International Journal of Dentistry

Purpose. The authors of this study proposed an innovative approach involving the use of Biodentine™ material as an intraorifice barrier in cracked teeth with root extension to promote internal crack sealing, preventing the possibility of microinfiltration and apical crack propagation. Materials and Methods. The dental records of 11 patients with 12 posterior cracked teeth with root extension were included with a precise protocol performed by a senior endodontist. The treatment protocol included pulp diagnosis, crack identification using a dental operating microscope (DOM), endodontic treatment, placing a Biodentine™ as an intraorifice barrier, and immediate full-coverage restoration. The effectiveness of the treatment was assessed at two intervals, 6 months, and 1−3 years posttreatment, evaluating clinical, radiographic, and tomographic aspects. The treatment was deemed successful if there were no indications of radiolucency, sinus tracts, edema, or periodontal pockets associated with the crack line. Results. The study observed remarkably positive outcomes during the follow-up period, which spanned from 1 to 3 years. All the cracked teeth (100%) remained asymptomatic, meaning they were free of pain or discomfort. Furthermore, these teeth were in occlusal function. Both radiographic and tomographic assessments revealed the absence of bone loss along the crack line. This outcome signifies that the treatment effectively prevented further deterioration of the surrounding bone. Conclusions. Integrating advanced biomaterials and conservative restorative techniques has paved the way for innovative approaches in dental care. This protocol suggests a proactive step for managing cracked teeth with root extension. It addresses both biological aspects by sealing internal cracks and mechanical aspects by preventing crack progression, thereby improving these teeth’ prognosis and long-term survival.

Objectives. Primary Sjögren’s syndrome (pSS) is a chronic autoimmune disorder characterized by dryness of mucous membranes, predominantly the eyes and mouth, following glandular tissue substitution. The onset of oral dryness constitutes a significant source of discomfort that negatively affects overall quality of life. This systematic review aimed at investigating the differences in Oral Health Impact Profile-14 (OHIP-14) questionnaire scores in patients diagnosed with Sjögren’s syndrome compared to sicca syndrome, to assess the influence of the two conditions on oral health. Study Design. A systematic electronic and manual search was performed up to December 2023 for studies reporting OHIP-14 questionnaire scores in pSS patients versus sicca syndrome. Two authors independently reviewed, selected, and extracted the data. The outcome was the assessment of OHIP-14 scores in studies comparing pSS- and sicca syndrome-affected patients. Meta-analysis was conducted on available quantitative data. Results. Literature search retrieved 30 articles, and 3 articles met the criteria for inclusion in the review. Meta-analysis revealed significantly higher scores in patients with sicca syndrome compared to pSS, although salivary flow was markedly reduced in pSS. Conclusions. While offering supplementary information to standard tests and supporting the assessment of pSS and sicca syndrome patients, further validation is necessary to establish OHIP-14 validity in determining the impact of pSS and sicca syndrome on patients’ quality of life.

Background. Medication-related osteonecrosis of the jaw (MRONJ) is a rare, serious, and debilitating disease of unknown cause that can be associated with significant health-related quality of life (HRQOL) impairment. Hematological disease is characterized by a nonhealing exposed jawbone in patients with a history of antiresorptive or antiangiogenic agent use without radiation exposure to the head or neck. Patients and Materials and Methods. This prospective study over the period from May 2020 to December 2021 included a representative sample consisting of 27 patients with at least stage 2 MRONJ lesions who underwent surgical rehabilitation via oral and maxillofacial surgery at the University Medical Center Göttingen, Germany. Quality of life data were collected over a 6-month postoperative period using the Health-Related QOL (SF-12) and Oral Health-Related QOL (OHIP-14) questionnaires. Results. A total of 27 patients considered in the study had a total of 42 MRONJ lesions, corresponding to a mean of 1.56 necroses per patient. MRONJ lesions were downstaged in 85% of the patients. HRQOL was evaluated with the SF-12 questionnaire. Significant improvements were found in six of the eight categories (General Health (), Bodily Pain (), Mental Health (), Vitality (), Role-Emotional (), and Social Functioning ()). The OHRQOL score also improved significantly after surgical intervention (). Conclusion. With completed surgical therapy, improvements in HRQOL and OHRQOL are measurable.

Objectives. The aims of this study were to assess the morphologic features of peri-implant defects, as measured on 2D intraoral radiographs, and to investigate the possible correlation between such morphology and other parameters related to the position and characteristics of the implant or the implant-supported prosthesis. Materials and Methods. Implants with peri-implantitis were included in this retrospective study. Data collected were related both to the patients and to the position/characteristics of the implants and the implant-supported prosthesis. Measurements of the morphologic defects were performed by two operators on digitalized intraoral periapical radiographs. Results and Conclusion. In total, 73 implants in 27 patients were included. The measurements of the periapical radiograph suggested that the most common defect conformation was crateriform, with both intraosseous and horizontal components. An inverse correlation was found between the extension of the peri-implant lesion and the time between the radiographic assessment and the implant placement. The total lesion area was strongly correlated to oral hygiene levels. No correlations between lesion extension and smoking, diabetes, history of periodontal were found. In conclusion, the results from this 2D radiographic study showed the prevalence of crateriform peri-implant defects, with a hygiene-correlated extension, perceptible on the mesial and distal aspects; 3D imaging could be used when available for further research and clinical investigation.

Objectives. The aim of this study was to evaluate the 1-day fracture resistance of simulated immature teeth with an apical plug with ProRoot MTA, MTA Angelus, and RetroMTA after calcium hydroxide intracanal medication. Materials and Methods. Sixty extracted, single-rooted human mandibular premolars were randomly divided into six groups of 10 teeth each. Firstly, to standardize the 9 mm root length, the crowns were cut off at and 9 mm below the cementoenamel junction transversely. Simulations for immature apices were carried out by using No. 1–6 Peeso reamers to pass through the apex to obtain a diameter of 1.7 mm at the apical opening. One group served as a negative control without any treatment, while the other groups received 30 days of calcium hydroxide intracanal medication. Four groups were plugs with 4 mm of ProRoot MTA, MTA Angelus, RetroMTA, and gutta-percha, respectively. The last one was served as a positive control group without filling inside. After 1 day of incubation, specimens were vertically loaded in a universal testing machine at a crosshead speed of 1 mm/min until fracture occurred. The peak load to fracture (Newton) and fracture pattern were recorded. A one-way analysis of variance (ANOVA) followed by Tukey’s HSD test was used for data analysis. Results. The highest mean load to fracture was shown in the negative control group (543.33 ± 37.17 N), followed by ProRoot MTA (432.82 ± 68.06 N), MTA Angelus (396.92 ± 59.93 N), RetroMTA (389.08 ± 56.25 N), and gutta-percha (283.28 ± 43.40 N), and the lowest belonged to the positive control group (239.98 ± 27.19 N). The significant differences were found between both the control and experimental groups with an apical plug with calcium silicate cement (). There were no significant differences among those three apical plugs (). Conclusion. Apical plugs with ProRoot MTA, MTA Angelus, and RetroMTA had an immediate strengthening effect on simulated immature teeth after calcium hydroxide intracanal medication had been used.

Objectives. Various researches have shown periodontitis to share common pathophysiological pathways with systemic diseases such as diabetes, cardiovascular diseases, and osteoporosis and recently neurological disorders. This article provides a narrative review summarizing the various linking mechanisms and the nature of association between two multifactorial diseases—periodontitis and migraine. Materials and Methods. A literature search was performed for articles related to periodontitis and migraine up till the year 2023 which yielded totally 14 articles. There were only three randomized controlled clinical trials; therefore, we were unable to conduct a systematic review and focused on a narrative review. The keywords searched were “migraine”, “periodontitis” and “biomarkers” in PubMed/Medline, Web of Science, and Embase databases. Any article related to the association of periodontitis and migraine and the dental management of subjects with headache disorders were included and studies with migraine and other dental diseases were excluded. Results. It is found that the occurrence of periodontitis and migraine are associated with each other. There is reasonable evidence to believe that periodontitis and migraine are linked by direct and indirect mechanisms which can eventually lead to chronic inflammatory conditions like periodontitis worsening neurovascular conditions such as migraine. However, upon detailed analysis it was found that the strength of association is weak owing to the presences of various common confounding and risk factors. Conclusions. The association between periodontitis and migraine cannot be denied, however, not all the criteria are fulfilled while examining the nature of association and future long-term studies are required to prove the same. Clinical Relevance. Various studies have reported poor periodontal health in patients with migraine. The risk of exacerbation of migraine also increases in subject undergoing dental therapy if the triggering factors are manipulated. Hence, knowing the precise pathophysiologic mechanisms linking both the diseases would be favorable in planning treatment protocols for subjects with migraine.