Single crowns versus conventional fillings for the restoration of root filled teeth

BackgroundEndodontic treatment, involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth which may influence long term survival and cost. The comparative in service clinical performance of crowns or conventional fillings used to restore root filled teeth is unclear.ObjectivesTo assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials.Search methodsWe searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME and the reference lists of articles as well as ongoing trials registries. There were no restrictions regarding language or date of publication. Date of last search was 13 February 2012.Selection criteriaRandomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth which have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration, as well as indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any.Data collection and analysisTwo review authors independently assessed trial quality and extracted data.Main resultsOne trial judged to be at high risk of bias due to missing outcome data, was included. 117 participants with a root filled premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. At 3 years there was no reported difference between the non-catastrophic failure rates in both groups. Decementation of the post and marginal gap formation occurred in a small number of teeth.Authors' conclusionsThere is insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth. Until more evidence becomes available clinicians should continue to base decisions on how to restore root filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.

Presence and morphology of the molar tubercle according to dentition, hemi-arch and sex

The purpose of this study was to assess the presence and the degree of expression of the molar tubercle according to sex, dentition and hemi-arches. Study casts of 126 patients were assessed, and those were under orthodontic treatment at the University of Franca, UNIFRAN; they were from both sexs, from 4 to 13 years old. The upper second primary molars and the upper first permanent molars, from both sides, were evaluated regarding the presence and the degree of expression of the molar tubercle. For an association study, the qui-square test was utilized. The concordance about the presence or absence of the molar tubercle according to dentition, hemi-arch and sex, was estimated by the Kappa Statistics. There was a sexual dimorphism concerning the presence/absence of the molar tubercle (p=0.009), however there was no significant association between the degree of expression of the tubercle and the sex (p=0.791). The molar tubercle was more frequently observed in the male sex, in upper second primary molars and in the form of depression. There was a significant and "moderate" concordance between the left and right sides in primary dentition (k=0.596), there was a "good" concordance in permanent dentition (k=0.708) and a "weak" and significant concordance between the presence of the molar tubercle and dentition (k=0.207).

The use of calcium hydroxide and mineral trioxide aggregate on apexification of a replanted tooth: a case report

To report the outcome of the endodontic treatment of a reimplanted central maxillary incisor with open apex after 8 years and 7 months of follow-up.This case report presents the treatment of a right central maxillary incisor of an 8-year old white male patient with history of traumatic avulsion and immediate replantation. The endodontic therapy consisted of periodical changes of calcium hydroxide dressing and a definitive root canal filling with mineral trioxide aggregate (MTA). The treatment was successful without pathologies up to 7 years of follow-up. After the institution of orthodontic treatment a localized and late root resorption was noticed at the last radiographic examination (8 years and 7 months postoperative follow-up). Moreover, the use of MTA promoted a mild crown grey discoloration.

Morphometrical analysis of cleaning capacity of a hybrid instrumentation in mesial flattened root canals

The cleaning capacity of hybrid and rotary instrumentation techniques in mesial flattened canals of mandibular first molars was evaluated by morphometrical analysis in this study. Twenty human mandibular first molars were randomly assigned into two groups, according to instrumentation technique, as follows: group 1, instrumentation with ProTaper Starter Kit (Dentsply/Maillefer) rotary system; group 2, manual instrumentation using K files (Dentsply/Maillefer) by crown-down technique in middle and apical thirds, cervical preparation with Gates-Glidden #1 and #2 (Dentsply/Maillefer) burs, and to finalise the preparation, ProTaper F2 and F3 rotary files. Serial transverse cross-sections (5 mu m) of the apical third, stained with hematoxylin and eosin, were analysed at 100 x original magnification. The images were submitted to morphometrical analysis with an integration grid to determine the percentage of root canal area with debris. Statiscal analysis (t-Student, P < 0.05) showed significant difference between the techniques (P < 0.05), although neither completely cleaned the root canal.

Persistence of endodontic methacrylate-based cement residues on dentin adhesive surface treated with different chemical removal protocols

The aim of this study was to evaluate the persistence of methacrylate-based cement residues on the dentin, after dentin surface cleaning with ethanol or acetone, with or without previous application of a dentin adhesive. Forty bovine crown fragments were obtained and the dentin surface was washed with 1.0 mL of 2.5% sodium hypochlorite (NaOCl), followed by 0.1 mL of 17% ethylenediaminetetraacetic acid application for 3 min, and final irrigation with 2.5% NaOCl. The specimens were air dried and resin-based cement was rubbed onto the dentine surface with a microbrush applicator. In 20 specimens, previously to cement, a dentin adhesive was applied in all surfaces. After 15 min, the surface was scrubbed with a cotton pellet and moistened with ethanol or acetone, compounding the following groups: G199.5% ethanol and G2acetone, without previous use of dentin adhesive; G399.5% ethanol and G4acetone, with previous use of dentin adhesive. The dentin surface was scrubbed until the cement residues could not be visually detected. Sections were then processed for scanning electron microscopy and evaluated at 500x magnification and scores were attributed to each image according to the area covered by residual sealer, and data were subjected to KruskalWallis at 5% significance. The lower residue presence was observed in G3 (P = 0.005). All surface presented cement residues when acetone was used as cleaning solution (P = 0.0005). The cleaning solutions were unable to completely remove the cement residues from both surfaces. The ethanol used after previous application of the dentin adhesive promoted the lower presence of residues.

In Vitro Study of Fracture Load and Fracture Pattern of Ceramic Crowns: A Finite Element and Fractography Analysis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of Resin Cement System and Root Region on the Push-out Bond Strength of a Translucent Fiber Post

Objectives: This study evaluated the bond strength of luting systems for bonding glass fiber posts to root canal dentin. The hypothesis tested was that there are no differences in bond strength of glass fiber posts luted with different cement systems.Methods: Forty bovine incisors were randomly assigned to five different resin cement groups (n=8). After endodontic treatment and crown removal, translucent glass fiber posts were bonded into the root canal using five different luting protocols (self-cured cement and etch-and-rinse adhesive system; dual-cured cement and etch-and-rinse adhesive system; self-cured cement and self-etch adhesive system; dual-cured cement and self-etch adhesive system; and dual-cured self-adhesive cement). Push-out bond strength was evaluated at three different radicular levels: cervical, middle, and apical. The interface between resinous cement and the post was observed using a stereoscopic microscope.Results: Analysis of variance showed a statistically significant difference among the cements (p<0.05) and the root canal thirds (p<0.05). The self-adhesive resinous cement had lower values of retention.Conclusions: The resin cements used with etch-and-rinse and self-etch adhesive systems seem to be adequate for glass fiber post cementation.

Growth and reproductive dynamics of the South American red shrimp, Pleoticus muelleri (Crustacea: Solenoceridae), from the southeastern coast of Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Repeated unrewarded scent exposure influences the food choice of stingless bee foragers, Melipona scutellaris

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Frugivory on Margaritaria nobilis L.f. (Euphorbiaceae): poor investment and mimetism.

Dehiscent fruits of Euphorbiaceae usually have two stages of seed dispersal, autochory followed by myrmecochory. Two stages of Margaritaria nobilis seed dispersal were described, the first stage autochoric followed by ornithocoric. Their dehiscent fruits are green and after they detached from the tree crown and fall on the ground, they open and expose blue metallic cocas. We studied the seed dispersal system of Margaritaria nobilis in a semi-deciduous forest in Brazil. In 80 h of focal observations, we recorded only 12 visits of frugivores, however the thrush Turdus leucomelas was the only frugivore that swallowed the fruits on the tree crown. Pitylus fuliginosus (Fringilidae) and Pionus maximiliani (Psittacidae) were mainly pulp eaters, dropping the seeds below the tree. on the forest floor, after fruits dehiscence, jays (Cyanocorax chrysops), guans (Penelope superciliaris), doves (Geotrygon montana) and collared-peccaries (Pecari tajacu) were observed eating the blue diaspores of M. nobilis. Experiments in captivity showed that scaly-headed parrots (Pionus maximiliani), toco toucans (Ramphastos toco), jays (Cyanochorax chrysops), and guans (Penelope superciliaris) consumed the fruits and did not prey on the seeds before consumption. The seeds collected from the feces did not germinate in spite of the high viability. The two stages of seed dispersal in M. nobilis resembles the dispersal strategies of some mimetic species. However M. nobilis seeds are associated with an endocarp, it showed low investment in nutrients, and consistent with this hypothesis, M. nobilis shared important characteristics with mimetic fruits, such as bright color display, long seed dormancy and protection by secondary compounds.

Morphology, development and homologies of the perianth and floral nectaries in Croton and Astraea (Euphorbiaceae-Malpighiales)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Visceral pigmentation in four Dendropsophus species (Anura: Hylidae): Occurrence and comparison

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microhabitat use by Peucetia flava (Oxyopidae) on the glandular plant Rhyncanthera dichotoma (Melastomataceae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Structural resistance in immature teeth using root reinforcements in vitro

The purpose of this study was to evaluate in vitro the efficacy of root reinforcements by light-cured composite resin or zirconium fiber post in simulated immature non-vital teeth. Fifty-six bovine incisors teeth were used for this study. The crown of each tooth was removed in the medium third to obtain a standard length of 30 mm. The specimens were divided into four groups (n = 14): G1) the root canals were instrumented and enlarged to simulate immature non-vital teeth and were reinforced with a light-cured composite resin using a translucent curing post (Luminex system); (G2) the specimens were instrumented, enlarged and they received root reinforcement with zirconium fiber post; G3 (positive control): they received similar treatment to the G1 and G2 groups, but did not receive root reinforcement; G4 (negative control): the roots were not weakened and did not receive reinforcement. Every tooth was submitted to compressive force using an Instron testing machine with an angle of 45&DEG; at a speed of 1 mm min(-1) until the fracture. The results showed a markedly increased resistance to fracture in the G1 and G2 (122.38 and 122.08 kgf, respectively). Among the results of G1 and G2 there was not any significant difference (P > 0.05) but they were significantly different from the control groups (P < 0.05). The conclusion is that the use of root reinforcements with zirconiun fiber post or composite resin can increase significantly the structural resistance of the weakened teeth, decreasing the risk of the fracture.

Dentine microhardness after different methods for detection and removal of carious dentine tissue

There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. Objectives: The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. Material and methods: The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10), according to the method used to identify and remove the carious tissue: "Papacarie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. Results: ANOVA and Tukey's test (alpha=0.05) were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacarie" (424.7 +/- 105.0; a), Caries-detector dye (370.5 +/- 78.3; ab), Tactile method (322.8 +/- 51.5; bc). Results for the remaining dentin microhardness were: "Papacarie" (42.2 +/- 10.5; bc), Caries-detector dye (44.6 +/- 11.8; bc), Tactile method (24.3 +/- 9.0; d). Conclusions: DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacarie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacarie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values.