The detectability of VRFs by CBCT in vitro and in vivo was dependent upon fracture width. The accuracy of CBCT in detecting VRFs of 50-300 μm width in vivo was significantly lower compared to the in vitro accuracy.
Aim To compare the in vivo accuracy of CBCT for the detection of fracture lines versus the diagnosis of vertical root fractures (VRFs) according to characteristic patterns of associated bone resorption. Methodology Eighty‐eight patients with symptoms typical of VRFs in root filled teeth, who underwent a CBCT examination and later had the teeth extracted, were divided into two groups: the fracture group (n = 65) and the control group (n = 23). Five blinded observers assessed the CBCT images in two sessions. During the first session, they were asked to state the diagnosis according to the CBCT and clinical data. During the second session after 2 weeks, they assessed only axial slices and were asked to detect a fracture line. The mean CBCT specificity, sensitivity, accuracy values and area under the receiver operating characteristic (AUROC) curve were calculated and compared using the Wilcoxon signed‐rank test. Results The average sensitivity of CBCT for the diagnosis of VRFs was 0.84 ± 0.2. The accuracy and AUC values were 0.81 ± 0.08 and 0.84 ± 0.17, respectively. The sensitivity, accuracy and AUC values for the detection of VRFs were significantly lower: 0.17 ± 0.24 (P = 0.042), 0.54 ± 0.07 (P = 0.043), and 0.52 ± 0.09 (P = 0.043), respectively. The specificity of CBCT for the detection and diagnosis of VRFs did not differ significantly (P = 0.50). Conclusion Cone‐beam computed tomography was helpful in VRF diagnosis even when it was not possible to visualize the fracture line.
Objectives: To compare the accuracy of cone-beam CT ex vivo and in vivo for the detection of artificially created large and small vertical root fractures in extracted teeth restored with post-core. Methods: Individual metal cast post-cores were fixed in the root canals of 50 extracted single-rooted human teeth. In 30 teeth fractures were created by tapping posts with a hammer. The teeth were sterilised in autoclave and embedded into bite-plates made of silicon impression material. Cone-beam CT scanning was performed ex vivo and in vivo . For the in vivo scanning, teeth in sterile plastic bags were inserted into the mouths of volunteers. Then the teeth were sectioned with low-speed saw and the widths of the VRFs were measured microscopically. The teeth were distributed into 2 groups in accordance with the measured fractures’ widths: large (wider than 180–250 µm) and small (80–150 µm). Five observers assessed the presence of vertical root fractures on axial CBCT slices. Sensitivity, specificity, accuracy and inter examiner agreement were calculated. Results: The accuracy of cone-beam CT in vitro for large and small vertical root fractures detection was 0.56 and 0.40 respectively (p = 0.043). The sensitivity values were 0.53 and 0.27 for large and small vertical root fractures, respectively (p = 0.043). The visualisation of fracture lines in vivo was impossible in 90 % of cases, because of low image quality. Inter examiner reliability analysis showed κ values ranging from 0.02 to 0.54. Conclusions: Fracture width affected the in vitro detectability of vertical root fractures by cone-beam CT in teeth with metal cast post-cores. The detectability of root fractures in vivo was decreased because of low image quality, making the assessment of sound tooth tissue impossible.
A BSTRACT Aims: The aim of this study was to compare the effect of toothpastes containing hydroxyapatite (nHAP), Zn-Mg-hydroxyapatite (nZnMgHAP), and fluorapatite (nFAP) nanocrystals on dentin hypersensitivity (DH) associated with noncarious cervical lesions. Materials and Methods: Thirty consenting volunteers aged 35−45 years with DH were enrolled in a double-blind, parallel study, randomly assigned to the nHAP group ( n = 10), the nZnMgHAP group ( n = 10), or the nFAP group ( n = 10), and instructed to use the toothpaste twice daily for one month. The primary outcome was Schiff scores at baseline and after 2 and 4 weeks. Results: All patients fulfilled the study requirements, and no adverse effects were registered. A reduction in DH was registered in 90%, 100%, and 50% of patients using nHAP, nZnMgHAP, and nFAP-containing toothpastes with effect sizes 2.52 (confidence interval [CI] 95%: 0.82, 4.14), 3.30 (CI 95%: 1.33, 5.20), and 1.44 (CI 95%: 0.09, 2.72), respectively. At 4 weeks, Schiff index scores decreased significantly in all groups compared to baseline. Conclusions: nZnMgHAP may be considered a promising agent for DH management.
We aimed to assess the effect of oral probiotics containing the Streptococcus salivarius K12 strain on the salivary level of secretory immunoglobulin A, salivation rate, and oral biofilm. Thirty-one consenting patients meeting the inclusion criteria were recruited in this double-blind, placebo-controlled, two-arm, parallel-group study and randomly divided into probiotic (n = 15) and placebo (n = 16) groups. Unstimulated salivation rate, concentration of salivary secretory immunoglobulin A, Turesky index, and Papillary-Marginal-Attached index were assessed after 4 weeks of intervention and 2 weeks of washout. Thirty patients completed the entire study protocol. We found no increase in salivary secretory immunoglobulin A levels and salivary flow rates in the probiotic group compared with placebo. Baseline and outcome salivary secretory immunoglobulin A concentrations (mg/L) were 226 ± 130 and 200 ± 113 for the probiotic group and 205 ± 92 and 191 ± 97 for the placebo group, respectively. A significant decrease in plaque accumulation was observed in the probiotic group at 4 and 6 weeks. Within the limitations of the present study, it may be concluded that probiotic intake (Streptococcus salivarius K12) does not affect salivation rates and secretory immunoglobulin A salivary levels but exhibits a positive effect on plaque accumulation. Trial registration NCT05039320. Funding: none.
We aimed to assess the effects of ultrasonic scaling and air-powder polishing on the roughness of enamel, three nanocomposites (Premise, Herculite Ultra, Harmonize), and composite/enamel and composite/cementum interfaces. Class V cavities were restored in 99 extracted third molars with one of the three nanocomposites and treated with ultrasonic scaler or air-powder polishing device (calcium carbonate or sodium bicarbonate powders). The roughness (Ra) of the investigated surfaces was measured with contact profilometer before and after treatment. The data were analyzed using repeated measures ANOVA. Specimens’ Ra values before instrumentation were near the clinically acceptable 0.2 μm threshold. All techniques increased the roughness of the tested surfaces; however, the enamel was slightly affected. The mean Ra values after prophylaxis for composite, composite/cementum and composite/enamel surfaces were 0.32–0.55, 1.33–1.73, and 1.25–1.36, respectively. The extent of composite surface damage was material dependent. Premise surface was not altered by ultrasonic scaling significantly. Air-powder polishing with both powders produced a greater increase in surface roughness of composite resin and restorations margins than ultrasonic scaling. The Ra values after both types of air polishing for Herculite Ultra and Harmonize were approximately 1.5 and 2 times higher, respectively, than those after ultrasonic scaling (p < 0.05).
Aims: Xerostomia syndrome is a significant medical and social problem. It is manifested by objective and subjective symptoms of a “dry mouth” and a decrease in sialometry. The aim of the study was to determine the dental status of students of different nationalities, to identify xerostomia induced on a background of stress, and to assess the effectiveness of the use of moisturizing foams in alleviating xerostomia. Materials and Methods: A prospective cohort study survey (Fox test) of 100 students of the dental faculty was conducted to detect false xerostomia. The study involved 60 people with false xerostomia, divided into four groups of 15 each according to the nationality. The level of oral hygiene was determined using the Simplified Oral Hygiene and Silness-Loe indices and the rate of salivation was assessed with sialometry method by Pozharitskaya. Oral hygiene instructions were given to the participants. They were to apply moisturizing foams with lactoferrin, lactoperoxidase, and aloe vera, two–three times during the day for 3 weeks. A set of statistical programs was used (Microsoft Excel [2007] and the Statistical Package for the Social Sciences [SPSS], version 23) to perform Kolmogorov–Smirnov, Shapiro–Wilk, Kruskal–Wallis, and Wilcoxon tests. Results: A statistically significant improvement in oral hygiene was observed in all study participants. A significant increase was detected in the rate of salivation in students from Russia ( P = 0.005), Transcaucasian countries ( P = 0.006), and Arab countries ( P = 0.005). Conclusion: It has been established that the use of moisturizing foam has a positive effect on the rate of salivation and improves the level of oral hygiene, thereby improving the quality of life for patients.
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