Friday, May 27, 2016

Mandibular Canal Location: Cone-beam Computed Tomography Examination

Journal of Endodontics



The increased use of implants and potential endodontic misadventures can lead to nerve damage. The purpose of this study was to use cone-beam computed tomography (CBCT) measurements to investigate mandibular canal (MC) location in relation to mandibular posterior teeth, the dimension of the buccal and lingual bone over the MC, the diameter of the MC, and the anterior loop location near the mental foramen.


CBCT scans from 106 patients (age, 18–69 years) were used to evaluate measurements from 636 teeth and respective MC areas.


Respective locations of MC to teeth (buccal, inferior, or lingual) were as follows: second molar (57% buccal, 40% inferior, and 3% lingual), first molar (18% buccal, 55% inferior, and 27% lingual), and second premolar (33% buccal, 55% inferior, and 11% lingual). Buccal bone thickness over the MC was thickest at mesial root of second molars and thinnest over the second premolar (5.4 versus 2.6 mm). The lingual bone next to the MC was thickest over the second premolar and thinnest at distal root of first molars (3.8 versus 1.7 mm). The average diameter of the MC along the length of the canal from second molar to second premolar was 3.03 mm on left and 2.91 mm on right. The anterior loop was present in 10.4% of patients, with the average depth below bone of 13.43 mm. The anterior loop was more often seen on the left side than right and occurred bilaterally 50% of the time.


Mandibular bone thickness, nerve location, and dimension data all contribute to a useful knowledge base for practitioners. The application of CBCT imaging techniques aids in the surgical treatment, while offering advantages over conventional periapical and panoramic films.

Thursday, May 26, 2016

Prevalence of inter-appointment endodontic flare-ups and host-related factors

Clinical Oral Investigations
pp 1-6
First online:



The aims of this study were to report the prevalence of inter-appointment flare-ups following adequate root canal disinfection and to investigate the host factors contributing to its occurrence.

Materials and methods

One thousand five hundred patient records were reviewed and the prevalence of flare-up was recorded. Patients’ root canal space status (vital, non-vital or retreatment), medical condition and demographics (age, gender, tooth type and position) were recorded from their dental records. Statistical analyses were performed to determine the impact of the recorded factors on flare-up occurrence.


Nine hundred fifty-one patient records met the inclusion criteria. The prevalence of flare-up was 2.3 %. There was a correlation between the canal space status and patient’s age with flare-up development (P < 0.05). There was no association between flare-up occurrence and tooth type, location, gender or medical condition (P > 0.5).


The root canal space status was the primary factor affecting flare-up occurrence. Patients >50 years had the highest risk in developing flare-ups.

Clinical relevance

This article provides evidence that patients suffering from inflamed pulp will not develop flare-up if adequate cleaning and shaping of the root canal space was performed. It also shows that patients above the age of 50 are a high-risk group that is prone to flare-up development.

Wednesday, May 25, 2016

Boyd Industries Debuts Concealed Delivery Unit® at AAPD 2016

This new treatment room fixture keeps anxiety-provoking dental equipment out of sight of pediatric patients, allaying fears and improving patient comfort and satisfaction.

(Clearwater, FL) May 24, 2016—Boyd Industries, a leading supplier of dental chairs and cabinetry (, will be exhibiting the Concealed Delivery Unit® (CDU), a groundbreaking new product for pediatric dentistry (, at AAPD 2016, the annual conference and trade show of the American Association of Pediatric Dentistry in San Antonio, TX May 26-29. The Concealed Delivery Unit keeps dental hand pieces and other anxiety-provoking pieces of the dental delivery system out of sight of young dental patients while making them easily accessible to dentists and their chairside assistants when performing procedures.

“The delivery system with its associated hand pieces in a majority of pediatric dentist’s offices today are in plain sight.” says Adrian LaTrace, CEO, Boyd Industries, “This can sometimes be disconcerting even for adults, and it can be downright frightening to children. By hiding the hand pieces and nitrous oxide unit behind a cabinet door and then easily extend it prior to starting a procedure can eliminate the immediate surge of anxiety children would experience if they see this equipment beforehand.”

The benefits of making a trip to the dentist a more positive experience for young patients, LaTrace notes, go far beyond immediate reassurance. Serious anxiety—rooted, often, in unpleasant childhood experiences—prevents millions from seeking proper preventative care. Peter Milgrom, DDS, director of the Dental Fears Research Center at the University of Washington in Seattle, estimates that between 5% and 8% of Americans avoid dentists out of fear. A higher percentage, perhaps 20%, experience enough anxiety that they will go to the dentist only when absolutely necessary. The consequences of this neglect, he points out, can go far beyond dental pain and lost teeth. Gum disease is a serious infection that can affect other parts of the body; studies now link it to such illnesses as heart disease, stroke, and diabetes.1

Underscoring this point is a recent study published by the European Journal of Dentistry. Children who have positive interactions with their dentist, the study says, will be less likely to develop a fear of dentists and will experience less anxiety during dentist appointments. As a result, they will be more likely to visit the dentist as adults and will have better dental health. Given the importance of dental health, all members of the dental profession need to be aware of patient perceptions, preferences, and fears in order to meet patient needs, and provide them with quality care in a manner that is comforting and reduces anxiety.2

“Helping dental practitioners provide that kind of care,” says LaTrace, “is what our company is all about. We supply furniture, fixtures, and office design to thousands of dental specialists around the country, and we stay in very close contact with our customers. The CDU was created out of our intimate understanding of the needs of a particular specialty, in this case pediatric dentistry. We believe the CDU represents the next generation of treatment room systems for pediatric dentists.”

The new Boyd Industries Concealed Delivery Unit will be demonstrated at the American Association of Pediatric Dentistry convention and trade show at the Henry B. Gonzales Convention Center, 200 E. Market St., San Antonio, TX, May 26-29. Attendees wishing to arrange a demonstration can contact Boyd Industries at

About Boyd Industries:

Boyd Industries is a market leader in the design and manufacture of specialty dental and medical operatory equipment. Its high-quality and reliable equipment has been the choice of orthodontists, pediatric dentist, oral surgeons and other healthcare professionals for over 55 years. Boyd’s products include a full line of dental exam, treatment and surgical chairs, dental delivery systems, LED exam and surgical lighting, custom sterilization and storage cabinetry, doctor or assistant seating, and video game consoles. Boyd equipment is specifically designed to provide maximum practice productivity while incorporating ergonomic characteristics for the doctor, staff and patient. To learn more about Boyd products, please visit

Tuesday, May 24, 2016

Informed consent comprehension and recollection in adult dental patients: A systematic review.

J Am Dent Assoc. 2016 May 10. pii: S0002-8177(16)30255-0. doi: 10.1016/j.adaj.2016.03.004. [Epub ahead of print]



Patients' ability to recollect and comprehend treatment information plays a fundamental role in their decision making.


The authors considered original studies assessing recollection or comprehension of dental informed consent in adults. The authors searched 6 electronic databases and partial gray literature and hand searched and cross-checked reference lists published through April 2015. The authors assessed the risk of bias in the included studies via different validated tools according to the study design.


Nineteen studies were included: 5 randomized clinical trials, 8 cross-sectional studies, 3 qualitative studies, 2 mixed-methods studies, and 1 case series. Conventional informed consent processes yielded comprehension results of 27% to 85% and recollection of 20% to 86%, whereas informed consent processes enhanced by additional media ranged from 44% to 93% for comprehension and from 30% to 94% for recollection. Patient self-reported understanding ranged positively, with most patients feeling that they understood all or almost all the information presented. Results of qualitative data analyses indicated that patients did not always understand explanations, although dentists thought they did. Some patients firmly stated that they did not receive any related information. Only a few patients were able to remember complications related to their treatment options.


Results of this systematic review should alert dentists that although patients in general report that they understand information given to them, they may have limited comprehension. Additional media may improve conventional informed consent processes in dentistry in a meaningful way.

Monday, May 23, 2016

Color stability of nanohybrid resin-based composites, ormocers and compomers

Clinical Oral Investigations
pp 1-7
First online:



The aim of this study is to evaluate the color stability of two nanohybrid resin-based composites, two organic modified ceramic resin composites (ormocers) and a compomer, following their immersion during 4 weeks in four usual drinks.

Material and methods

Forty discs of each of the following materials were prepared: GrandioSO (GR), Esthet X (EX), Dyract EXTRA (DY), Ceram X duo (CX), and Admira Fusion (AD). The discs were polished and stored in distilled water during 24 h at 37 °C. Color according to the CIEL*a*b* scale was recoded. Ten randomly selected samples of each material were immersed in red wine (RW), coffee (CF), cola (CK), and distilled water (DW). The color was recorded after 1, 7, 21 and 28 days of immersion. The ΔE values between the baseline color and each of the study timepoints were calculated. The data were analyzed based on the Kruskal-Wallis test, Wilcoxon test, and Mann-Whitney U test.


After 1 day of immersion, all the materials showed ΔE > 3.3, except EX, CF, and CX in CK. RD was the most staining beverage (ΔE 15.36 to 31.09). EX and CX were significantly less stained than the rest of the materials (p < 0.05).


All the staining solutions produced darkening beyond clinically acceptable limits. EX and CX were the materials who experimented less staining, followed by GD. AD and DY were the materials more stained. RW was the drink that produced more staining, followed by CF and CK.

Clinical relevance

After 24 h of immersion in all the solutions, equivalent to 1 month of exposure in the mouth, the evaluated materials showed clinically unacceptable ΔE values.

Friday, May 20, 2016

Comedic legend Jerry Seinfeld slated to regale SIROWORLD 2016 attendees

The legendary comic and former sitcom star will amuse eventgoers on the first evening of the inaugural event

CHARLOTTE, N.C. (May 19, 2016) - Dentsply Sirona, The Dental Solutions Company, announced today that revered comedian Jerry Seinfeld will perform a private standup act for SIROWORLD attendees in Orlando, Florida, on Thursday evening, Aug. 11*.
Seinfeld broke into the comedic scene when he appeared on “The Tonight Show” with Johnny Carson in 1981, then later appeared on similar shows such as “Late Night with David Letterman” and the “Merv Griffin” show.
After starring in his own TV special in 1987, he and fellow comedian Larry David created the hilarious and critically-acclaimed sitcom “Seinfeld,” which premiered in 1989, ran for nine seasons and was one of the highest-rated and most successful shows in the United States.
Since the sitcom’s finale, Seinfeld has performed and recorded several standup specials, authored numerous books including the best-seller “Seinlanguage,” starred in various films like the animated “Bee Movie” in which he co-wrote and co-produced as well and created the popular web series “Comedians in Cars Getting Coffee” in 2012 that is now in its seventh season.
“Jerry Seinfeld is a comedic titan and we’re ecstatic to welcome him to our lineup of entertainment this year!” said Group Senior Vice President of the U.S. Commercial Organization Michael Augins. “After a full day of educational sessions and training, his performance at SIROWORLD is sure to give the audience a boost of energy that will carry throughout the remainder of the event.”
A three-day educational extravaganza, SIROWORLD offers groundbreaking general sessions, innovative and informative breakout sessions, copious networking opportunities and astonishing entertainment for all who attend the inaugural event at the Rosen Shingle Creek Resort.
Early Bird registration rates are available for SIROWORLD through May 31. Doctor registration is offered for only $1,695 (regularly $1,995). Staff/spouse/guest/technician registration is only $995 (regularly $1,195) and is buy three, get one free. Other specials are available as well, visit to learn more about different registration types and specialty rates.
VIP tickets can be purchased for an additional $500. VIP tickets include reserved seating, upgraded dining options and special admittance into SIROWORLD entertainment events, including Jerry Seinfeld!
For more information on the various registration types and to register for SIROWORLD, visit, or contact our help desk at or call 844-GO2-SIRO (844-462-7476).

Thursday, May 19, 2016

Influence of increased patient age on longitudinal outcomes of root canal treatment: a systematic review

Gerodontology 2016; doi:10.1111/ger.12231 Influence of increased patient age on longitudinal outcomes of root canal treatment: a systematic review



To conduct a systematic review of longitudinal endodontic outcomes in elders.


Negative opinions about the prognosis of non-surgical root canal treatment (NSRCT) in elders affect decisions made by patients and dentists. Patient, caregiver and dentist attitudes and behaviours may interact to decrease the provision of NSRCT. Critical examination of the available evidence through systematic review could provide objective data to assist patients, caregivers, healthcare providers and third-party payers in making decisions about the efficacy of NSRCT in elders and provide a robust foundation for the health promotion of NSRCT in elders.


Inclusion/exclusion criteria were used for defined searches in MEDLINE and Cochrane CENTRAL. Title lists were scanned, and abstracts read to determine utility; articles meeting inclusion/exclusion criteria were analysed. Data were extracted and compiled into a table of evidence.


Defined searching produced 3605 titles; 24 articles were included, nine prospective and 15 retrospective. Overall study quality was good. Patient samples mostly represented modern populations from countries with very high human development indices. Over 17 430 teeth were included. Meta-analysis was not attempted due to heterogeneity in reporting. All 24 included papers demonstrated that increased patient age did not decrease the success or survival rates of NSRCT.


This systematic review of longitudinal NSRCT outcomes demonstrated that increased patient age did not decrease the success of NSRCT. Patient age is not a prognostic factor for NSRCT. Age should not be considered by dentists or patients when making NSRCT decisions.