Anna Kierklo

Dental caries in primary and permanent molars in 7-8-year-old schoolchildren evaluated with Caries Assessment Spectrum and Treatment (CAST) index

BackgroundNo reports on a caries pattern covering the full spectrum of the disease could be found in the literature. The aim of this study was to evaluate caries in primary and first permanent molars of 7-8-year-old Polish children by the Caries Assessment Spectrum and Treatment (CAST) index and to find whether there was any correlation between the caries stages in such teeth.MethodsThe study covered 284 7-8-year-old children from randomly selected schools in the Bialystok District, Poland. The prevalence of CAST categories was evaluated with regard to the first and second primary, and first permanent, molars. The Spearman’s rank correlation coefficient was used to explore the correlation of the distribution of CAST codes among the evaluated teeth. The level of statistical significance was established at p < 0.05. The intra-examiner reliability was determined by the unweighted kappa coefficient.ResultsWith regard to the permanent molars, caries was observed in 14.8% to 17.3% of the molar and most lesions were scored at the non-cavitation level. Caries in primary molars was most often recorded at the stage of cavitated dentine lesion. Teeth with pulpal involvement, sepsis and extracted due to caries were found to be more prevalent in first, and then in second primary molars. A strong correlation was found between the status of teeth from the right and left sides of the oral cavity. The correlation of the status of first and second primary teeth was stronger for the left than for the right side of the mouth, r was 0.627 and 0.472 in maxilla and 0.513 and 0.483 in mandible (p < 0.001), respectively. For the neighbouring primary and permanent molars the correlation was assessed to be weak. With regard to the teeth situated in opposite jaws the study revealed that the correlations were moderate - r between 0.33 and 0.49. The intra-examiner reliability was established at 0.96 for the primary dentition and at 0.878 for permanent molars.ConclusionThe strongest correlation found in the evaluated population concerned the distribution of caries in primary molars on the left side of the mouth. The study proved the usefulness of the CAST index in epidemiological surveys.

Cytotoxicity evaluation of three light-cured dentin adhesive materials on human gingival fibroblasts, ex vivo

PURPOSE To evaluate the cytotoxic effects of three current light-cured dentin adhesives, in both uncured and post-cured conditions, on human gingival fibroblasts. MATERIAL AND METHODS The materials tested were Heliobond, Adper Single Bond 2 and Xeno V, which are characterized by various compositions and application procedures. Each agent, in volumes of 5 and 10 μL, was tested after polymerization, and those unpolymerized were diluted in DMEM to 10-3 and 10-5. The cytotoxicity of the adhesives was assessed on the basis of a test of cell viability in a culture of human gingival fibroblasts, with the use of tetrazolic salt (MTT assay). RESULTS The results showed that, among the adhesive/bonding systems tested, Xeno V was the least cytotoxic. There were statistically significant differences in cell survival between polymerized Xeno V, Adper Single Bond 2 and Heliobond in the amount of 5 μL as well as between the Xeno V and Adper Single Bond 2 in 10-5 dilutions. The tested adhesives were more toxic in the polymerized form than in the dilutions. Samples of 10 μL resulted in a lower survival percentage of fibroblasts compared to 5 μL. CONCLUSION All the tested adhesives demonstrated cytopathic effects towards human gingival fibroblasts, but varied in their cytotoxicity. This has clinical implications. Dentists should follow the rules of adhesive application, precisely dose them and not allow direct contact with the gums as, even after polymerization, adhesive agents exhibit potential cytotoxic activity.

A microcomputed tomography-based comparison of root canal filling quality following different instrumentation and obturation techniques.

Objective: With a microcomputed tomography (microCT) imaging device, we aimed to quantitatively evaluate root canal fillings after commonly used endodontic procedures and also tested the suitability of microCT for this purpose. Materials and Methods: Eighty single roots were instrumented and obturated with gutta-percha and Tubli-Seal. They were divided into 4 groups of 20. The Hand groups were instrumented with hand files and filled with thermoplastic (Th) compaction and cold lateral (CL) condensation, i.e. Hand-Th and Hand-CL, respectively. The Rot groups, i.e. Rot-Th and Rot-CL, were instrumented with a rotary ProFile system and filled as above. The roots were scanned and 3-dimensional (3D) visualization was obtained. The number, size, percentage of volume and distribution of voids at the filling/dentine interface (i-voids) and voids surrounded by filling material (s-voids) were measured. Results: Canal fillings differed significantly with regard to the size of both types of voids and the average number of i-voids. All canals presented a low volume of voids. The highest percentage (0.69%) was found for i-voids in the Hand-CL group, while the lowest volume (0.11% for s-voids and 0.14% for i-voids) was in the Hand-Th canals. Apically, in the last 3 mm, i-voids were observed mainly in the Th groups, and s-voids occurred mostly in the coronal part of the canal filling in all cases. Conclusion: MicroCT was a useful tool for 3D quantitative evaluations of these root canal fillings. None of the root canal instrumentation and filling methods ensured void-free obturation. CL condensation produced mainly i-voids. With Th compaction, internal s-voids were particularly common, but there were mainly i-voids in the apical part.

New endodontic obturation systems and their interfacial bond strength with intraradicular dentine – ex vivo studies

PURPOSE To comparatively evaluate adhesive properties of selected root canal fillings through the measurement of the material-dentine interfacial bond strength. MATERIAL AND METHODS Fifty extracted single-rooted human teeth with one canal each were prepared using Hero instruments to size 30.04. Teeth were divided into four subgroups depending on the root canal filling material and the method of obturation: Resilon/Epiphany - a thermoplastic method (IA), Resilon/Epiphany - a matching single-point method (IB), gutta-percha/Roeko Seal Automix - a thermoplastic method (IIA) and gutta-percha/Roeko Seal Automix - a matching single-point method (IIB). The obturated roots were cut perpendicular to the long axis to create 1.7 mm thick slices. The bond strength was measured for each test slice with push -out testing machine. RESULTS The highest push-out bond strength was registered in subgroup IB (3.98 ± 1.33 MPa). Significantly lower bond strength was observed in subgroups IA (0.50 ± 0.24 MPa), IIA (0.33 ± 0.18 MPa) and IIB (0.08 ± 0.03 MPa) (p<0.001). No statistically significant differences in material-dentine interfacial bond strength values were observed between IA and IIA, IA and IIB, IIA and IIB subgroups (p > 0.05). CONCLUSIONS The push-out bond strength of the material-dentine interface was dependent on the type of material used and the root canal filling technique. The R/E system exhibited better adhesion ability to intraradicular dentine than G/RSA. The highest bond strength was observed for Resilon/Epiphany introduced with the single-cone technique.

Application of microcomputed tomography for quantitative analysis of dental root canal obturations.

INTRODUCTION The aim of the study was to apply microcomputed tomography to quantitative evaluation of voids and to test any specific location of voids in tooths root canal obturations. MATERIALS AND METHODS Twenty root canals were prepared and obturated with gutta-percha and Tubli-Seal sealer using the thermoplastic compaction method (System B+Obtura II). Roots were scanned and three-dimensional visualization was obtained. The volume and Ferets diameter of I-voids (at the filling/dentine interface) and S-voids (surrounded by filling material) were measured. RESULTS The results revealed that none of the scanned root canal fillings were void-free. For I-voids, the volume fraction was significantly larger, but their number was lower (P=0.0007), than for S-voids. Both types of voids occurred in characteristic regions (P<0.001). I-voids occurred mainly in the apical third, while S-voids in the coronal third of the canal filling. CONCLUSIONS Within the limitations of this study, our results indicate that microtomography, with proposed semi-automatic algorithm, is a useful tools for three-dimensional quantitative evaluation of dental root canal fillings. In canals filled with thermoplastic gutta-percha and Tubli-Seal, voids at the interface between the filling and canal dentine deserve special attention due to of their periapical location, which might promote apical microleakage. Further studies might help to elucidate the clinical relevance of these results.

Assessment of cytotoxic potential of root canal sealers after hardening - an ex vivo study.

AIM The aim of this study was to perform a comparative assessment of the toxic action of root canal sealers currently on the market on human gingival fibroblasts after setting. MATERIAL/METHODS The inserts with an equal quantity of set root canal sealers were transferred into 24-well culture dishes containing human gingival fibroblasts cultured in Dulbeccos Modified Eagles Medium (DMEM) supplemented with 10% fetal calf serum (FCS). The dishes with materials were incubated at 37°C, 100% humidity and in an atmosphere of 5% CO2 for 24 h. The cytotoxic effects of the root canal materials were measured by the mitochondrial succinate dehydrogenase activity in living cells using tetrazolium bromide (MTT assay). RESULTS Epiphany and Sealapex exhibited high toxicity towards human gingival fibroblasts - 25.57% ± 0.88 and 27.63 % ± 2.35 respectively (less than 30% live cells in the culture). The remaining materials were characterized by lack of a cytotoxic effect (over 90% of live cells in the culture). None of the preparations exhibited moderate or low toxicity. CONCLUSIONS The majority of root canal sealers tested after hardening were well tolerated by human gingival fibroblasts. Only two materials were characterized by high toxicity: with methacrylate (Epiphany) and calcium hydroxide (Sealapex).

Juvenile idiopathic arthritis and oral health

Juvenile idiopathic arthritis (JIA) is the most common autoimmune inflammatory disease of connective tissue in children. It is characterized by progressive joint destruction which causes preserved changes in the musculoskeletal system. The literature describes fully clinical symptoms and radiological images in different subtypes of JIA. However, there is still a limited number of studies reporting on the medical condition of the oral cavity of ill children. JIA can affect hard and soft tissues of the oral cavity by: the general condition of the childs health, arthritis of the upper limbs, as the result of the pharmacotherapy, changes in secretion and composition of saliva, inflammation of the temporomandibular joint and facial deformity. The study summarizes the available literature on the condition of the teeth and periodontal and oral hygiene in the course of JIA. The presence of diverse factors that modify the oral cavity, such as facial growth, functioning of salivary glands, or the supervision and care provided by adults, prevents clear identification if JIA leads to severe dental caries and periodontal disease. Despite conflicting results in studies concerning the clinical oral status, individuals with JIA require special attention regarding disease prevention and maintenance of oral health.

Detection of voids of dental root canal obturation using Micro-CT

In the present paper an algorithm for the detection of voids of dental root canal obturation in microCT images of the root is described. The algorithm consists of segmentation of the filling material, based on histogram analysis, detection of the voids surrounded by the filling material, detection of voids at the interface of dentine and root canal filling and final processing. The segmentation requires selecting two threshold levels and involves histogram thresholding followed by region growing. To detect the voids at the interface of the filling material a variant of a hit-or-miss filter is proposed. The performance of the algorithm is tested, based on a set of microCT images.

A comparative assessment of the antibacterial activityof root canal sealers on 2 Actinomyces species: An in vitro study

BACKGROUND Actinomyces species have a low virulence and pathogenicity, but under specific circumstances they may be involved in root canal and periapical tissue infections. OBJECTIVES The aim of the study was to investigate the antibacterial activity of various root canal sealers on standardized strains of Actinomyces. MATERIAL AND METHODS The materials tested in this study included AH Plus™ Jet (AH), Apexit® Plus (AP), Endomethasone N (EN), GuttaFlow® (GF), Hybrid Root SEAL (HB), MTA Fillapex (FL), Real® Seal (RCS), Roeko Seal Automix (RSA), Sealapex™ (SP), and Tubli-Seal™ (TS). The antibacterial effect of the freshly mixed sealers on standardized strains of Actinomyces israelii NCTC 8047 and Actinomyces viscosus ATCC 15987 was evaluated with the use of the agar diffusion test (ADT). The results were obtained by measuring the diameter of the growth inhibition zone at 96 h and 1, 2, 3, and 4 weeks, and were analyzed in time using repeated measures analysis of variance (ANOVA). Statistically significant differences among the materials were determined by using one-way ANOVA and Tukeys post hoc testing. A paired Students t-test was applied to compare the susceptibility of particular strains to each sealer. The critical level of significance for all tests was p < 0.05. RESULTS Most sealers demonstrated growth inhibition zones against both tested bacteria, except for RSA and GF. Actinomyces viscosus was significantly more susceptible than A. israelii to AP, RCS (p < 0.001) and TS (p = 0.012). Actinomyces israelii was significantly more susceptible than A. viscosus to EN, HB and SP (p < 0.001). CONCLUSIONS The antimicrobial effect of the examined materials varied considerably depending on the type of material and bacterial species tested. Most of the tested root canal sealers exhibited antibacterial activity on standardized strains of Actinomyces, with FL showing the highest antibacterial effect on both bacterial strains. Importantly, both standardized strains of Actinomyces were characterized by varied sensitivity to root canal sealers.

Importance of dental care to maintain oral health of children and youth with type 1 diabetes

BACKGROUND Dental care for children and youth with type 1 diabetes should rely on reliable examination of the oral cavity, early treatment of dental caries and maintenance of the treatment results. This can be achieved through regular control visits consistent with the standards, and also through following the recommendations for prevention of dental caries and periodontal disease. The aim of the study was to investigate whether dental care allows to preserve good oral health of children and youth with type 1 diabetes. MATERIAL AND METHODS The study included 60 patients with type 1 diabetes, aged 7-17 years, and 30 healthy children and youth within the same age range. There were evaluated intensity of caries, the effectiveness of conservative treatment, periodontal health and oral hygiene. RESULTS The results of examinations showed significantly lower caries prevalence and better periodontal health in the children and youth with type 1 diabetes. The effectiveness of conservative treatment was significantly higher among patients with mixed dentition. There was no significant difference in oral hygiene between the compared groups. CONCLUSIONS Diabetes is a risk factor for oral diseases, so children and youth with type 1 diabetes should be provided with special preventive care and curative measures. The main goal of the insulin-dependent diabetes care program is to early classify them to highrisk groups to improve general oral health and thus improve the quality of life. Proper dental care for children and yuoth with type 1 diabetes is a condition to maintain oral health. Med Pr 2018;69(1):37-44.