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Nowadays, the ceramic veneer approach can be considered more predictable than direct composite veneer. To date, there is a lack of studies comparing the clinical performance of anterior veneers cemented on vital teeth (VT) and non-vital teeth (NVT). This longitudinal clinical study investigated the performance of ceramic veneers in VT or anterior NVT. A total of 55 patients were evaluated in the study. Two groups were defined based on the vitality status of the teeth (93 teeth—vital and 61 teeth—non-vital). The United States Public Health Service (USPHS) criteria were used to assess the clinical status. The data were evaluated statistically with the Mann–Whitney U test. All restorations were considered acceptable, and only one veneer in VT failed for the criteria of secondary caries. There were no statistically significant differences in any of the criteria evaluated (p ≤ 0.671). The ceramic veneers evaluated showed a satisfactory clinical performance both in VT and NVT.

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Background During endodontic treatment, endodontists must be aware of the various factors that may decrease or increase blood pressure. This study aimed to assess the mean percentages of systolic, diastolic, and arterial blood pressure (MSBP, MDAP, MABP) reduction in patients with vital irreversible pulpitis in teeth and who were treated at three visits to endodontists in three age groups (20–34 years, 35–50 years, 51–65 years). Materials and methods A total of 100 teeth with vital irreversible pulpitis from 100 patients were included. All patients underwent 3 visits for endodontic treatment. The 1st visit included removal of vital pulp tissue and a determination of working length, the 2nd visit included canal preparation and widening, and at the 3rd visit the canal was obturated and sealed by gutta percha and sealer. Blood pressure for all patients was checked and documented once before starting treatment and three times during treatment at different intervals during all visits. Results There were significantly higher percentage reductions in MSBP, MDBP, and MABP at the 1st visit for endodontic treatment in comparison to other visits (2nd and 3rd) for all patients. Additionally, there were significantly higher percentage reductions in MSBP, MDBP, and MABP at the 1st visit for endodontic treatment in comparison to other visits in males and females, for all age groups, both anesthesia injection-type groups (infiltration and block), and all treated tooth types except mandibular anterior teeth, and there were nonsignificant differences among groups. However, there were nonsignificant differences in MSBP, MDBP, and MABP between males and females, between infiltration and block injection groups and in relation to teeth types at all visits. Conclusions The reduction of blood pressure in patients undergoing endodontic treatment of vital teeth with irreversible pulpits is common, especially at the 1st visit for pulp extirpation.

Bu çalışmada bir ya da daha fazla tüberkül hasarını da içine alan geniş ve büyük lezyonlu posterior bölge dişlerinin direkt, indirekt rezin kompozit ya da bir CAD/CAM rezin nano-seramik ile restore edilmesi ve 30 ay süreyle klinik olarak izlenmesi amaçlandı. Bu arada elde edilen klinik bulgulara göre restorasyon tiplerinin performansları birbirleriyle kıyaslandı. Bu amaçla çalışmaya 82 hastada toplam 139 restorasyon dahil edildi. Direkt rezin kompozit uygulanan kavitelere preparasyon sonrası "self-etch" yani kendinden asitli bir adeziv sistem (Clearfil SE Bond, Kuraray, Okayama, Japonya) uygulandı. Ardından kavitelere mikro-hibrit rezin kompozit (Gaenial Posterior, GC Dental Products Corp., Aichi, Japonya) yerleştirilerek restorasyonlar tamamlanıp, polisaj ve bitirme işlemleri yapıldı. İndirekt restorasyonlar için mekanik kavite prensiplerine göre kaviteler hazırlandıktan sonra, ölçüsü alınıp alçı modelleri elde edildi. Alçı modeller üzerinde, mikro-hibrit rezin kompozitle (TesceraTM Indirect Composite System, Bisco, Schaumburg, IL, Amerika) restorasyonlar laboratuvarda hazırlandı ve sistemin kendine özgü kompozit fırınınında (TesceraTMATLTM Bisco, Schaumburg, IL, Amerika) su, ısı, ışık ve basınç altında polimerizasyon tamamlandı. Bitirme işlemi laboratuvarda tamamlanan restorasyonlar, bir "self-adhesive" yani kendinden bağlanan rezin yapıştırıcı siman (RelyX U-200, 3M ESPE, St.Paul, MN, ABD) aracılığıyla sadece minenin asit ile pürüzlendirilmesini takiben kavitelere yerleştirildi. Bilgisayar destekli tasarım ve bilgisayar destekli üretim "CAD/CAM" restorasyonlar için yine mekanik kavite prensiplerine göre hazırlanan kavitelerin ağız içi kamerayla dijital ölçüleri (Bluecam AC, Sirona, Bensheim, Almanya) alındı. Alınan bu ölçüler bilgisayara (Cerec System, Sirona, Bensheim, Almanya) aktarılıp ilgili yazılımla (Cerec 4.2, Sirona, Bensheim, Almanya) tasarımı gerçekleştirildi (bilgisayar destekli tasarım = CAD). Tasarımı tamamlanan restorasyonlar sisteme bağlı kazıma ünitesine yerleştirilen rezin nano-seramik blokların (LavaTM Ultimate, 3M ESPE, II St.Paul, MN, ABD) hasta başında işlenmesi sonucu üretildi (bilgisayar destekli üretim = CAM). Ardından restorasyonlar yine "self-adhesive" rezin yapıştırıcı siman aracılığıyla sadece minenin asit ile pürüzlendirilmesini takiben kavitelere yerleştirildi. Restorasyonların klinik başarısı, FDI kriterleri (World Dental Federation-Clinical criteria) kullanılarak estetik, biyolojik ve fonksiyonel parametrelerde yer alan toplamda 14 adet kriter üzerinden başlangıçta ve 6, 12, 18, 24 ve 30.aylarda değerlendirildi. Restorasyon tipleri arasında biyolojik açıdan çalışmanın herhangi bir döneminde anlamlı bir farklılık izlenmezken (p>0.05); estetik parametrelerde direkt rezin restorasyonların, fonksiyonel parametrede ise indirekt restorasyonların üstünlüğü (p0.05). Böylece çalışmanın sonunda genel değerlendirmede restorasyon tipleri arasında herhangi bir farka rastlanmadı (p>0.05). Restorasyon tipleri kendi içlerinde değerlendirildiklerinde; indirekt restorasyonların başarısının çalışmanın başından sonuna kadar değişmeden aynı kaldığı gözlendi. Direkt ve CAD/CAM restorasyonlarda çeşitli kontrol dönemlerinde performans değişiklikleri izlendi. Bu çalışmanın sonuçlarına göre, restorasyonların ağızda kalma oranları 30 aylık izleme periyodunun sonunda indirekt rezin kompozit restorasyonlar için %95,6 direkt rezin restorasyonlar için %89,4 ve CAD/CAM restorasyonlar için %84,4'tü., The aim of this study was to follow the clinical performance of direct, indirect resin composite and CAD/CAM resin nano-ceramic restorations in wide and deep lesions of posterior teeth during 30 months. Additionally, clinical success of indirect, direct and CAD/CAM restorations were compared with each other. 139 restorations in 82 patients were included to this study. For direct restorations, following the preparation of the cavities as usual, microhybrid resin composites (Gaenial posterior, GC Dental Products Corp., Aichi, Japan) were applied with the self-etch adhesive system (Clearfil SE Bond, Kuraray, NewYork, USA). After placement of the restorations, finishing and polishing procedures were completed. For indirect restorations, cavities were prepared according to mechanical cavity designs and stone moulds were obtained after the impression. Via those moulds, microhybrid resin composite restorations (TesceraTM Indirect Composite System, Bisco, Schaumburg, IL, USA) were tailored and polymerized under pressure/water/heat/light oven of the system TesceraTM ATLTM (Bisco, Schaumburg, IL, USA). Before placement of the restorations to the cavity, finishing and polishing procedures were completed. Obtained restorations which were completed in the laboratory were placed to the cavities by self-adhesive luting cement (RelyX U-200, 3M ESPE, St.Paul, MN, USA) after selective enamel etching. For another group computer aided design and computer aided manifacturing "CAD/CAM" resin nano-ceramic restorations, cavities were prepared according to mechanical cavity designs and digital impressions were made with intraoral camera (Bluecam, Sirona, Bensheim, Germany). The digital impressions transferred to the computer (Cerec System, Sirona, Bensheim, Germany) and were carried out of the design with the corresponding software (Cerec 4.2, Sirona, Bensheim, Germany) (computer aided design = CAD). The completely designed restorations were produced IV by using a chairside CAD/CAM technology (computer aided manifacturing = CAM) after resin nano-ceramic blocks (LavaTM Ultimate, 3M ESPE, St.Paul, MN, USA) were placed in the scraping unit attached to the system. Then fabricated restorations were luted using a self-adhesive resin cement with selective enamel conditioning. The clinical success of all restorations were evaluated with FDI Criteria as esthetically, biologically and functionally at baseline, 6, 12, 18, 24 and 30 months. While there was no significant difference biologically in restoration types at any time during the whole study (p>0.05); it was emphasized the superiority of indirect restorations in functional parameters and direct resin restorations in esthetic parameters were observed (p0.05). Thus, at the end of the study, no difference was found between the types of restorations in overall clinical success (p>0.05). When restoration types are evaluated within themselves; the success of indirect restorations remained unchanged from beginning to end of the study. The performance of the direct and CAD / CAM restorations were changed at various control periods of this study. As a result, survival rate of this study was 95.6% for the indirect resin composite restorations, 89.4% for the direct resin restorations and 84.4% for CAD/CAM restorations at the end of the 30-month follow-up period of study.

Introduction. Acute periapical inflammation is the most common cause of postoperative pain developing as a result of mechanical, chemical and/or microbial injury of periapical tissue. The major inflammatory event responsible for periapical pain is increased vasodilatation and vascular permeability, partly caused by prostaglandin E2, with consequent edema, which leads to the compression of nerve fibers. Objective. The aim of this study was to determine the concentrations of prostaglandin E2 in apical tissue fluid after endodontic treatment of intact and teeth with large restorations and to compare it with the occurrence and intensity of postoperative pain. Methods. Single-rooted teeth of 24 patients, selected for this study, were distributed into two groups: intact (group 1, n=27) and asymptomatic teeth with large restorations (group 2, n=20). Clinical examination of the involved teeth included the electric pulp test, recording pain on percussion, spontaneous pain, and a radiographic examination. Samples of apical tissues fluid were obtained from root canals at two treatment visits, and prostaglandin E2 concentrations were measured using radioimmunoassay. Pain intensity was assessed by visual analogue scale. Results. Prostaglandin E2 concentrations at the second visit, in teeth with large restorations, was significantly higher (36%) than at the first treatment visit (Wilcoxon signed rank test, p lt 0.05). Occurrence and intensity of spontaneous pain after the first visit were significantly higher in group 2 (p lt 0.05) than in group 1. Conclusion. These results suggest that the increased prostaglandin E2 concentration, caused by endodontic treatment of teeth with large restorations, is well correlated with the intensity of postoperative pain., Uvod. Akutno periapikalno zapaljenje je najčešći uzrok postoperacionog bola koji se javlja kao rezultat mehaničke, hemijske i/ili mikrobne povrede periapikalnog tkiva. Glavni zapaljenjski proces odgovoran za periapikalni bol je povećana vazodilatacija i vaskularna propustljivost, delimično uzrokovana prostaglandinom E2, s posledičnim edemom, što dovodi do kompresije nervnih vlakana. Cilj rada. Cilj rada je bio da se utvrdi koncentracija prostaglandina E2 u tečnosti apikalnog tkiva posle endodontskog lečenja intaktnih i zuba s velikim restoracijama, a zatim uporedi s pojavom i intenzitetom postoperacionog bola. Metode rada. Jednokoreni zubi 24 odabrana pacijenta svrstani su u dve grupe: intaktni zubi (grupa 1, 27 zuba) i asimptomatski zubi s velikim restoracijama (grupa 2, 20 zuba). Klinički pregled zuba sastojao se od elektrotesta, registrovanja bola na perkusiju ili spontanog bola i radiografskog ispitivanja. Uzorci tečnosti apikalnog tkiva sakupljani su iz kanala korena tokom dve posete stomatologu, a koncentracija prostaglandina E2 merena je radioimunoesej analizom. Intenzitet bola je određivan na vizuelnoj analognoj skali. Rezultati. Koncentracija prostaglandina E2 kod zuba s velikim restoracijama prilikom druge posete bila je značajno veća (36%) nego tokom prve posete (Vilkoksonov test, p lt 0,05). Intenzitet spontanog bola posle prve posete bio je značajno veći u grupi 2 (p lt 0,05) nego u grupi 1. Zaključak. Rezultati pokazuju da je povećana koncentracija prostaglandina E2 uzrokovana endodontskim lečenjem zuba s velikim restoracijama u korelaciji s intenzitetom postoperacionog bola.

オーバーデンチャーのための生活歯根骨内埋伏法について,歯の切断面を粘膜骨膜弁で完全に被覆する方法を考案し,イヌの前臼歯を用いて,その組織所見を観察した結果,歯根埋伏後28日目では被験歯の約半数で歯髄切断面は新生象牙質により覆われていた.また,歯髄切断面に象牙質の新生のみられなかったものでも,何らの病的所見は認められなかった.埋伏後55日では歯髄切断面を覆う象牙質はさらに厚くなり,その細管構造も規則的であった.歯髄切断面の象牙質の形成量が少ない例では,切断面のやや上方に多くの梁状骨が形成されていた.埋伏後28日経過例および55日経過例のいずれにおいても治癒経過の不良と思われるものはなかった

Purpose: The purpose of this umbrella review was to retrieve and assess the available systematic reviews reporting on pulp treatment of vital primary teeth with deep carious lesions. Methods: A literature search was conducted on electronic bibliographic databases to locate systematic reviews reporting on vital pulp therapy techniques or medicaments with two-arm comparisons and a follow-up period of at least 24 months. Eligible reviews were selected, data were extracted, and the risk of bias was assessed using a risk of bias in systematic reviews (ROBIS) tool. The degree of overlap was evaluated by calculating the corrected covered area (CCA). Results: Nine systematic reviews that cited 96 primary studies, with a high degree of overlap (14 percent CCA) were included. Indirect pulp capping had the highest success rate (94 percent) at 24 months, followed by direct pulp capping (88.8 percent), with different medicaments not significantly affecting the outcome. Pulpotomy showed the lowest success rate (82.6 percent), with the highest quality of evidence supporting the effective application of mineral trioxide aggregate (MTA) and formocresol (FC). Conclusions: The high success rate of pulp therapy techniques for the management of deep caries in vital primary teeth is evident; nevertheless, there remains insufficient evidence to draw scientifically solid conclusions about which technique and material are superior.

Made available in DSpace on 2022-04-28T18:55:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-05-01 Objective: This in vitro study aimed to evaluate the effect of bleaching agents on dentin microhardness during and after bleaching. Method and materials: Specimens were randomly assigned to seven groups (n = 15): Nite White Excel 2 Z [NW] 10% and 22%; Rembrandt [REM] 10% and 22%; Opalescence [OPA] 10% and 20%; and a placebo agent. The 42-day whitening treatment consisted of daily application of the agents to the dentin surfaces for 8 hours, followed by immersion in artificial saliva for 16 hours. After the bleaching treatment, specimens were kept immersed in artificial saliva for 14 days. Microhardness was measured at baseline, 8 hours, and 7, 14, 21, 28, 35, and 42 days of bleaching and during the posttreatment period (7 and 14 days). Results: The analysis of variance for split-plot showed a significant effect on the interaction between bleaching agent and time. Tukey's test and regression analyses revealed that during the bleaching period, the agents NW 10%, NW 22%, and OPA 20%, which did not differ from each other, did not alter dentin microhardness, showing constant microhardness values. There were no differences among REM 10%, REM 22%, and OPA 10%, which showed significant reductions in microhardness after day 14 compared to other agents. After bleaching procedures, there was an increase in dentin microhardness for all groups. Conclusion: Throughout the bleaching treatment, depending on the agent applied, dentin showed a transitory decrease in microhardness values. In the posttreatment period, artificial saliva presented a remineralizing effect on the bleached surfaces. Department of Restorative Dentistry School of Dentistry of Piracicaba State University of Campinas, Piracicaba Department of Restorative Dentistry Sch. of Dent. of Ribeirao Preto State University of São Paulo, Ribeirão Preto Faculdade Odontol. Ribeirao P. Depto. Odontol. Restauradora-D., Ave. do Cafe s/n - Monte Alegre, CEP: 14040-904 Ribeirao Preto, SP