Guidance for dental treatment of patients with disabilities during COVID-19 pandemic

People with disabilities are challenged managing their oral hygiene and more often burdened with oral diseases. They often require immediate dental treatment for severe pain and greater precautions are needed to cope with COVID-19. The potential for COVID-19 infection can be relatively high in patients with disabilities due to concomitant systemic diseases, unique individual circumstances, relationship with caregivers and the living conditions of long-term care facilities, which make them vulnerable to the virus. For behavior management, dental treatment is often provided under general anesthesia with meticulous preoperative evaluation and the use of high-quality viral filters. In response to COVID-19, additional considerations should be taken for dental procedures on patients with special needs. These recommendations for dental treatment of the disabled are based on 6 months of authors COVID-19 pandemic experience

Non-thermal atmospheric pressure plasma-conditioned root dentin promotes attraction and attachment of primary human dental pulp stem cells in real-time Ex Vivo

This study investigated if non-thermal atmospheric pressure plasma (NTAPP) treatment of root dentin surfaces promotes human dental pulp stem cell (hDPSCs) adhesion. Freshly extracted human single-rooted teeth (n = 36) were decoronated and cut (first vertically, then horizontally) into root dentin slices (3 mm thick). Primary hDPSCs cultures were seeded onto slices randomly assigned to pretreatment groups (n = 9/group): NaOCl (1.5%), EDTA (17%) then NTAPP (Group I); NaOCl then NTAPP (Group II); NaOCl then EDTA (Group III); and NaOCl alone (Group IV). Cell viability and proliferation were measured using MTT assay with log-linear statistical analysis. Cell attachment and spreading morphologies on dentin slices (n = 3/group) were examined through scanning electron microscopy. Early cell adhesion events and subcellular activities were observed in real time by live-cell imaging through holotomographic microscopy. Cell viability and proliferation were significantly higher on NTAPP-treated dentin (p \u3c 0.05), without interactions with EDTA (p \u3e 0.05). The attachment, spreading, extensions and multiple layers of hDPSCs were heightened on NTAPP-treated dentin. Cell adhesion, spreading, and dentinal tubule penetration were hastened on NTAPP-treated dentin surfaces in real-time, with elevated subcellular activities and intracellular lipid droplet formation. NTAPP-treated root dentin surfaces support enhanced cellular responses, potentially promoting pulp-dentin regeneration

Root canals shaped by nickel-titanium instrumentation with automated computerized numerical control systems

Background: To investigate the efficacy of a nickel-titanium (NiTi) file with an automated computerized numerical control (CNC) system for root canal shaping. Methods: The movement of the automated device and the insertion angle were investigated. In Experiment 1, simulated resin root canals were randomly divided into four groups (n = 20): manual downward movement using a handpiece (Group 1), vertical downward movement by CNC (Group 2), reciprocating up and down movement by CNC (Group 3), and spiral up and down movement by CNC (Group 4). In Experiment 2, five different insertion angles of the NiTi file were evaluated (n = 20). Four parameters were used to evaluate the shaping ability: change in the working length, central axis offset, curvature variation, and preparation time. Groups were compared using one-way analysis of variance (ANOVA) with significance was set at P \u3c 0.05. Results: The change in central axis position in the curved part of the root canal was found to be smaller in Group 4 than in other groups (P \u3c 0.05). The curvature changes and preparation time of Groups 1 and 4 were significantly reduced compared with Groups 2 and 3 (P \u3c 0.05). The variation in working length and curvature in the 5° insertion angle group was significantly smaller than in the other groups (P \u3c 0.05). Conclusions: A spiral up and down movement, controlled by the CNC machine, and 5° insertion angle, maintained original root canal shape more precisely than other methods

Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years

The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (alpha = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60-168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663-17.571;p= 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374-31.024;p< 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032-0.900;p= 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035-0.994;p= 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.Y

bending resistance and cyclic fatigue resistance of waveone gold reciproc blue and hyflex edm instruments

Abstract Background/purpose Several single-file systems manufactured using different heat treatment and operated by different kinematics have been released. This study compared the bending resistance and cyclic fatigue resistance of three NiTi files, and examined their phase-transformation behavior. Materials and methods WaveOne Gold Primary (WOG), Reciproc Blue R25 (RPB), and HyFlex EDM OneFile (HDM) were tested (N = 40/instrument). A vertical load was applied to a point 3 mm from the tip, and the stress was measured until a displacement of 3 mm. Tests were conducted at either room temperature (RT: 22 °C) or body temperature (BT: 37 °C) (n = 10). Cyclic fatigue resistance tests were performed in an artificial canal, which had a curvature angle of 40° and a 5-mm radius. Tests were conducted at either RT or BT (n = 10). Instruments were operated according to the manufacturers' instructions. Test results were analyzed using the Kruskal–Wallis and the Mann–Whitney tests. Additional three instruments of each brand were subjected to differential scanning calorimetry (DSC). Results At RT the bending resistance of three files were not significantly different. However, at BT the bending resistance of RPB was highest, followed by WOG, and HDM (P  Conclusion HDM presented superior flexibility and cyclic fatigue resistance at BT

Mandibular molar C-shaped root canals in 5th millennium BC China

Objective: The aim of this study was to analyze the occurrence and variations in C-shaped canals in ancient Chinese teeth and compare the differences of these features between ancient and age-matched modern populations. Design: Approximately 5000-year-old craniofacial bone remains were collected from the fossils of 38 individuals (total: 68 mandibular second molars) excavated from the Jiaojia site. The control group comprised of an equal number of randomly selected modern samples. We used cone-beam computed tomography to scan the mandible along the apex-crown axis and analyzed the canal morphology, based on Fan's categorization criterion, at 2 mm, 5 mm, and 8 mm to the apical level. Grooves on the lingual and buccal sides were also recorded. Results: The proportion of C-shaped roots among ancient samples on the left and right sides were 48.57 % (17/35 teeth) and 54.55 % (18/33 teeth), respectively, and 51.47 % (35/68 teeth) in the total sample. Conversely, in the control group, 44.12 % (15/34) and 38.24 % (13/34) occurred on the left and right sides, respectively, and 41.18 % (28/68) in the total sample. Among the C-shaped canals from the Jiaojia site samples, the classification type changed between two adjacent levels in 84.31 % of samples. Approximately 35 (51.5 %) teeth had a fused root, 20 (29.41 %) had one shallow buccal and one deep lingual groove. The occurrence of C-shape variation was not significantly correlated with time (p>0.05). Conclusions: This study identified a high rate of C-shaped root canals among individuals of Jiaojia who lived approximately 5000 years ago.N

Evaluation of cyclic fatigue and bending resistance of coronal preflaring niti file manufactured with different heat treatments

Coronal preflaring NiTi files should possess proper hardness, resistance to fracture and flexibility. This study compared the bending resistance and cyclic fatigue resistance of three orifice preflaring NiTi files. HyFlex EDM Orifice opener (#25/12), HyFlex CM (#25/08) and One Flare (#25/09) were tested (n = 46/instrument). Bending resistance was assessed with the stress when perpendicular displacement was applied to a 3 mm point from the file tip, and was performed at either room temperature (RT, n = 10) or body temperature (BT, n = 10). Cyclic fatigue resistance was tested with an artificial ceramic root canal at RT (n = 10) and BT (n = 10), and the number of cycles to failure (NCF) was obtained. The bending resistance and the NCF results were analyzed by two-way ANOVA and Tukey’s test. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analyses were performed (n = 3, respectively). HyFlex EDM exhibited the highest bending resistance, followed by One Flare and HyFlex CM (p \u3c 0.05), irrespective of the tested temperature. At RT, HyFlex CM demonstrated the highest NCF (p = 0.001), while HyFlex EDM had the highest NCF at BT (p \u3c 0.001). The tested NiTi files were composed of austenite and martensite according to the DSC and XRD results. HyFlex EDM had the highest bending resistance and NCF measured at BT

The Effect of Hydrofluoric Acid Surface Treatment on the Cyclic Fatigue Resistance of K3 NiTi Instruments

The aim of this study was to investigate the effect of 50% hydrofluoric acid (HF) surface treatment on the cyclic fatigue resistance (CFR) of K3 NiTi instruments. Twenty as-received and twenty HF-treated K3 NiTi instruments were compared in CFR. The surface texture and fracture surface of two instrument groups were examined with a scanning electron microscope (SEM). Additionally, any change of Ni and Ti composition from both instrument groups was investigated using energy dispersive spectrometry. The results were analyzed with t-test. The HF-treated K3 group showed statistically higher cyclic fatigue resistance than as-received K3 group (P<0.05). HF-treated K3 instruments showed smoother and rounded surface compared to as-received K3 under SEM observation. The fracture surfaces of both groups showed typical patterns of cyclic fatigue fracture. There was no difference in surface Ni and Ti composition between two groups. HF treatment of K3 instruments smoothed the file surface and increased the cyclic fatigue resistance, while it had no effect on surface ion composition and the file fracture pattern

The effect of hydrofluoric acid surface treatment on the cyclic fatigue resistance of K3 NiTi Iistruments

The aim of this study was to investigate the effect of 50% hydrofluoric acid (HF) surface treatment on the cyclic fatigue resistance (CFR) of K3 NiTi instruments. Twenty as-received and twenty HF-treated K3 NiTi instruments were compared in CFR. The surface texture and fracture surface of two instrument groups were examined with a scanning electron microscope (SEM). Additionally, any change of Ni and Ti composition from both instrument groups was investigated using energy dispersive spectrometry. The results were analyzed with t-test. The HF-treated K3 group showed statistically higher cyclic fatigue resistance than as-received K3 group (P &lt; 0.05). HF-treated K3 instruments showed smoother and rounded surface compared to as-received K3 under SEM observation. The fracture surfaces of both groups showed typical patterns of cyclic fatigue fracture. There was no difference in surface Ni and Ti composition between two groups. HF treatment of K3 instruments smoothed the file surface and increased the cyclic fatigue resistance, while it had no effect on surface ion composition and the file fracture pattern.OAIID:RECH_ACHV_DSTSH_NO:T201703106RECH_ACHV_FG:RR00200001ADJUST_YN:EMP_ID:A076889CITE_RATE:1.974FILENAME:3189729-HFA-BIC.pdfDEPT_NM:치의학과EMAIL:[email protected]_YN:YFILEURL:https://srnd.snu.ac.kr/eXrepEIR/fws/file/4b412374-9447-4cc0-ad82-424fb5cb5a51/linkY