Background. Dental caries is a multifactorial disease and its management requires a thorough analysis of its etiological factors. Objectives. The present study used a multivariate approach to investigate the associations of socioeco-nomic and health-related determinants with untreated tooth decay and level of oral hygiene in adult in-dividuals.Material and methods. A cross-sectional study involved 597 adult patients. Health and socioeconomic status were assessed using a self-administered structured questionnaire. The presence of decayed teeth was recorded clinically using the World Health Organization diagnostic thresholds. Oral hygiene level was estimated using the plaque index. Multiple linear regression analysis was used to explore the associations of socioeconomic and health-related variables with the number of decayed teeth and level of oral hygiene.Results. Socioeconomic and health-related variables explained 34.1% of the observed variation in the number of decayed teeth (p < 0.001) and 19.2% of the observed variation in the plaque index (p < 0.001). Analysis revealed several significant associations for both decayed teeth and plaque index scores. Males had 2.3 more untreated decayed teeth than women and an increased plaque index score of 0.3 units (unique contributions of 6.6 and 4.2%, respectively). An increase in self-assessed household economic status decreased the average number of decayed teeth by 1.3 and the plaque level score by 0.13 (unique contributions of 3.13% and 1.46%, respectively). Smokers presented with 1.78 more decayed teeth than non-smokers (unique contribution of 2.1%) and an increase in the plaque index by 0.48 units (unique contribution of 8.5%).Conclusions. Untreated dental caries and dental plaque severity share the same socioeconomic and health-related determinants.

Objectives The aim of this prospective study was to compare the healing of periapical bone between smokers and nonsmokers after root canal therapy. The effects of duration and intensity of smoking on the healing rate of apical periodontitis were analyzed. Materials and Methods Fifty-five smokers were included in this study. The control group consisted of healthy nonsmokers who matched the smoker group in age and sex. Only teeth with a favorable periodontal prognosis and adequate coronal restoration were included in the study. The periapical status of treated teeth was assessed using the periapical index system at follow-ups after 6 and 12 months. Statistical Analysis The chi-squared test and Mann–Whitney U test were used to assess the changes in periapical index score at baseline and in subsequent time intervals between the two groups examining dichotomized and ordinal data, respectively. Multivariate logistic regression analysis was used to test the association of independent variables age, gender, tooth type, arch type, and smoking index with the outcome variable. The outcome variable was set as the presence versus absence of apical periodontitis. Results The analysis at 12-month follow-up revealed a significantly higher healing rate in control group than in smokers (90.9 vs. 58.2; χ2 = 13.846; p < 0.001). Smokers had significantly higher periapical index scores than the control group (p = 0.024). The multivariate logistic regression analysis demonstrated that an increase in the value of the smoking index significantly increases the risk of apical periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51–23.28; p < 0.001) for smoking index < 400 and (OR = 9.65; 95% CI: 1.45–64.14; p = 0.019) for smoking index 400 to 799. Conclusion The results from this study show a lower rate of apical periodontitis healing in a group of smokers at 1-year follow-up. Delayed periapical healing seems to be associated with the cigarette smoking exposure.

The aim of this study was to evaluate the amounts of apically extruded 3% sodium hypochlorite using two modes of Er:YAG laser-activated irrigation (LAI), super short pulse (SSP) and shock wave enhanced emission photoacoustic streaming (SWEEPS®) by combining three types of laser tips (FT) and conventional syringe needle irrigation (SNI). Twenty extracted human maxillary central incisors were prepared using Reciproc® instruments (size 40, taper 0.06). The irrigant volumetric flow (IVF) was accurately standardized using a precision syringe pump with constant irrigant delivery through the 27G needle. The tested irrigation protocols (60 s) were groups 1: 27-G SNI with 0.05 ml/s constant IVF; group 2: SSP (10 mJ, 15 Hz, pulse duration 50 μs) + Radial SWEEPS FT; group 3: SSP + photon-induced photoacoustic streaming (PIPS) FT; group 4: SSP+SWEEPS FT; group 5: AutoSWEEPS (20 mJ, 15 Hz, pulse duration 25 µs) + Radial SWEEPS FT; group 6: AutoSWEEPS+PIPS FT; group 7: AutoSWEEPS+SWEEPS FT. Each protocol was evaluated in 10 repetitions each. Apically extruded irrigant was collected, and net weighted. There were significantly lower amounts of extruded irrigant with SNI and SSP using radial SWEEPS and PIPS FTs compared to the other tested laser protocols (p0.05). In straight root canals, the use of various fiber FTs in the AutoSWEEPS mode exhibited a higher potential for irrigant extrusion.

To compare the frequency of apical periodontitis (AP) in non-endodontically treated teeth restored with full coverage crowns, amalgam and resin composite fillings, and to disclose the association of type and quality of coronal restoration with periapical disease. The cross-sectional study involved 597 subjects who attended the Dental Clinic of the Clinical Hospital Centre, Rijeka, Croatia for the first time. Data were collected by means of a clinical and radiological survey. The following data were recorded for all permanently restored non-endodontically treated teeth: the type, the quality of coronal restoration according to clinical and radiographic criteria for marginal integrity as well as the recurrent caries presence, periapical status and marginal bone loss. Chi-square tests were used to analyze the difference in periapical status regarding the type and the quality of restoration. The multivariate logistic regression analysis was used to assess the effect of explanatory tooth-specific variables on periapical status. There was no significant difference in the proportion of AP with regards to the type and material of adequate quality coronal restorations (χ2=5.000, P=0.082). The regression analysis revealed significant positive associations with outcome variable (AP) for crowns (OR=3.39; P<0.001), recurrent caries (OR=4.67; P<0.001) and premolar teeth (OR=1.73; P=0.002). If the quality of restorations is adequate, there is no difference in the periapical status of non-endodontically treated teeth regarding the type and material of coronal restoration.

Calcium silicate–based materials, known for their bioactive properties, are increasingly being used in endodontic therapy. Accidental extrusion of these materials into the periapical tissue is a relatively common phenomenon that can impede periapical healing. The aim of this article is to present three endodontically retreated case reports with moderate to extensive periapical lesions and to review the literature on this topic. The comprehensive search and analysis of the relevant literature included a review of 51 articles, of which nine case reports/series from 2010 to 2023 were considered. Based on the summarized data, over 80% of the retreated cases showed complete healing of the periapical lesions, while the success rate in initially treated teeth was over 90%. Healing of periapical lesions is the most common therapeutic outcome, even in cases where extrusion occurs. Despite this conclusion, extrusion of materials into periapical tissues should be avoided. Further case reports on the extrusion of calcium silicate–based materials other than MTA are recommended. When evaluating the success rate of periapical healing in such cases, it is recommended to extend the follow‐up periods to several years.

Objectives The present study aimed to compare dental, endodontic, and periodontal status in patients with Hashimoto's disease and healthy patients, as well as to disclose the relation between dental variables and Hashimoto's disease. Materials and Methods The research included 85 patients affected by Hashimoto's thyroiditis (analyzed group) and 85 healthy patients (control group). The two groups were matched according to age and gender. Data regarding patients' health status was acquired from their medical records. Data regarding dental, endodontic, and periodontal status were acquired from patients' dental records and digital panoramic radiographs. Statistical Analysis Since a nonnormal distribution of data was detected, a median and interquartile range were used as a measure of central tendency and dispersion. Mann–Whitney U test and chi-squared test were used to test the differences between the groups. Multiple linear regression analysis and logistic regression analysis were used to test the association of the data. Results Healthy participants had significantly higher median number of teeth with secondary caries (median 2; interquartile range 1–3) when compared with participants with Hashimoto's disease (median 1; interquartile range 0–2; p < 0.001). Periodontal disease was present in significantly more participants with Hashimoto's disease than healthy patients (68.2% vs. 45.9%; chi-square = 7.779; p = 0.005). The presence of Hashimoto's disease increased the risk of periodontal disease presence three times (odds ratio [OR] = 3.14; 95% confidence interval [CI] 1.38–7.15; p = 0.007). The presence of periodontal disease increased the risk of Hashimoto's disease presence by 2.5 times (OR 2.54; 95% CI: 1.36–4.73; p = 0.004). Conclusion With the study limitations in mind, it may be concluded that a positive relationship between periodontal disease and Hashimoto's thyroiditis exists.