Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth: A systematic review and meta-analysis.

OBJECTIVES Different materials have been used for capping the pulp after exposure during caries removal in permanent teeth. The purpose of this study was to collate and analyze all pertinent evidence from randomized controlled trials (RCTs) on different materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth. MATERIALS AND METHODS Trials comparing two or more capping agents used for direct pulp capping (DPC) or pulpotomy were considered eligible. An electronic search of four databases and two clinical trial registries was carried out up to February 28, 2021 using a search strategy properly adapted to the PICO framework. Screening, data extraction, and risk of bias (RoB) assessment of primary studies were performed in duplicate and independently. The primary outcome was clinical and radiological success; secondary outcomes included continued root formation, tooth discoloration, and dentin bridge formation. RESULTS 21 RCTs were included in the study. The RoB assessment indicated a moderate risk among the studies. Due to significant clinical and statistical heterogeneity among the studies, performing network meta-analysis (NMA) was not possible. An ad hoc subgroup analysis revealed strong evidence of a higher success of DPC with Mineral Trioxide Aggregate (MTA) compared to calcium hydroxide (CH) (odds ratio [OR] = 3.10, 95% confidence interval [CI]: 1.66-5.79). MTA performed better than CH in pulp capping (both DPC and pulpotomy) of mature compared to immature teeth (OR = 3.34, 95% CI: 1.81-6.17). The GRADE assessment revealed moderate strength of evidence for DPC and mature teeth, and low to very low strength of evidence for the remaining subgroups. CONCLUSIONS Considerable clinical and statistical heterogeneity among the trials did not allow NMA. The ad hoc subgroup analysis indicated that the clinical and radiographic success of MTA was higher than that of CH but only in mature teeth and DPC cases where the strength of evidence was moderate. PROSPERO Registration: number CRD42020127239

Adjunctive steps for the removal of hard tissue debris from the anatomic complexities of the mesial root canal system of mandibular molars : a micro-computed tomographic study

Introduction: This in vitro study sought to compare the efficacy of a sonic irrigant activation device with ultrasonic activation and needle irrigation in removing hard tissue debris (HTD) from anatomic complexities of the root canal system. Methods: Twenty-seven mesial roots of extracted human mandibular molars with 2 canals connected by an isthmus were selected based on micro–computed tomography scans (12-μm voxel size). The mesial canals were mechanically prepared to ProTaper Next X3 (Dentsply Maillefer, Ballaigues, Switzerland) and anatomically distributed into 3 groups (n = 9) according to the final irrigation protocol: sonically activated irrigation (SAI) using the EDDY system (VDW GbmH, Munich, Germany) for 3 × 20 seconds, ultrasonically activated irrigation (UAI) using a size 20 Irrisafe tip (Satelec Acteon, Mérignac, France) for 3 × 20 seconds, and conventional irrigation using a 30-G needle adapted to a syringe. Micro–computed tomographic scans were taken after instrumentation and after supplementary activation of the irrigant. After reconstruction and coregistration, the volume filled with HTD before and after irrigant activation was calculated, and the mean percentage of HTD reduction after final irrigation was compared within and among groups using the paired sample t test and 1-way analysis of variance post hoc Tukey test, respectively (α = 5%). Results: A significant reduction in the volume filled with HTD after irrigant activation was observed in all groups (P .05). Conclusions: All tested supplementary irrigation steps significantly reduced the amount of debris created during root canal preparation. Ultrasonic activation resulted in the highest mean debris reduction

Het tandheelkundig jaar 2015

Het tandheelkundig jaar 2015 biedt een overzicht van de meest recente ontwikkelingen in de tandheelkunde. Een breed scala aan onderwerpen komt aan bod, zoals: - Moderne keramische materialen voor het indirect restaureren van natuurlijke gebitselementen - Botvervangers: wat gebruik ik waar? - Een vrijgelegde cuspidaat die niet wil bewegen, wat nu? - Preventie in de kindertandheelkunde; de functie van de ruimtehouder tijdens de gebitsontwikkeling - Irrigatie en reiniging van het wortelkanaal: de noodzaak om irrigantia te activeren De bijdragen zijn geschreven door een keur aan gezaghebbende Vlaamse en Nederlandse auteurs

Aandoeningen van het bewegingsapparaat bij tandartsen en studenten tandheelkunde: een inventarisatie. /

Master of Science in de tandheelkund

Microleakage of glass ionomer formulations after erbium:yttrium-aluminium-garnet laser preparation.

The aim of this study was to investigate the microleakage in class V cavities restored with four conventionally setting glass ionomers (CGIs) and one resin-modified glass ionomer (RMGI) following erbium:yttrium-aluminium-garnet (Er:YAG) laser or conventional preparation. Four hundred class V cavities were assigned to four groups: A and B were prepared by an Er:YAG laser; C and D were conventionally prepared. In groups B and D, the surface was additionally conditioned with Ketac conditioner. Each group was divided into five subgroups according to the glass ionomer cement (GIC) used: groups 1 (Ketac Fil), 2 (Ketac Molar), 3 (Ionofil Molar), 4 (Ionofil Molar Quick) and 5 (Photac Fil Quick). After thermocycling, a 2% methylene blue solution was used as dye. Scanning electron microscope (SEM) photographs were taken to show the conditioner's effect. Complete marginal sealing could not be reached. PhotacFil showed less microleakage than the conventionally setting glass ionomer cements (CGICs) investigated. Conditioning laser-prepared cavities did not negatively influence microleakage results except for Ionofil Molar Quick