METHODS: A questionnaire survey was conducted to assess self-reported dental injuries and knowledge of their management. An intraoral examination was performed using the decayed, missing, and filled teeth (DMFT) index following the World Health Organization guidelines.
RESULTS: A total of 61 para-athletes (men = 90.16%, n = 55; women = 9.84%, n = 6) from different sports categories with different disabilities randomly participated in this study. The incidence of self-reported dental injuries was 18.0% (n = 11), with the most common injury being crown tooth fracture (72.7%) and lip laceration (63.6%). However, the majority of the athletes (70.5%, n = 43) did nothing after experiencing dental trauma, and 82.0% (n = 50) were unaware of the immediate management of dental trauma. Based on the intraoral examination, only 9.8% (n = 6) of the athletes had perfectly sound teeth. The mean total DMFT index was 3.49 ± 2.371, while the mean DMFT index for decayed, missing, and filled teeth was 1.28 ± 1.293, 0.74 ± 0.705, and 1.48 ± 1.120, respectively. The mean DMFT index for decayed, missing, and filled teeth and total DMFT index significantly differed among the types of disabilities (P .05).
CONCLUSION: The most commonly reported injuries among para-athletes are crown tooth fractures and lip lacerations. The total DMFT index among para-athletes is moderate, emphasising the need for improvements.
OBJECTIVES: The aim of the study was to evaluate the effect of fiber post location on fracture resistance and failure mode of endodontically treated premolars with 2 roots.
MATERIAL AND METHODS: Fifty extracted maxillary first premolars with 2 roots were divided randomly into 5 groups. Group 1 was comprised of sound teeth, which received only metal crowns (control). Teeth from groups 2, 3, 4, and 5 were decoronated 2 mm above the cementoenamel junction (CEJ) and were endodontically treated. No post was placed in group 2 teeth. Teeth from groups 3, 4 and 5 were given a fiber post placed in the buccal canal, palatal canal, and both buccal and palatal canals, respectively. All teeth in groups 2, 3, 4, and 5 were built up with composite and full coverage metal crowns. A compressive static load was applied at an angle of 25° to the crowns with a crosshead speed of 0.5 mm/min, until fracture.
RESULTS: One-way analysis of variance (ANOVA) showed significant differences among the groups (p = 0.002). A post hoc test showed significantly lower fracture resistance of group 4 compared to group 5 (p = 0.011). Furthermore, group 2 had significantly less fracture resistance compared to group 1 (p = 0.021) and group 5 (p = 0.002). According to Fisher's exact test, different post locations are non-significantly associated with fracture mode (p = 0.256).
CONCLUSIONS: Fiber post location has a significant effect on fracture resistance of severely damaged, endodontically treated maxillary premolars with 2 roots. However, post placement in the palatal root is preferred, as it maintains the restorability of the tooth.
MATERIALS AND METHODS: A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05).
RESULTS: A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P 0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P tooth structure are lost. To date, the evidence available does not support the application of TrussAC. UltraAC might be applied in limited occasions.
CLINICAL RELEVANCE: Maintaining the extent of AC design as small as practical without jeopardizing the root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.
METHODS: 75 human mandibular molars were randomly divided into five equal groups. Teeth were standardized, endodontically-treated and restored according the assigned group as follows: amalgam core only, prefabricated titanium post in the distal canal and amalgam core, composite core only; fiber post in the distal canal and composite core. One group of untreated sound teeth was used as a control. Non-precious metal crowns were fabricated and cemented on the prepared specimens with Rely X U200 resin cement. All specimens were subjected to a compressive load at crosshead speed 0.5 mm/minute, 25° to the long axis of the tooth. Failure loads and modes were recorded.
RESULTS: Mean failure loads among the groups were significantly different (P= 0.035). Post-hoc multiple pair-wise comparisons revealed the amalgam core and composite core groups produced significantly lower fracture resistance than the control group (P= 0.041 and P= 0.025, respectively) and no significant differences among the different intra-radicular techniques (P> 0.05). The composite core with fiber post and amalgam core with titanium posts showed the highest percentage of favorable failures (67%) and non-favorable failures (87%) respectively.
CLINICAL SIGNIFICANCE: The composite core with fiber post is the most appropriate intraradicular restoration in cases of severely compromised molars.