In vitro randomized-trial on the sealing ability of carrier-based systems in curved root canals

Objetivo: comparar el porcentaje de área de gutapercha, cemento y huecos en conductos curvos obturados con sistemas con vástago y evaluar la influencia de la activación del cemento durante su colocación. Metodología: 120 conductos curvos de molares mandibulares fueron preparados a un diámetro apical ProFile 30, 0.04. Se obturaron con los sistemas GuttaCore, GuttaFusion o condensación lateral y AHplus (n = 40). Se subdividieron los grupos (n = 20) y se colocó el cemento con activación sónica o no. El cemento se mezcló con Rodamina B para permitir el análisis mediante microscopía confocal. Se calculó el área de gutapercha, cemento y huecos a 3, 6 y 9 mm del ápice. Se realizó el análisis estadístico utilizando ANOVA de dos vías. Para la comparación por pares se realizó el test de Sidak. Resultados: cuando se comparan los sistemas de gutapercha a 3 mm, GF mostró un mejor comportamiento. CL obtuvo los peores resultados. No se encontró influencia entre los sistemas de obturación y la activación del cemento. Cuando se comparó el porcentaje de huecos entre todos los grupos, los perores resultados fueron para CL a 6 y 9 mm. Conclusiones: bajo las condiciones de este estudio, el área de gutepercha, cemento y huecos depende del sistema de obturación utilizado. El uso de activación del cemento no influye en la calidad de la obturación

CBCT Management of Previously Treated Mandibular Incisor with Extensive Internal Root Resorption: A Case Report

ABSTRACT This case report describes a central mandibular incisor's retreatment. Follow-up with perforating internal root resorption managed using a reciprocating file and obturated with down-pack and backfill technique, a surgical approach to seal the perforation. The medical history was non-contributory, and he had a history of traumatic injury resolved by a general dentist one year before. Tooth (4.1) presented pain and, after inspection and exploration, the clinical diagnosis was established as a previously-treated tooth with apical periodontitis. During periodic clinical and radiographic follow-up, the patient remained symptom-free, meeting functional expectations after eight years. Understanding the pathology and knowing the techniques to manage it could help recover the function of teeth considered lost.Sin financiaciónNo data 2020UE

Sonic activation improves bioceramic sealers penetration into dentinal tubules of curved root canals: a confocal laser scanning microscopy study

Background: the aim was to determine the influence of sonic activation in the tubular dentine penetration of bioceramic sealers. Methods: forty mesiobuccal curved root canals of mandibular molars with an apical diameter smaller than #30 were prepared, divided into two groups, and filled with EndoSequence BC sealer, with or without sonic activation during its placement. Roots were sectioned at 3 mm, 6 mm, and 9 mm from the apex, producing a sample size of 120. The samples were evaluated using a confocal laser scanning microscope and comparing these images to the images obtained from an operatory microscope. The percentage of sealer penetration and maximum sealer penetration were evaluated. Statistical analysis was performed using the two-tailed Mann-Whitney U test, where statistical significance was set to p < 0.05. Results: sonic activation showed higher values for the percentage of sealer penetration when compared at the 9 mm level (p = 0.03). A higher value of maximum sealer penetration was observed at all levels when the sealer was activated. Conclusions: the sonic activation of bioceramic cement resulted in higher sealer penetration into dentinal tubules

Antimicrobial Prescription Habits of Dentists Performing Dental Implant Treatments in Santo Domingo, Dominican Republic

The use of antibiotics in implant treatments is controversial. The purpose of this research was to study the behaviors of Santo Domingo dentists who prescribe antimicrobials to patients for the placement of dental implants. A total of 99 dentists participated in the study. A share of 1.2% of dentists prescribed antimicrobials solely in the preoperative period, 8.6% after surgery, 44.4% before and after, 19.8% only in specific situations, and 25.9% did not prescribe at all. Amoxicillin was the predominant antimicrobial of choice. A cross-sectional, observational, survey-based study was conducted. The items studied were demographics, self-assessment of knowledge about antibiotics and when they are used, as well as their recommended dosage and duration, in healthy and non-allergic patients. Notable variability was found in the prescription behaviors of antimicrobials. Bridging gaps in knowledge on the subject could help to standardize prescription guidelines.Sin financiación4.639 JCR (2020) Q2, 26/93 Infectious Diseases0.960 SJR (2020) Q1, 12/97 Pharmacology, Toxicology and Pharmaceutics (miscellaneous)No data IDR 2020UE

Knowledge, Attitudes, and Practices among Dental Practitioners Regarding Antibiotic Prescriptions for Pregnant and Breastfeeding Women in the Dominican Republic

In this study, we aimed to explore the trends among dentists in the Dominican Republic of providing antibiotic prescriptions to regnant/breastfeeding dental patients. A survey was conducted among 98 dentists, using a self-administered questionnaire, about their knowledge and attitudes regarding antibiotic usage in pregnant/lactating women and the translation of these into practice. The majority of the survey population were female dentists (63.3%) aged 45–54 years. A chi-square test showed statistically significant differences in the knowledge sources between older and younger dentists, with a minority having chosen scientific literature as a source (p-value of 0.04). There were statistically significant associations between gender and certain attitudes and practice-based questions, with p-values of 0.04 and 0.01, respectively. The Spearman’s correlation test showed a statistically significant correlation between knowledge and attitude (p-value 0.001), whereas no correlation was found with practice (p-value 0.23). A multiple response analysis showed that the majority of the respondents chose the second and third trimester for antibiotic prescriptions for acute conditions such as cellulitis, periodontal abscess, and pericoronitis. Most dentists had sufficient knowledge about antibiotic usage in pregnant/lactating women, but it did not translate into practice, and a certain proportion of the participants followed incongruent drug prescription. These findings can be used to focus on judicious antibiotic usage by dentists in the Dominican Republic.Sin financiación4.639 JCR (2020) Q2, 26/93 Infectious Diseases0.960 SJR (2020) Q1, 12/97 Pharmacology, Toxicology and Pharmaceutics (miscellaneous)No data IDR 2020UE

Evaluation of the Current Knowledge About Bacterial Endocarditis Prevention Among General Dentists in the City of Santo Domingo, Dominican Republic

Infective endocarditis (IE) is a life-threatening disease caused by bacterial adherence to the lining of the heart and heart valve, and it can be caused by bacterial contamination of the bloodstream during invasive dental procedures. The American Heart Association (AHA) recommended guidelines for antibiotic prophylaxis in 2008 before invasive dental procedures; however, in the Dominican Republic, no official guidelines or regulations on this topic have been yet established. This study aimed to evaluate the current knowledge about bacterial endocarditis prevention among dentists in Santo Domingo. The study participants were dentists who attended a conference organized by Universidad Federico Henríquez y Carvajal (n = 95), of which 74 responded to the questionnaire survey. Seventy-eight percentage of the participants responded that an indication of antibiotics is recommended in cases of prophylaxis for IE. The prescription of antibiotics was applied to patients with prosthetic valves (78.4%), presented a history of previous IE (77%) among others. Among all the interventions in which the respondents would prescribe antibiotics, tooth extraction (70.7%) was the most frequent. Amoxicillin was the preferred drug choice (63.5%) and clindamycin was the antibiotic of choice in allergic patients (55.4%). Even though the choice of antibiotics were according to AHA guidelines (2008), majority of the dentists (58.82 and 55.4%) were not aware of the correct dosage and timing of administration of azithromycin and clindamycin in drugs in patients allergic to penicillin.Sin financiación3.709 JCR (2020) Q1, 36/176 Public, Environmental & Occupational Health0.908 SJR (2020) Q2, 139/560 Public Health, Environmental and Occupational HealthNo data IDR 2020UE

Oral Manifestations of COVID-19: Updated Systematic Review With Meta-Analysis

There is increasing evidence for oral lesions and manifestations of COVID-19. The aim of this meta-analysis was to investigate the types of oral manifestations of COVID-19 and their prevalence. PubMed/Medline, Scopus, Web of Science, and Google Scholar databases were used to search for publications on oral manifestations in patients with PCR-confirmed COVID-19. A total of 310 records were selected, and 74 were included. Oral lesions in COVID-19 were classified according to their etiologies, including iatrogenic lesions caused by intubation and opportunistic infections. Of the included studies, 35 reported oral lesions probably caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection. Meta-analysis of prevalence data on oral manifestations and aphthous lesions indicated high heterogeneity, while meta-analysis of xerostomia prevalence data revealed a pooled prevalence, with considerable heterogeneity. In conclusion, the meta-analysis yielded high heterogeneity between studies: oral lesions yielded a prevalence of 0.33 (95% CI 0.11–0.60), xerostomia lesions a prevalence of 0.44 (95% CI 0.36–0.52) and aphthous lesions 0.10 (95% CI 0.01–0.24). In addition, a gap in the evidence regarding the prevalence of oral lesions in COVID-19 was identified and the need for further observational studies focusing on this issue and on the causal relationships between oral lesions and COVID-19 was highlighted.Sin financiación5.091 JCR (2020) Q1, 28/169 Medicine, General & Internal1.388 SJR (2020) Q1, 304/2447 Medicine (miscellaneous)No data IDR 2019UE

Using a Virtual Patient via an Artificial Intelligence Chatbot to Develop Dental Students’ Diagnostic Skills

Knowing how to diagnose effectively and efficiently is a fundamental skill that a good dental professional should acquire. If students perform a greater number of clinical cases, they will improve their performance with patients. In this sense, virtual patients with artificial intelligence offer a controlled, stimulating, and safe environment for students. To assess student satisfaction after interaction with an artificially intelligent chatbot that recreates a virtual patient, a descriptive cross-sectional study was carried out in which a virtual patient was created with artificial intelligence in the form of a chatbot and presented to fourth and fifth year dental students. After several weeks interacting with the AI, they were given a survey to find out their assessment. A total of 193 students participated. A large majority of the students were satisfied with the interaction (mean 4.36), the fifth year students rated the interaction better and showed higher satisfaction values. The students who reached a correct diagnosis rated this technology more positively. Our research suggests that the incorporation of this technology in dental curricula would be positively valued by students and would also ensure their training and adaptation to new technological developments.Sin financiación4.614 JCR (2021) Q1, 45/182 Public, Environmental & Occupational Health0.814 SJR (2021) Q1, 34/136 Health, Toxicology and MutagenesisNo data IDR 2021UE

A Comparative Study of Two Martensitic Alloy Systems in Endodontic Files Carried out by Unskilled Hands

The aim of this study was to compare the behavior of two heat-treated file systems on resin blocks in unskilled hands. For this purpose, an in vitro, randomized, cross-sectional study was conducted to compare ProTaper Gold (PTG) with BlueShaper (BS) files. A total of 81 resin blocks were used and analyzed photographically to assess the amount of material removed during instrumentation. PTG removed more material on the outside of the curve in the coronal and apical third, while BS removed more material on the inner part of the curve in the middle third. The procedural errors observed in the total sample were apical transportation (33.8%), blockages (4.9%), ledges (3.7%), and canal perforation. PTG produced more apical transportation, and there were no statistically significant differences between the groups in the formation of ledges, canal perforations, or blockages. No file fractures were recorded during the study. Within the limitations of this study, we can affirm that neither file excessively deformed the artificial canals, and the PTG file produced more apical transportationSin financiación2.838 JCR (2021) Q2, 39/92 Engineering, Multidisciplinary0.507 SJR (2021) Q2, 124/414 Engineering (miscellaneous)No data IDR 2021UE

Updated critical review of the obturation with the Thermafil System and its successor: GuttaCore

El sistema de obturación Thermafil se basa en un vástago de plástico recubierto de gutapercha. Su evolución, GuttaCore, consta de un núcleo de gutapercha entrelazada con el objetivo de facilitar la remoción de éste manteniendo a la vez las buenas propiedades ofrecidas por la gutapercha termoplástica. El objetivo de este trabajo es describir ambos sistemas y analizar algunos de los aspectos más importantes de la obturación endodóntica como la capacidad de sellado, la facilidad de retratamiento y la filtración apical. Para ello se ha efectuado un búsqueda bibliográfica a través de Medline utilizando publicaciones posteriores al año 2002, exceptuando la inclusión de artículos más antiguos dada su relevancia. Como resultado, hemos observado que el sistema Thermafil consigue obturaciones herméticas y tridimensionales en todo tipo de conductos a excepción de reabsorciones internas o ausencia de constricción apical. Su curva de aprendizaje es rápida, así como su tiempo de ejecución. Los inconvenientes de este sistema son un mayor tiempo para la remoción de su vástago y las frecuentes sobreobturaciones. El sistema GuttaCore parece facilitar el tiempo de retratamiento pero faltan estudios acerca su comportamiento a largo plazo. Dado que la mayoría de los estudios sobre el comportamiento de Thermafil se han realizado ex vivo, los resultados no pueden extrapolarse directamente a la práctica clínica.No data (2014)UE