In-depth morphological evaluation of tooth anatomic lengths with root canal configurations using cone beam computed tomography in North American population

Objective: This study aimed to assess the association between tooth size and root canal morphology by using CBCT analysis. Methodology: In this retrospective study, tooth anatomic lengths (crown and root lengths, buccolingual and mesiodistal dimensions) of 384 patients were assessed and correlated with Vertucci’s root canal morphology classification. Data was analyzed for gender-related differences using the independent sample t-test, ANOVA, and the Pearson’s correlation for a possible relation between anatomic lengths and canal morphology. Results: The maxillary first and second premolars showed a greater predilection for Type IV and II variants, respectively, while the mandibular first premolar showed a greater predilection for Type II canal system. The root canal system of the mandibular second premolar showed maximal diversity (47% Type I, 30% Type II, and 20% Type III). The dimensions were greater in men regardless of tooth type. The most significant relation (p<0.05) between the anatomic size and canal morphology was observed in the maxillary first premolars, followed by the mandibular canines (buccolingual dimension) and the lower second premolars (crown length). Negative correlations existed between the crown length and the patient’s age for the anterior teeth and mandibular second premolar (r=−0.2, p<0.01). Conclusions: The most common canal formation for anterior teeth was the Type I. The anatomic lengths had the strongest influence on the canal configuration of the maxillary first premolar, with Type IV being the most common root canal system. The mandibular second premolars showed maximal diversity in the canal classification terms and had a significant correlation with their crown lengths

Kistik Fibrozisli Hastalarda Periodontal Durumun Klinik, İmmünolojik ve Mikrobiyolojik Olarak Değerlendirilmesi

The aim of this study was to evaluate periodontal status of cystic fibrosis patients, to measure level of cytokines and biochemical molecules in gingival crevicular fluid (GCF), and to detect presence of P. aeruginosa in oral plaque samples. GCF and oral plaque samples were collected from 41 cystic fibrosis patients and 39 healthy subjects. GCF volume values were recorded. Level of IL-1ß, IL-17, IL-10, ELA2, CFTR, and ß-defensin-1 were detected by ELISA method. Oral plaque samples were evaluated by using EMB broth, MHB broth, and PCR. Level of IL-1ß, ELA2, and ß-defensin-1 in cystic fibrosis patients were significantly higher than control subjects. However, level of IL-10 in cystic fibrosis patients was significantly lower than healthy control subjects. Although P. aeruginosa were observed in four samples of 18 cystic fibrosis patients, none was detected in control subjects. As a result of this study, which is the first study aiming to detect levels of immunologic and biochemical parameters in GCF and to evaluate periodontal status, CF causes hyper pro-inflammation response and low anti-inflammation response, locally. Due to this pro-inflammatory balance, patients with CF should be followed-up more often than healthy individuals and CF should be classified as high-risk systemic disorders for periodontal diseases.Bu çalışmanın amacı; kistik fibrozisli hastaların periodontal durumlarını belirlemek, dişeti oluğu sıvısındaki (DOS) sitokin ve biyokimyasal moleküllerin düzeylerini ölçmek ve hastaların bakteri plağında P. aeruginosa varlığını değerlendirmektir. KF’li 41 hasta ve 39 sağlıklı hastanın DOS ve plak örnekleri toplanarak, klinik ölçümleri yapıldı. Hastaların DOS hacmi kaydedildi. DOS’ta IL-1ß, IL-17, IL-10, ELA2, KFTR ve ß-defensin-1 miktarları ELİSA ile ölçüldü. Toplanan plak örneklerinin EMB ve MHB besiyerlerinde ekimi ve PCR ile değerlendirilmeleri yapıldı. KF’li hastalarda DOS IL-1ß, ELA2, ß-defensin-1 düzeyi, kontrol grubuna göre istatiksel olarak anlamlı yüksek ölçülürken; DOS IL-10 düzeyi ise kontrol grubuna göre anlamlı derecede düşük bulundu. Kontrol grubundaki hastaların plak örneklerinde P. aeruginosa tespit edilemezken; KF grubunda incelenen 18 hastanın 4’ünün plak örneklerinde P. aeruginosa saptandı. Periodontal durum, immünolojik ve biyokimyasal parametrelerin DOS’ta incelendiği ilk çalışma olan bu araştırmanın sonucunda; KF hastalığının, periodontal durumdan bağımsız olarak, lokal pro-enflamasyona ve düşük anti-enflamatuvar yanıta neden olduğu gösterilmiştir. Bu nedenle, KF hastalığının, sık aralıklarla periodontal açıdan kontrol altına alınması gereken, riskli sistemik hastalıklar grubuna dahil edilerek değerlendirilmesinin önemli olacağı kanaatine varılmıştır

Morphological Classification of Extraction Sockets and Clinical Decision Tree for Socket Preservation/Augmentation after Tooth Extraction

Objectives The aim of present study was to review current literature concerning extraction socket classification immediately following tooth extraction and the rationales for socket preservation/augmentation procedures and with reference to it suggest novel clinical decision tree for extraction socket preservation/augmentation in aesthetic and non-aesthetic area. Material and Methods The search protocol used the electronic MEDLINE (PubMed) and EMBASE databases for articles published between January 1 2009 and May 1 2019. The search included only human studies published in English. Outcomes were the indications and reasons for socket preservation/augmentation and classification of extraction sockets. Results Ten studies fulfilled the inclusion criteria and were selected for the study. Although there are various types of extraction socket classifications none of them could completely evaluate all morphological parameters of alveolar ridge. Furthermore, present study revealed that indications for extraction socket preservation/augmentation have wider spectrum than socket morphology and are related to surrounding tissue anatomy or dental implantation operation indications and timing. Based on currently proposed extraction socket classifications and rationales, a novel decision tree for extraction socket preservation/augmentation immediately after tooth extraction in aesthetic and non-aesthetic area was suggested. Conclusions The need of extraction socket preservation/augmentation immediately after tooth extraction should be determined by the aesthetic, functional and risk-related viewpoint. A novel clinical decision tree for extraction socket preservation/augmentation immediately after tooth extraction in aesthetic and non-aesthetic zones can be useful tool in socket preservation/augmentation procedures.PubMe

Effects of Crest Morphology on Lingual Concavity in Mandibular Molar Region: an Observational Study

Objectives: The aim of this radiological study is to evaluate the lingual concavity dimensions and possible implant length in each posterior tooth region according to posterior crest type classification by using cone-beam computed tomography. Material and Methods: According to inclusion criteria, 836 molar teeth regions from 209 cone-beam computed tomography images were evaluated. Posterior crest type (concave, parallel, or convex), possible implant length, lingual concavity angle, width, and depth were recorded. Results: In each posterior tooth region, concave (U-type) crest was detected most frequently while convex (C-type) was the lowest. Possible implant length values were higher in second molar regions than first molars. Lingual concavity width and depth were decreasing from second molars to first molars for both sides. Additionally, lingual concavity angle showed higher values in second molar sites than first molars. In all molar teeth regions, lingual concavity width values were the highest in concave (U-type) crest type while they were the lowest in convex (C-type) crest type (P < 0.05). Lingual concavity angle values were recorded as the highest in concave (U-type) and the lowest in convex (C-type) crest type at the left first molar and right molars (P < 0.05). Conclusions: The lingual concavity dimensions and possible implant length may vary according to crest type and edentulous tooth region. Due to this effect, the surgeons should examine crest type clinically and radiologically. All parameters in the present study are decreasing while moving from anterior to posterior as well as from concave (U-type) to convex (C-type) morphologies

Levels of pro- and anti-inflammatory cytokines in cystic fibrosis patients with or without gingivitis

Background: Inflammatory periodontal diseases are caused by interaction between gram negative, anaerobic bacteria and host response. Persistent infection of Pseudomonas aeruginosa in cystic fibrosis (CF) patients also cause increased pro-inflammatory response and the imbalance of pro- and anti-inflammatory response in brochoalveolar lavage fluid which leads to destruction of lungs. The aim of this study is to evaluate periodontal status of CF patients, to measure level of cytokines and biochemical molecules in gingival crevicular fluid (GCF), and to detect presence of P. aeruginosa in dental plaque samples. Materials and methods: GCF samples were collected from 41 CF patients and 39 healthy (non-CF) subjects. Interleukin (IL)-1ß, IL-17, IL-10, human neutrophil elastase (HNE), cystic fibrosis transmembrane regulator (CFTR) protein, and human β-defensin-1 (HBD1) in GCF were evaluated by ELISA method. Dental plaque samples were collected from 18 CF patients with history of P. aeruginosa colonization and 15 non-CF subjects. Presence of P. aeruginosa was evaluated by using conventional culture methods and molecular methods. Results: Levels of IL-1ß, HNE, and HBD1 in CF patients were significantly higher than non-CF subjects. However, IL-10 level was significantly lower in CF patients. Increased pro-inflammatory (IL-1ß) and decreased anti-inflammatory (IL-10) cytokine levels were observed in GCF samples from CF patients, irrespective of their periodontal status. P. aeruginosa were detected in four samples of 18 CF patients, and all were negative in non-CF group. Conclusions: As a result of this study, CF coexists increasing pro-inflammatory and decreasing anti-inflammatory response locally. Due to increasing pro-inflammation, CF patients should be followed-up more often than non-CF children

The 2nd Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2019. Summary and Consensus Statements

Introduction The task of Group I was to review and update the existing data concerning the physiologic process of socket healing, in the absence or presence of grafting materials or platelet concentrates, addressing the associated molecular and cellular events that culminate in the restoration of the lost tissue architecture and functionality. The second task was to review current literature concerning extraction socket classification immediately following tooth extraction and the rationales for socket preservation/augmentation procedures and with reference to it suggest novel clinical decision tree for extraction socket preservation/augmentation in aesthetic and non-aesthetic area. Material and Methods The main areas indicated by this group were as follows: socket healing process, including haemostasis and coagulation, inflammatory phase, proliferative phase, bone tissue modelling and remodelling; socket healing with graft materials and autologous platelet concentrates; extraction socket classifications; indications and reasons for extraction socket preservation/augmentation. The systematic reviews and/or meta-analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was screened and reported following the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in Preface chapter. Results The results and conclusions of the review process are presented in the respective papers. One theoretical review-analysis and one systematic review were performed. The group's general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.PubMe