Peer-rewieved journal "Endodontics Today"
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Identification of factors contributing to the appearance of inflammatory periodontal diseases preclinical symptoms in prison persons
AIM. The analysis of the main factors causing bleeding in the oral cavity in persons in places of deprivation of liberty, and the search for ways to eliminate this symptom, considering the limited capabilities of the respondents. MATERIALS AND METHODS. The study involved 402 prisoners, 330 of whom were men and 72 women. The respondents were divided into age groups, the group of respondents under the age of 18 included 110 people, 18–25 years old – 7 people, 26–35 years old – 127 people, 36–45 years old – 94 people, 46–55 years old – 44 people and the group of 56 years and older consisted of 20 people. The respondents’ responses were analyzed using the StatTech v 4.6.1 (developed by Stattech LLC, Russia). RESULTS. 25 questions were analyzed, among which reliable correlations between bleeding and its development factors were established. CONCLUSIONS. Based on the analyzed data, bleeding as an objective symptom was noticed by 157 respondents who noted brushing their teeth and eating hard food as factors provoking the development of this pathology. In this regard, it is necessary to develop a program aimed at improving the hygienic status and raising awareness of prisoners about proper oral care, considering their stay in places of deprivation of liberty. Such a program should primarily be based on the motivation of prisoners to adjust and improve their personal oral hygiene. In addition, in addition to preventive conversations, it is necessary to conduct master classes on the technique of proper dental cleaning and the use of additional personal oral hygiene products.
A method for assessing changes in mandibular biomechanics using a software-hardware system
INTRODUCTION. The temporomandibular joint (TMJ) plays a crucial role in mastication, speech, and maintaining overall postural balance. Dysfunction in TMJ biomechanics can lead to local pain, functional limitations, and postural disturbances. Despite advances in digital technologies and the integration of osteopathy into dental practice, there remains a lack of accessible and validated tools for dynamic TMJ monitoring. AIM. To develop and validate a method for quantitative assessment of mandibular biomechanics using craniometric measurements and digital technologies. MATERIALS AND METHODS. Ninety patients aged 19 to 61 years with TMJ dysfunction and extra-occlusal disorders were enrolled. Participants were divided into a main group, which received both dental and osteopathic treatment, and a control group, which received dental treatment only. Standardized digital imaging was performed pre- and post-treatment. Mandibular deviation was assessed by measuring the angle and perpendicular distance from the sagittal plane using a mobile application. Statistical analysis was performed using IBM SPSS Statistics version 26.0, with significance set at p < 0.05. RESULTS. A statistically significant reduction in mandibular deviation was observed in both groups (p < 0.05), with the main group showing greater improvements. The findings support the effectiveness of combining osteopathic correction with dental therapy in restoring mandibular biomechanics. CONCLUSIONS. The proposed method provides an objective and efficient tool for assessing the outcomes of dental and osteopathic interventions in patients with TMJ dysfunction and offers potential for early detection of biomechanical impairments.
The possibility of full-arch rehabilitation for edentulous patients supported by 4 dental implants
AIM. The objective of this study is to review possible methods of fixed prosthesis for patients with complete edentulousness using 4 dental implants. RESULTS. Patients with complete edentulousness and significant alveolar bone atrophy often complain about unsatisfactory fixation of complete removable dentures. Dental implantation is used to make prostheses with stable fixation. Full fixed prostheses supported by 6–8 dental implants have the greatest stability and strength indicators, however, in some cases, with significant bone atrophy, the placement of a large number of implants is impossible. The “All-on-4” technique was proposed to accelerate the rehabilitation of elderly edentulous patients, which allows making fixed prosthesis supported by 4 dental implants without bone grafting procedures. This treatment method involves the installation of distal implants at an angle to the frontal plane in order to position the prosthetic platforms in the premolar area, which reduces the length of the distal console elements and distributes the occlusal load more evenly. CONCLUSIONS. The “All-on-4” technique has become widespread among dentists due to its relative ease of performance, low cost and quick rehabilitation of edentulous patients. This treatment method shows high survival and success rates, and thus can be an effective alternative to placing more implants. However, this method of treatment requires further study from the point of view of functional changes of the dento-alveolar system in patients with complete absence of teeth and justification using the methods of electromyography of masticatory muscles and digital analysis of occlusion, as well as determination of critical values of angles of inclination of distal implants using the method of mathematical modeling.
Morphological evaluation of the fibrin framework in the treatment of dental pulp hyperemia: experimental study
INTRODUCTION. The complexity of the prognosis in the early and late stages of the conservative method of pulpitis treatment has limited its wide application. The article is aimed at studying and analyzing the potential of regenerative dentistry, which consists in restoring the function and structure of the dental pulp using innovative technologies. It is considered how biomaterials, fibrin framework (PRF) can be used to achieve this goal based on an experimental study and morphological assessment of the effect of these materials on the dental pulp. Platelet-rich fibrin (PRF) is a concentrate of platelets, which in recent years has become increasingly popular for regenerative procedures. An analysis of the materials used with appropriate conclusions is carried out. AIM. To conduct a comparative morphological assessment of the use of modern bioactive materials and fibrin (PRF) as a scaffold in the treatment of pulp hyperemia. MATERIALS AND METHODS. The experimental part of the study was performed on 8 white laboratory rats of 64 molars of teeth, Wistar lineage, of both sexes, with a body weight of 350–600 g, quarantined for at least 10–14 days, and kept in standard vivarium conditions of the Federal State Budgetary Educational Institution of Higher Medical Education of the Ministry of Health of the Russian Federation. The animals were divided into 4 groups – 2 individuals and 16 teeth in each group. Group 1 animals used fibrin (PRF) + “Trioxident” “Vladmiva”, Group 2 collagen membrane Geistlich Bio-Gide® + “Biodentine”, Group 3 fibrin (PRF) + “Biodentine” “Septodont”, Group 4 “Dycal” “Dentsply”. The experiment was conducted under anesthesia (protocol of the Ethics Committee of the Federal State Budgetary Educational Institution of Higher Education of the Ministry of Health of the Russian Federation No. 125 dated 09/12/2023). On the chewing surfaces of the 1 st and 2 nd molars, diamond carbide spherical borons were used to open the tooth cavity with partial pulp exposure. The formed cavity was treated with 0.05% chlorhexidine solution and dried. The test materials were then applied to the autopsy area. Experimental animals were removed from the experiment on days 3, 14, and 30. The resulting biological material was fixed in a 10% neutral formalin solution, decalcified, then poured into a histological medium and stained with hematoxylin and eosin according to Van Gieson. The sections were obtained on an Accu-Cut SRM 200 rotary microtome. RESULTS. In the course of an experimental study in group 1 using fibrin (PRF) + Trioxidant in the area of contact with the therapeutic material, activation of reactive and compensatory processes in the tooth pulp tissue was detected while maintaining its viability for 30 days, which indicated the most pronounced regenerative potential among all the studied groups. As a result of a morphological assessment of micro-preparations of pulp with direct coating with “Dycal” material, group 4 showed that on the 30th day the pathological process developed in the pulp is irreversible, because morphological changes were most pronounced: inflammatory infiltration with the presence of lymphocytes and neutrophils in the infiltrate, sclerotic changes, as well as granulation tissue and necrosis focus in the area of contact with the therapeutic material were noted. CONCLUSIONS. The results of an experimental study conducted to compare histological changes in the pulp state with the use of various groups of materials in the near and long-term follow-up periods showed that the combined use of bioactive materials and fibrin (PRF) for direct coating of pulp increases the effectiveness of dental treatment with diagnoses of pulp hyperemia, and is also a promising direction in regenerative dentistry, due to the high the potential to influence the stimulation of reparative processes in the tooth pulp.
Experimental evaluation of the effectiveness of non-pigmented laser photoablation in the treatment of periodontal diseases
INTRODUCTION. High-quality treatment of periodontitis and prevention of further progression of periodontal diseases can be achieved with complex and systematic adherence to algorithms for performing manipulations at all stages of therapy using physical factors. This is possible with the use of laser radiation with the effects of non-pigmented laser photoablation. AIM. Improving the effectiveness of periodontal disease treatment using pigment-free laser photoablation. MATERIALS AND METHODS. An experimental comparative study of 70 animals with model periodontitis under the influence of laser radiation with non-pigmented photoablation, photodynamic laser therapy and standard drug therapy was conducted in 3 groups. Morphological studies were performed for group I (main) and group II (comparison) were withdrawn from the experiment on the 7th, 14th and 21st days of treatment. Animals of group III (control) were withdrawn from the experiment on the 21st day. RESULTS. Morphological analysis showed that the use of non-pigmented laser photoablation helps to reduce inflammation in periodontal tissues, accelerate regeneration due to stimulation of fibroblast production and stimulation of neoangiogenesis. On the 21st day of the experiment, in the group using non-pigmented laser photoablation, based on morphological analysis, acceleration of the processes of formation of the periodontal ligament with even bundles of collagen and elastic fibers perpendicular to the tooth root was confirmed. CONCLUSIONS. Our experimental studies confirm the effectiveness of non-pigmented laser photoablation in the treatment of periodontitis.
Changes in the dentin-pulp complex of teeth through the prism of CBCT-studies: A retrospective analysis
INTRODUCTION. Calcifying metamorphosis and obliteration of the pulp chamber often complicate endodontic treatment, requiring the use of modern visualization and monitoring techniques during therapy. The application of CBCT diagnostics allows for a better assessment of the condition of the dentin-pulp complex, which helps reduce risks and increase the effectiveness of complex endodontic treatment. AIM. To conduct a statistical assessment of the prevalence of degenerative changes in the dentin-pulp complex of teeth based on data obtained from CBCT studies, as well as to identify possible correlational relationships between potential factors contributing to the development of calcifying metamorphosis in the pulp space of vital teeth. MATERIALS AND METHODS. For the retrospective analysis, 187 archival CBCT study data were selected. The obtained images were examined in all planes for the presence of discrete radiopaque masses in the radiolucent pulp space of the teeth, while the obliteration of the root pulp was determined based on the narrowing or complete closure of the root canal space visible on the radiograph. Statistical analysis was performed using SPSS software with a significance level set at p < 0.05. RESULTS. During the statistical analysis, the prevalence of pulp calcifications was identified in 56.7% of cases, and pulp space obliteration was observed in 24%. Teeth with pulp stones were 1.8 times more likely to exhibit radiographic and clinical signs of caries compared to teeth with root canal obliteration. Among all examined teeth, nearly half in each calcification group had restorations. According to the obtained results, a positive correlation was found between pulp calcification and the dental status of the teeth. CONCLUSIONS. According to the obtained data, a higher frequency of calcifications is associated with pulp inflammation caused by local prolonged irritants, such as the presence of deep restorations, carious processes, previously performed biological treatments, prior orthodontic treatment, trauma, and wear, as well as other systemic aspects.
Adaptation potential of secretory functional of the small salivary glands and gustatory analyzer besides flying composition of civil aviation
AIM. The feature of adaptive potential of secretory function of the small salivary glands besides flying composition of the civil aviation. MATERIALS AND METHODS. In the article presented results of the study of secretory function of small salivary glands beside 20 employees of flying and 15 overland compositions of civil aviation at the age 20–50 years with pathology of oral cavity and with sound condition of dentistry status. For achievement delivered purposes have developed and felt the way, concluding in revealing the small salivary glands on emerged secret and fixation its paper pattern in the manner of imprint. About level of the secretions of the small salivary glands witnessed the different diameter an imprint of secret. As a matter of convenience count small salivary glands divided in four orders in depending of diameter heel secret – from the most small, referred to IV order, before the most large (I order). RESULTS. Amongst flying composition with sound condition of dentistry status at observation of the paper pattern revealed area of the lips with concentration of the small salivary glands only 1-st and 2-nd degree. Beside they comes to light scant few of the small salivary glands II and III order, density their small, on upper lip they, as contrasted with glands IV order, concentrated to medium closer, but on lower lip – on side left and right half. Beside flying composition with dentistry pathology discovered quite other regularity in respect of concentrations of the small salivary glands on upper and lower lip: both on upper and on lower lip practically were not discovered small salivary glands III and IV orders. Together with that quantitative importance of the small salivary glands II order besides flying composition with pathology of oral cavity turned out to be similar to patient without dentistry pathology. CONCLUSIONS. Beside flying composition with dentistry pathology on amount of the secretions in the first place answer the glands II order, then to them are connected the glands III order. Beside they practically do not exist the appearances of the secret of the small salivary glands IV order that is indicative of absence their reserve function, conditioned stress-induced influence extreme factor of aircraft flight
The effect of the type of jaw growth caused by the change of baby teeth on the bioelectric activity of the chewing muscles
INTRODUCTION. The bioelectric activity of the masticatory muscles is influenced by many factors due to the parameters of the craniofacial complex – morphometric parameters of the head. However, there is no data in the literature on the effect of the type of jaw growth during periods of alternating bite on the functional activity of the muscles that lift the lower jaw. AIM. To determine the impact of jaw growth type, associated with the transition from deciduous to permanent teeth, on the bioelectrical activity of the masticatory muscles. MATERIALS AND METHODS. A survey of 150 children aged 5 to 14 years was conducted, randomized into 5 groups – group I – the final period of milk bite and preparation of the jaw for tooth replacement. Group II – the first permanent molars and incisors of the lower jaw erupted. Group III – there was a change of permanent milk incisors. Group IV – there was a complete change of all baby teeth. Group V – the second permanent molars have erupted. An analysis of the telerentgenogram and the functional activity of the masticatory muscles is presented by determining absolute and relative indicators. RESULTS. In patients of groups I, II and III, low bioelectric activity was detected, which increases during the complete change of all baby teeth and the eruption of the second permanent molars, which is due to the formation of chewing activity of the muscles. Also, during this period, the symmetry and synchronicity of the work of the masticatory and temporal muscles proper was noted. CONCLUSIONS. Minimal changes during jaw growth due to the change of baby teeth lead to a change in the functional activity of the masticatory muscles, which may subsequently be a predictor factor for the development of neuromuscular imbalance in the maxillofacial region.
Fiber post retrieval and furcal perforation repair in maxillary molar: A case report with one year follow-up
INTRODUCTION. Furcal perforation is a complex endodontic complication that can jeopardize treatment outcomes. Accurate diagnosis and appropriate management are essential to prevent periodontal breakdown and tooth loss. AIM. This case report aims to present the non-surgical management of a furcal perforation in a maxillary first molar caused by fiber post-placement, emphasizing the role of CBCT, biomaterials, and magnification. MATERIALS AND METHODS. A 33-year-old female presented with mild pain and swelling in the upper left maxillary region. Clinical examination revealed a sinus tract near the cervical area. Cone Beam Computed Tomography (CBCT) confirmed a furcal perforation with extrusion of a fiber post. The fiber post was carefully removed under magnification using ultrasonic tips. Hemostasis was achieved, and a calcium hydroxide dressing was applied to the perforation site to promote healing. After 10 days, the site was sealed with mineral trioxide aggregate (MTA). The tooth was then permanently restored following core buildup. RESULTS. At the one-year follow-up, the tooth was asymptomatic. CBCT showed bone healing at the perforation site, and the sinus tract had resolved. Clinical and radiographic evaluation confirmed successful tissue repair and preservation of periodontal health. CONCLUSIONS. This case highlights the importance of early detection and precise management of furcal perforations. The use of CBCT, magnification, and MTA enables predictable, non-surgical repair. Even in delayed cases, MTA provides effective sealing and promotes long-term clinical success.
Ex vivo study of the efficacy of two irrigation systems in retreatment of root canals filled with bioceramic sealers
AIM. To evaluate the presence of residual filling material in the root canal walls after retreatment and final irrigation using scanning electron microscopy (SEM). MATERIALS AND METHODS. Fifty-two mandibular oval premolars were instrumented with ProTaper Next X1–X3 and divided into 2 groups: Group BC, filled with Bio-C Sealer and Group AH, filled with AH Plus. The experimental groups were retreated with a ProTaper Next X4 file and received different irrigation protocols (n = 13): Group BC-PUI: agitation with ultrasound; Group BC-EC: agitation with Easy Clean; Group AH-PUI: agitation with ultrasound; and Group AH-EC: agitation with Easy Clean. The remaining filling material in the dentinal tubules was evaluated in scanning electron microscope images by three evaluators who scored the samples. The Kappa test was performed to check interexaminer agreement. Pearson’s chi-square test with a significance level < of 5% was performed to compare the groups. RESULTS. It was found that the BC-EC group showed better results in the apical and middle thirds. In the coronal third, the BC-PUI group also performed well. AH Plus showed the lower results in all situations. CONCLUSIONS. In the apical third, the BC-EC group showed better performance, in the middle third, the AH-PUI group had the worst performance, and in the coronal third, the BC-PUI group stood out in terms of cleaning. This manuscript provides the importance of thorough cleaning, especially in difficult areas such as the apical third, is emphasized to improve the overall outcome of treatment
Endodontic management of C-shaped canals: A case series
INTRODUCTION. C-shaped root canals represent a complex anatomical variation, primarily seen in mandibular molars. Their intricate morphology poses significant challenges for diagnosis, cleaning, shaping, and obturation in endodontic practice. AIM. To present a series of clinical cases illustrating the diagnosis and endodontic management of different types of C-shaped canals based on Fan’s classification. MATERIALS AND METHODS. Four clinical cases involving mandibular molars with C-shaped canal configurations were managed in accordance with CARE and PRICE guidelines. Each case included clinical and radiographic diagnosis, working length determination, cleaning and shaping with either the R2 Reciproc (VDW) or PlexV (Orodeka) system, irrigation with NaOCl and EDTA under ultrasonic activation, and obturation using thermocompaction or single-cone techniques with bioceramic sealers. RESULTS. All cases demonstrated successful identification and management of C-shaped canal systems (types C1 to C4). Clinical and radiological follow-up at 1 and 3 months showed favorable healing with resolution of symptoms and periapical pathology. CONCLUSIONS. Early and accurate diagnosis of C-shaped canals, supported by clinical and radiographic examination, is critical for successful endodontic outcomes. The use of magnification, appropriate canal preparation techniques, and bioceramic materials significantly enhances treatment success in such complex anatomical variations.
Apexification of traumatized anterior teeth with blunderbuss canals using MTA putty and collagen membrane: A case report
INTRODUCTION. Trauma to developing permanent teeth can disrupt root formation, leading to open apices and weakened tooth structure. AIM. This report details the non-surgical management of an 8-year-old male with blunderbuss canals in anterior teeth using mineral trioxide aggregate (MTA) putty and a resorbable collagen membrane to support apical barrier formation and healing. MATERIALS AND METHODS. Non-surgical apexification was performed using MTA putty as the primary apical barrier material, supplemented by a resorbable collagen membrane to aid in barrier formation and periapical healing. RESULTS. Over 12 months, clinical and radiographic follow-ups showed successful healing with no periapical pathology.
Modern aspects of the use of hardware methods for diagnosing pulp vitality (Part 2. Non-traditional diagnostic methods)
INTRODUCTION. Diagnosis of pulp diseases remains a pressing issue in dentistry, which is determined by their high prevalence and, in some cases, latent course. AIM. To study new technologies developed for hardware testing of pulp vitality based on modern literature data. MATERIALS AND METHODS. A systematic search was performed in the electronic databases PubMed, Google Scholar, eLibrary, Google Patents. The search depth was 6 years – from 2019 to 2024. RESULTS. The search in the electronic library databases initially yielded 793 results. After screening titles and abstracts and removing duplicates, 368 articles were identified, assessed by reading their full text, and analysis of whether the publication criteria were met; 65 articles were included in the systematic review. Based on the results preliminary screening and application of the eligibility criteria, 15 publications were included in the qualitative analysis and 7 publications in the quantitative analysis, 43 publications were used to write the introduction text and in the discussion of the study results. Based on the patent search, 4 patents were included in the analysis. Most of the well-conducted and documented studies were devoted to the pulse oximetry method. CONCLUSIONS. An analysis of modern literature sources showed that the most common methods for assessing pulp vitality are laser Doppler flowmetry and pulse oximetry. Pulse oximetry is the most accurate diagnostic tool. Alternative diagnostic methods are increasingly being explored for their potential to assess pulp vitality. The most frequently mentioned methods in scientific publications for 2019–2024 are: ultrasound Doppler flowmetry, transillumination, magnetic resonance imaging, speckle imaging, tooth temperature measurements, electroodontometry and plethysmography. However, to date, none of the alternative methods for diagnosing pulp vitality have been integrated into clinical practice, indicating an ongoing challenge in creating a reliable approach to assessing pulp vitality
Effect of calcium silicate-based repair sealers on bone healing in rat skull defects: histological and histomorphometric study
AIM. This study investigated the impact of calcium silicate sealers on bone healing in rat calvaria defects. MATERIALS AND METHODS. Twenty-six rats were divided into 3 groups. Calvaria defects were prepared and treated in 3 different ways: CG (n = 6): Filling with clot; ES (n = 10): Filling with Endosequence BC RRM Putty repair sealer and BC (n = 10): Filling with Bio C repair sealer. RESULTS. After 15 and 30 days, histological evaluations revealed varied levels of bone regeneration and inflammation. The group treated with a blood clot showed more bone regeneration without inflammation at 15 days. However, after 30 days, complete closure of the defect with immature tissue was observed in this group, while limited new bone formation occurred in the other groups, accompanied by mild inflammation. CONCLUSIONS. Overall, the study suggests that calcium silicate-based sealers can induce new bone formation, but they do not offer superior bone repair compared to natural healing with a blood clot alone.
An ex vivo antimicrobial evaluation after the preparation with XP-Endo Shaper and Trunatomy systems
AIM. The aim of this study was to evaluate bacterial reduction in root canals with the XP-Endo Shaper (XP) and Trunatomy (TN) systems. MATERIALS AND METHODS. Twenty-eight permanent human type I, oval-shaped Vertucci premolars and straight root canals were contaminated with Enterococcus faecalis for 30 days at 37°C. Samples were collected prior to instrumentation. The teeth were divided into two groups (n = 14) and processed with the tested groups at 37°C: XP group – (30/0.04) and TN group – Small (20/0.04) and Prime (26/0.04). Biological samples before and after instrumentation were collected using a sterile paper cone inserted into the canal for one minute. Bacteria were counted using colony forming units (CFU/mL) and results were subjected to Kruskal-Wallis test at 5 level of significance. RESULTS. Both the XP and TN systems significantly reduced bacterial counts (p < 0.0001), but did not eliminate bacteria in the root canals. CONCLUSIONS. Both the Trunatomy and XP-Endo Shaper systems were similar in terms of antimicrobial efficacy, but neither system was able to eliminate bacteria from the root canals.
Histopathological patterns of periapical lesions in root canal treated teeth: A systematic review
INTRODUCTION. Periapical lesions are common sequelae of pulpal necrosis and endodontic infections, presenting significant diagnostic challenges in clinical practice. Accurate histopathological characterization is essential for appropriate treatment planning and prognostic assessment. AIM. To systematically evaluate and summarize the histopathological features, prevalence patterns, and diagnostic concordance of periapical lesions in root canal treated teeth. MATERIALS AND METHODS. A systematic review was conducted following PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for studies published between 2000–2024. Inclusion criteria encompassed histopathological studies of periapical lesions from root canal treated teeth. Quality assessment was performed using the Newcastle-Ottawa Scale and QUADAS-2 tools. RESULTS. Twelve studies involving 1,847 periapical lesion specimens were included. Histopathological analysis revealed periapical granulomas as the most prevalent lesions (50–84.2%), followed by radicular cysts (15–42%) and periapical abscesses (5–35%). Clinical-histopathological concordance was poor, with overall agreement ranging from 51.4–55.8% (Cohen’s kappa κ = 0.059). Larger lesions (> 200 mm²) showed higher prevalence of radicular cysts (92–100%). Periapical scars represented 1–6% of cases. DISCUSSION. Significant discrepancies between clinical and histopathological diagnoses highlight limitations of radiographic assessment alone. Lesion size, location, and duration influence histopathological patterns. The predominance of granulomatous tissue suggests ongoing inflammatory processes despite endodontic intervention. CONCLUSIONS. Histopathological examination remains the gold standard for definitive diagnosis of periapical lesions. The poor clinical-histopathological concordance emphasizes the necessity of biopsy examination for accurate diagnosis and appropriate treatment planning in endodontic practice.
Scanning electron microscopy studies of biofilm in teeth with chronic apical periodontitis
INTRODUCTION. For a long time, the inflammatory process can be asymptomatic in the periapical space. Apical periodontitis is often associated with the presence of biofilm. The latter has a great influence on the prognosis of endodontic treatment. AIM. Using scanning electron microscopy, to determine the presence and localization of biofilm and microflora in the roots of teeth with chronic apical periodontitis. MATERIALS AND METHODS. Grins of 6 roots of teeth with chronic forms of apical periodontitis were studied for detection of microflora using the scanning electron microscopy method. RESULTS. In 100% of cases, biofilm was found in the root canals of teeth with chronic forms of apical periodontitis. It was located focally, unevenly capturing different areas of both the root canal and the surrounding dentin of the tooth root. DISCUSSION. Biofilm is observed in the necrotic dentin of the cervical third of the root canal, covers the pulp tissue of the tooth, penetrates into the thickness of the dentin. Microflora fills the lumen of the dentinal tubules, but does not penetrate through the intact cementum of the tooth root. CONCLUSIONS. Microflora in the root canals of teeth with chronic forms of apical periodontitis is present not only in the form of individual cultures, but mainly in the form of biofilm, which covers not only the canal, but also penetrates to different depths into the thickness of the dentin of the tooth root. Biofilm covers dentin unevenly in different parts of the root.
Analysis of the surface microbiome of removable monomeric and monomer-free plastics dentures treated with various hygiene products
AIM. The aim of this study is to investigate the differences in the surface microbiome of removable dentures depending on the base material and hygiene products. MATERIALS AND METHODS. The study was attended by 30 patients aged 65 to 70 years using different hygiene products. The study included the determination of the prothesis hygiene index and PCR analysis of the material from the surface of the plate. Statistical analysis of the data included a description of accounting characteristics and assessment of the statistical significance of changes in the studied indicators. RESULTS. Statistical analysis showed a pronounced, statistically significant negative dynamics for all microbiological indicators in the structure of the removable apparatus and an improvement in the hygiene of the plate and the oral cavity. CONCLUSIONS. A study of patients using orthopedic structures with different bases, as well as the use of different hygiene products using a visual-index assessment and microbiological analysis will allow you to choose the most optimal hygiene option and device design.
Analysis of the surface microbiome of removable orthodontic appliances cleaned with various hygiene products
AIM. The aim of this study is to investigate the differences in the microbiota of the surface of orthodontic plates depending on the used hygiene products. MATERIALS AND METHODS. The study was attended by 36 patients aged 6 to 12 years, undergoing treatment on removable orthodontic equipment using various hygiene products. The study was carried out using the determination of the prosthesis hygiene index and microbiological analysis of the material from the surface of the plate. Statistically, the data analysis included a description of the accounting features, an assessment of the statistical significance of changes in the indicators under study. RESULTS. In the structure of the biofilm of a removable plate, microbiological indicators before and after the experiment showed a pronounced, statistically significant negative dynamics. And also, an improvement in the hygiene index of the plate and oral cavity. CONCLUSIONS. The use of various hygiene products with orthodontic patients and the study of the microbiological status of the surface of the plate after cleaning them will allow you to choose the most optimal option for cleansing the removable apparatus.
XRF analysis of tooth enamel under conditions of experimental erosion in vitro
INTRODUCTION. Dental erosion is a result of chemical processes – specifically, “acid attacks” on the tooth surface that occur without bacterial involvement – leading to alterations in the mineral structure of dental tissues. In recent years, the erosive potential of fruit juices, carbonated and non-carbonated soft drinks, as well as alcoholic beverages, has been actively studied in an effort to better understand the mechanisms of demineralization and to assess the impact of drink acidity. However, there is a lack of data on experiments that provide a comprehensive profile of macro- and microelement content in erosion zones of varying severity compared to intact enamel and dentin. AIM. To examine, using X-ray fluorescence analysis, the dynamics of changes in the calcium-to-phosphorus (Ca/P) ratio–an important indicator of tooth mineral content–under conditions of artificial erosion caused by various acidic food and beverage solutions. MATERIALS AND METHODS. The exogenous acidic agents used included solutions of lactic, acetic, and hydrochloric acids; lemon juice; dry red wine; Dobry Cola; and a solution of Acidin-Pepsin tablets (a drug prescribed for hypoacid and anacid gastritis). Recently extracted intact teeth were immersed in the test liquids for three days. Demineralization was assessed based on observed changes in elemental composition. The chemical analysis of the solid dental tissues was performed using an M4 TORNADO X-ray fluorescence spectrometer (Bruker). RESULTS. In all test conditions, demineralization occurred as evidenced by the active release of calcium and phosphorus – the main macroelements – from the crystal lattices of hydroxyapatite, carbonate apatite, chlorapatite, fluorapatite, and other mixed apatite forms found in enamel. Notably, the kinetics of calcium and phosphorus loss differed significantly. In all cases, the Ca/P ratio increased substantially after three days of exposure to the erosive medium, compared to baseline values in intact enamel. This finding indicates that phosphate groups are the first to be lost during erosion, dissolving into the oral environment, followed by calcium loss as a less intense secondary process. CONCLUSIONS. Based on analysis of Ca/P ratios, enamel erosion appears to begin with dephosphorylation of the crystalline lattice, followed by decalcification.
Morphological assessment of furcal portals in human molars using scanning electron microscopy
AIM. To evaluate the prevalence of furcal portals in human molars using scanning electron microscopy (SEM), as well as to analyze their morphological characteristics and potential associations with sex, age, and anatomical localization. MATERIALS AND METHODS. The study included 230 molars extracted from patients of both sexes for reasons unrelated to the research. Samples were prepared following a standard protocol: fixation, dehydration, sputter-coating with platinum, and visualization using a Vega3 TESCAN SEM. The following parameters were assessed: presence of a furcal portal, its shape, localization, and the patient’s sex and age. Statistical analysis included Pearson’s χ² test, Student’s t-test, and one-way analysis of variance (ANOVA); significance level was set at p < 0.05. RESULTS. Furcal portals were identified in 34 cases (14.8%). A statistically significant correlation was found between patient age and presence of a portal (p = 0.000043). The association with sex did not reach statistical significance, although a tendency toward higher prevalence in males was observed. The most common portal shape was round (44.1%), followed by oval (41.2%) and slit-like (14.7%). In most cases, portals were localized in the center of the bifurcation (76.5%), less frequently in the center of the trifurcation (23.5%). No significant associations between shape or localization and age were found (p = 0.704 and p = 0.681, respectively). By anatomical groups, the highest prevalence of portals was recorded in mandibular first molars (47.1%), followed by mandibular second molars and maxillary first molars. CONCLUSIONS. Furcal portals represent a stable morphological structure, more frequently observed in older patients. The most common shape is round, and the predominant localization is in the center of the bifurcation. Their prevalence varies across anatomical groups, with mandibular first molars showing the highest frequency. These findings have practical implications for periodontic and endodontic treatment planning, underscoring the importance of considering morphological features of the furcal region.
Interdisciplinary management of dental avulsion: from emergency care to long-term prognosis
INTRODUCTION. Dental avulsion is a traumatic dental injury defined by the total displacement of a tooth from its alveolar socket. The most effective intervention in these cases is the reimplantation of the avulsed tooth. Additionally, a long-term follow-up plays a crucial role in managing potential complications. AIM. To present and analyze two clinical cases of dental avulsion in children, emphasizing the importance of immediate reimplantation, appropriate storage media, and strict follow-up protocols in determining long-term prognosis. MATERIAL AND METHODS. Two pediatric patients with dental avulsion were examined and treated: Case 1: A 12-year-old patient with avulsion of two mature upper central teeth stored in milk, presented 15 minutes post-trauma. Initial reimplantation and rigid contention were performed by a general practitioner. Root canal treatment was initiated 2 weeks later at the Pediatric Dentistry and Prevention Department, Monastir Dental Clinic, followed by interceptive treatment and a 24-month follow-up. Case 2: A 10-year-old patient with avulsion of two immature upper central teeth stored in milk for 24 hours. Reimplantation and rigid contention were carried out after the appearance of inflammatory signs, followed by further management. RESULTS. In Case 1, the rapid intervention, appropriate storage medium, and timely endodontic treatment contributed to favorable healing and tooth retention over a 24-month follow-up. In Case 2, the delayed reimplantation and prolonged extraoral time negatively affected prognosis, with clinical signs of inflammation influencing the long-term stability of the teeth. CONCLUSION. These cases highlight that immediate reimplantation, correct choice of storage medium, and strict adherence to follow-up protocols are critical for successful management of avulsed teeth. Prompt intervention and compliant follow-up care significantly influence the long-term prognosis and survival of reimplanted teeth.
Non-surgical endodontic management of calcific metamorphosis with periapical lesion using bioactive glass: a case report
INTRODUCTION. Calcified root canals lead to various complications in endodontic treatment, as they complicate the locating of canal orifices, negotiating access, preparing the canals, and factoring in the time required for these procedures. Even with extensive precautions, the most serious problems can occur at any phase of the root canal treatment process. The pulpal chamber or root canal space is most frequently partially or completely obliterated in a tooth that has experienced a traumatic injury. A total or partial loss of pulp space is the most typical radiological representation of such a tooth. Pulp necrosis and radiographic signs of chronic periapical periodontitis are present in 7–27% of teeth with partial canal calcification. Small percentage of teeth (2–3%) may exhibit a complete occlusion of the pulp chamber and root canal system. AIM. To describe the clinical management of a calcified mandibular lateral incisor with a periapical lesion using a bioactive glass-based sealer. MATERIALS AND METHODS. A traumatized mandibular lateral incisor with radiographic evidence of canal calcification and a periapical lesion was identified. The root canal was located, negotiated, and prepared using standard endodontic techniques with special consideration for calcified anatomy. A recently developed bioactive glass-based sealer was selected for obturation. RESULTS. The calcified canal was successfully located and treated. Radiographic follow-up demonstrated proper canal obturation with resolution of the periapical lesion. CONCLUSIONS. Bioactive glass-based sealers show promising outcomes in the treatment of calcified root canals. Their bioactivity and sealing ability may enhance prognosis in complex endodontic cases involving traumatic canal calcification.