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.
METHODS: The electronic databases Cochrane Central Library, PubMed, Scopus, and ScienceDirect were searched based on specific MeSH keywords. The Randomized controlled clinical trials (RCTs) and prospective clinical trials on BOPT printed in English up to July 2022 were selected. Screening, selection, and data extraction were done. The studies were assessed for risk of bias, and descriptive and meta-analyses were performed.
RESULTS: Eight studies were included in the systematic review and only three RCTs were involved in the meta-analysis. Two RCTs were assessed as low risk while one has some concerns. were grouped as good, fair, and poor based on NOS. Three of the prospective studies were considered to be of good quality and one study was fair. The meta-analysis revealed no statistically significant difference in the effect of BOPT and chamfer preparation on periodontal health status and success rate (P > 0.05).
CONCLUSIONS: Considering the limitation of this review, the BOPT is comparable to chamfer preparation and it resulted in an acceptable effect to maintain periodontal health with a high success rate. However, more evidence is required to support these findings.
METHODS: Medline/PubMed and Scopus databases were searched using "Middle mesial canal," "Middle mesial root canal," OR "Accessory mesial canal" keywords from 1 January 1970 and 1 February 2023. The most pertinent articles were chosen for the review from the retrieved articles. In addition, relevant articles were added by manually searching the list of references.
RESULTS: The incidence of MMC is noticeable in younger people, and the confluent canal is the most common type. The majority of MMCs merged with mesiobuccal (MB) canals rather than mesiolingual (ML) canals. Clinical management could be employed using the standard endodontics protocol, and recent radiography technologies, magnification, rotary, and obturation materials can facilitate the procedures.
CONCLUSION: The possibility of the incidence of MMC is not unusual. Detection and thorough debridement followed by obturation of the canal could increase the success rate of clinical outcomes.
METHODS: 80 teeth were selected and divided into two groups which were stained with black coffee and red wine respectively. The stained specimens were subdivided into four subgroups to be bleached with Opalescence, LumiBrite, WhiteLight and strawberry extract. Color measurements were made using spectrophotometer at baseline level, after staining, after bleaching and 1 week after bleaching. The ΔE₀₀ was calculated post bleaching (ΔE₀₀1), after 1-week follow up (ΔE₀₀2) and color changes between 1-week follow up and baseline (ΔE₀₀3). Data were analyzed by paired t-test and ANOVA with a significant difference of P< 0.05.
RESULTS: Paired t-test showed significant differences in ΔE₀₀1 and ΔE₀₀2 for both stained specimens (P< 0.001). For black coffee stained specimens, Whitelight had significantly higher ΔE₀₀2 compared to the other bleaching agents (P< 0.05). For red wine stain, Whitelight also showed the significantly lowest ΔE₀₀1 (P< 0.001) and the highest ΔE₀₀2 (P< 0.001) compared to other groups. LumiBrite showed the significantly lowest ΔE₀₀3 for red wine stained specimens (P< 0.05). Whitelight had the poorest bleaching efficacy with deterioration effect after 1-week follow up. Opalescence, LumiBrite and strawberry extract had clinically perceptible and comparable bleaching efficacy. Strawberry extract appeared to be a potential natural bleaching agent with a desirable effect.
CLINICAL SIGNIFICANCE: Commercial tooth bleaching agents can cause several undesirable side effects such as damage to enamel, hypersensitivity and even affecting the pulp. Strawberry extract is a natural, effective bleaching agent that may have reduced side effects.
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: Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots.
RESULTS: Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: p < 0.001, 95% CI: 0.96-1.00, I2 = 77.84%; 10 years: p < 0.001, 95% CI: 0.88-0.95, I2 = 93.59%; 15 years: p < 0.001, 95% CI: 0.92-0.96, I2 = 94.83%; and 20 years: p < 0.001, 95% CI: 0.94-0.96, I2 = 95.01%.
CONCLUSIONS: The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper.
AIM: The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET.
DESIGN: A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period.
RESULTS: Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%-3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period.
CONCLUSION: According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.
METHODS: A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus.
RESULTS: The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient's situation and surgeon's experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively.
CONCLUSION: Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.
METHODS: Eighty-nine recognized MBS surgeons from 42 countries participated in the Modified Delphi consensus to vote on 30 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.
RESULTS: Consensus was reached on 29 out of 30 statements. Most experts agreed that before getting privileges to perform MBS, surgeons must hold a general surgery degree and complete or have completed a dedicated fellowship training program. The experts agreed that the learning curves for the various operative procedures are approximately 25-50 operations for the LSG, 50-75 for the OAGB, and 75-100 for the RYGB. 93.1% of experts agreed that MBS surgeons should diligently record patients' data in their National or Global database.
CONCLUSION: MBS surgeons should have a degree in general surgery and have been enrolled in a dedicated fellowship training program with a structured curriculum. The learning curve of MBS procedures is procedure dependent. MBS surgeons must demonstrate proficiency in managing postoperative complications, collaborate within a multidisciplinary team, commit to a minimum 2-year patient follow-up, and actively engage in national and international MBS societies.