MATERIALS AND METHODS: Sound extracted human molars were randomly divided into: manufacturer's instructions (MI), manual blend 2 mm (MB2), and manual blend 4 mm (MB4). Occlusal enamel was removed and flattened, dentin surfaces were bonded by Prime & Bond universal (Dentsply and Optibond FL, Kerr). For the MI group, adhesives were applied following the manufacturer's instructions then light-cured. For MB groups, SDR flow+ bulk-fill flowable composite resin was applied in 2- or 4-mm increment then manually rubbed by a micro brush for 15 s with uncured dentine bonding agents and the mixture was light-cured. Composite buildup was fabricated incrementally using Ceram.X One, Dentsply nanohybrid composite resin restorative material. After 24-h water storage, the teeth were sectioned to obtain beams of about 0.8 mm2 for 24-h and thermocycled micro-tensile bond strength at 0.5 mm/min crosshead speed. Degree of conversion was evaluated with micro-Raman spectroscopy. Contraction gaps at 24 h after polymerization were evaluated and atomic force microscopy (AFM) nano-indentation processes were undertaken for measuring the hardness across the interface. Depth of resin penetration was studied using a scanning electron microscope (SEM). Bond strength data was expressed using two-way ANOVA followed by Tukey's test. Nanoindentation hardness was separately analyzed using one-way ANOVA.
RESULTS: Factors "storage F = 6.3" and "application F = 30.11" significantly affected the bond strength to dentine. For Optibond FL, no significant difference in nanoleakage was found in MI/MB4 groups between baseline and aged specimens; significant difference in nanoleakage score was observed in MB2 groups. Confocal microscopy analysis showed MB2 Optibond FL and Prime & Bond universal specimens diffusing within the dentine. Contraction gap was significantly reduced in MB2 specimens in both adhesive systems. Degree of conversion (DC) of the MB2 specimens were numerically more compared to MS1 in both adhesive systems.
CONCLUSION: Present study suggests that the new co-blend technique might have a positive effect on bond strengths of etch-and-rinse adhesives to dentine.
Materials and methods: A total of 40 patients were recruited, (mean age = 23 years) and were assigned to low and moderate caries risk groups (n = 20). Eighty occlusal surfaces of posterior teeth were examined for early caries lesion visually and using SoproLife® at baseline and at a recall visit six months later. At baseline visit, patients were given oral hygiene education, fluoridated toothpaste for homecare and topical fluoride application. SoproLife® images acquired were analysed using Image J software version 1.50. Difference in the mean value of intensity of the red wavelength spectrum between baseline and recall visits, (ΔI), were analysed for both risk groups. ΔI for upper and lower first molar teeth were also analysed.
Results: Results show no statistical difference for ΔI between low and moderate risk groups (p = 0.13). There is no statistical difference in ΔI within the low caries risk group (p = 0.42) but there is significant difference in the moderate risk group (p = 0.02). No statistically significant difference in ΔI value between upper first molars (UFM) (p = 0.80) and lower first molars (LFM) (p = 0.07) were detected. There was also no statistically significant difference in ΔI value within the upper and lower first molars (UFM: p = 0.31, LFM: p = 0.27).
Conclusion: SoproLife® generated images did not show significant differences in remineralisation of early caries between low and moderate caries risk patients and between the upper first and lower first permanent molars in these patients.
METHODS: PubMed, EBSCOhost, and Scopus databases were searched. Additional searching was performed in clinical trial registry, reference lists of systematic reviews, and textbooks. Randomized clinical trials (RCTs) published in the English language through October 2017 comparing the success of pulpotomies in vital primary molars with a follow-up of at least 6 months were selected. Study selection, data extraction, and risk of bias assessment were performed. MA by random effects model, TSA, and GRADE were performed.
RESULTS: Eight RCTs (n = 474) were included. Two RCTs had low risk of bias. No significant difference was observed between MTA and BD in clinical success at 6 months (risk ratio [RR], 1.00; 95% confidence interval [95% CI], 0.97-1.02; I2 = 0%), 12 months (RR, 1.00; 95% CI, 0.96-1.05; I2 = 0%), and 18 months (RR, 1.00; 95% CI, 0.93-1.08; I2 = 0%). No difference was observed in radiographic success at follow-up of 6 months (RR, 0.99; 95% CI, 0.96-1.02; I2 = 0%), 12 months (RR, 1.02; 95% CI, 0.47-2.21; I2 = 0%), and 18 months (RR, 1.02; 95% CI, 0.91-1.15; I2 = 0%). TSA indicated lack of firm evidence for the results of the meta-analytic outcomes on clinical and radiographic success. GRADE assessed the evidence from the MA comparing the effect of MTA and BD in pulpotomy to be of low quality.
CONCLUSION: BD and MTA have similar clinical and radiographic success rates based on limited and low-quality evidence. Future high-quality RCTs between MTA and BD is required to confirm the evidence.
Materials and Methods: A randomized-controlled split-mouth study was conducted to compare the retention and the caries preventive effect of light-cured resin-based sealant (3M ESPE) and glass ionomer sealant (Fuji VII). The sealants were applied to either the right or the left lower mandibular molars (7-9 yrs of age) in 120 school children, based on the randomization process. They were recalled for assessment of clinical retention at intervals of 3, 6, and 12 months. The caries-preventive effect between the two materials was tested statistically by the McNemar's test for matched pairs, and the differences observed with regard to the retention of the materials was tested by Chi-square tests. The level of significance was set to be at P < 0.05.
Results: At the end of 12th month, sealant retention is found to be higher in the resin-based sealant group compared to the glass ionomer group. In the glass ionomer sealants placed, 101 (91%) were caries-free and 10 (9%) had caries. In the resin-based sealant, 105 (94.60%) had sound teeth and 6 (5.4%) had dental caries (P = 0.34).
Conclusion: The glass ionomer sealant was less retentive when compared to resin sealants. The caries incidence between the glass ionomer and resin-based sealants was not statistically significant.
MATERIALS AND METHODS: This is an in vitro study using two extracted sound human mandibular molars. One tooth was prepared to receive the metal onlays and another one for the RNC onlays which were fabricated using the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. Twelve metals and 12 ceramic onlays were fabricated before they were placed at their respective preparation and examined under the Leica stereomicroscope, M125C (Leica Microsystems, Wetzlar, Germany) for a marginal analysis. The gap width was measured at 10 predefined landmarks which included 3 points on the buccal and lingual surfaces each and 2 points each on the mesial and distal surfaces, respectively.
STATISTICAL ANALYSIS: Mann-Whitney post hoc test was used for statistical analysis (P ≤ 0.05).
RESULTS: Overall, the RNC onlays showed significant lower marginal gap with the exception of the landmarks 5 and 6 (on distolingual) and no significant difference at landmark 7 (on midlingual). It was observed that the marginal gap were all within the clinically acceptable limit of 120 μm.
CONCLUSIONS: Based on the results obtained, it can be concluded that the RNC CAD/CAM onlays are a promising alternative to the metal onlays.
METHODS: A total of 208 CBCT images were examined retrospectively. Prevalence of an extra root/canal and internal morphology based on Vertucci's classification were observed in human maxillary and mandibular permanent teeth. Variations in the external and internal morphology were compared in relation to gender and tooth side (left vs right) using Pearson Chi-square and Fisher's exact tests with significance level set at p molars were 36.3 and 8.5%, respectively. Males displayed significantly higher prevalence of a second mesiobuccal canal in maxillary second molars than females (p molars were 0.9 and 0.6%, respectively. In the mandibular arch, the prevalence of two canals were observed in 5.1% of central incisors, 12.3% of lateral incisors, 6.1% of canines, 18.7% of first premolars and 0.5% of second premolars. The prevalence of a middle mesial canal, second distal canal and extra root (radix entomolaris) were detected in 1.9, 19.5 and 21.4% of mandibular first molars, respectively. The prevalence of a C-shaped canal was observed in 48.7% of mandibular second molars. Females displayed significantly higher prevalence of a C-shaped canal in the right mandibular second molars than males (p
Materials and Methods: CBCT images which show MFPMs recorded in HUSM Dental Clinic between January 2015 and June 2016 was obtained and analyzed for their number of roots and canals. A total of 208 CBCT images of MFPMs were collected; 118 patients had unilateral molars and 90 patients had bilateral molars. The following observations were made: (1) root number; (2) number of canals per root; and (3) comparisons of number of roots and canals according to gender, ethnicity, and position.
Results: The majority of cases of bilateral MFPM had the same number of roots (95.6%, 95% confidence interval [CI]: 89.01%, 98.78%) on both the right and left side and only 4 cases (4.4%, 95% CI: 1.22%, 10.99%) had 3 roots on the right and 2 roots on the left sides. The majority of cases had the same number of canals on both sides (66.7%, 95% CI: 55.95, 76.26%) and 33.3% (95% CI: 23.74%, 44.05%) with unequal number of canals. The occurrence of the number of canals was not independent of the sides of the arch (P < 0.001) and there was statistically significantly greater proportion of cases who had greater number of canals on the right side than the left (P = 0.03). The prevalence of right single-rooted MFPM was very small at 0.3% (n = 1) in a Malay male (95% CI: 0.00, 1.83) and the most prevalent was two roots first molar (88.4%). The number of roots was not associated with sex or ethnic group (P > 0.05). The MFPM with a single root was found to have only one mesial canal. For two rooted MFPM, the most prevalent occurrence was two canals at the mesial and one canal at the distal roots (59%); followed by single canals in each mesial and distal (21%) and double canals per root (18%). Three roots MFPM have either single or double canals in the mesial root and double canals in the distal root.
Conclusions: The majority of population in the East Coast region of Malaysia has two roots and three root canals in their MFPMs. There was no difference in the number of roots between gender and ethnic and canals between ethnic.
DESIGN: Dental pulp from extracted human permanent teeth was processed for fluorescence immunohistochemistry. Ten asymptomatic (normal) and 10 symptomatic (symptoms associated with pulpitis) teeth were used in this study. Nerve fibers were identified by immunostaining for a marker, protein gene product 9.5, and the cells were counterstained with 4',6-diamidino-2-phenylindole. An anti-TRPV4 antibody was used to trace TRPV4 expression.
RESULTS: TRPV4 expression was co-localized with the nerve fiber marker. Immunoreactivity for TRPV4 was more intense (p
BACKGROUND: The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice.
METHODS: A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software.
RESULTS: The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients <60 years of age, without molar support, can attain acceptable chewing function and that SDA treatment does not lead to loss of occlusal vertical dimension (P < 0.05). A larger number of participants with ≤5 years of work experience than with >5 years of work experience perceived that the SDA concept enables simpler treatment planning (P < 0.05). Finally, a larger number of participants who graduated abroad than who graduated locally observed that patients without molar support had temporomandibular joint problems (P < 0.05).
CONCLUSION: Although Malaysian government dentists have good knowledge and perceptions of the SDA concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs.