IN VIVO EVALUATION OF PERIODONTAL MICROCIRCULATORY CHANGES ASSOCIATED WITH ENDODONTIC TREATMENT

The purpose of this study was to investigate in vivo the gingival microcirculatory changes associated with endodontic treatment using the continuous wave of condensation technique. MATERIALS AND METHODS: Twenty necrotic one canal roots of 20 cooperative patients of both sexes, aged between 20 and 43 years, were selected. All patients were examined by capillaroscopy before, immediately after endodontic treatment, and after 7 days. The last examination was carried out by the same operator, and repeated twice for each examined area: masticatory, buccal and labial mucosa corresponding to the endodontically treated root. All canals were prepared using a simultaneous technique with Ni-Ti files (MTwo files). RESULTS: The images of the masticatory mucosa after root canal obturation showed evident micro-areas of extravasation, with significant bleeding and angio-morphological alterations due to heat. One hour after the endodontic treatment evident extravasation was observed, but a decrease of all altered parameters, was present. After seven days from treatment, in the periodontal tissues, a complete healing was observed. The in vivo evaluation of the vascular pattern during root canal obturation with System B showed that the high temperature in the canal determines visible effects on the vasculature of adjacent sites. It was found that microangiotectonic alterations decrease up to a complete healing after 7 days from treatment. CONCLUSION: All the changes in microcirculation, due to thermal shock of periodontal tissues, are reversible

Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage

Background: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient’s quality of life. Purpose: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients. Methods: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria. Results: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient’s motivation to enhance oral hygiene can lead to a significant improvement. Conclusion: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia

Conservative Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw with Er,Cr:YSGG Laser and Platelet-Rich Plasma: A Longitudinal Study

Abstract Introduction: The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ), with no evidence-based guidelines, remains controversial. We aimed to evaluate the efficiency of a conservative surgical treatment combining Er,Cr:YSGG laser and platelet-rich plasma (PRP) for the treatment of BRONJ in cancer patients.Methods:We performed a longitudinal cohort study. Inclusion criteria were (1) age 65 18 years; (2) cancer diagnosis; (3) treatment with NBP because of the underlying cancer. Results:We consecutively recruited ten patients diagnosed with BRONJ in stage I or II. These patients underwent a surgical laser-assisted therapy together with autologous PRP. At the latest follow-up at 12 months, clinical improvement was observed in eight patients. Registration Number is IRCT20180329039159N1. Conclusion:We could successfully manage the BRONJ utilizing this combined protocol to heal the 30% of surgically treated sites and to improve the 50% of patients' lesions clinically. Our findings suggest that a surgical approach combined with Er,Cr:YSGG laser and PRP benefit cancer patients with general health issues

System B, Endo-Twinn and E-Fill. True temperatures inside the canal

Background: The aim of this study is to verify the variations of the temperature inside the root canal with three different gutta-percha heating systems. Materials and Methods: A split-tooth model was built with a lateral groove at 3.5-mm from working length (WL) in order to insert a Chromel-Alumel K-type thermocouple placed in contact with gutta-percha. The thermocouple was connected to a digital thermometer. Sixty obturations were made with medium gutta-percha points. For 20 specimens the System B was used with the Buchanan fine plugger and the temperature was set at 200C; for other 20 specimens the Endo-Twinn with a fine plugger was used and for the last 20 specimens we used the E-Fill with a 40.04 plugger. All pluggers were pushed to 3.5 mm from WL so that the tips were in contact to the probe. Results: The analysis of 60 samples showed the highest temperature average using the System B after 10 seconds (86.85C), after 15 seconds (94.9C), after 20 seconds (100.4C) and after 25 seconds (104.5C). The Endo-Twinn average values are similar to System-B ones. The E-Fill average values are lower (69.9C) than the other two systems evaluated only after 10 seconds due to limited working time. The temperatures average obtained using different systems of warm vertical compaction are lower than what was declared by the producing companies. Conclusion: Time is one the most important parameters to consider using these systems. Temperatures reached from the System B and Endo-Twinn after 25 seconds; however, seem to be sufficient to ensure an optimal adaptation of the gutta-percha in the anatomical complexity of root canals. The temperatures obtained from the E-Fill, only after 10 seconds, instead seems to be insufficient to assure the rheological characteristics of gutta-percha

Current dental adhesives system. A narrative review

Adhesive dentistry is based on the development of materials which establish an effective bond with the tooth tissues. In this context, adhesive systems have attracted considerable research interest in recent years. Successful adhesive bonding depends on the chemistry of the adhesive, on appropriate clinical handling of the material as well as on the knowledge of the morphological changes caused on dental tissue by different bonding procedures. This paper outlines the status of contemporary adhesive systems, with particular emphasis on chemical characteristics and mode of interaction of the adhesives with enamel and dentinal tissues. Dental adhesives are used for several clinical applications and they can be classified based on the clinical regimen in "etch-and-rinse adhesives" and "self-etch adhesives". Other important considerations concern the different anatomical characteristics of enamel and dentine which are involved in the bonding procedures that have also implications for the technique used as well as for the quality of the bond. Etch-and-rinse adhesive systems generally perform better on enamel than self-etching systems which may be more suitable for bonding to dentine. In order to avoid a possible loss of the restoration, secondary caries or pulp damage due to bacteria penetration or due to cytotoxicity effects of eluted adhesive components, careful consideration of several factors is essential in selecting the suitable bonding procedure and adhesive system for the individual patient situation. © 2012 Bentham Science Publishers