Endodontic treatment failure is usually characterised by the presence of post-treatment apical periodontitis, which may be persistent, emergent or recurrent. Understanding the causes of endodontic treatment failure and making a correct diagnosis are of paramount importance for the proper management of this condition. In clinical practise, endodontic treatment failure is mainly related to the poor quality of root canal treatment (RCT), the nature of the disease and the concomitant disease of the tooth. This article focuses on the above three factors and discusses the indications and basics of the procedures for optimal clinical management of this condition.
Objective To investigate the effective surgical methods for facial asymmetrical deformity caused by temporomandibular joint tumors and condylar tumor-like lesions as well as the post-surgical influence on cosmetic aspects and occlusal function.Methods The study included 82 cases with temporomandibular joint tumors and condylar tumor-like lesions from 1995 to 2015 in the Hospital of Stomatology, Sun Yat-sen University. Among them, 54 cases (65.9%) were diagnosed with benign tumor, 25 cases (30.5%) with tumor-like lesions (hyperplasia of condyle) and 3 cases with malignant neoplasm (3.7%). 61 cases with the chief complaint of progressive facial deformity underwent surgeries, including: simple resection of neoplasms and hyperplasia condyle for 34 cases; resection of neoplasms plus repair with costochondral graft for 9 cases; vertical ramus osteotomy of the affected side (EVRO) and re-implantation of condyle after tumor excision for 3 cases; subcondylar ramus"L"-shaped osteotomy for 3 cases; bilateral ramus vertical osteotomy for 4 cases; bilateral sagittal split ramus osteotomy for 3 cases; bilateral sagittal split ramus osteotomy (BSSRO) plus LeFortⅠosteotomy for correction of the upper occlusal plane for 3 cases. Resection of partial or hemimandible for 2 cases. All patients were followed up from 6 months to 10 years after operation.Results During the follow-up period, no recurrence was found in the 58 cases with benign tumor, and 53 cases got satisfactory restoration in appearance and occlusal function. Among the cases who underwent simple resection of tumors and condyle, two patients appeared a serial of clinical symptoms because of unstable occlusal relationship, three cases did not obtain satisfied appearance. Among the three cases with malignant neoplasm, two cases got stable results and one died.Conclusion Simple resection of the temporomandibular joint neoplasms is the main surgical methods for facial asymmetrical deformity caused by temporomandibular joint tumors and condylar tumor-like lesions. But results of some cases are not satisfied. Comprehensive surgical techniques could be applied in the treatment of asymmetric deformity of face based on different scenarios to improve the appearance, occlusal relationship and temporomandibular joint function.
Objective To compare the enamel demineralization effect of different dairy (drink) goods for providing evidence for choosing children dairy (drink) products.Methods Immerse in vitro deciduous teeth in different dairy (drink) goods (milk powder solution group; yogurt group; fruit juice milk drinks group; distilled water group) for a week, the enamel surface ultrastructure in deciduous teeth immersed in different dairy (drink) were observed and compared by scanning electron microscope.Results Three kinds of dairy products (drink) can lead to deciduous teeth enamel surface microhardness decreased (P < 0.05). Different dairy products (drink) on isolated teeth enamel demineralization degree (F = 20.14, P < 0.05), juice milk drinks after immersion of the enamel surface microhardness of the lowest, followed by milk powder solution group and yogurt group. Deciduous teeth with three different dairy (drink) after 1 weeks of immersion, the enamel surface had different degree of demineralization phenomenon, observation showed irregular enamel surface morphology under scanning electron microscope, the phenomena of dissolution and removal of cracks, voids and so on, partial visible appearance or honeycomb pit.Conclusion Dairy (drink) product all can lead to a variety of deciduous teeth enamel demineralization of different level fruit juice milk drinks can cause serious demineralization.
Objective To evaluate the antimicrobial properties of 2 different pulp capping materials (ProRoot MTA and iRoot BP Plus).Methods Modified direct contact test (DCT) was performed as follow. ProRoot MTA and iRoot BP Plus were set for 7 days, then crushed and immersed into deionized water at concentrations of 200 g·L -1 for another 7 days. PH values of the supernatants of the aqueous extracts were measured with a pH meter. The germfree supernatants were mixed with Streptococcus mutans suspensions and then incubated for 24 hours. The survival of bacteria was assessed by measuring the optical density (OD) at 600 nm with an automated microplate reader.Results PH values of the aqueous extracts of ProRoot MTA and iRoot BP Plus were between 12 and 13, and no statistically significant difference was found (t = 0.133, P = 0.899). Both ProRoot MTA and iRoot BP Plus demonstrated good antibacterial properties (P < 0.05), and iRoot BP Plus performed a better antibacterial effect (P < 0.05).Conclusion IRoot BP Plus performed a better antibacterial effect against Streptococcus mutans when compared to ProRoot MTA.
Objective To investigate the advantage and disadvantage between annular bone block embedded in maxillary sinus lift and conventional maxillary sinus lift.Methods =One hundred and twenty sinuses from 80 patients of serious insufficient of bone quantity (0-4 mm height of residual bone in the posterior maxilla) were divided into two groups randomly. Each group contained 60 sinuses. By preparing annular bone block at the alveolar ridge crest, 60 sinuses augmentation were carried out by repetitive knocking annular bone block under light force in the group of route from the crest of alveolar bone and 60 mucosa of maxillary sinuses were lifted up by routine fenestration operation on the maxillary lateral wall in the conventional sinus lifting group. Implants were implanted after six months. The perpetual prosthesis was made in 6 months. Misery index of patients, lifting height of sinus floor, the perforating rate of sinus mucosa and the success rate of implantation were compared between two methods. Lifting height of sinus floor was examined through x-ray imaging.Results No nostril hemorrhage was found in the group of route from crest sinus lifting whereas two patients occurred nostril hemorrhage in the conventional group; the mean operation time of route group from the crest of alveolar bone and the route group form the lateral wall was (42.82 ± 3.46) min, (88.38 ± 4.37) min, the difference was statistically significant (t = 35.237, P = 0.001) ; misery index of route group from the crest of alveolar bone and the route group form the lateral wall was (4.20 ± 0.68), (6.34 ± 0.45), the difference was statistically significant (t = 3.056, P = 0.003) ; lifting height of sinus floor of route group from the crest of alveolar and the route group form the lateral wall was (12.44 ± 2.48) mm, (12.28 ± 2.87) mm , and there was no statistical significance (t = 0.908, P = 0.390).Conclusion The route from the crest of alveolar bone could obviously reduce operative wound and postoperative complications, shorten operative time, lessen the trauma of operation, the difference was statistically significant between two methods. Two groups had no significant difference on lifting height of sinus floor, the perforating rate of sinus mucosa and the success rate of implantation.
Objective To evaluate the clinical restorative effect of anterior thin porcelain laminate veneers.Methods Thin Porcelain laminate veneers were applied to 112 teeth of 64 patients for anterior aesthetic restoration. The follow-up time was 24 months. The veneers were examined with a modified Ryge criteria.Results The fracture of the incisal edge on 2 veneers was noticed after 12 months. After 24 months, the partial fracture of the distal incisal corner on 1 veneer was noticed; a gap was detected on the margin of another veneer and discoloration was observed on 5 ones. None of cases showed dentin hypersensitivity or gingivitis.Conclusion A satisfying effect could be gotten by using thin porcelain laminate veneer in the anterior teeth with the advantages of less tooth preparation, high repair strength, and not easy to fall off break.
Objective To explore the relationship between periodontitis and preeclampsia (PE) using Meta-analysis method.Methods The EMBASE, PubMed, CNKI, WanFang and CBM databases were searched up to Oct. 31, 2015, and the relevant references of the included studies were also retrieved manually. The literatures were screened according to the inclusion and exclusion criterias by 2 reviewers independently. The methodology quality was evaluated after data abstraction. RevMan 5.3 software was used for Meta-analyses.Results 13 studies consist of 12 case-control studies and 1 cohort study were included. A total of 5 744 patients were involved, with 1 248 preeclampsia (PE) patients and 4 496 non PE patients. Meta-analysis showed that periodontitis increased the risk of PE with 2.67 times (OR = 2.67, 95％CI = 1.56-4.57, P<0.001). 3 subgroups of periodontitis were defined by pocket probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP), or by PPD with BOP, or by PPD. 3 subgroup analysis all revealed periodontitis was a risk factor, and the OR values were 2.91(95％CI = 2.05-4.11, P<0.001), 2.33(95％CI = 1.28-4.26, P = 0.006) and 2.8 (95％CI = 1.11-7.09, P = 0.03) respectively. Sensitivity analysis showed the results was stable and no publication bias was detected.Conclusion Periodontitis is a significant risk factor in PE according to this Meta analysis.
Objective To assess the clinical effect of cognitive behavior therapy on the oral treatment of preschool children with dental anxiety.Methods 86 children aged 3-6 years with dental anxiety were divided into experimental group and control group randomly. Children in experimental group were treated with cognitive behavioral therapy. Children in control group were treated with the Tell-Show-Do behavioral therapy. Through the observation of children’s cooperation and evaluation of Frankl treatment index, treatment effect of cognitive behavioral therapy applied in preschool children with dental anxiety was evaluated.Results In experimental group, 38 children can cooperate with treatment, while 5 children can’t cooperate. In control group, 24 children can cooperate with treatment, while 19 cases can’t cooperate. Children in the experimental group is significantly more cooperative (χ 2 = 11.328, P<0.01). Frankl index shows 2.61 ± 0.82 in experimental group and 1.93 ± 0.96 in the control group respectively. Treatment effect of the experimental group is significant (F = 1.956, P<0.01).Conclusion When cognitive behavioral therapy applied on preschool children with dental anxiety, first of all we should make necessary emotional control, then painless treatment, the children’s fear can be gradually relieved.
Human dental erosion is an irreversible loss of dental structure caused by acid dissolution, which can leads to tooth fracture, clinical crown loss and occlusal disorders. Early diagnosis, timely blocking the destruction of acidic substances and do the corresponding repairment according to the tooth defect is a challenge for dentists. This paper reports a case of porcelain laminate veneer restoration of tooth defect caused by early acid etching with minimal invasive and bonding repair in order to protect and repair the remaining tooth structure.
Objective To study the anti-caries efficacy of arginine dentifrice on early childhood caries in the rural area of Chengdu city in order to explore better early intervention measures on caries.Methods Two schools in Chengdu rural area were randomly chosen. Subjects were chosen according to the inclusion and exclusion criteria. All subjects were randomly divided into 2 groups, the experimental group used toothpaste containing 1.5% arginine and 1 450 F - ppm, control group used toothpaste containing 1 450 F - ppm, a comprehensive inspection of the dental caries of the 2 groups of subjects were recorded. The results were recorded by EpiData software for data entry, using SPSS 13.0 statistical software analysis data.Results 1 years later, the prevalence, the mean decayed missing filled teeth of deciduous teeth (dmft) of the experimental group was significantly lower than the control group. The number of new dmft score (t = 1.58, P = 0.001), the new decayed missing filled teeth surfaces (dmfs) number (t = 1.16, P = 0.001), The new permanent teeth DMFT number (t = 1.02, P = 0.005), new permanent teeth decay missing filling surface number (t = 1.03, P = 0.002) in the experimental group of deciduous teeth were lower than the control group. And the difference was statistically significant.Conclusion Toothpaste containing 1.5% arginine and 1 450 F - ppm is more significant on children’s dental caries prevention effect compared with the toothpaste containing 1 450 F - ppm only.
The pain from the angina pectoris of coronary heart disease sometimes can be delivered to neck, face, mandibular or maxillary teeth, which tend to be easily misdiagnosed by the pulpitis pain. This case report stated how to diagnosis and treat the toothache caused by cardiac origin, and provided the clinical reference for the differential diagnosis of the toothache from the cardiac originor odontogenic origin.
Objective To compare the clinical effect of three different kinds of materials used in apexification.Methods Sixty immature permanent teeth with pulpitis, pulp necrosis, periapical periodontitis were selected and randomly assigned to 3 groups according to registration order. Group A was treated with mineral trioxide aggregate (MTA), group B with Vitapex, and the control group with calcium hydroxide. All patients were recalled 3, 6 and 12 months after initial treatment.Results Pearson Chi-square test showed that the efficacy rate of group A was significantly higher than group B and the control group (P<0.05) in the visits of 3 months and 6 months after treatment. And efficacy rate of group B is also higher than the control group, but no statistical difference was found between two groups in the final visit (12 months). The efficacy rate of group A is 94.1%, group B is 75.0% and the control group is 58.8%. The statistical difference was found between group A and control group, but it was not found between group A and group B or between group B and the control group.Conclusion Compared with calcium hydroxide and Viatapex, MTA for apexification has better performance in apexification.
Children’s fear and anxiety and dental behavioral management problems are relatively usual in dental settings, and it is a barrier to dental care. Many factors associated with these problems will be reviewed from the aspects of doctor, patient and guardian, in order to reduce the incidence of dental fear and anxiety/dental behavioral management problem in dental departments.
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