The dual purpose of this study was, to evaluate the fracture rate of Ni-Ti rotary instruments when following a manual glide path and using stainless steel hand files before carrying out instrumentation by means of rotary files and, to compare the results in this study with those obtained in two previous analyses, in which the glide path technique was not used. A total of 208 canals obtained from a pool of freshly extracted human mandibular and maxillary molars was divided into three groups corresponding to; K3, ProFile and ProTaper. The coronal 2/3 of each tooth were used. In all three groups the apical portion of the samples was prepared with size 10-20 stainless steel K-type hand files. The apical stops were prepared using K3, ProFile and ProTaper rotary instruments. Logistic regression model analysis indicated that breakage was significantly associated with the angle of curvature of the canal (OR = 1.078; 95% CI = 1.032-1.12; p = 0.001), and with the number of clinical uses (files used more than eight times broke more frequently that those used 1 or 2 times; OR: 22.686; 95% CI: 2.6-191.3; p = 0.004). The breakage rate obtained in the present study is significantly lower than in our previous studies, in which the angle of curvature was also greater than 30 degrees and rotational speed a constant 350 rpm, but in which the canals were not first prepared with hand files (25/205 = 12% versus 16/61 = 26%, p = 0.007). Based on the results of this study, we recommend the use of stainless steel hand files to prepare the apical 1/3 of curved canals before introducing rotary files.
From the skeletal perspective, patients with Down's syndrome who are in a period of growth demonstrate a reduction of the anterior skull base. From the dentoalveolar perspective, they show protrusion and proinclination of lower incisors, which is related to a tendency to anterior cross-bite and, to a lesser extent, to diminished overbite. Likewise, the lower lip protrusion observed in this study is related to the position of the lower incisor.
For much human activity there exists a 'lateral preference', that is a tendency to use one side of the body or the other; with respect to the hands for example, the vast majority of individuals have a preference for either the right or left hand. Most experts agree that mastication is no exception in that there is a 'preferred chewing side' but the determination of this preference is somewhat complex. This research analyses the mastication of 60 healthy subjects by means of preferred chewing side or 'PCS' tests, the Kazazoglu test, and kinesiography (KGF). While some authors consider the PCS to be the side which first comes into contact with the food we prefer to define it as the side on which the majority of the cycles analysed and registered take place. The objective of this research was to analyse the relationship that might exist between the two different methods used for determining a lateral chewing preference. Although there was no statistically significant agreement between the two techniques, both reflected the fact that there was a marked preference for the right hand side.
Aim This case report demonstrates a positive outcome of the adjuvant use of fragile fracture (FF), which is a technique used to harvest dental pulp stem cells (DPSCs), and platelet‐rich plasma (PRP) in a mandibular premolar (tooth 44) with a completely formed root that was transplanted into a surgically created socket and which maintained pulp vitality and function. Summary After virtual surgical planning, a 3D tooth replica of tooth 44 was fabricated. A surgical socket was created in the position of tooth 14; then, tooth 44 was extracted and the root dentine was abraded using a turbine diamond bur 3 mm from the apex until a circular groove was prepared around the outer circumference of the root; and then, an FF was performed without damaging the pulp tissue. PRP was placed in the socket, after which the donor tooth was inserted in the recipient area. At 2 weeks post‐treatment, orthodontic traction was applied. At 3‐year follow‐up, the tooth had adequate alignment and was asymptomatic. Response to pulp testing was positive, and the presence of pulp canal obliteration was observed as a sign of pulpal healing. Key learning points Autotransplantation is a good alternative for replacing missing teeth, with repair of tissues and pulp revascularization. Revascularization of an autotransplanted mature tooth using the fragile fracture technique and PRP scaffold is a feasible option and might have positive effects on the long‐term outcome of the procedure. Including completely formed teeth as donors in autotransplantation, maintaining vitality and their functions is an option that warrants further study.
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