybrid composite; Group C: Smart dentin replacement). All cavities were restored using resin composite (Aelite LS, low shrinkage posterior composite). Specimens were stained with 0.5% basic fuchsin and evaluated dye penetration.

Results:

There was no significant difference in dye penetration was found between the control and the experimental groups.

Conclusions:

Micro-leakage is not affected by the application of either conventional or new-generation flowable composite resin as an intermediate material between composite resin and dental substrates.

Effects of demineralizaton-inhibition procedures on the bond strength of brackets bonded to demineralized enamel surface

Objective

To study and compare the effects of different demineralization-inhibition methods on the shear bond strength (SBS) and fracture mode of an adhesive used to bond orthodontic brackets to demineralized enamel surfaces.

Methods

Eighty freshly extracted, human maxillary premolars were divided into 4 equal groups and demineralized over the course of 21 days. Brackets were bonded to the demineralized enamel of teeth in Group 1. In Group 2, bonding was performed following resin infiltration (ICON®, DMG, Hamburg, Germany). Before bonding, pre-treatment with acidulated phosphate fluoride (APF) or solutions containing casein phosphopeptide-amorphous calcium phosphate with 2% neutral sodium fluoride (CPP-ACP/wF) was performed in Groups 3 and 4, respectively. The SBS values of the brackets were measured and recorded following mechanical shearing of the bracket from the tooth surface. The adhesive remnant index (ARI) scores were determined after the brackets failed. Statistical comparisons were performed using one-way ANOVA, Tukey's post-tests, and G-tests.

Results

Significant differences were found in some of the intergroup comparisons of the SBS values (F = 39.287, p < 0.001). No significant differences were found between the values for the APF-gel and control groups, whereas significantly higher SBS values were recorded for the resin-infiltrated and CPP-ACP/wF-treated groups. The ARI scores were also significantly different among the 4 groups (p < 0.001).

Conclusions

Tooth surfaces exposed to resin infiltration and CPP-ACP/wF application showed higher debonding forces than the untreated, demineralized surfaces.

Direct laminate veneers with resin composites: two case reports with five-year follow-ups

AIM

The aim of this report is to present five-year follow-ups of two different applications for the use of direct laminate resin-based composite veneers to improve esthetics.

BACKGROUND

Defects in the maxillary anterior teeth, such as enamel hypoplasia and peg lateral, can present esthetic challenges. Furthermore, a treatment plan that can be completed in a single appointment is highly desirable. This case report presents two different clinical cases involving the use of direct laminate resin-based composite veneers with five-year follow-ups.

CASE REPORT

Case 1: A 17-year-old female patient was referred for treatment of her anterior teeth, which were unesthetically altered due to enamel hypoplasia and dental caries. A treatment plan was developed that included restoring the affected teeth with direct resin-based composite laminate veneers to improve the patient's appearance. The six maxillary anterior teeth were prepared for and restored with direct resin-based composite laminate veneers. At the five-year follow-up, the patient was satisfied with the restorations both esthetically and functionally. Case 2: A 15-year-old female patient also was referred for treatment to improve the appearance of her maxillary anterior teeth. A treatment plan was developed with two objectives: (1) to restore the undersized supernumerary crown in the area of the maxillary right lateral incisor and (2) to close the anterior diastemas. The facial surfaces were conservatively prepared and resin-based composite was applied with the aid of transparent crown forms. After completion of the treatment, the patient was recalled at six-month intervals. At the five-year follow-up appointment, the restorations were intact, no adverse effects were noted, and the resultant appearance was highly satisfactory for the patient.

SUMMARY

The use of direct resin-based composite laminate veneers and adhesive bonding systems has been shown to provide an esthetic alternative to metal-ceramic or all-ceramic crowns for the rehabilitation of anterior teeth. This treatment option offers another advantage, namely a lower cost compared to an indirect technique. Other more complex and costly treatment options in the future are not ruled out.

CLINICAL SIGNIFICANCE

In the present two cases, the initial and five-year follow-up results support the use of direct resin-based composite laminate veneers with minimal altering of healthy tooth structure. Such results should encourage clinicians to seek a cost-effective technique such as direct resin restorations to improve a patient's esthetic appearance in a single appointment.

Effect of different cavity disinfectants on shear bond strength of composite resin to dentin

PURPOSE

The aim of this study was to evaluate the effect of different cavity disinfectants on dentin bond strengths of composite resin applied with two different adhesive systems.

MATERIALS AND METHODS

One hundred mandibular third molars were sectioned parallel to the occlusal surface to expose midcoronal dentin. The dentin surfaces were polished with waterproof-polishing papers. The specimens were randomly divided into 5 groups of 20 each. In group 1, the specimens were not treated with any cavity disinfectants and served as control. From groups 2 to 5, dentin surfaces were treated with the following cavity disinfectants, respectively; 2% chlorhexidine solution, 2.5% NaOCl, 1% chlorhexidine gel, 3% H2O2. The specimens were then randomly divided into 2 subgroups including ten teeth each to evaluate the effect of different bonding systems. Dentin bonding systems were applied to the dentin surfaces and the composite buildups were created. After the specimens were stored in an incubator for 24 h, the shear bond strength was measured at a crosshead speed of 1 mm/min. The bond strength data were analyzed with one way analysis of variance and Tukey-HSD tests.

RESULTS

There was no significant difference between chlorhexidine gel and control groups regardless of the type of the bonding agent (p > 0.05). On the other hand, pretreatment with NaOCl, H2O2 or chlorhexidine solutions had a negative effect on the shear bond strength of self-etching bonding systems.

CONCLUSION

The findings of this study suggest that when NaOCl, H2O2 or chlorhexidine solution are used as a cavity disinfectant, an etch-and-rinse bonding system should be preferred.

Incidence of postoperative pain after single- and multi-visit endodontic treatment in teeth with vital and non-vital pulp

OBJECTIVES

To assess the incidence of postoperative pain after single- and multi-visit endodontic treatment of teeth with vital and non-vital pulp.

METHODS

In total, 306 patients with teeth requiring endodontic treatment were identified and were included in this study. Two experienced clinicians treated the patients, who were randomly assigned to two groups. While the teeth of patients in group 1 were obturated, group 2 were temporarily sealed and obturated after one week. Three days after the root canal instrumentation of each tooth, the patients were asked whether they experienced any postoperative pain and to rate the level of discomfort as no, mild, moderate, or severe pain. Data were analyzed statistically using the chi-square test.

RESULTS

No significant difference in postoperative pain was found between vital and non-vital teeth (P>.01). Mild, moderate, and severe pain occurred in 31.4, 13.7, and 4.6% of vital teeth, respectively. Postoperative pain occurred in 107 (69.9%) and 106 (69.3%) teeth in the single- and multi-visit treatment groups, respectively. There was no significant difference in postoperative pain between the two groups (P>.01).

CONCLUSIONS

The prevalence of postoperative pain did not differ between vital and non-vital teeth. The majority of patients in either groups reported no or only mild pain.

Treatment of traumatized maxillary permanent lateral and central incisors horizontal root fractures

Traumatic injuries of teeth are the main cause of emergency treatment in dental practice. Horizontal root fractures are more frequently observed in the maxillary anterior region and young male patients. The most common type of root fracture is in the middle third, followed by apical, and coronal part. This case report describes two horizontal root fractures of the maxillary right central and lateral incisors due to a sport injury. The lateral incisor was healed satisfactorily without treatment. The central incisor was endodontically treated.

Reattachment of coronal fragment using fiber-reinforced post: a case report

Coronal fractures of permanent dentition are the most frequent type of dental injury. If the original tooth fragment is retained following fracture, the natural tooth structures can be reattached using adhesive protocols. The development and use of fiber-reinforced composite root canal posts make possible of the reattachment of the crown esthetically. This case report presents a clinical technique to reattachment maxillary lateral incisor tooth after trauma using direct fiber-reinforced post systems. At the 1-year follow-up, a slightly marginal discoloration, but no recurrent decay or composite clefts were detected and the resultant appearance was acceptable to the patient.