Contemporary Clinical Dentistry最新文献

Regenerative endodontic treatment (RET) promotes tissue regeneration and root development in immature necrotic teeth. This case series examines RET outcomes in varied cases, including immature and mature teeth with periapical pathology, failed root canal treatments, large cyst-like lesions, and internal inflammatory root resorption. Five cases were treated using standardized RET protocols, including sodium hypochlorite and ethylenediaminetetraacetic acid irrigation, intracanal medicaments, and biological scaffolds (blood clot, platelet-rich plasma, and platelet-rich fibrin). Canals were sealed with biocompatible materials, followed by clinical and radiographic monitoring. All patients remained asymptomatic, with radiographic evidence of periapical healing. Some teeth showed canal narrowing due to calcific tissue deposition. Despite the absence of pulp sensibility responses, all cases demonstrated successful healing. RET is a promising, versatile approach for managing complex endodontic conditions. Success depends on effective disinfection, scaffold selection, and individualized planning. Continued research and protocol refinement are essential for broader clinical application.

Root fractures are common in dental trauma cases, and treatment depends on fracture location and extent, requiring proper knowledge for effective management. This study reports the case of an oblique root fracture in the maxillary left central incisor due to dental trauma after a fall. Clinical and radiographic evaluations revealed mild cervical crown darkening, Grade I mobility, mild extrusion, and negative cold-sensitivity tests, indicating pulp necrosis. Cone-beam computed tomography showed a hypodense line compatible with a root fracture, and the diagnosis was asymptomatic apical periodontitis. Endodontic treatment involved chemical-mechanical preparation and root canal filling with Bio-C Sealer (Angelus, Brazil) using the single-cone technique. After 2 years, follow-up showed no symptoms or hypodense images. Accurate diagnosis, timely treatment, and proper management are essential for successful outcomes in oblique root fractures.

Aim: The aim of this study was to compare the effect of salivary contamination on the reverse torque values (RTVs) of abutment screws in two different types of internal hex implant-abutment connections, namely, standard internal hex and conical hex, before and after occlusal loading at different time intervals.

Settings and design: This was an in vitro study.

Materials and methods: Fifteen implants (Adin) and corresponding abutments with standard internal hex connection and 15 implants (Osstem) and corresponding abutments with conical hex connection were embedded in acrylic resin blocks. The screw-access holes of the fixture bodies were contaminated with artificial saliva. The abutments were inserted into the fixture screw holes, and an initial torque of 25 Ncm and a second torque of 25 Ncm after 15 min were applied with a digital torque meter. The implant-abutment units were then immersed in a beaker containing artificial saliva. RTVs were measured at 24, 48, and 72 h intervals. Occlusal load simulating occlusal force (400N) was exerted onto the specimens using universal testing machine. The specimens were submerged in artificial saliva again, and the RTVs were recorded at intervals of 24 h, 48 h, and 72 h.

Statistical analysis: An Independent t-test was done for comparing the RTVs of the sample groups.

Results: Statistically significant reduction in torque loss was observed in conical hex implant-abutment connections when compared to internal hex connections at various time intervals, before and after occlusal loading.

Conclusion: With respect to microleakage and screw loosening, conical hex connections demonstrated an advantage over internal hex implant-abutment connections.

Background: In the case of oral potentially malignant disorders such as oral submucous fibrosis (OSMF), leukoplakia and in oral cancer, cancer stem cells are reported to be present. Cluster of differentiation 44 (CD44) is a stem cell involved in various cellular regulation pathways and detected in proficient amounts as molecular biomarkers in saliva that are cleaved and released but surprisingly no evidence to support its diagnostic value in OSMF.

Aim: The aim of the study was to determine the CD44 expression in the salivary sample of OSMF patients and to evaluate its effectiveness as a noninvasive diagnostic marker.

Materials and methods: Group 1 included 30 controls and Group 2 included 30 OSMF cases. Salivary samples were collected and subjected to enzyme-linked immunosorbent assay for determining the CD44 values. Grading of OSMF was done based on clinical examination and histopathological investigation. The data obtained were subjected to statistical analysis (SPSS Version 24) Chi-square test, independent t-test, one-way ANOVA, Pearson, and Spearman correlation were performed.

Results: In Group 2, there was male predominance with 86.7% (n = 26) males. The mean CD44 expression in Group 1 (Normal) was 5.57 ± 0.77 pg/ml and the mean expression in Group 2 (OSMF) was 5.37 ± 0.76 pg/ml. There was a decrease of CD44 value in Group 2 (OSMF) when compared to Group 1 though not statistically significant. Similarly, the mean CD44 values decreased with the progression of grades of OSMF from 5.493 ± 0.278 in Grade 1 patients to 4.794 ± 1.020 in Grade 4B.

Conclusion: Our study was the first of its kind to assess the expression of CD44 in OSMF patients. Results infer that CD44 may decrease with the progression of normal mucosa to OSMF and with different grades, however, future studies are required with larger sample size to determine CD44 as molecular biomarker.

Background: Dental fear and anxiety are the major hurdles for providing successive treatment for children. Effective use of behavior guidance techniques is essential for addressing these challenges. Hence, this study aimed to evaluate the effectiveness of reframing and tell-show-do (TSD) behavior guidance technique in reducing anxiety in children during dental procedures without and with administration of local anesthesia (LA).

Subjects and methods: Fifty children of 6-12 years of age with no previous dental experience were randomly assigned to either the reframing group or the TSD group. They underwent dental procedures without (restoration) and with administration of LA. Subjective anxiety was evaluated using the Venham Picture Scale (VPS) and physiologically by measuring pulse rate (PR) before and after the procedures.

Results: The intragroup analysis was done using paired t-test and intergroup by independent t-test. For the procedure without LA (restoration), the intragroup analysis showed significant anxiety reduction in children both in TSD (P = 0.0404* VPS) and reframing group (P = 0.0289* VPS) postoperatively. However, intergroup analysis showed no significant difference. For the procedure with LA, higher anxiety was seen in the TSD group (P = 0.0042* VPS, P = 0.0005* PR) compared to reframing both in intragroup analysis (P = 0.0042* VPS, P = 0.0005* PR) as well as intergroup analysis (P = 0.0222*) compared to children in the reframing group.

Conclusion: This study showed both reframing and TSD are effective in reducing anxiety for restorative procedures in children. However, reframing is better suited when LA administration is required.

Background: Oral squamous cell carcinoma (OSCC) is the most prevalent carcinoma of the head-and-neck region. Despite advanced tissue diagnosis, the survival period remains at 5 years. New molecular and cell markers are under investigation to improve survival rate.

Objective: The objective of this study was to assess angiogenic activity by analyzing CD105 microvascular density (MVD) count in different histologic grades of OSCC.

Subjects and methods: Sixty samples are categorized into four groups. Immunohistochemical method with anti-CD105 was used for analyzing MVD.

Results: The mean count of MVD is higher in OSCC than in normal mucosa and also significant among different histologic grades. A highly significant correlation is observed among different groups of OSCC samples.

Conclusion: CD105 is a predictive marker for neoangiogenesis in OSCC.

Spindle cell squamous cell carcinoma (SCSCC) is a rare and aggressive variant of squamous cell carcinoma (SCC). It accounts for 2%-3% of all the SCC and usually arises over sun-exposed areas, prior ionizing radiation sites, or immunocompromised individuals. This uncommon subtype is characterized by the proliferation of both epithelial and mesenchymal components, making diagnosis challenging due to its histopathological resemblance to neoplastic or reactive spindle cell lesions of mesenchymal origin. SCSCC is noteworthy for its high potential for recurrence and early metastasis. immunohistochemistry (IHC) studies play a critical role in differentiating SCSCC from other spindle cell neoplasms, such as spindle cell desmoplastic melanoma, cutaneous leiomyosarcoma, and atypical fibroxanthoma. Herein, we present a rare case report of a 55-year-old male presenting with ulceroproliferative growth on buccal mucosa.

Introduction: The primary aim of endodontic treatment is to preserve the structural integrity of teeth while enhancing their resistance to fractures. Endodontically treated teeth are more susceptible to fractures due to the removal of tooth structure and radicular dentin. This study evaluates and compares the fracture resistance of teeth instrumented using three rotary file systems: self-adjusting file (SAF), ProTaper NEXT, and Hyflex EDM.

Methodology: Sixty extracted human mandibular premolars were randomly divided into four groups: Group I (control, uninstrumented), Group II (SAF), Group III (ProTaper NEXT), and Group IV (Hyflex EDM). Following instrumentation, root canals were obturated with gutta-percha and AH Plus sealer, except in the control group. Samples were embedded in acrylic resin, and fracture resistance was tested using a universal testing machine. Statistical analysis included analysis of variance and Tukey's post hoc tests to compare group differences.

Results: The control group exhibited the highest fracture resistance (560.46 ± 125.0 N). Among the instrumented groups, SAF demonstrated the greatest fracture resistance (537.8 ± 126.3 N), followed by Hyflex EDM (440.7 ± 210.3 N), whereas ProTaper NEXT exhibited the lowest (379.93 ± 130.0 N). Significant differences were noted between groups (P < 0.001). SAF preserved dentinal integrity most effectively, whereas ProTaper NEXT induced more structural damage.

Conclusion: The SAF system, with its adaptive design and minimal dentin removal, was superior in preserving root strength. ProTaper NEXT, although efficient in shaping, increased fracture risk due to higher stress generation. Hyflex EDM offered intermediate outcomes, combining flexibility and reduced dentin damage.

Basaloid squamous cell carcinoma (BSCC) is an aggressive, high grade, and histologically distinct variant of squamous cell carcinoma (SCC) in the head and neck region. It shows a predisposition toward males of 60-70 years of age frequently with a history of heavy smoking and alcohol consumption. It is contemplated as an advanced-stage disease with widespread metastases, higher recurrence rate, and poor prognosis. In the present article, we report a case of BSCC in the mandibular anterior gingiva of a 60-year-old male, histopathologically which appeared as sarcoma.