Comparison between Prescription of Regular or On-demand Ibuprofen on Postoperative Pain after Single-visit Root Canal Treatment of Teeth with Irreversible Pulpitis.

J Endod. 2014 Feb;40(2):151-4. doi: 10.1016/j.joen.2013.09.024. Epub 2013 Oct 27.

Comparison between Prescription of Regular or On-demand Ibuprofen on Postoperative Pain after Single-visit Root Canal Treatment of Teeth with Irreversible Pulpitis.

Abstract

INTRODUCTION:

Pain management is very important in endodontic practice. The aim of this study was to compare the effect on pain relief of on-demand versus regular prescription of ibuprofen after single-visit root canal treatment in teeth with irreversible pulpitis.

METHODS:

Sixty mandibular and maxillary molar teeth with irreversible pulpitis without spontaneous pain had single-visit root canal treatment. After this treatment, patients were randomly allocated to 2 groups of 30 patients each. Patients in group 1 received a single dose of 400 mg ibuprofen and a rescue bag of the same medication to use if they felt pain and needed further medication. Patients in group 2 received the same medication as group 1 patients after treatment, and they were also provided with a prescription to use 400 mg ibuprofen every 6 hours for at least 24 hours. The patients were asked to rate their pain on a visual analog scale for up to 48 hours after treatment. The data were analyzed with Mann-Whiney, chi-square, Fisher exact, and McNemar tests.

RESULTS:

Two patients were excluded because they did not return their pain record forms. Data analysis of the remaining 58 patients showed no significant difference in pain felt by the patients in groups 1 and 2 at either 24 or 48 hours after treatment (P = .849 and P = .732, respectively). Patients in group 2 used significantly more medication compared with patients in group 1 (P = .04).

CONCLUSIONS:

In patients who had irreversible pulpitis with no moderate to severe spontaneous pain, prescribing ibuprofen on a regular basis after root canal treatment had no significant effect on pain relief compared with an on-demand regimen up to 48 hours after treatment.

Do long-faced subjects really have a long anterior face? A longitudinal study.

Abstract

INTRODUCTION:

The aims of this study were to investigate and compare the anterior facial heights of children with long, normal, and short faces during growth and to discover whether long-faced subjects have long dimensions in both the upper and lower anterior facial heights compared with the others.

METHODS:

Longitudinal lateral cephalometric data of 167 children (83 girls, 84 boys) from 6 to 14 years of age were used. Total anterior face height, upper anterior face height, lower anterior face height, and the closest distance from the Frankfort horizontal plane to nasion were measured. The samples were classified as long-faced, normal-faced, and short-faced according to the ratio of lower to total face heights at 14 years old. All data were analyzed statistically and compared between the groups according to age.

RESULTS:

The mean lower anterior face height in the long-faced group was larger than in the normal-faced and short-faced groups for all ages in both sexes. In contrast, subjects in the normal-faced group had a longer mean upper anterior face height than did subjects in the long-faced and short-faced groups. In addition, the mean upper anterior face height of the short-faced group was larger than the long-faced group for girls at all ages and for boys at 12 to 14 years.

CONCLUSIONS:

The long-faced children did not have longer upper facial heights compared with normal-faced and short-faced children, and their long faces were mainly determined by the length of the lower face.

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Contributions of dental colour to the physical attractiveness stereotype.

Abstract

Dental appearance may play a key role on the way we develop a first impression of another person. To test whether relatively minor changes in the lightness of tooth colour would influence the perceived social appeal (social, intellectual, psychological and relational abilities) of an unknown male and unknown female, this cross-sectional study was performed on 555 Spanish adults. The two major independent variables related to the photograph were tooth lightness (computer-derived), divided into three levels that included lightened teeth, natural teeth and darkened teeth, and the gender of the observed face. Moreover, six independent variables related to the observer were assessed (age, gender, educational level, place of residence, frequency of brushing and self-reported health status). The dependent variables were scored on five-point Likert scales designed to quantify four domains (social, intellectual, psychological and relationship competences) of the Social Appeal Scale (SAS). Tooth lightness influences the perception of social appeal in all dimensions, as darkened smiles received significantly poorer scores than natural-colour smiles, but these were also worse than lightened smiles. A logistic regression analysis revealed that the major predictor of social appeal was tooth lightness, and for each increment in lightness (from darkened to lightened smiles), the odds ratio (OR) of positive values being perceived increased significantly in all items (from 2·3 in Popularity to 6·9 in Happiness). A perceptible change in dental lightness is the strongest factor associated with the dental attractiveness stereotype, affecting significantly the 12 traits assessed, but mainly the Happiness, Social Relations and Academic Performance.

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Can repair increase the useful life of composite resins? Clinical trial: Triple-blind controlled – 10 year follow-up

Abstract

OBJECTIVES:

The aim of this clinical randomized, triple-blind cohort study was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement.

METHODS:

Twenty-eight patients aged 18-80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were “clinically judged” to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n=25) or Replacement (n=25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. Two blind examiners scored with Cohen Kappa 0.74 at the baseline and 0.87 at 10 years. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group.

RESULTS:

Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (AM) (p>0.05), secondary caries (SC) (p>0.05), anatomy (A) (p<0.05), and colour (C) (p>0.05).

CONCLUSIONS:

Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations.

CLINICAL SIGNIFICANCE:

The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term.

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A Comparison of Fracture Resistance of Endodontically Treated Teeth Restored With Bonded Partial Restorations and Full-Coverage Porcelain-Fused-to-Metal Crowns.

Int J Periodontics Restorative Dent. 2014 May-Jun;34(3):405-11. doi: 10.11607/prd.1706.

Abstract

The aim of this study was to evaluate the use of bonded partial restorations compared with full-coverage porcelain-fused-to-metal (PFM) crowns as a viable treatment option for endodontically treated posterior teeth. Forty-five recently extracted maxillary first premolars were collected, endodontically treated, and mounted in acrylic blocks. The specimens were randomly divided into three groups and prepared to receive their respective restorations. The teeth in group 1 received full-coverage porcelain-fused-to-metal crowns. The teeth in group 2 received bonded partial restorations made from pressed ceramics (lithium disilicate) involving a functional cusp (palatal). Finally, group 3 received bonded partial restorations made from pressed ceramics involving the buccal cusp and keeping a functional cusp (palatal) intact. All group 1 restorations were cemented using glass ionomer cement. Restorations in groups 2 and 3 were bonded using a dual-cured resin cement. All specimens were subjected to an aging process and tested for shear bond strength using a universal loading machine. The mean force applied in Newtons to cause failure for group I was 674.90 ± 94.16 N, for group 2, 463.46 ± 61.11 N, and for group 3, 849.33 ± 68.92 N. P values obtained using one-way analysis of variance showed a highly significant difference between groups 2 and 3 (P = .001), groups 1 and 2 (P = .001), and groups 1 and 3 (P = .001). The fracture modes observed in all groups involved restorations and tooth fracture. This in vitro study suggests that endodontically treated posterior teeth with intact functional cusps can be restored with bonded partial porcelain restorations. However, if the loss of tooth structure involves the functional cusp, full-coverage PFM crowns are the treatment of choice.

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The influence of varying layer thicknesses on the color predictability of two different composite layering concepts.

Dent Mater. 2014 May;30(5):493-8. doi: 10.1016/j.dental.2014.02.002. Epub 2014 Mar 3.

Abstract

OBJECTIVE:

Optical properties of teeth are mimicked by composite layering techniques by combining a relatively opaque layer (dentin) with more translucent layers (enamel). However, the replacing material cannot always optically imitate the tooth when applied in the same thickness as that of the natural tissues. The natural layering composite system is available in 2 concepts: (1) dentin (D) and enamel (E) have the same

shade but with different translucencies; (2) D and E have different shades where E is always the same high translucent shade. The objective was to evaluate the influence of varying thicknesses of E and D composites on the overall color and on the translucency for both concepts.

METHODS:

For each concept three composite brands were tested; Concept 1: Clearfil Photo Bright (Kuraray), Herculite XRV Ultra (Kerr), Venus Diamond (Heraeus Kulzer); Concept 2: Amaris (VOCO), CeramX Duo (DENTSPLY) and Point4 (Kerr). Two specimens of each shade (A1-A3) per composite were made of standardized thicknesses with a poly-acrylic mold and Teflon cover, making 36 specimens of wedge-like dimension. The L*a*b* values were measured three times against a white and black background (n=216). Student’s t-tests revealed significant levels between the average ΔE* values of the 3 areas for each composite.

RESULTS:

Statistically significant differences (p<0.05) were found for all thicknesses and for all shades between the concepts. Concept 2 showed greater variations in ΔE* with increased thicknesses.

SIGNIFICANCE:

Concept 2 composites are more sensitive to layer thickness changes, which implicates less predictability in a daily clinical routine.

Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

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Ultra-fast light-curing resin composite with increased conversion and reduced monomer elution.

Dent Mater. 2014 May;30(5):594-604. doi: 10.1016/j.dental.2014.02.023. Epub 2014 Mar 26.

Ultra-fast light-curing resin composite with increased conversion and reduced monomer elution.

Abstract

OBJECTIVES:

To test the null hypotheses that photoactive resin composites containing a Type I photoinitiator would exhibit reduced DC or increased monomer elution at substantially short curing times compared with materials based on a Type 2 ketone/amine system.

METHODS:

Two experimental resin composites were prepared, using either Lucirin-TPO or camphorquinone/DMAEMA. Specimens were light-cured using appropriate spectral emission that coincided with the absorption properties of each initiator using different irradiation protocols (0.5, 1, 3, 9s at 500, 1000 and 2000mW/cm(2) for Lucirin-TPO based composites and 20 or 40s at 1000mW/cm(2) for Lucirin-TPO and camphorquinone-based composites). Degree of conversion (DC) was measured by Raman spectroscopy, propagating radical concentrations were collected by means of electron paramagnetic resonance (EPR) and monomer leaching was characterized using high-performance liquid chromatography (HPLC).

RESULTS:

The null hypotheses were rejected, except for a single irradiation protocol (0.5s @ 500mW/cm(2)). Lucirin-TPO-based composites could cure 20 times faster and release at least 4 times less monomers in comparison to camphorquinone-based composites. At 1000mW/cm(2), and 1s irradiation time for curing times of 1s, Lucirin-TPO based composites displayed 10% higher DC. The difference in polymerization efficiency of Lucirin-TPO compared with camphorquinone-based resin composites were explained using EPR; the former showing a significantly greater yield of radicals which varied logarithmically with radiant exposure.

SIGNIFICANCE:

Lucirin-TPO is substantially more efficient at absorbing and converting photon energy when using a curing-light with an appropriate spectral emission and otherwise a limitation noted in several previous publications. At concentrations of 0.0134mol/L, Lucirin-TPO-based composites require a minimum light intensity of 1000mW/cm(2) and an exposure time of 1s to provide significantly improved DC and minimal elution compared with a conventional photoinitiator system. The use of a wide range of curing protocols in the current experiment has realized the significant potential of Lucirin-TPO and its impact for clinical applications, in replacement to materials using camphorquinone.

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Έρευνα:Effect of resin cements and aging on cuspal deflection and fracture resistance of teeth restored with composite resin inlays.

J Adhes Dent. 2013 Dec;15(6):561-8. doi: 10.3290/j.jad.a29608.

PURPOSE:

To evaluate the influence of resin cements and aging on cuspal deflection, fracture resistance, and mode of failure of endodontically treated teeth restored with composite resin inlays.

MATERIALS AND METHODS:

Seventy-two maxillary premolars were divided into 6 groups: 1: sound teeth as control (C); 2: preparations without restoration (WR); 3: inlays luted with RelyX ARC (ARC); 4: inlays luted with RelyX Unicem (RLXU); 5: inlays luted with Maxcem Elite (MCE); 6: inlays luted with SeT

(ST). Groups 2 to 6 received mesio-occlusal-distal preparations and endodontic treatment. Stone casts were made for groups 3 to 6. Composite resin inlays were built over each cast and luted with the resin cements. A 200-N load was applied on the occlusal aspect and the cuspal deflection was measured using a micrometer before and after 500,000 cycles of fatigue loading (200 N; 500,000 cycles). The specimens were then submitted to an axial load until failure.

RESULTS:

The median cuspal deflection (µm) and median fracture resistance (N) were calculated and statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (p < 0.01). Values followed by the same letter represent no statistically significant difference. Cuspal deflection before cyclic loading: C = 3 µma; ARC = 4 µmab; RLXU= 5 µmab; MCE = 21 µmb; ST = 51 µmbc; WR = 69 µmc. Cuspal deflection after cyclic loading: ARC = 6 µma; RLXU = 19 µmab; MCE = 33 µmb; ST = 62 µmb. Fracture resistance in N: C = 1902a; ARC = 980b; RLXU = 670c; MCE = 533c; ST = 601c; WR = 526c. According to the Wilcoxon test, there was no statistical difference between the cuspal deflection before and after cyclic loading only for ARC (p = 0.015). There was a predominance of recovery fractures for the restored groups.

CONCLUSION:

Composite resin inlays luted with RelyX ARC maintained cuspal deflection stability and showed higher fracture resistance of the teeth than did inlays luted with the other cements tested.

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Έρευνα : Effect of Bleaching on Mercury Release from Amalgam Fillings and Antioxidant Enzyme Activities: A Pilot Study

  1. Filiz Yalcin Cakir DDS, PhD Professor1,*,
  2. Esra Ergin DDS, PhD Associate Professor1,
  3. Sevil Gurgan DDS, PhD Professor1,
  4. Suna Sabuncuoglu PhD Research Assistant2,
  5. Cigdem Sahin Arpa PhD Research Assistant3,
  6. İlknur Tokgoz MSc, PhD Student Professor3,
  7. Hilal Ozgunes PhD Professor2,
  8. Arlin Kiremitci DDS, PhD Professor1

Objective

The aim of this pilot clinical study was to determine the mercury release from amalgam fillings and antioxidant enzyme activities (Superoxide Dismutase [SOD] and Catalase[CAT] ) in body fluids after exposure to two different vital tooth bleaching systems.

Material and Methods

Twenty eight subjects with an average age of 25.6 years (18–41) having at least two but not more than four Class II amalgam fillings on each quadrant arch in the mouth participated in the study. Baseline concentrations of mercury levels in whole blood, urine, and saliva were measured by a

Vapor Generation Accessory connected to an Atomic Absorption Spectrometer. Erythrocyte enzymes, SOD, and CAT activities in blood were determined kinetically. Subjects were randomly assigned to two groups of 14 volunteers. Group 1 was treated with an at-home bleaching system (Opalescence PF 35% Carbamide Peroxide, Ultradent), and Group 2 was treated with a chemically activated office bleaching system (Opalescence Xtra Boost 38% Hydrogen Peroxide, Ultradent) according to the manufacturer’s recommendations. Twenty-four hours after bleaching treatments, concentrations of mercury and enzymes were remeasured.

Results

 There were no significant differences on mercury levels in blood, urine, and saliva before and after bleaching treatments (p > 0.05). No differences were also found in the level of antioxidant enzyme activities (SOD and CAT) before and after treatments (p > 0.05). Mercury release did not affect the enzyme activities (p > 0.05).

Conclusion

 Bleaching treatments either office or home did not affect the amount of mercury released from amalgam fillings in blood, urine, and saliva and the antioxidant-enzyme activities in blood.

Clinical Significance

Bleaching treatments with the systems tested in this pilot study have no deleterious effect on the mercury release from amalgam fillings and antioxidant enzymes in body fluids.

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