Marcio Guelmann

Periradicular radiographic assessment in diabetic and control individuals

OBJECTIVE The purpose of this study was to investigate the prevalence of radiographic periradicular radiolucencies in endodontically treated and untreated teeth in patients with and without diabetes. STUDY DESIGN The records of 30 subjects with diabetes and 23 control subjects attending the Endodontic Graduate Clinic at the University of Florida, Gainesville, were reviewed. The number of teeth with root canal treatments with and without periradicular radiolucencies and the number of teeth without endodontic treatment but with periradicular lesions were recorded. RESULTS There were no main effects of sex, diabetes diagnosis, or age (the covariate) on the 3 outcomes of interest- nonsurgical endodontic treatment (NSE) with lesions, NSE without lesions, and no NSE with lesions. However, there were significant interactions between sex and diabetes diagnosis for both of the endodontic outcomes, NSE with lesions (F = 4.292; P <.05) and NSE without lesions (F = 4.241; P <.05). This meant that men with type 2 diabetes who had endodontic treatments were more likely to have residual lesions after treatment. CONCLUSION Type 2 diabetes is associated with an increased risk of ill response by the periradicular tissues to odontogenic pathogens.

Shear bond strength of one etch-and-rinse and five self-etching dental adhesives when used by six operators

Objective. To test the hypothesis that some single-bottle self-etching adhesives bond as well to enamel and dentin as a typical two-bottle etch-and-rinse adhesive. Material and methods. Six operators used one two-bottle etch-and-rinse dentin adhesive (Scotchbond MP) and five all-in-one self-etching adhesives (iBond Gluma Inside, Clearfil S3 Bond, iBond Experimental, Xeno IV, and G-BOND). Each operator carried out six bondings to enamel and six bondings to dentin with each adhesive. After 24 h of storage in water at 37°C, bond strength was determined in shear. Results. The pooled results of all the adhesives revealed no significant difference (p>0.05) in bond strength between dentin and enamel. However, there were significant differences (p<0.0001) between the different adhesives. The etch-and-rinse adhesive did better than the self-etching adhesives when substrate was not an issue (pooled enamel and dentin results). On comparing the performance of the different adhesives, it became clear that there were significant interactions (p<0.0001) between substrates and products. There were also significant differences (p<0.0001) between operators, and the interaction between operators and products was significant (p<0.0002). Conclusions. The tested etch-and-rinse adhesive did better than the tested self-etching adhesives. The shear bond strength results were also strongly affected by the operator as well as by the interaction between operator and used product. The pooled bond strength values of the different adhesives revealed no difference in bond strength to dentin versus enamel.

Oral characteristics of children with attention-deficit hyperactivity disorder.

The purpose of this study was to compare the oral and demographic characteristics of children with attention-deficit hyperactivity disorder (ADHD) to those of a control group of children. A sample of 25 dental records of children medicated for ADHD was compared to 127 records of healthy children not receiving any medication. The children with ADHD had a statistically higher prevalence of toothache, bruxism, bleeding gums, and oral trauma histories than the control group (chi square, p < 0.05). The differences in other recorded oral characteristics and habits, such as plaque accumulation, gingival inflammation, calculus, oral hygiene compliance, dental caries experience, and unmet dental needs, were not statistically significant. The demographic characteristics such as age, gender, residence, ethnicity, income, and payment method were also not significantly different between the two groups. There is a need to develop and implement specific strategies for the early prevention and treatment of oral diseases in children with ADHD.

Impact of Er,Cr:YSGG Laser Therapy on the Cleanliness of the Root Canal Walls of Primary Teeth

Root canal therapy might be required for primary teeth displaying signs of pulpal inflammation or necrosis. Cleaning and shaping followed by obturation of the canal space with a resorbable paste have been widely performed with remarkable clinical success. However, lengthy endodontic procedures might be contraindicated when treating certain pediatric patients. The aim of this study was to compare the cleanliness of the root canal walls of primary teeth and the time required for the completion of the cleaning and shaping procedures performed by the Er,Cr:YSGG laser, manual or rotary instrumentation techniques. Thirty-five extracted, single-rooted, primary teeth were divided into 4 groups: I, canals were instrumented with Profile .04 rotary instruments to a master apical file size #35; II, the laser was used (parameters: 1.50 W, 20 pps, 30% water and 50% air) with a Z3 laser tip (0.32-mm diameter); III, canals were instrumented with stainless steel K-files; and IV, no instrumentation was performed (control). The teeth were split in 2 halves and prepared for scanning electron microscopy analysis. Images from the coronal, middle, and apical thirds of the roots were analyzed independently by 2 calibrated, blinded evaluators. Statistical analysis revealed significant differences among the groups (Kruskal-Wallis, P = .0001). The techniques were not capable of providing completely clean canals. Treatment with Er,Cr:YSGG laser provided similar cleanliness when compared with rotary instrumentation technique and was superior to manual instrumentation. The laser technique required less time for completion of the cleaning and shaping procedures when compared with both rotary or hand instrumentation.

Pulp Therapy for the Primary Dentition

Several treatment options for pulp therapy in primary teeth are reviewed. Conservative treatments are recommended for primary teeth whose pulps have the potential to recover once the irritation has been removed. The role of dentin permeability and microleakage is emphasized when protective basis and indirect pulp treatment are discussed. Alternative dressings for formocresol pulpotomies such as 6.25% glutaraldehyde solution, antigen-extracted allogeneic dentin matrix, and crude bone morphogenetic protein are reported with promising results. Pulpectomy is recommended for teeth with evidence of chronic inflammation involving radicular pulp or pulp necrosis with and without periapical involvement. The main disadvantage of zinc oxide-eugenol paste, widely used for primary root fillings in the United States, is its slow resorption rate, frequently much slower than that of the root. Other root canal pastes containing iodoform, or a modification of this with the addition of calcium hydroxide, are being utilized in South America, Japan, and Europe.

Clinical Characteristics of Localized Aggressive Periodontitis in Primary Dentition

OBJECTIVES Due to the low prevalence of localized aggressive periodontitis (LAP), clinical characteristics of LAP in primary dentition are derived from a few case reports/series in the literature. The goal of this study was to determine common clinical characteristics such as bone and root resorption patterns, in a series of cases with LAP in primary dentition. We hypothesize these cases present aggressive periodontal bone destruction starting mostly around first primary molars and atypical root resorption patterns. STUDY DESIGN We have evaluated 33 LAP cases in primary dentition for pattern of bone destruction, root resorption and early exfoliation. RESULTS Cases evaluated were aged 5-12 (mean=8.7 years). Thirty cases presented more severe bone loss on first than second molars, with relatively fast progression to second molars, altered pattern of root resorption, mostly external (n=16) and early exfoliation of primary teeth due to periodontal bone loss, rather than physiologic root resorption (n=11). CONCLUSIONS This study showed common clinical characteristics found in LAP in primary molars, including possible initiation on first primary molars and abnormal root resorption patterns. These characteristics are important to be early identified and treated in order to prevent possible progression into the permanent dentition.

Fluoride varnish application: not always effective in public health trials.

Article Title and Bibliographic Information A Cluster Randomized Controlled Trial to Evaluate the Effectiveness of Fluoride Varnish as a Public Health Measure to Reduce Caries in Children Hardman MC, Davies GM, Duxbury JT, Davies RM. Caries Res 2007;41:371-6 Level of Evidence 1 Purpose The purpose of this study was to assess the effectiveness of twice-yearly application of Duraphat varnish as a public health measure to reduce dental caries in children living in relatively deprived communities. Source of Funding Information not provided. Type of Study/Design A Cluster Randomized Control Trial

Clinical Pulpal Diagnosis

As of today, very little or no correlation exists between clinical diagnostic findings and the histopathologic status of the pulp [1]. Technologically advanced tests and tools to indicate the vitality condition of the pulp, such as laser Doppler flowmetry and pulse oximetry, are available. However, even these new technologies may lead to unreliable response when providing dental care for very young children and/or for patients with special health-care needs, due to uncooperative behavior.

Direct pulp capping in primary molars: Report of two cases

Pulpotomy has been the preferred therapy for carious pulpal exposure in primary teeth. Direct pulp capping (DPC) is considered controversial on these types of cases due to the belief that the pulp may be compromised due to the bacterial invasion with subsequent treatment failure. This case report describes two cases of primary molars effectively treated with DPC after small pulpal exposures during caries excavation.

Bilateral complicated crown fractures secondary to chin injury: a case report

Traumatic injuries to the chin are not uncommon in children. Nevertheless, crown fractures, which are common sequelae to this type of injury, might be overlooked, especially if dental care is not sought immediately after a visit to a non-dental facility. The present case report reviews the delayed diagnosis and treatment outcome of a bilateral posterior complicated crown fracture affecting mandibular second primary molars in a young child. Pharmacologic and orthodontic considerations are also discussed in the paper.