Rita Cauwels

Low level laser therapy in oral mucositis: a pilot study

AIM: The goal of this pilot study was to investigate the capacity of pain relief and wound healing of low level laser therapy (LLLT) in chemotherapy-induced oral mucositis (OM) in a paediatric oncology population group. STUDY DESIGN AND METHODS: 16 children (mean age 9.4 years) from the Gent University Hospital — Department Paediatric Oncology/haematology, suffering from chemotherapy-induced OM were selected. During clinical investigations, the OM grade was assessed using the WHO classification. All children were treated using a GaAlAs diode laser with 830nm wavelength and a potency of 150 mW. The energy released was adapted according to the severity of the OM lesions. The same protocol was repeated every 48 hrs until healing of each lesion occurred. Subjective pain was monitored before and immediately after treatment by an appropriate pain scale and functional impairment was recorded. At each visit, related blood cell counts were recorded. RESULTS: After 12 mths, records were evaluated and information about treatment sequence, treatment sessions and frequencies related to the pain sensation and comfort were registered. Immediately after beaming the OM, pain relief was noticed. Depending on the severity of OM, on average, 2.5 treatments per lesion in a period of 1 week were sufficient to heal a mucositis lesion. CONCLUSIONS: LLLT, one of the most recent and promising treatment therapies, has been shown to reduce the severity and duration of mucositis and to relieve pain significantly. In the present study similar effects were obtained with the GaAlAs 830nm diode laser. It became clear that using the latter diode device, new guidelines could be developed as a function of the WHO-OM grades i.e. the lower the grade, the less energy needed. Immediate pain relief and improved wound healing resolved functional impairment that was obtained in all cases.

Biodentine™ material characteristics and clinical applications: a review of the literature

IntroductionBiodentine™ is a new version of calcium silicate-based inorganic cement.AimThe aim of this review is to provide a detailed analysis of the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements viz. mineral trioxide aggregate (MTA) and Bioaggregate™ (Bioaggregate).Study designA comprehensive systematic literature search for all publications to date was performed on 20th November 2013 by two independent reviewers in Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov using the search terms Biodentine, “tricalcium silicate”, Ca3SiO5, “dentine substitute”, “dentin substitute” and RD 94. In addition to the electronic search, hand searches and reference searches were performed to include articles published in journals that were not indexed in Medline. Randomised control trials (RCT), case control studies, case series, case reports, in vitro studies, animal studies and short communications in English language were considered for this review.ConclusionsConsidering the superior physical and biologic properties, Biodentine™ could be an efficient alternative to MTA to be used in a variety of clinical applications. There appears to be a wide range of clinical applications where Biodentine™ could be used in the field of endodontics, dental traumatology, restorative dentistry and pediatric dentistry. Although it seems to be good clinical practice, currently there is little clinical evidence to support all potential indications.

Dental caries and dental care level (restorative index) in children with diabetes mellitus type 1

INTRODUCTION The aim of the study was to investigate caries experience and dental care index in diabetic children and to determine if correlation exists between caries experience and metabolic control, insulin treatment, and the duration of diabetes. MATERIALS AND METHODS The study group consisted of 52 children and adolescents, 3-16 years of age with type 1 diabetes attending the outpatient diabetic clinic at Ghent University Hospital, Belgium. Fifty healthy subjects recruited from the paediatric dental clinic served as the control group. Caries lesions were assessed using DMF-index both at cavity and non-cavity levels. Participants and/or their guardians provided information about oral hygiene habits and dietary habits. Diabetes-related data (type, duration, insulin regimen) were collected from medical records and completed with the lab data on HbAlc. CONCLUSION It became clear that, although children with type 1 diabetes mellitus could be expected to run a potential high caries risk taking into account the diabetes-associated biological and behavioural alterations, no significant differences were observed regarding caries experience and dental care between diabetic children and healthy controls. The level of untreated dental decay among the diabetic children is, however, considerably high, which was reflected by a significant lower dental attendance.

Fracture resistance and reinforcement of immature roots with gutta percha, mineral trioxide aggregate and calcium phosphate bone cement: a standardized in vitro model

Endodontic treatment of immature teeth is often complicated because of flaring root canals and open apices for which apexification is needed. Long-term prognosis for these teeth is surprisingly low because of cervical root fractures occurring after an impact of weak forces. In this study, an experimental model was developed to determine the fracture resistance of immature teeth and to test the hypothesis that endodontic materials succeed in reinforcing them. Compact and hollow bone cylinders from bovine femurs were used as standardized samples. In order to evaluate the experimental model, fracture resistance in both groups was evaluated by determining the ultimate force to fracture (UFF) under diametral tensile stress. Analysis of variance (ANOVA) revealed a statistically significant difference between the mean values of UFF for both groups, independently of the sampling location or subject. In a following setting, the hypothesis that obturation with gutta percha (GP), mineral trioxide aggregate (MTA), or calcium phosphate bone cement (CPBC) reinforces the hollow bone samples was investigated. Obturation resulted in a significant reinforcement for all materials, but the degree of reinforcement depended on the material. The experimental model appeared to be suitable for in vitro investigation of reinforcement and fracture resistance in a standardized way.

Microleakage and penetration of a hydrophilic sealant and a conventional resin-based sealant as a function of preparation techniques: a laboratory study.

BACKGROUND Optimal pit and fissure sealing is determined by surface preparation techniques and choice of materials. AIM This study aimed (i) to compare the microleakage and penetration depth of a hydrophilic sealant and a conventional resin-based sealant using one of the following preparation techniques: acid etching (AE) only, a diamond bur + AE, and Er:YAG laser combined with AE, and (ii) to evaluate the microleakage and penetration depth of the hydrophilic pit and fissure sealant on different surface conditions. DESIGN Eighty recently extracted 3rd molars were randomly assigned to eight groups of ten teeth according to the material, preparation technique, and surface condition. For saliva contamination, 0.1 mL of fresh whole human saliva was used. All samples were submitted to 1000 thermal cycles and immersed in 2% methylene blue dye for 4 h. Sections were examined by a light microscope and analysed using image analysis software (Sigmascan(®)). RESULTS The combination of Er:YAG + AE + conventional sealant showed the least microleakage. The sealing ability of the hydrophilic sealant was influenced by the surface condition. CONCLUSION Er:YAG ablation significantly decreased the microleakage at the tooth-sealant interface compared to the non-invasive technique. The hydrophilic sealant applied on different surface conditions showed comparable result to the conventional resin-based sealant.

Fracture resistance of endodontically restored, weakened incisors

OBJECTIVES To test the fracture strength of weakened bovine incisors endodontically treated with mineral trioxide aggregate (MTA), calcium phosphate bone cement (CPBC) or fibre reinforced composite (FRC) posts, and to evaluate the fracture mode. METHODS Weakened bovine incisors (n = 75), standardized according to the dentinal wall thickness at the cervical area, were randomly assigned to one control group and three experimental groups. Unfilled teeth were assigned to group 1 (n = 20) and served as control group. Group 2 (n = 17) consisted of teeth filled with MTA. In group 3 (n = 18), the incisors were filled with CPBC and in group 4 (n = 20) with FRC posts. All specimens were subjected to load at a cross-head speed of 60 mm min(-1) until fracture occurred. The initial (IL) and final fracture (FL) loads (N) were recorded, and the failure mode among the different groups was evaluated. RESULTS anova showed a statistically significant difference in fracture load among the groups. Tukeys test revealed a significant difference for the IL between the control group and the experimental groups with exception of the MTA group. The FL was not significantly different among the experimental groups. A high percentage of favourable fractures was seen in the FRC and CPBC groups. CONCLUSION FRC posts and CPBC could be promising materials to strengthen non-vital structurally compromised teeth.

Biodentine™ material characteristics and clinical applications: a 3 year literature review and update

IntroductionBiodentine™ has frequently been acknowledged in the literature as a promising material and serves as an important representative of tricalcium silicate based cements used in dentistry.AimTo provide an update on the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements namely, different variants of mineral trioxide aggregate (MTA) such as ProRoot MTA, MTA Angelus, Micro Mega MTA (MM-MTA), Retro MTA, Ortho MTA, MTA Plus, GCMTA, MTA HP and calcium enriched mixture (CEM), Endosequence and Bioaggregate™.Study designA comprehensive literature search for publications from November 20, 2013 to November 20, 2016 was performed by two independent reviewers on Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov. Electronic and hand search was carried out to identify randomised control trials (RCTs), case control studies, case series, case reports, as well as in vitro and animal studies published in the English language.ConclusionsThe enhanced physical and biologic properties of Biodentine™ could be attributed to the presence of finer particle size, use of zirconium oxide as radiopacifier, purity of tricalcium silicate, absence of dicalcium silicate, and the addition of calcium chloride and hydrosoluble polymer. Furthermore, as Biodentine™ overcomes the major drawbacks of MTA it has great potential to revolutionise the different treatment modalities in paediatric dentistry and endodontics especially after traumatic injuries. Nevertheless, high quality long-term clinical studies are required to facilitate definitive conclusions.

Fracture resistance of bone samples filled with fibre-reinforced composite posts: an ex vivo model

AIM To evaluate the strengthening effect of two different types of fibre-reinforced composite (FRC) posts in an ex vivo experimental model. METHODOLOGY Compact and hollow bone samples from bovine femurs were used as standardized samples. A total of 80 hollow samples were divided into two groups and filled either with a prefabricated FRC post or with individually adapted FRC posts. For each group, half of the samples were subjected to thermocycling (5-55 °C, 5000×). The remaining samples were kept for 24 h at 37 °C at 100% relative humidity. All samples were loaded diametrically until fracture. The null hypothesis tested was that the fracture resistance of standardized bone samples is not influenced by the type of FRC post, independently of the exposure to thermocycling. Results were evaluated by anova, and subsequent multiple comparisons were performed. RESULTS The samples filled with the individually adapted FRC posts were more resistant to fracture than the prefabricated ones (P < 0.001), but this difference was not apparent in the thermocycled groups. Detachment of the posts upon fracture was highest after thermocycling for both groups, amounting to 55% and 95% for the individual adapted posts and the prefabricated posts, respectively. CONCLUSIONS Initially, the samples filled with the individually adapted FRC posts were more resistant to fracture than those filled with the prefabricated ones. However, after ageing of the samples, both types of posts had similar strengthening effects.

Correction to: Biodentine™ material characteristics and clinical applications: a 3 year literature review and update

Owing to a misunderstanding on the part of the authors, the name of the last author, Prof. R. M. H. Verbeeck, was omitted from this article.

Biodentine™: eigenschappen en klinische toepassingen

Biodentine™, een nieuw anorganisch restauratief cement gebaseerd op tricalciumsilicaat (Ca3SiO5) cement, wordt op de markt gebracht als een ‘bioactief dentinesubstituut’. De auteurs geven in dit hoofdstuk een samenvatting van de bestaande literatuur om zo na te gaan of het een geschikt alternatief vormt voor andere tricalciumsilicaat cementen in de endodontie en traumatologie. Een uitgebreid literatuur onderzoek werd uitgevoerd voor publicaties tussen 1980 en januari 2015. Rekening houdend met de fysische (hogere druksterkte, push-out hechtsterkte, densiteit en porositeit), biologische (vorming van calciumhydroxide, hogere afgifte en incorporatie van calciumionen) en verwerkingseigenschappen (snellere uitharding) van Biodentine™, zou dit bioactief tricalciumsilicaatcement een waardig alternatief kunnen betekenen voor mineraal trioxide aggregaat (MTA) in het kader van endodontie, dentale traumatologie, restauratieve tandheelkunde en kindertandheelkunde.