Distance between mandibular canal and third molar root among 20-year-old subjects

Abstract

Objectives

The aim of the study was to evaluate the proximity of the mandibular third molar (M3) and the inferior alveolar canal (IAC) in a panoramic radiograph of 20-year-old subjects. The specific aim was to assess differences in this proximity over time.

Materials and methods

Two similar samples of panoramic radiographs taken in a routine oral health examination with 20-year time interval were examined retrospectively and images with both mandibular M3s were included. The material consisted of 300 subjects (25% men, mean age 20.5 ± 0.6 years). The radiographic relationship between the mandibular M3 root and the IAC was assessed as follows: the M3 root was either apart from, tangential to, superimposed with, or inferior to the IAC. Differences between frequencies were tested using the chi-squared test.

Results

In the combined samples, only 16% of the M3s located apart from the IAC, 15% located tangential to, 61% superimposed with, and 8% inferior to the IAC. The proportion of the intimate locations had increased during the 20-year time interval from 79 to 88% (P < 0.01) and especially in females (P < 0.05).

Conclusion

The vast majority of the mandibular M3s situated very close to the mandibular canal.

Clinical relevance

Our results suggest that in the cohort of 20-year-old non-extraction subjects, most of the M3s are possibly at risk for inferior alveolar nerve injury at removal, as judged from the panoramic radiograph, and also the number of such teeth has increased over the 20-year period.

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Lactobacillus rhamnosus intake can prevent the development of Candidiasis

Abstract

Objective

This study aimed to investigate the influence of Lactobacillus rhamnosus intake on the development of candidiasis and cytokines release.

Material and methods

Candida suspensions were inoculated into the oral cavity of experimentally immunosuppressed mice for candidiasis induction. The animals were divided into experimental groups: candidiasis with no probiotic intake (F), candidiasis with probiotic intake during Candida inoculation (FP), and candidiasis with probiotic intake 14 days before inoculation with Candida (FPP); and control groups: (C), (CP), and (CPP) without inducing candidiasis with probiotic intake in the same manner as groups F, FP, and FPP, respectively. After these periods, samples were collected from the oral cavity for yeast counts and, after euthanasia, the tongues of the animals were removed for histological analysis. Sera samples were also collected for analysis of IL-1 beta, TNF-alpha, INF-gamma, IL-12, IL-4, and IL-10.

Results

FP group showed lower Candida counts in the oral cavity, and the presence of Candida was almost not detected in FPP group. In tissues, the counts of fungi were significantly lower in FPP group, followed by FP. Groups that consumed probiotics also had lower histological and inflammatory infiltrates compared to F. Cytokines analysis demonstrated low concentrations of TNF-α, IL-12, IL-4, and IL-10 in all the groups, and no statistical difference between them. The production of IL-6 could be better detected, and the experimental groups that consumed the probiotic showed significant lower levels of this cytokine.

Conclusions

The results suggest that L. rhamnosus intake, especially preventively, may avoid or decrease the development of candidiasis in immunosuppressed mice.

Clinical relevance

This work adds scientific evidences that probiotics intake can avoid the development of candidiasis.

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Sensitivity of caries pathogens to antimicrobial peptides related to caries risk

Abstract

Objectives

Antimicrobial peptides (AMPs) represent important facets of the immune system controlling infectious diseases. However, pathogens show varying susceptibilities to AMPs. This study investigates the susceptibilities of strains of Streptococcus mutans (SM), Actinomyces naeslundii (AN), and Lactobacillus spp. (LB) towards AMPs and if there are correlations between the appearance of such high-risk strains and clinical caries status.

Material and methods

Plaque samples were collected from patients along with clinical examinations. Bacterial strains were identified via selective media, matrix-assisted laser desorption/ionization analysis-time of flight (MALDI-TOF), and arbitrary-primed-PCR (AP-PCR). Each strain was tested for susceptibility to LL-37, HBD-2, HNP-1, and HNP-3 or phosphate-buffered saline as negative control in a biofilm model on hydroxylapatite discs. Survival rates and resulting risk classification for each strain were determined. Correlations were calculated between the number of high-risk strains (all/S. mutans) appearing in patients and their clinical caries status.

Results

Forty-seven patients were included with mean DMFT values of 11.4 ± 8.7. A total of 8 different SM, 30 LB, and 47 AN strains were detected. One-way ANOVA indicated that type/concentration of AMPs had major influence on reductions of Lactobacilli and Actinomyces. Seventeen strains of AN, 2 of SM, and 6 of LB had low susceptibilities to AMPs. The number of such strains in patients showed significant positive correlations to the DMFT values (all p = 0.001; r = 0.452; S. mutans p < 0.0001, r = 0.558).

Conclusion

The occurrence of low susceptible strains to AMPs seems to correlate with the individual caries status.

Clinical relevance

The results may lead to new ways to identify individuals with increased caries risk.

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Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies

Abstract

Objectives

Reduction of microbial load from the root canal systems is a pre-requisite for healing of lesions of endodontic origin. Such microbial reduction is influenced by the method of irrigant delivery and activation. The aim of this systematic review was to compare the effect of ultrasonically activated irrigation (UAI) with other irrigation techniques on the reduction of microorganisms during root canal disinfection.

Materials and methods

The research question was created based on the PICO strategy. Two reviewers independently performed a comprehensive literature search in electronic databases. Following application of inclusion and exclusion criteria to the selected articles, a systematic data extraction sheet was constructed. The selected articles were assessed using methodological quality scoring protocol. The risk of bias in selected studies was critically assessed by two reviewers.

Results

A total of 15 articles were included for the systematic review. The included studies were heterogeneous in study design; hence, meta-analysis was not performed. The overall risk of bias for the selected studies was moderate. Overall, UAI showed superior reduction of microbial counts, resulting in better disinfection compared to other irrigation systems chosen for comparison in this review.

Conclusion

The use of UAI can bring about superior microbial reduction within the root canal system compared to other irrigant activation techniques.

Clinical relevance

Activation of irrigants with ultrasonic brings about significant bacterial reduction from the root canal systems compared to other methods of irrigant activation and conventional syringe irrigation. This might help in improving the outcome of root canal treatment.

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A web-based endodontic case difficulty assessment tool

Abstract

Objective

To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment.

Materials and methods

Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s.

Results

The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3–5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an 'educational tool' and for 'primary care triage' was deemed the most popular features and of greater importance than the secondary options of 'fee setting' and as a 'dento-legal justification tool'.

Conclusions

Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress.

Clinical relevance

EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing appropriate guidance on endodontic case management.

http://ift.tt/2rF4Bi9

Case 3-2018: A 5-Month-Old Boy with Hypoglycemia

Presentation of Case. Dr. Micaela R. Atkins (Pediatrics): A 5-month-old boy was admitted to the pediatric intensive care unit (ICU) of this hospital for evaluation of suspected hypoglycemia. The patient was born at another hospital after 40 weeks 4 days of gestation. His mother had had a positive…

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upper respiratory tract infection; +29 new citations

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