Enhancing Coronal Adaptation of Root Canal Fillings with a Modified Single-Cone Obturation Technique: Two Case Reports

The single-cone technique, also known as the hydraulic condensation technique, is widely employed in endodontics. However, the aforementioned method is presented with certain limitations; specifically concerning the coronal seal and the adaptation of the coronal third of a master gutta-percha (GP) with a round cross-section to the coronal dentinal walls of root canals with semi-round or oval cross-sections. Through two case reports, the current article introduces the coronal vertical condensation (CVC) technique; aiming to enhance GP adaptation to canal walls in similar scenarios. In fact, the coronal vertical condensation technique amalgamates the different aspects of warm vertical condensation and single-cone techniques. In CVC, following the placement of the master GP cone, an electrical heat carrier is inserted immediately a few millimeters apical from the canal orifice to remove the coronal portion of the master GP cone. Subsequently, a hand plugger is used to condense GP in the vertical dimension, and the coronal space is backfilled using melted GP. The implementation of CVC technique has demonstrated an improved coronal adaptation of GP with canal walls. The stated technique seems beneficial; especially in the obturation of severely curved canals or root canals with a final preparation shape of variable taper

Functional treatment of skeletal Class II malocclusion using bone-anchored devices and intermaxillary elastics

Introduction: Dentofacial functional appliances used for the treatment of skeletal Class II malocclusion are divided into two groups: Removable appliances and fixed (bonded) appliances, each with certain advantages and disadvantages. Considering the problems related to functional appliances such as high volume in the oral cavity, patient noncompliance, esthetics, tissue irritation or ulceration, speech or breathing difficulties, etc., there is considerable demand to develop a new appliance that can overcome these issues. Thus, the aim of the current study is to present a hypothesis regarding a new functional treatment technique. The hypothesis: We hypothesize that by fixing mini-plates or -implants in the posterior region of the mandible and the anterior part of the infrazygomatic crest region of the maxilla using intermaxillary elastics, we can expect a forward growth of the mandible in a growing child. Using this technique, the force vector will be in the oblique (forward-upward) direction. By installing mini-plates with a long connecting bar in the infrazygomatic crest region (with the orthodontic attachment head approximating the level of the occlusal plane), and mini-plates or -implants in the most posterior and superior regions of the mandible, such as the retromolar region, the force vector can be placed in the most horizontal direction possible. Evaluation of the hypothesis: In the literature, significant growth modification results were reported in skeletal Class III patients using intermaxillary elastics and bone-anchored devices fixed in both jaws, when compared with those in the nontreatment group. Therefore, in practice, intermaxillary elastics can produce enough traction to stimulate the bone to change and grow. Thus, we presume that inverting the direction of the force vector (i.e., posterior-anterior force) may have similar growth effects on the mandibles of growing children

Bioadhesive chlorhexidine gel for reduction of alveolar osteitis incidence: Systematic review and meta-analysis of randomized controlled trials

Introduction: Alveolar osteitis (AO) creates severe and self-limiting pain, which needs to be treated with several postoperative visits, leading to increases in patient′s morbidity and costs. Hence, the most basic and best treatment could be prevention. The aim of this study was to investigate the efficacy of bioadhesive chlorhexidine (CHX) gel in reducing AO occurrence with published studies. Materials and Methods: Medline/PubMed, Scopus, EBSCO, Ovid and Cochrane central registry for control trial were searched up to 28 February 2014 using "alveolar osteitis" and "chlorhexidine" as key words for systematic review and meta-analysis. Inclusion criteria were prospective and randomized controlled trials (RCTs) published on this topic. From the chosen studies, the eligible articles were reviewed. Data were analyzed using Review Manager 5.2 software. Results: Out of 43 studies, seven eligible trials with 593 participants were selected. Bioadhesive 0.2% CHX gel prevented approximately 72% of AO (Odd ratio (OR) = 0.28, 95% confidence Interval (CI): 0.18-0.44; P < 0.001). Conclusion: Bioadhesive 0.2% CHX gel may be effective as a post-medication to reduce incidence of AO

An in vitro evaluation of novel NHA/zircon plasma coating on 316L stainless steel dental implant

The surface characteristics of an implant that influence the speed and strength of osseointegration include crystal structure and bioactivity. The aim of this study was to evaluate the bioactivity of a novel natural hydroxyapatite/zircon (NHA/zircon) nanobiocomposite coating on 316L stainless steel (SS) dental implants soaking in simulated body fluid. A novel NHA/zircon nanobiocomposite was fabricated with 0 (control), 5, 10, and 15 wt% of zircon in NHA using ball mill for 1 h. The composite mixture was coated on SS implants using a plasma spray method. Scanning electron microscopy (SEM) was used to evaluate surface morphology, and X-ray diffraction (XRD) was used to analyze phase composition and crystallinity (Xc). Further, calcium ion release was measured to evaluate the coated nanobiocomposite samples. The prepared NHA/zircon coating had a nanoscale morphological structure with a mean crystallite size of 30–40 nm in diameter and a bone-like composition, which is similar to that of the biological apatite of a bone. For the prepared NHA powder, high bioactivity was observed owing to the formation of apatite crystals on its surface. Both minimum crystallinity (Xc=41.1%) and maximum bioactivity occurred in the sample containing 10 wt% of zircon because of minimum Xc and maximum biodegradation of the coating sample

Micro-CT Evaluation of Four Root Canal Obturation Techniques

Purpose. The aim of this in vitro study was to evaluate the quality of four root canal obturation techniques using microcomputed tomography (micro-CT). Materials and Methods. A total of 36 mandibular first premolars with mostly round canals were decoronated, then instrumented up to a size F3 rotary file, and dressed with an epoxy resin-based sealer. Subsequently, they were divided into 4 different groups (n=9) based on the method of obturation: lateral condensation using 0.02 tapered master cone (LC2), lateral condensation using 0.04 tapered master cone (LC4), matched single-cone technique (MS), and matched single cone-mediated ultrasonic activation (MSUA). All the teeth were scanned using micro-CT (resolution of 19 μm), and the percentage volume of voids was calculated. One-way analysis of variance and Tukey test were used to analyze the data (α=0.05). Results. The total percentage volume of voids was significantly lower in the MSUA group compared to all other groups (P<0.05). The total percentage volume of voids was significantly lower in the MS group compared to the LC4 (P<0.001) and LC2 (P<0.001) groups. However, there was no significant difference between the LC2 and LC4 groups (P<0.65). Conclusions. MSUA, significantly, showed the least root canal filling voids amongst all the obturation techniques studied. MSUA can be considered an effective method for the filling of the round root canals. In general, lateral condensation using either 0.02 or 0.04 tapered master cones had significantly the highest volume percentage of voids amongst the experimental groups

Oral health and quality of life in children: A cross-sectional study

Introduction: The relationship of oral health (OH) with the quality of life (QL) is multidimensional; the extent to which oral disorders disrupt an individual′s normal function may affect health-related QL, particularly among children. The current study aimed to examine the relationship between clinical OH variables, psychological, social, and demographic factors with regard to OH-related QL (OHRQL) in the children of Isfahan province, Iran. Materials and Methods: Data relevant to the characteristics, psychological, dental, and demographic factors of 336 children aged 11-15 were assessed. These characteristics included sociodemographic data, sense of coherence (SOC), self-esteem, and children′s health locus of control (HLC). The clinical variables that were implicated to be effective on the QL were assessed via an oral examination. The parameters assessed included caries, periodontal disease, malocclusion, and traumatic dental injuries. Finally, the data was analyzed using Statistical Package for the Social Sciences (SPSS) software and P-value was set at 0.05. Results: The results indicate that oral disease, the extent of treatment-need, self-reported symptoms, and degree of dysfunction were influential in QL. Bivariate (Spearman and Pearson) analysis showed that there was a relationship between decayed, missing, and filled teeth (DMFT) and QL score (r = 0.4, P-value = 0.03) and gender and total self-esteem (r = 0.8, P-value = 0.009). Self-esteem and index of orthodontic treatment need (IOTN) (P-value = 0.01), education level of the parents (P-value = 0.03), and overall health (P-value = 0.001) significantly influenced OHRQL. Conclusions: The findings of our study indicate that oral disease, the extent of treatment-need, self-reported symptoms, and degree of dysfunction were influential in the QL

Technical quality of root canal therapies performed by novice dental students in preclinical practice

Background: For improving the quality of endodontic performance of practitioners in clinical practice, their basic, preclinical performance and knowledge must be taken into consideration. This study aimed to radiographically evaluate the technical quality of preclinical molar root canal treatments (RCTs) performed by undergraduate dental students at a dental school in Iran. Further, the effect of using Gates-Glidden (GG) drills on the final quality of RCTs was evaluated. Materials and Methods: In this retrospective cross-sectional study, 315 roots of 105 endodontically treated teeth in preclinical practice were evaluated radiographically. The analyzed quality parameters included length, taper and density of fillings, which were scored as S2 (adequate standard), the S1 (slight deviation), or S0 (considerable deviation). For all the parameters, acceptable, moderate and poor fillings received total scores of 6, 3-5 and 0-2, respectively. There were two groups of students: One group had used only K-files, and the other had used K-files along with GG drills. The quality of RCTs between these groups was evaluated using the aforementioned scoring protocol. The results were analyzed using Chi-square, Mann-Whitney and Fisher′s exact tests (α = 0.05). Results: Under-fillings (P = 0.001) and under-shapings (P = 0.007) occurred mostly in mandibular root fillings. A lower density was found in maxillary fillings (P < 0.001). No relationship was observed between the technique used (irrespective of GG drills usage) and length (P = 0.499) and taper of fillings (P = 0.238). The roots instrumented with GG drills had a higher filling density (P = 0.004). The quality mean score of RCTs was improved when GG drills were used (P = 0.008). Conclusion: The technical quality of preclinical molar RCTs performed by undergraduate dental students was considered acceptable in 35.6% of the cases. When GG drills were used along with K-files, the technical quality of RCTs was enhanced