Ukrainian Dental Journal

Regenerative endodontics: vary of scaffolds and its benefits for pediatric dentistry

2023-12-29T14:47:11+00:00

Background. Regenerative Endodontic Procedures deliver a suitable environment to promote natural regeneration/repair with a functional pulp–dentin wall and apical closure. However, REPs have a number of features that can complicate their implementation, especially for children. One of them is scaffold formation.

Objective. To describe alternative scaffold formation options for pulp revitalization and compare their effectiveness and describe possible causes of periapical tissues not bleeding during endodontic regenerative procedures.

Materials and methods. A comprehensive search strategy was done through PubMed and Cochrane Library databases by using MESH terms equivalent to the keywords. Review articles for the last 5 years were selected according to the keywords with exclusion criteria.

Results. According to the search criteria and keywords, 801 articles were obtained, after applying the exclusion criteria, 11 ones that met the selection requirements were left.

Conclusions. The main method of scaffold obtaining is the blood clot formation. However, if it is not possible to make the periapical tissues bleed for clot formation, then the use of platelet-enriched autologous plasma or platelet-rich fibrin is recommended. This technique has proven to be as effective as the main one. It can prevent painfulness caused by bleeding provoking for blood clot formation.

Diagnostic criteria for odontogenic sinusitis: narrative review of relevant literature data

2023-12-29T15:35:11+00:00

Background. Specific tendency could be observed regarding increasing number of odontogenic sinusitis related publications within decades between 1990 and 2019, but even with upgrowing pool of literature data regarding odontogenic sinusitis evidences reported within it remains of low quality. Also, it should be noted that yet no evidence-based consensus decision have been made regarding strict diagnostic criteria of maxillary odontogenic sinusitis.

Objective. To systematize relevant data regarding odontogenic maxillary sinusitis diagnostic criteria based on available guidelines, consensus reports, CBCT-based and clinical researches.

Materials and Methods. Study was provided in the form of retrospective literature review. Seach of publications related with the objective of the research was held within PubMed Central database (https://www.ncbi.nlm.nih.gov/pmc/) by applying Mesh-terms combinations. Articles included into study group were processed due to the following categories of content-analysis: signs and symptoms which may be used to prove odontogenic origin of maxillary sinusitis; diagnostic significance of different manifestations which may be used to prove odontogenic origin of maxillary sinusitis; approaches which should be followed to provide correct diagnostics of odontogenic maxillary sinusitis.

Results. Out of 15 targeted publications, which formed study group, 2 were represented in the form of systematic review, 1 – in the form of online-survey study, 6 – in the form of literature/comprehensive/state-of-art review, 4 – in the form of retrospective study, 1 – in the form of international multidisciplinary consensus statement, 1 – in the form of experimental imaging study. Considering only one available international multidisciplinary consensus statement regarding odontogenic sinusitis diagnosis next approach should be followed in mentioned order for correct diagnostics of such pathology: 1) suspect odontogenic maxillary sinusitis; 2) confirm sinusitis; 3) confirm odontogenic pathology.

Conclusion. Tomographical methods of examination are more accurate for the odontogenic maxillary sinusitis diagnostics, nevertheless if multidisciplinary diagnostic approach (endoscopy, tomography and clinical examination) is possible for realization it should be held as a primary diagnostic strategy. Cases of asymptomatic maxillary odontogenic sinusitis, while also symptomatic ones developing without background of recent dental treatment, may also be observed in clinical practice, and thus should be correctly diagnosed for appropriate treatment planning.

Role of endodontic treatment related signs for the forensic odontology practice considering real-life quality of comparable radiographs

2023-12-29T15:57:37+00:00

Background. Real life quality of periapical radiographic images widely varies, while also periapical radiographs not always have been taken at the same angulation, especially in multirooted tooth cases, which in turn potentially may limit the value of obtained information received during endodontic treatment for the further comparative dental identification.

Objective. To objectify possibility of using real-life quality periapical radiographs obtained during endodontic treatment for the comparative dental identification.

Materials and Methods. Research was organized in the form of cross-sectional hospital-based study. Copies of ten pairs of selected radiographs were distributed for the Set 1 (simulation of ante-mortem images), which contained 10 radiographs of before root canal treatment, and Set 2 (simulation of post-mortem images), which contained 10 radiographs of after endodontic interventions. Set 1 and Set 2 images were randomized, and structured via Google Form, and five teaching assistants from the Department of Restorative Dentistry were asked to match the images through provided Google Form.

Results. The range of 50-80% correct pre- and post-treatment images matching levels were registered among five operators. The mean correct matching level reached 68.0 ± 7.2%. Experience within endodontics seems to be valuable regressor regarding outcome performance (p < 0.05), while additional Radiology specialization did not significantly improved performance level for matching pre- and post-treatment images (p > 0.05). Operator graded 5 out of 10 images pair as relatively easy to match, 2 images – as moderately difficult to match, and 3 images – as hard to match (Fig. 3), while their agreement on the obtained above-mentioned scores reached 0.8.

Conclusion. Significance of endodontics within forensic odontology field in most cases dictated by using the results of periapical radiology as evidences of ante-mortem origin, while also considering the fact of root canal morphology uniqueness and individualized endodontic treatment pattern consistency both ante- and post-mortem even under the influence of various disturbing factors. On the other hand identification role of endodontic signs may be diminished within the absence of proper quality radiographs, or when such were provided at critically different angulations, while also when endodontic-related evidences could not be supported by dental records.

Evidences From Systematic Reviews Regarding Miniscrew-Assisted Rapid Palatal Expansion (MARPE) Approach In Orthodontics

2023-12-29T16:15:19+00:00

Background. Miniscrew-assisted rapid palatal expansion (MARPE) has been considered as relatively novel and effective method of orthodontic treatment, but the discussion is still ongoing regarding effectiveness of MARPE for different age population groups, while also in comparison with surgically assisted rapid palatal expansion or conventional rapid maxillary expansions, since evidences available for MARPE is mostly of insufficient quality.

Objective. To collect and represent evidences of MARPE treatment outcomes in orthodontics based on the data available within systematic reviews.

Materials and Methods. Search was provided via PubMed Central, Web of Science and Scopus databases, while also within Cochrane Library. Only systematic reviews written in English were considered for analysis. Primary outcomes such as success rate (percentage of cases, where required maxillary width was achieved) and maxillary expansion rate in means of midpalatal split, dental intermolar width, skeletal and dentoalveolar expansion, palatal suture opening, palatal width measured in millimeters or percentage were tabulated and analyzed. Secondary outcomes were presented in descriptive manner

Results. Overall 12 systematic reviews were enrolled into study group of targeted publications. Among these 12 systematic reviews primary outcomes were extracted from 8 of them, while rest 4 systematic reviews were used for analysis of secondary outcomes. Succes rate of MARPE varied in the range of 82.8-100%, while intermolar width increase after MARPE treatment – in the range of 4.79-6.55 mm.

Conclusion. Considering data available within systematic reviews MARPE approach seems to be reliable orthodontic treatment option, which help to gain significant increase for skeletal and dental intermolar width among patients with maxillary transverse deficiency. Such treatment strategy provides better results than conventional rapid maxillary expansion and lesser periodontal negative consequences compare to surgical-assisted rapid palatal expansion, even though quality of data supporting these statements are insufficient and debatable.

Modification of surgical and positioning splint for orthognathic surgical treatment of facial asymmetry

2023-12-29T16:33:48+00:00

Present short communication demonstrates innovative approach for surgical and positioning splint modification, which could improve accuracy of orthognathic surgery during facial asymmetry treatment. Usage of traditionally designed splint leads to the orientation of the midline based just on visual control, which inevitably associated with some level of maxilla deviation. It was proposed to design splint with mutually perpendicular planes in its’ frontal part at the specialized software. Such approach helps to align vertical plane of the splint with the midline vertical facial plane, while horizontal component could be aligned with the horizontal one accordingly. Proposed approach was approbated in five different clinical cases of facial asymmetry treated by orthognathic surgery. In all analyzed cases dental midline aligned perfectly with the planned one, in two cases the midline sagittal plane deviations (from ANS to PNS) resulted to be less than 2°. The horizontal occlusal plane deviations were considered clinically non-significant. Modification of the surgical splint for jaws positioning in orthognathic surgery treatment enables possibilities to check and control position of maxilla regarding reference facial planes intraoperatively, which in turn increases the accuracy of bone fragments placement and assure high precision of orthognathic surgery for asymmetric cases.