Comparison of Er:YAG modalities (PIPS-SWEEPS) onEliminating of enterococcus faecalis populations

Comparison of Er:YAG Modalities (PIPS-SWEEPS) on Eliminating of Enterococcus Faecalis Populations Background: To determine the effectiveness of novel two Er:YAG lasers modalities, photon-initiated photoacoustic streaming (PIPS\SSP) and shock wave-enhanced emission photoacoustic streaming (SWEEPS\AutoSWEEPS) in terms of removal Enterococcus faecalis (E. faecalis) with or without antimicrobial agents [Sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX)]. Methods: Forty-two extracted single-rooted mandibular premolars were prepared, sterilized, and then inoculated with E. faecalis for 4 weeks, and randomly divided into to two main and three subgroups (n= 7). Group Ia ( PIPS + distilled water), Group Ib (PIPS + 5% NaOCl), Group Ic (PIPS + CHX), and Group IIa (SWEEPS + distilled water), Group IIb (SWEEPS + 5% NaOCl), and Group IIc (SWEEPS + CHX). Following incubation for 48 hours at 37°C, the colony forming units (CFU) were counted. Results: NaOCl and CHX activated with PIPS\SSP or SWEEPS\AutoSWEEPS modalities showed significantly higher reduction rates than distilled water activated with both laseractivated methods (p<0.05), but no significant differences were detected between the NaOCl and CHX groups. Besides, in all groups, no significant difference was detected between PIPS\SSP and SWEEPS\AutoSWEEPS performances in the reduction of CFU counts (p>0.05). Conclusion: Even novel laser activation methods or modalities are not sufficient alone to adequately reduce bacterial load and using antimicrobial agents with laser activation is necessary for the best reduction for microbial elimination. Novel SWEEPS\AutoSWEEPS modalıty with the conical 600μm tip showed no increased efficacy compared with PIPS\SSP mode. Besides, smaller fiber tip may increase the success of applications for minimally invasive access cavities and preparationEnterococcus Faecalis Biyofilmlerinin Ortadan Kaldırılmasında Er: YAG Yöntemlerinin (PIPS-SWEEPS) Karşılaştırılması Amaç: İki yeni Er: YAG lazer modalitesi olan foton-indüklü fotoakustik dalgalanma (PIPS \ SSP) ve şok dalgası ile geliştirilmiş emisyon fotoakustik akımının (SWEEPS \ AutoSWEEP) antimikrobiyal ajanlar (NaOCl ve klorheksidin glukonat) kullanılarak veya kullanılmadan E. faecalis uzaklaştırmadaki etkinliğinin belirlenmesidir. Gereç ve Yöntemler: Kırk iki ekstrakte tek köklü mandibular premolar hazırlandı, sterilize edildi ve daha sonra 4 hafta boyunca E. faecalis ekimi yapıldı ve rastgele iki ana ve üç alt gruba (n = 7) ayrıldı. Grup Ia (PIPS + distile su), Grup Ib (PIPS +% 5 NaOCl), Grup Ic (PIPS + CHX) ve Grup IIa (SWEEPS +distile su), Grup IIb (SWEEPS +% 5 NaOCl) ve Grup IIc (SWEEPS + CHX). 37 ° C'de 48 saat süreyle inkübasyonun ardından, oluşan koloniler (CFU) sayıldı. Bulgular: PIPS \ SSP veya SWEEPS \ AutoSWEEPS yöntemleri ile aktive edilen NaOCl ve CHX, her iki lazer aktivasyon metodu ile aktive edilen distile sudan anlamlı şekilde daha yüksek indirgeme oranları gösterdi (p <0.05), ancak NaOCl ve CHX grupları arasında anlamlı bir fark bulunmadı. Ayrıca, tüm gruplarda, CFU sayılarının azaltılmasında PIPS \ SSP ve SWEEPS \ AutoSWEEPS performansları arasında anlamlı bir fark saptanmamıştır (p> 0.05). Sonuç: Yeni lazer aktivasyon metod veya modülleri bile bakteri yükünü yeterince azaltmak için tek başına yeterli değildir. En etkili mikrobiyal eliminasyon için lazer aktivasyonun antimikrobiyal ajanlar ile birlikte kullanılması gerekmektedir. Konik 600μm uçla uygulanan yeni SWEEPS \ AutoSWEEPS modalitesi, PIPS \ SSP’e kıyasla artan bir etkinlik göstermedi. Daha küçük fiber uç kullanımı, minimal invaziv giriş kavitesi ve preperasyonlarda uygulamaların başarısını artırabilir

Salivary flow rate, pH, and buffer capacity in the individuals with obesity and overweight; A meta-analysis

Background: Weight in individuals can affect the saliva structure, which has an essential role in caries prevention. Aim: This meta-analysis aimed to compare individuals with obesity (OB)/overweight (OW) and normal weight (NW) in terms of salivary flow rate (SFR), salivary pH (SpH), salivary buffer capacity (SBC). Materials and Methods: After electronic databases (Web of Science, PubMed, Scopus, Cochrane Library, and Open Grey databases) were screened, studies were selected depending on inclusion criteria. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the risk of bias in individual studies. Mean differences (MD) were used to measure the effect estimates in the comparisons of OB vs NW, OW vs NW, and OB+OW vs NW. Additional analyzes such as subgroup, moderator, sensitivity, and grade were also performed. Results: 24 studies and 2072 participants (SFR: 748 OB, 896 NW, SpH: 137 OB, 166 NW, SBC: 62 OB, 63 NW) were included in the quantitative synthesis. Significantly lower SFR was found in the group with OB compared to NW when saliva was stimulated (MD = -0.21, 95% CI [-0.30, -0.12], P < 0.001), but no significance was obtained when saliva was unstimulated (MD = -0.02, 95% CI [-0.11, 0.06], P = 0.55). No significant difference was found in the group with OB compared to NW in SpH (MD = -0.07, 95% CI [-0.26,0.12], P = 0.48) and SBC (MD = -1.10, 95% CI [-2.29,0.09], P = 0.07). Conclusions: SFR significantly decreases in individuals with OB, notably when saliva is stimulated. Besides, the decrease in SFR is much more prominent in adolescence and adulthood than in childhood. Furthermore, the increase in the severity of OB causes a much greater decrease in SFR. However, regarding SpH and SBC, no significant association exists

Caries-related salivary parameters and oral microbial flora in patients with type 1 diabetes: A meta-analysis

Objectives This study aimed to conduct a meta-analysis by synthesising the outcomes of studies that investigated the relationship between type 1 diabetes (T1D) and salivary flow rate (SFR), salivary pH (SpH), salivary buffer capacity (SBC), streptococcus Mutans (SM), and lactobacillus (LB) counts. Material and Methods The PRISMA statement guide was followed for the meta-analysis. Electronic databases were searched, and study selection and data collection processes were performed. The risks of bias in individual studies and across studies were assessed. Mean differences (MD) and Odds Ratio (OR) were used to measure the effect estimates in the comparisons. Results 29 studies were included in the qualitative and quantitative syntheses. Significantly higher SFR (MD = -0.22, CI: -0.26, -0.18; p < 0.001) and SpH (MD = -0.59, CI: -0.81, -0.36; p < 0.001) were observed in the healthy individuals than T1D individuals. No significant difference was observed among groups in terms of SBC (MD = 0.10, CI: -0.46,0.66; p = 0.73). An increased odds ratio of SM counts were observed regarding the T1D (OR = 3.09, 95% CI: 1.16, 8.20; p = 0.02). No association was found between LB counts and T1D (OR = 2.15, 95% CI: 0.38, 11.98; p = 0.38). Conclusions Subjects with T1D have a significantly lesser SFR and SpH than healthy individuals. But no significant difference is available in terms of SBC. Lower SM counts were observed in individuals with T1D, while no association was observed regarding LB counts. The tendency to dental caries is more likely in subjects with T1D due to lower SFR, SpH, and higher SM

Evaluation of color stability of experimental dental composite resins prepared from Bis-EFMA, a novel monomer system

Color stabilities of experimental composite resins based on Bis-EFMA (a novel bisphenol A [BPA]-free monomer system) with 3M ESPE FiltekTM Z250 (FZ) and experimental composite resins based on bisphenol A-glycidyl methacrylate (Bis-GMA) and urethane dimethacrylate (UDMA) were compared. Bis-EFMA was synthesized via the reaction between 9,9-bis[4-(2-hydroxyethoxy)phenyl]fluorene and 2-(methacryloyloxy)ethyl isocyanate. Experimental Bis-EFMA-, Bis-GMA-, and UMDA-based composites were prepared (20% of each of Bis-EFMA, Bis-GMA, UDMA, or triethylene glycol dimethacrylate (TEGDMA) and 60% glass filler). Eighty composite resin materials were produced (n=5). The initial color values of composites on the first day, first week, and after the first month after immersion into black tea, coffee, cola, and water solutions were measured using a spectrophotometer (VITA Easyshade (R) V; Zahnfabrik, Bad Sackingen, Germany) against a white background. UDMA- and Bis-EFMA-based composite resins exhibited significantly less Delta E and Delta L compared to Bis-GMA based composite resins (p 0.05). Tea and coffee caused significant changes in total color, light value, red-green, and blue-green coordinate values changes (Delta E, Delta L, Delta a, and Delta b, respectively) compared to water and cola (p < 0.05). At one month compared to one week and one day, Delta E, Delta L, Delta a, and Delta b were significantly different (p < 0.05). Bis-EFMA has the potential to be used in commercial dental composites as a substitute for Bis-GMA in terms of better color stability.Kahramanmaras Sutcu Imam University 2019/1-24

Assessment of bone quality of apical periodontitis treated with MTA plug and regenerative endodontic techniques

Fractal analysis (FA) is a quantitative, objective and non-invasive method that facilitates the characterisation of the tissue architecture. This study aims to compare the periapical healing at 1-year follow-up by evaluating newly generated trabecular bone with FA after Mineral trioxide aggregate (MTA) plug and regenerative endodontic treatment (RET). A total of 55 asymptomatic teeth with a single-canal, open apex and periapical lesion, treated with MTA plug or RET, were evaluated retrospectively. After considering the inclusion/exclusion criteria, FA was conducted on 30 periapical images using the box-counting method. In both groups, a significant decrease was observed in the periapical lesion size at 1-year follow-up (p 0.01). Significantly higher fractal dimension values were detected at 1-year follow-up in both MTA plug and RET cases (p 0.01). Both procedures seem to improve periapical healing with a new resistant bone of similar density and complexity

Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists:A multinational survey from 13 countries

Background: Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp–dentine complex to its normal physiological state. Aim: The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET. Design: A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period. Results: Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%–3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period. Conclusion: According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.</p

Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis

Background: An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence. Methods: Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded. Results: In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05). Conclusions: The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral

Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners:A Multinational Survey from 16 Countries with Meta-analysis

Introduction: Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had 3 purposes: (1) to investigate the factors that affect clinicians’ decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC. Methods: The questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients’ age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. Results: A tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P &lt; .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P &lt; .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P &lt; .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P &lt; .05). Conclusions: While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials.</p