Nili Tickotsky

Long-term follow up of root canal treated primary molars.

BACKGROUND Root canal treatment (RCT) is commonly performed to preserve primary molars with an infected or necrotic pulp. AIM This study evaluates the long-term effects of RCT in primary molars on the development and eruption of their permanent successors. METHODS This is a retrospective study of treatment of pulpectomised primary molars in a public dental clinic. All teeth were treated by the same operator using the same material (Endoflas F.S.) and the same method. Records of 194 patients with 242 pulpectomised primary molars (124 in 97 boys and 118 in 97 girls) met the inclusion criteria. The childrens age at the time of treatment ranged from 5 to 11 years (mean 6.72). Follow-up time ranged from 6 to 113 months (mean 33.5). RESULTS Eight (3.3%) of the 242 primary molars presented a new radiolucent defect or enlargement of existing periapical radiolucency. Of the 106 molars followed until eruption of the permanent successor, none had radiographic pathological signs. Of 17 permanent teeth evaluated clinically, three were erupted into a rotated alignment, and one premolar presented hypocalcified defect in the enamel. CONCLUSIONS Failure of root canal treatment in primary molars may be evident from development of new radiolucent defects or enlargement of existing defects. No relationship was found between RCT in the primary molars and the appearance of enamel defects or the ectopic eruption of following permanent teeth.

Cytotoxicity and proliferative effects of Iodoform-containing root canal-filling material on RAW 264.7 macrophage and RKO epithelial cell lines.

OBJECTIVE The present study investigated the effect of the Iodoform-containing root canal filling material on the viability of cultured macrophages and epithelial cells, and on cytokine secretion. DESIGN The effect of Endoflas F.S. on the proliferation of a RAW 264.7 macrophage cell line and on a RKO epithelial cell line, and on the production of tumour necrosis factor alpha (TNFα) from macrophages was examined. Cell vitality was evaluated using a colourimetric XTT (sodium 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)-carbonyl]-2H-tetrazolium inner salt) assay. The presence of cytokines was determined by two-site enzyme-linked immunosorbent assay (ELISA). RESULTS Direct exposure of Endoflas F.S. and its media, up to a dilution of 1/8, decreased the viability of macrophages and epithelial cells by ∼70% compared to control media (P<0.05). Media dilution from 1/16 to 1/1024 demonstrated a proliferative effect, increasing cell viability by about 60% compared to media without Iodoform-containing root canal filling material. CONCLUSIONS Direct and indirect exposure to high concentrations of iodoform-containing root canal filling material showed a cytotoxic effect on macrophages and epithelial cells, while low concentrations induced cell proliferation.

Age Related Prevalence of Pre-Eruptive Intracoronal Radiolucent Defects in the Permanent Dentition

OBJECTIVE The present study aimed to determine if the prevalence of pre-eruptive intracoronal radiolucent defects is higher for young age groups, in which there are more unerupted teeth. STUDY DESIGN A retrospective study of panoramic and bitewing radiographs was conducted. An inclusion criterion was the presence of un-erupted permanent teeth with a formed and clearly visible crown. Age groups were: young (6-8 years), intermediate (9-12 years) and adults (13-53 years). Significance level was set at p≤0.05. RESULTS Thirteen (3.9%) pre-eruptive lesions were detected in 335 records. No lesions were found in the young group (7.4%), in the intermediate and adult age groups six and seven lesions were found, respectively. In most cases the pre-eruptive lesion was found in a third molar. CONCLUSION The prevalence of pre-eruptive intracoronal lesions was not higher for young age groups. The prevalence of pre-eruptive intra coronal radiolucent lesions is 3.9%, irrespective of age.

Renal agenesis in Kallmann syndrome: a network approach.

Kallmann syndrome (KS) is defined by the combination of isolated hypogonadotrophic hypogonadism (IHH) and anosmia, with renal agenesis occurring in 30% of KS cases with KAL1 gene mutations. Unlike other KS‐related disorders, renal agenesis cannot be directly associated with mutations in the KAL1 gene. We hypothesized that protein interaction networks may suggest a link between genes currently known to be associated with KS on the one hand and those associated with renal agenesis on the other hand.

Caries Progression Rate in Primary Teeth: A Retrospective Study

OBJECTIVES The rate of caries progression in primary teeth has rarely been studied, with most studies on early childhood caries reporting the percentage of lesions that remain at a certain stage of disease over a period of time. The aim of the present study was to examine the prevalence and behavior of proximal and occlusal carious lesions in primary teeth among children from low socio-economic status. STUDY DESIGN This retrospective study was based on bite-wing radiographs of 95 children aged 5-12 taken at 6-12 months intervals, with a follow-up period of at least three years. One hundred thirty-five teeth and 141 tooth surfaces were examined. The degree of proximal surfaces and occlusal caries advancement was scored and statistical analyses (Mann-Whitney, Kruskal-Wallis and Kaplan-Meier analysis) were performed to evaluate caries progression rate. RESULTS The results revealed that approximately 0.8 years were required for a carious lesion to progress from the outer enamel to the dentino-enamel junction, and an additional 1.4 years for it to reach the inner part of the dentin. CONCLUSIONS The caries progression rate found in the present study is more rapid than previously found and affects more the lower socio economic population.

Dental pulp therapy for primary teeth in children undergoing cancer therapy.

Childhood cancer treatment negatively affects the immune system, increasing the risk for bacteremia and septicemia. As the oral cavity is a major entry portal for pathogens into the bloodstream dental care in such children tends to be radical, favouring tooth extraction over less drastic treatments such as pulpotomy, the amputation of infected dental pulp. The present study aimed to compare pulpotomy treatment success rate in children with cancer receiving immunosuppressive therapy with that of healthy children, and investigate if unsuccessful pulpotomy treatment in oncologic patients may lead to systemic complications.

Clinical Performance of Heat-Cured High-Viscosity Glass Ionomer Class II Restorations in Primary Molars: A Preliminary Study

OBJECTIVES The present preliminary study evaluated the clinical and radiographic performances of heat-cured high viscosity glass ionomer (HCHVGI) in class II restorations of primary molars. STUDY DESIGN A retrospective study on a cohort of patients who had dental caries restored at a private practice was conducted. Restorations were evaluated radiographically and photographically by two separate examiners. RESULTS Ninety-three Class II restorations in 44 patients (average age: 108 months ± 25.3, 24 males, 20 females) were examined. Average recall time was 22.2 months ± 4.2. All but three restorations (96.8%) were present and intact, with no incidents of secondary caries. Three additional restorations had occlusal defects that required retreatment, resulting in an overall success rate of 93.5%. Ninety-seven percent of the restorations were rated optimal for marginal integrity with no staining of the restoration surfaces. No patients complained of post-operative sensitivity. The most common flaw found was a concavity on the proximal wall of the cavity box (27%, mean age 16 months ± 3.9). CONCLUSION The findings in this preliminary study suggest that heat cured high viscosity glass ionomer cement may be an effective restorative material for Class II restorations in primary molars that are a year or two from shedding.

Integrating genomic data from high-throughput studies with computational modeling reveals differences in the molecular basis of hyposalivation between type 1 and type 2 diabetes

ObjectivesBoth type 1 and type 2 diabetes are accompanied by a high prevalence of hyposalivation (decreased salivary secretion), resulting in oral tissue damage. However, the molecular basis for the hyposalivation is yet unknown. Identifying genes and proteins that account for diabetes-related hyposalivation will help understanding the basis for this condition and identifying disease biomarkers in saliva.Materials and methodsWe integrated genomic data from 110 high-throughput studies with computational modeling, to explore the relationship between diabetes and salivary glands on a genomic scale.ResultsA significant overlap exists between genes that are altered in both types of diabetes and genes that are expressed in salivary glands; 87 type 1 diabetes and 34 type 2 diabetes associated genes are also common to salivary glands. However, the overlap between these genes is not significant.ConclusionsType 1 and type 2 diabetes associated genes are involved in the salivary secretion process, but mostly at different parts of it. This suggests that type 1 and type 2 diabetes impair salivary secretion by affecting different processes in the salivary tissue.Clinical relevanceThe genomic characteristics of Type 1 and type 2 diabetes may explain differences in salivary gland tissues morphology and saliva composition in people with diabetes, and suggest candidate proteins for diabetes salivary biomarkers.

Post-and-Core Restoration of Severely Damaged Permanent Posterior Teeth in Young Adolescents

PURPOSE This retrospective study evaluated the survival rates of postendodontic severely decayed posterior permanent teeth in young adolescents. MATERIALS AND METHODS A total of 48 teeth (patient age range: 8.8-16.9 years) restored with a Kurer post- and core-system (Anchor System, Kurer K4) were assessed. Follow-up appointments 1 to 6 years posttreatment included radiographs and a clinical examination. RESULTS A total of 5 teeth (10.4%) were extracted, and 13 restorations (27%) required repair. Average restoration-to-failure time was 27 months (SD 12.2 months). CONCLUSION In view of these findings, clinicians should consider post-and-core restorations an alternative to extractions of endodontically treated severely damaged teeth in adolescents.

Pulpectomy and Root Canal Treatment (RCT) in Primary Teeth: Techniques and Materials

When confronted with an infected and/or necrotic pulp in primary teeth, dentists have two options: the first is to extract the tooth and provide a space maintainer (when needed) to preserve space for the erupting permanent successor, and the other option includes removal of pulp remnants and root canal obturation followed by crown reconstruction. The lack of treatment is not an option as it can cause damage to the succedaneous tooth (e.g., enamel hypo-mineralization or hypoplasia) [1] and negatively impact the child’s oral health-related quality of life (e.g., pain, eating preferences, quantity of food eaten, and sleep habits) [2].