Patients with cervical dentine exposures do not always complain of dentine hypersensitivity. The identification of morphological features connected to symptoms is important for both prevention and management of dentine hypersensitivity. The aim of the study was to determine the relationship between the dentine ultrastructure and clinical symptoms in patients with cervical dentine exposures. Replica models for a total of 28 teeth (from 10 patients) with cervical non caroius lesions and dentine exposures were obtained before and after acid etching. The replica models were studied blindly in the scanning electron microscope (SEM). 12 of these were classified clinically as hypersensitive and 16 as non-sensitive. Because of the morphological heterogeneity of all specimens, a grid was used to isolate smaller, more homogeneous areas. 120 (75 non-sensitive and 45 hypersensitive areas) grid areas randomly selected from the 28 dentine surfaces were analyzed. The presence and morphology (amorphous or crystalline) of smear layers and the density and diameter of dentine tubules were recorded. The chi 2 test was used for statistical analysis. In unetched specimens, the surfaces classified as non-sensitive were frequently coated by an amorphous smear layer (88.0%) and occasionally by a crystalline smear layer (2.7%). Only a few and narrow tubules were observed (9.3%). On the other hand, the unetched specimens of the hypersensitive dentine exhibited less frequently (31.3%) an amorphous smear layer. The presence of crystalline smear layer (33.3%), many and wider patent tubules and, sometimes, loss of intertubular dentine manifested as grooves between tubules, were observed (35.6%). The differences were significant (p < .001). In hypersensitive dentine, the acid etching always removed the smear layer whereas removal in non-sensitive dentine was partial or absent. These morphological findings underline the rôle of smear layer in reducing permeability of dentine in patients with dentine sensitivity.

The endodontic anatomy of primary molars is difficult to predict because of the balance of resorption and hard tissue deposition. In particular, the resorption causes perforating lacunae across the wall of the root, even at the furcation level, and modifies shape, dimension and position of endodontic apex. The phenomenon can be so deep as to compromise endodontic therapy. The first aim of the study was to verify if reliable criteria can be found for treatability in primary molars undergoing resorption, i.e. if it is possible to predict if perforating lacunae are present or not. The second aim of the study was to verify if other informations needed for endodontic treatment, as shape, dimension and location of the apex, and curvature of the root canal can be predicted. For the study, 80 extracted primary molars, 75 of which pulpally involved by caries, were selected. The treatability was evaluated in term of root length, root shape, dimension and shape of endodontic apex, age of the patient and X-ray index of resorption. The association between variables was performed by multiple correspondence analysis. The results suggested that root length was the most reliable criterion of the integrity of the root. The borderline of treatability was at the length of 4 mm. The position of endodontic apex related to anatomical apex, and the lingual related to the buccal root length were analyzed by linear regression analysis. The canal length was often similar to the root length (i.e. the endo and anatomical apices were very close) in lower and upper molars. However, in lower molars, if two or more canals were present in the same root, a discrepancy was observed between buccal and lingual root length. This finding was constant in first lower molars. In addition regression analysis provided a linear function between the lengths of the buccal and lingual side of the same root in lower molars. Its coefficient b was 0.73.

This in vitro study evaluated the ability of a warm gutta-percha obturation system Thermafil to fill lateral channels in presence/absence of smear layer. Forty single-rooted extracted human teeth were randomly divided into two groups for which different irrigation regimens were used: group A, 5 ml of 5% NaOCl + 2.5 ml of 3.6% H(2)O(2); group B, 5 ml of 5% NaOCl 5% + 2.5 ml of 17% ethylenediamine tetraacetic acid. A conventional crown-down preparation technique was employed. Obturation was performed using epoxy resin-based cement (AH Plus) and a warm gutta-percha plastic carrier system (Thermafil). Specimens were cleared in methyl salicylate and analyzed under a stereomicroscope to evaluate the number, length, and diameter of lateral channels. Lateral channels were identified in both groups at medium and apical thirds. Additional samples were prepared for scanning electron microscopy inspection to confirm the presence of smear layer in group A, and the absence of smear layer in group B. All lateral channels resulted filled in both groups. No statistically significant differences regarding number, length, and diameter were observed between the two groups. Smear layer did not prevent the sealing of lateral channels.

The use of calcium-phosphate casein on hypomineralized molars (molar incisor hypomineralization, MIH) has been proposed but not clinically investigated. Qualitative and quantitative effects of supplementation with a calcium-phosphate casein product on MIH molars were monitored over a period of three years. Molar replicas, minimally invasive biopsies and their SEM microphotographs, plus ESEM/EDX semi-quantitative peaks of elements present in affected enamel were evaluated. Mineralization, morphology, and porosity appeared markedly improved, with calcium and phosphate levels reaching almost normal levels at three years' follow-up. The hypothesis tested was rejected, since calcium-phosphate casein improved enamel morphology in vivo.

No abstract