2014 Apr-Jun; Vol 5, No 2
Accuracy of Digital Radiography and Cone Beam Computed Tomography on Periapical Radiolucency Detection in Endodontically Treated Teeth
J Oral Maxillofac Res 2014 (Apr-Jun);5(2):e1
Objectives: The aim of the present study was to compare the accuracy of intraoral digital periapical radiography and cone beam computed tomography in the detection of periapical radiolucencies in endodontically treated teeth.
Material and Methods: Radiographic images (cone beam computed tomography [CBCT] scans and digital periapical radiography [PR] images) from 60 patients, achieved from September 2008 to July 2013, were retrieved from databases of the Department of Oral Diseases, Lithuanian University of Health Sciences. Twenty patients met inclusion criteria and were selected for further evaluation.
Results: In 20 patients (42.4 [SD 12.1] years, 65% men and 35% women) a total of 35 endodontically treated teeth (1.75 [SD 0.91]; 27 in maxilla and 8 in mandible) were evaluated. Overall, it was observed a statistical significant difference between the number of periapical lesions observed in the CBCT (n = 42) and radiographic (n = 24) examinations (P < 0.05). In molar teeth, CBCT identify a significantly higher amount of periapical lesions than with the radiographic method (P < 0.05). There were significant differences between CBCT and PR in the mean number of lesions identified per tooth (1.2 vs 0.66, P = 0.03), number of teeth with lesions (0.71 vs 0.46, P = 0.03) and number of lesions identified per canal (0.57 vs 0.33, P = 0.005). Considering CBCT as “gold standard” in lesion detection with the sensitivity, specificity and accuracy considering as score 1, then the same parameters of PR were 0.57, 1 and 0.76 respectively.
Conclusions: Within the limitations of the present study, it can be concluded that cone beam computed tomography scans were more accurate compared to digital periapical radiographs for detecting periapical radiolucencies in endodontically treated teeth. The difference was more pronounced in molar teeth.
Keywords: cone-beam computed tomography; dental radiography; endodontics; periapical periodontitis; root canal therapy; X-ray diagnosis.
A Comparative Clinical Evaluation of the Effect of Preoperative and Postoperative Antimicrobial Therapy on Postoperative Sequelae after Impacted Mandibular Third Molar Extraction
J Oral Maxillofac Res 2014 (Apr-Jun);5(2):e2
Objectives: To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions.
Material and Methods: This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31) had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31) had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7.
Results: The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001) between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively) with subjects in Group II having a reduced facial width compared to those in Group I.
Conclusions: This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions.
Keywords: clinical research; drug therapy; sequelae; third molar; tooth impacted.
A Reliable and Valid Survey to Predict a Patient’s Gagging Intensity
J Oral Maxillofac Res 2014 (Apr-Jun);5(2):e3
Objectives: The aim of this study was to devise a reliable and valid survey to predict the intensity of someone’s gag reflex.
Material and Methods: A 10-question Predictive Gagging Survey was created, refined, and tested on 59 undergraduate participants. The questions focused on risk factors and experiences that would indicate the presence and strength of someone’s gag reflex. Reliability was assessed by administering the survey to a group of 17 participants twice, with 3 weeks separating the two administrations. Finally, the survey was given to 25 dental patients. In these cases, patients completed an informed consent form, filled out the survey, and then had a maxillary impression taken while their gagging response was quantified from 1 to 5 on the Fiske and Dickinson Gagging Intensity Index.
Results: There was a moderate positive correlation between the Predictive Gagging Survey and Fiske and Dickinson’s Gagging Severity Index, r = +0.64, demonstrating the survey’s validity. Furthermore, the test-retest reliability was r = +0.96, demonstrating the survey’s reliability.
Conclusions: The Predictive Gagging Survey is a 10-question survey about gag-related experiences and behaviours. We established that it is a reliable and valid method to assess the strength of someone’s gag reflex.
Keywords: dentistry; gagging; surveys.
Influence of Different Apical Preparations on Root Canal Cleanliness in Human Molars: a SEM Study
J Oral Maxillofac Res 2014 (Apr-Jun);5(2):e4
Objectives: To compare the influence of type and dimensions of the apical preparation on the cleanliness of the apical area in molars.
Material and Methods: A total of 120 root canals (MB and DB root canals from 30 maxillary molars and mesial root canals from 30 mandibular molars) were instrumented with Mtwo NiTi rotary instruments to a size 25/0.06 taper and were equally divided into three different experimental groups depending on the subsequently apical root canal preparation: Group 1: no further apical preparation, Group 2: apical preparation with Mtwo files to a size 40/0.04 taper, Group 3: apical preparation with Mtwo Apical Files. All root canals were observed through scanning electron microscopy (SEM). Presence of superficial debris and smear layer was evaluated using a score system. Data were statistically analysed using the Kruskal-Wallis and Bonferroni tests with a level of significance set at P < 0.05.
Results: Kruskal-Wallis test revealed no differences among groups in the middle and coronal third (P > 0.05), while at the apical level, there was a significant difference for both residual debris and presence of smear layer between Group 1 and both Group 2 (P = 0.003 and P = 0.014) and 3 (P = 0.012 and P = 0.021), while no difference was present between Group 2 and Group 3 (P = 0.871 and P = 0.923).
Conclusions: Cleanliness of the apical third in terms of debris and smear layer was statistically better when an apical preparation was performed to a size 40/0.04 taper or with the use of the Mtwo Apical Files.
Keywords: nickel-titanium alloy; root canal preparation; scanning electron microscopy.
Nitrite and Nitrate Levels of Gingival Crevicular Fluid and Saliva in Subjects with Gingivitis and Chronic Periodontitis
J Oral Maxillofac Res 2014 (Apr-Jun);5(2):e5
Objectives: Nitrosative stress plays an essential role in the pathogenesis of periodontal disease. The aim of this study is to analyze the gingival crevicular fluid and saliva nitrite and nitrate levels in periodontally healthy and diseased sites.
Material and Methods: A total of 60 individuals including, 20 chronic periodontitis and 20 gingivitis patients and 20 periodontally healthy controls participated in the present study. Probing depth, clinical attachment level, bleeding on probing, gingival index and plaque index were assessed, gingival crevicular fluid (GCF) and saliva samples were obtained from the subjects, including 480 GCF samples and 60 unstimulated whole saliva samples. Nitrite and nitrate were analyzed by Griess reagent.
Results: Total GCF nitrite levels were higher in gingivitis and periodontitis groups (1.07 [SD 0.62] nmol and 1.08 [SD 0.59] nmol) than the control group (0.83 [SD 0.31] nmol) (P < 0.05) but did not differ significantly between gingivitis and periodontitis groups (P > 0.05). The difference in GCF nitrate level was not significant among the control, gingivitis and periodontitis groups (7.7 [SD 2.71] nmol, 7.51 [SD 4.16] nmol and 7.38 [SD 1.91] nmol). Saliva nitrite and nitrate levels did not differ significantly among three study groups. Saliva nitrate/nitrite ratios were higher in periodontitis and gingivitis groups than the control group. A gradual decrease in nitrate/nitrite ratio in GCF was detected with the presence of inflammation.
Conclusions: It may be suggested that nitrite in gingival crevicular fluid is a better periodontal disease marker than nitrate and may be used as an early detection marker of periodontal inflammation, and that local nitrosative stress markers don’t show significant difference between the initial and advanced stages of periodontal disease.
Keywords: gingival crevicular fluid; inflammation; nitric oxide; periodontitis; saliva.
Prevalence of Dental Erosion among the Young Regular Swimmers in Kaunas, Lithuania
J Oral Maxillofac Res 2014 (Apr-Jun);5(2):e6
Objectives: To determine prevalence of dental erosion among competitive swimmers in Kaunas, the second largest city in Lithuania.
Material and Methods: The study was designed as a cross-sectional survey, with a questionnaire and clinical examination protocols. The participants were 12 - 25 year-old swimmers regularly practicing in the swimming pools of Kaunas. Of the total of 132 participants there were 76 (12 - 17 year-old) and 56 (18 - 25 year-old) individuals; in Groups 1 and 2, respectively. Participants were examined for dental erosion, using a portable dental unit equipped with fibre-optic light, compressed air and suction, and standard dental instruments for oral inspection. Lussi index was applied for recording dental erosion. The completed questionnaires focused on the common erosion risk factors were returned by all participants.
Results: Dental erosion was found in 25% of the 12 - 17 year-olds, and in 50% of 18 - 25 years-olds. Mean value of the surfaces with erosion was 6.31 (SD 4.37). All eroded surfaces were evaluated as grade 1. Swimming training duration and the participants’ age correlated positively (Kendall correlation, r = 0.65, P < 0.001), meaning that older swimmers had practiced for longer period. No significant correlation between occurrence of dental erosion and the analyzed risk factors (gastroesophageal reflux disease, frequent vomiting, dry mouth, regular intake of acidic medicines, carbonated drinks) was found in both study groups.
Conclusions: Prevalence of dental erosion of very low degree was high among the regular swimmers in Kaunas, and was significantly related to swimmers’ age.
Keywords: tooth erosion; swimming; swimming pools.