New treatment option for an incomplete vertical root fracture:a preliminary case report

Instead of extraction this case report presents an alternative treatment option for a maxillary incisor with a vertical root fracture (VRF) causing pain in a 78-year-old patient. After retreatment of the existing root canal filling the tooth was stabilized with a dentine adhesive and a composite restoration. Then the tooth was extracted, the VRF gap enlarged with a small diamond bur and the existing retrograde root canal filling removed. The enlarged fracture line and the retrograde preparation were filled with a calcium-silicate-cement (Biodentine). Afterwards the tooth was replanted and a titanium trauma splint was applied for 12d. A 24 months clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depths from 7 mm prior to treatment to 3 mm and gingival reattachment in the area of the fracture with no sign of ankylosis. Hence, the treatment of VRF with Biodentine seems to be a possible and promising option

Restorative treatment in a case of amelogenesis imperfecta and 9-year follow-up: a case report

Background!#!Amelogenesis imperfecta is a hereditary malformation showing various manifestations regarding enamel dysplasia. This case report shows a 9-year follow-up after restorative treatment of a 16-year old female patient affected by a hypoplastic type of amelogenesis imperfecta. The caries-free, hypersensitive teeth of the patient were restored by direct dentin adhesive composite restorations performed in total etch technique.!##!Case presentation!#!After rehabilitation the patient reported a marked improvement of the mastication ability and quality of life especially during food intake. Accumulation of plaque was reduced and the ability to perform adequate oral hygiene was improved. During follow-up of 9 years recurring secondary caries and debonding of fillings were recognized and retreated.!##!Conclusions!#!The retrospective assessment exhibits that the performed restorative treatment prolonged the time until further treatment has to be considered, such as prosthetic treatment

Remineralization and protection from demineralization: effects of a hydroxyapatite-containing, a fluoride-containing and a fluoride- and hydroxyapatite-free toothpaste on human enamel in vitro

Abstract Background The aim was to evaluate the remineralization potential as well as the extent of protection against renewed demineralization of enamel by hydroxyapatite-containing toothpaste (Karex) in comparison to fluoride-containing (Elmex) and fluoride- and hydroxyapatite-free toothpaste (Ajona) as control. Methods Fifty-seven enamel samples were obtained from 19 human teeth. Five demarcated surfaces were created on each tooth (S0—S4). Four of the surfaces (S1—S4) were exposed to lactic acid (pH 3) for 8 h (demineralization). S0 was left untreated as control. S1 was solely treated with acid. After demineralization, S2 was exposed to Karex for 2 min, of which 15 s were brushing. S3 was treated with Elmex and S4 with Ajona, accordingly. Then, the samples were evaluated using a scanning electron microscope and ImageJ image analysis software to determine the percentage of demineralization. Afterwards, S2-S4 were again exposed to lactic acid for 2 h, and subjected to pixel analysis another time. Data were statistically analysed using ANOVA with post-hoc Scheffé test and the Kurskal-Wallis test. Results The surfaces treated with Elmex showed the lowest percentage of demineralization (mean 5.01 ± 0.98%) (p < 0.01). Thus, Elmex remineralized more effectively compared to Ajona (8.89 ± 1.41%) and Karex (9.85 ± 1.63%) (p < 0.01). Furthermore, Elmex showed the lowest percentage of demineralized enamel after new demineralization (median 6.29%), followed by Ajona (11.92%) and Karex (13.46%) (p < 0.001). Conclusion In terms of remineralization and protection against renewed demineralization, a hydroxyapatite-containing toothpaste (Karex) appears to be inferior to a fluoride-containing toothpaste (Elmex) and a fluoride- and hydroxyapatite-free toothpaste (Ajona). Hence, the recommendation to use Karex to protect against demineralization should be critically questioned

The push-out bond strength of calcium silicate-based endodontic sealers

Abstract Background The aim was to compare the dislodgement resistance of calcium silicate-based sealers (Total Fill BC Sealer, Endo CPM Sealer, BioRoot RCS) with an epoxy resin-based sealer (AH Plus). Methods The root canals of 80 single-rooted human teeth were instrumented with F360 up to size 45.04. All canals were obturated using matching gutta-percha cones according to the single-cone technique in combination with one of the mentioned sealers (n = 20 per group). After eight weeks of incubation (37 °C, 100% humidity), the roots were embedded in resin. Starting with a distance of 7 mm from the apex, four slices of 1 mm thickness were cut. Dislodgement resistance was measured using a universal testing machine and the push-out bond strength was calculated. Specimens were examined under 4×-magnification to determine the mode of bond failure. Statistical analysis was performed using ANOVA and Student-Newman-Keuls-test. Results Regarding the pooled data of all sections, the push-out bond strength of AH Plus was significantly higher than the push-out bond strength of all calcium silicate-containing sealers (P < 0.05). Out of all calcium silicate-based sealers, Total Fill BC Sealer showed the highest push-out bond strength (P < 0.05). BioRoot RCS had significant higher push-out bond strength than Endo CPM Sealer (P < 0.05). Nearly the same results were found for all four sections. BioRoot RCS only differed significantly from Endo CPM Sealer in the third section (P < 0.05). Conclusions The push-out bond strength of the investigated calcium silicate-based sealers was lower than of AH Plus. Total Fill BC showed the highest push-out bond strength of the calcium silicate-based sealers

Restorative treatment in a case of amelogenesis imperfecta and 9-year follow-up: a case report

Background:Amelogenesis imperfecta is a hereditary malformation showing various manifestations regarding enamel dysplasia. This case report shows a 9-year follow-up after restorative treatment of a 16-year old female patient affected by a hypoplastic type of amelogenesis imperfecta. The caries-free, hypersensitive teeth of the patient were restored by direct dentin adhesive composite restorations performed in total etch technique. Case presentation:After rehabilitation the patient reported a marked improvement of the mastication ability and quality of life especially during food intake. Accumulation of plaque was reduced and the ability to perform adequate oral hygiene was improved. During follow-up of 9 years recurring secondary caries and debonding of fillings were recognized and retreated. Conclusions:The retrospective assessment exhibits that the performed restorative treatment prolonged the time until further treatment has to be considered, such as prosthetic treatment