Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive therapy, characterized by compromised bone and soft tissue integrity. However, the underlying tissue-level mechanisms remain poorly understood. To uncover cell functions and spatial organization surrounding ONJ lesions, imaging mass cytometry is used to profile lesions at single-cell resolution across epithelial, stromal, and vascular regions. Widespread immune infiltration is observed, with regulatory T cells, M2-like macrophages, exhausted T cells, and natural killer cells shifting from dispersed to clustered spatial patterns, indicating altered immune organization. Epithelial regions show reduced epithelial marker expression and disrupted architecture despite elevated proliferation-related markers, while fibroblasts and endothelial cells display signs of activation. Functional profiling reveals concurrent proliferative, apoptotic, and stress-associated signatures across multiple cell populations. This comprehensive spatial and functional atlas provides insights into the pathophysiology of MRONJ and may inform future therapeutic strategies aimed at restoring tissue homeostasis and promoting effective healing.

AIM:To assess the effect of a dental traumatology educational intervention on general dentists' knowledge. The study was conducted at Vestland County's Public Dental Service (PDS) in Western Norway. MATERIALS AND METHODS:All PDS dental clinics of Vestland County (n = 52) were purposively assigned to a control group receiving no intervention (CC, n = 19), a webinar group (IC1, n = 17), and a combined webinar and in-person physical course group (IC2, n = 16). To examine the effect of the intervention, participants received a post-intervention online questionnaire (Q2) with clinical cases. A generalized linear mixed-effects model (GLMM) was used to compare the individual proportion of correct answers in Q2 between the three groups of educational intervention, where the clinic was set as a random effect factor. Additionally, a GLMM with a binary response variable was used to analyze the answers to individual cases. p < 0.05 was considered statistically significant. RESULTS:The response rate was 57% (n = 94). The overall proportion of correct answers was 67.7%, 71.0%, and 75.0% for the CC, IC1, and IC2 groups, respectively. There was no statistically significant difference in the overall proportion of correct answers between the groups when accounting for the dependency structure caused by clinics. However, for the individual cases, the IC2 group had a statistically significantly higher proportion of correct answers in complicated crown fracture of the immature tooth (p = 0.02) and first aid after avulsion (p = 0.02) compared to the CC group. Furthermore, the IC2 group had a trend of difference in complicated crown fracture of the mature tooth (p = 0.09) compared to the CC group and in emergency treatment of root fracture (p = 0.08) compared with IC1. CONCLUSION:This study demonstrates that an educational intervention combining webinars with in-person interactive courses has a positive effect on general dentists' knowledge of dental trauma.

BACKGROUND:Dentists require continuous professional development (CPD) to maintain and enhance the quality of their services. However, there remains a gap in our understanding of the most effective methods for delivering such professional education. OBJECTIVE:In order to develop CPD that is relevant and effective for general dentists, the aim of this study was to explore general dentists' experiences with and attitudes about two educational formats in dental traumatology: purely theoretical asynchronous webinars versus webinars complemented by an in-person, interactive course. DESIGN, PARTICIPANTS, AND SETTING:All general dentists in the public dental service (PDS) in the Vestland County of Western Norway participated in an educational intervention in dental traumatology between November 2022 and February 2023. We recruited dentists from a group that attended webinars alone (N = 31) and a group that participated in webinars combined with an interactive in-person course (N = 36), referred to as a combined approach. In total, 16 dentists agreed to participate in focus group discussions through the electronic platform Teams. The discussions were video recorded, and the transcripts were analyzed using thematic analysis. Prior to the focus group discussions, participants completed a questionnaire with demographic information and course evaluation. RESULTS:Participants represented diversity in clinical experience, age, gender, and they were overall satisfied with the content, organization, and learning outcomes of the given educational formats. Three themes emerged from the qualitative data analysis: Webinars offer flexibility but with limited learning outcomes; a combined approach supports knowledge application; balancing feasibility with participatory learning. While webinars in dental traumatology as an educational format offer accessibility and flexibility, the combined format made the general dentists reflect more, in addition to gaining ideas on better workflow as a team in their clinical settings. Regarding course design, results revealed the importance of well-structured content, interaction with relevant educators, and the need for a combined educational model. CONCLUSION:The study demonstrates that a combined educational format with high-quality content and a degree of interaction is the preferred method for CPD in dental traumatology for general dentists.

BACKGROUND/AIM:Most children and adolescents in Norway attend the Public Dental Service (PDS) where they are treated free-of-charge until the age of 19 years. Thus, general dentists employed in the PDS are the primary care providers for traumatic dental injuries (TDI) in young patients. This cross-sectional study assessed the knowledge of PDS general dentists on the acute management and follow-up of TDI and its socio-demographic and attitudinal covariates. MATERIALS AND METHODS:All general dentists employed in the Vestland County PDS, Western Norway, (N = 170) received an online questionnaire. Socio-demographic and professional profiles of respondents as well as attitudinal indicators were queried. Clinical case scenarios on emergency treatment and further follow-ups of TDI were used to calculate a dental trauma knowledge score (DTKS; range: 0-21). Mann-Whitney U tests and Kruskal-Wallis tests determined differences between the demographic subgroups. Logistic regressions determined the potential of single factors in explaining the variability in dental trauma knowledge. RESULTS:The response rate was 46%. Most participants (60.5%) had not participated in a TDI course after graduation but would like such a course (84.2%). Mean DTKS was 13.82 (±2.6). Knowledge scores differed significantly between age groups (p = .014) and years since graduation (p = .0018). Younger dentists and recently graduated dentists scored highest. Dentists under the age of 30 years scored higher than 30-39- and 40-49-year-old dentists in these areas: emergency treatment of crown fractures with pulp exposure, identification of complications after avulsion, and management of severe intrusive luxation injury. CONCLUSION:Younger dentists had a higher theoretical knowledge of TDI. Continuing professional development among dentists in the Norwegian PDS is needed for emergency treatment and complication management after TDI.

BACKGROUND/AIM:This study explored perceived challenges in the management of traumatic dental injuries (TDI) among general dentists in the public dental service (PDS) of Vestland County in Western Norway and their needs for improving treatment care for TDI patients. PARTICIPANTS AND METHODS:This qualitative study conducted three focus group discussions. We recruited a purposive sample of seven general dentists employed in the PDS in Vestland County in Western Norway. The three focus groups consisted of two, two, and three participants, respectively. The focus group discussion took place via the Microsoft electronic platform Teams, and it was visual, and audio recorded. Transcripts of the interviews were analyzed using systematic text condensation. RESULTS:The general dentists in this study experienced the management of TDI as a set of complex procedures that require good theoretical knowledge, clinical experience, skills, and teamwork. We were able to group these challenges into three results categories: (1) proficiency challenges, (2) the challenge of stress and discomfort during dental procedures, and (3) the challenge of the organization of the PDS. The participants also expressed the need for practical courses, calibration, and refresher courses in dental traumatology. Their needs fell into two categories: (1) regular, clinically relevant continuing professional development and (2) collective efforts in TDI management. CONCLUSION:Increasing awareness of the challenges in TDI management and addressing the need for improved dental treatment for TDI patients may lead to targeted programs to enhance dentists' knowledge and skills. There is considerable potential for training dentists in dental traumatology.

Lymphatics are involved in the resolution of inflammation and wound healing, but their role in the oral wound healing process after tooth extraction has never been investigated. We therefore sought to evaluate the healing process following the extraction of maxillary molars in two transgenic mouse models: K14-VEGFR3-Ig mice, which lack initial mucosal lymphatic vessels, and K14-VEGFC mice, which have hyperplastic mucosal lymphatics. Maxillary molars were extracted from both transgenic mouse types and their corresponding wild-type (WT) controls. Mucosal and alveolar bone healing were evaluated. A delayed epithelialization and bone regeneration were observed in K14-VEGFR3-Ig mice compared with their WT littermates. The hampered wound closure was accompanied by decreased levels of epidermal growth factor (EGF) and persistent inflammation, characterized by infiltrates of immune cells and elevated levels of pro-inflammatory markers in the wounds. Hyperplastic mucosal lymphatics did not enhance the healing process after tooth extraction in K14-VEGFC mice. The findings indicate that initial mucosal lymphatics play a major role in the initial phase of the oral wound healing process.

Background Biomarkers may be useful in monitoring disease activity in juvenile idiopathic arthritis (JIA). With new treatment options and treatment goals in JIA, there is an urgent need for more sensitive and responsive biomarkers. Objective We aimed to investigate the patterns of 92 inflammation-related biomarkers in serum and saliva in a group of Norwegian children and adolescents with JIA and controls and in active and inactive JIA. In addition, we explored whether treatment with tumor necrosis factor inhibitors (TNFi) affected the biomarker levels. Methods This explorative, cross-sectional study comprised a subset of children and adolescents with non-systemic JIA and matched controls from the Norwegian juvenile idiopathic arthritis study (NorJIA Study). The JIA group included individuals with clinically active or inactive JIA. Serum and unstimulated saliva were analyzed using a multiplex assay of 92 inflammation-related biomarkers. Welch’s t-test and Mann–Whitney U-test were used to analyze the differences in biomarker levels between JIA and controls and between active and inactive disease. Results We included 42 participants with JIA and 30 controls, predominantly females, with a median age of 14 years. Of the 92 biomarkers, 87 were detected in serum, 73 in saliva, and 71 in both biofluids. A pronounced difference between serum and salivary biomarker patterns was found. Most biomarkers had higher levels in serum and lower levels in saliva in JIA versus controls, and in active versus inactive disease. In serum, TNF and S100A12 levels were notably higher in JIA and active disease. The TNF increase was less pronounced when excluding TNFi-treated individuals. In saliva, several biomarkers from the chemokine family were distinctly lower in the JIA group, and levels were even lower in active disease. Conclusion In this explorative study, the serum and salivary biomarker patterns differed markedly, suggesting that saliva may not be a suitable substitute for serum when assessing systemic inflammation in JIA. Increased TNF levels in serum may not be a reliable biomarker for inflammatory activity in TNFi-treated children and adolescents with JIA. The lower levels of chemokines in saliva in JIA compared to controls and in active compared to inactive disease, warrant further investigation.

Huvudpunkter Att välja minimalinvasiva behandlingar, såsom vital pulpabehandling när det är möjligt, förefaller angeläget. Stegvis exkavering minskar sannolikheten för exponering av pulpan i tänder med djupa karieslesioner. Vital pulpabehandling av den exponerade pulpan är ett område under utveckling, men svårigheterna gällande att bedöma graden av irreversibel pulpaskada kvarstår fortfarande.

OBJECTIVE:The aim of this study was to investigate the response of gingival epithelial cells to microbial and inflammatory signals.BACKGROUND:The gingival epithelial barrier provides the first line of defense and supports tissue homeostasis by maintaining the cross-talk between gingival epithelium, oral microbiota, and immune cells. Lymphatic vessels are essential to sustaining this homeostasis. The gingival epithelial cells have been shown to produce prolymphangiogenic factors during physiologic conditions, but their role in response to microbial and inflammatory signals is unknown.METHODS:Immortalized human gingival epithelial cells (HGEC) and human dermal lymphatic microvascular endothelial cells (LEC) were cultured. HGEC were exposed to Porphyromonas gingivalis derived-LPS, human IL-1 beta/IL-1F2 protein, or recombinant human IL-6/IL-6R. Levels of vascular growth factors (VEGF-A, VEGF-C, and VEGF-D) in cell supernatants were determined by ELISA. LEC were grown to confluence, and a scratch was induced in the monolayer. Uncovered area was measured up to 48 h after exposure to conditioned medium (CM) from HGEC. Tube formation assays were performed with LEC cocultured with labelled HGEC or exposed to CM.RESULTS:VEGF-A, VEGF-C, and low levels of VEGF-D were constitutively expressed by HGEC. The expression of VEGF-C and VEGF-D, but not VEGF-A, was upregulated in response to proinflammatory mediators. VEGF-C was upregulated in response to P. gingivalis LPS, but not to Escherichia coli LPS. A scratch migration assay showed that LEC migration was significantly increased by CM from HGEC. Both the CM and coculture with HGEC induced significant tube formation of LEC.CONCLUSIONS:HGEC can regulate production of lymphangiogenic/angiogenic factors during inflammatory insults and can stimulate proliferation, migration, and tube formation of LEC in vitro in a paracrine manner.

Objective To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes. Material and methods In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual. Results 144 and 159 adolescents with JIA were evaluated according to OHI-S and GBI; corresponding numbers of controls were 154 and 161. Plaque and gingival bleeding were more frequent in individuals with JIA than controls. Adjusted analyses showed association between JIA status and OHI-S > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups. Conclusions Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.

Abstract Background Few studies have investigated oral health-related quality of life (OHRQoL) in young individuals with juvenile idiopathic arthritis (JIA). Aims were to investigate whether OHRQoL differs between children and adolescents with JIA compared to controls without JIA, while adjusting for socio-demographic-, behavioral- and oral health-related covariates. Furthermore, to explore whether socio-behavioral and oral health-related covariates of OHRQoL vary according to group affiliation and finally, specifically for individuals with JIA, to investigate whether disease-specific features associate with OHRQoL. We hypothesized that participants with JIA have poorer OHRQoL compared to participants without JIA. Methods In this comparative cross-sectional study participants with JIA (n = 224) were matched to controls without JIA (n = 224). OHRQoL was assessed according to Early Childhood Oral Health Impact Scale (ECOHIS) (4–11-years-olds) and the child version of Oral Impacts on Daily Performances (Child-OIDP) (12–16-years-olds). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-demographic, behavioral and self-reported oral health information collected by questionnaires. Index teeth were examined for caries by calibrated dentists. Multiple variable analyses were performed using logistic regression, reporting odds ratio (OR) and 95% confidence interval (CI). Two-way interactions were tested between group affiliation and the socio-behavioral- and oral health-related variables on the respective outcome variables. Results In total, 96 participants with JIA and 98 controls were evaluated according to ECOHIS, corresponding numbers for Child-OIDP was 125 and 124. Group affiliation was not associated with impaired ECOHIS or Child-OIDP in adjusted analyses (OR = 1.95, 95% CI 0.94–4.04 and OR = 0.99, 95% CI 0.46–2.17, respectively). Female adolescents with JIA were more likely than males to report oral impacts according to Child-OIDP. Continued activity or flare was found to adversely affect Child-OIDP, also self-reported outcome measures in JIA associated with Child-OIDP. Conclusions This study did not provide consistent evidence to confirm the hypothesis that children and adolescents with JIA are more likely to have impaired OHRQoL compared to their peers without JIA. However, female adolescents with JIA were more likely than males to report impacts on OHRQoL. Furthermore, within the JIA group, adolescents with continued disease activity, flare or reporting pain, physical disability, had higher risk than their counterparts of impaired OHRQoL.

Abstract Background Vitamin D deficiency has been associated with autoimmune diseases and oral health. Knowledge about the association between vitamin D status and oral conditions in JIA is limited. We aimed to investigate vitamin D status in a cohort of Norwegian children and adolescents with JIA and possible associations between serum vitamin D levels, clinical indicators of oral health, and JIA disease characteristics. Methods This multi-center, cross-sectional study, included individuals with JIA aged 4–16 years from three geographically spread regions in Norway. Demographic data, age at disease onset, disease duration, JIA category, disease status, medication, and vitamin D intake were registered. One blood sample per individual was analyzed for 25(OH) vitamin D, and the level of insufficiency was defined as < 50 nmol/L. A clinical oral examination was performed applying commonly used indices in epidemiological studies of dental caries, dental erosion, enamel defects, gingival bleeding, and oral hygiene. Serum vitamin D was used as exposure variable in multivariable regression analyses to estimate the associations between insufficient vitamin D level, JIA disease status, and oral conditions, with adjustments for age, sex, geographical region, BMI, seasonal blood sampling, and parental education. Results Among the 223 participants with JIA, 97.3% were Caucasians, 59.2% were girls, and median age was 12.6 years. Median disease duration was 4.6 years, and 44.4% had oligoarticular JIA. Mean serum vitamin D level was 61.4 nmol/L and 29.6% had insufficient levels. Vitamin D levels did not differ between sexes, but between regions, iso-BMI categories, age groups, and seasons for blood sampling. Insufficient vitamin D levels were associated with dentin caries (adjusted OR 2.89, 95% CI 1.43–5.86) and gingival bleeding (adjusted OR 2.36, 95% CI 1.10–5.01). No associations were found with active JIA disease or more severe disease characteristics. Conclusion In our study, nearly 30% had vitamin D insufficiency, with a particularly high prevalence among adolescents. Vitamin D insufficiency was associated with dentin caries and gingival bleeding, but not with JIA disease activity. These results point to the need for a multidisciplinary approach in the follow-up of children with JIA, including an increased focus on vitamin D status and oral health.

HovedbudskapAntall henvisninger til endodontister ved Tannhelsetjenestens kompetansesenter Vest-Hordaland (TkV/H) økte over en fireårsperiode fra 2015 til 2018Ni av ti henvisninger kom fra Den offentlige tannhelsetjenesten (DOT), mens privatpraktiserende tannleger henviste lite.Hovedandel av henvisninger gjaldt pasienter med rettigheter innenfor DOT, hvor barn og unge (gruppe A) utgjorde den største henvisningsgruppen.Sannsynligheten for henvisning til endodontist minker med økt geografisk avstand.Teknisk utfordrende kasus, mangel på utstyr og behov for tverrfaglig samarbeid med andre spesialister var de vanligste årsaker for henvisning.

Objective To estimate the prevalence of dental erosive wear among five-year-olds in Bergen, Norway, and to investigate associations between background factors and the condition. Methods A total of 387 children received a dental examination in five Public Dental Service clinics in Bergen, Norway. The parents responded to items about the children's dental hygiene and drinking habits, type of beverage container, diet, and other habits, and about their own age, educational level and country of origin. We explored background variables for possible associations with the outcome status as worst affected by erosive wear (19.4%,n = 75). Chi-squared statistics and logistic regression (Odds Ratios (OR): 95% Confidence Intervals (CI), served as statistical tools). Results Approximately 80% showed erosive wear (by SEPRS and by adopted diagnostic instrument (78.5%vs79.8%)). The condition affected maxillary anterior teeth in 13.9% (n = 54), and cuppings in molars in 79.3% (n = 307) of cases. Grinding teeth during the day and/or night (OR: 1.87, CI: 1.07-3.25) and male sex (OR: 1.76, CI: 1.05-2.96) significantly related to outcome status as worst affected by erosive wear, respectively. Conclusion Dental erosive wear was widespread. Grinding teeth and male sex associated with outcome status as worst affected by erosive wear.

AIM:The aim of this study was to compare the effects of white MTA-Angelus (wMTA), Biodentine® (Biodentine) and TotalFill® BC Root Repair MaterialTM putty (TotalFill) on human dental pulp stromal cells (hDPSCs) in vitro.MATERIALS AND METHODS:hDPSCs were isolated from third molars of healthy young adults. Material elutes at different concentrations were prepared. Cells were exposed to the eluates for 1, 3, and 7 days. Cell proliferation was evaluated using 3-(4,5-dimethyl-thiazoyl)-2, 5-diphenyl-tetrazolium bromide assay. The expression of alkaline phosphatase (ALP), osteoprotegerin (OPG), osteocalcin (OC), collagen1A (Col1A), runt-related transcription factor 2 (RUNX2), vascular endothelial growth factor-A (VEGF-A), fibroblast growth factor-1 (FGF-1), interleukin 6 (IL6), tumor necrosis factor alpha (TNFα), and interleukin-1-beta (IL1β) was determined by reverse transcription-polymerase chain reaction (RT-PCR). VEGF-A protein levels and ALP activity were quantified in the culture supernatant. Data were analyzed by two-way analysis of variance (ANOVA). p values <0.05 were considered statistically significant.RESULTS:hDPSC proliferation was decreased in a dose-related manner for all materials on day 3. The same effect was observed with wMTA and TotalFill on day 7. RT-PCR showed that Biodentine increased the expression of the osteogenic markers ALP, OPG, and OC. TotalFill decreased the ALP expression and activity, enhanced the production of angiogenic VEGF-A, and downregulated the inflammatory IL6 on day 7.CONCLUSION:Although the tested materials are used interchangeably in vital pulp therapy, the findings showed varied hDPSC responses. Biodentine did not affect cell proliferation and increased the expression of osteo-/odontogenic markers compared to wMTA and TotalFill, whereas TotalFill decreased cell proliferation and exhibited enhanced angiogenic and anti-inflammatory effects over time.CLINICAL SIGNIFICANCE:The clinical significance of the results needs further investigation in an attempt to provide recommendations on the selection of bioceramic pulp capping material under different scenarios of pulpal pathosis.

Hovedbudskap Tannleger i Den offentlige tannhelsetjenesten i to Vestlandsfylker følger stort sett de gjeldende retningslinjer for endodontisk behandling. Yngre tannleger utfører oftere trinnvis ekskavering og behandler mer dyp karies i melketenner enn de mer erfarne tannlegene.

AIM:This case report illustrates the multidisciplinary treatment of a 12-year-old boy with esthetic challenges and endodontic problems in his maxillary incisors after severe dental injury at the age of 2½ years.BACKGROUND:The close anatomic relationship of the primary tooth to the permanent tooth germ explains why traumatic dental injuries in primary dentition may affect the development of permanent teeth especially in the maxillary anterior region. Developmental defects of enamel (DDE) as well as crown/root dilacerations are often seen after displacement injuries such as intrusion or avulsion occurring at lower age.CASE DESCRIPTION:A 12-year-old boy with severe discoloration and enamel hypoplasia of his maxillary incisors was treated with composite restorations. History of avulsion injury of teeth 51 and 61 at the age of 2½ years explained the DDE, the severe dilaceration, and delayed tooth eruption of tooth 21. Use of cone-beam computed tomography (CBCT) was decisive in diagnosis and treatment planning of esthetic concerns and endodontic complications.CONCLUSION:Trauma to primary teeth taking place at early childhood may have severe consequences on permanent successors.CLINICAL SIGNIFICANCE:Severe morphological variations in permanent incisors caused by dental injuries in the predecessor teeth require monitoring and multidisciplinary approach. Advanced three-dimensional radiographic imaging is useful in identification and treatment planning of such cases.HOW TO CITE THIS ARTICLE:Bletsa A, Bessonova MV, Iden O. Using Cone-beam CT in Diagnosis and Management of Severe Dilaceration Following Trauma in Primary Teeth: A Case Report. Int J Clin Pediatr Dent 2020;13(S-1):S110-S114.

Observational studies examining the association between oral health and juvenile idiopathic arthritis (JIA) among children and adolescents have reported inconsistent findings. The aims of this systematic review and meta-analysis were to ascertain a potential difference in oral health and oral health-related quality of life (OHRQoL) among children and adolescents with JIA and healthy peers, and to assess the association of prevalence of oral diseases/conditions, temporomandibular disorders (TMD), including temporomandibular joint (TMJ) diseases, in relation to activity and severity of JIA.Medline Ovid, Embase, CINAHL, SweMed+ and Cochrane Library were searched up to 25 November 2018. All articles published in English, German and Scandinavian languages focusing on children and adolescents with JIA and without JIA in relation to oral health measures, were considered. Two authors independently evaluated observational studies for inclusion. The study quality was assessed using modified Newcastle Ottawa Scale. Meta-analysis was performed for studies focusing on dental caries as an outcome.Nineteen articles met the inclusion criteria, covering a range of oral diseases/conditions and OHRQoL. Eighteen studies had cross-sectional design. No mean difference of dmft/DMFT indices (decayed/missed/filled teeth) was observed between the JIA - and healthy group. None of the oral health measures including dental erosive wear, enamel defects, dental maturation and OHRQoL, indicated better oral health among children and adolescents with JIA compared to healthy group. However, periodontal conditions and TMD were more predominant among children and adolescents with JIA compared to healthy peers.Based on the cross-sectional studies, periodontal diseases and TMD were found to be more frequent in children and adolescents with JIA compared to healthy peers. Furthermore, more high-quality studies with large sample size are needed before we infer any concrete conclusion regarding the association between the prevalence of oral and TMJ diseases or oral conditions in relation to activity and severity of JIA.

Objectives: To collect information on endodontic treatment procedures among dentists in the public dental service (PDS) in Western Norway and relate this information to their work experience. Materials and methods: A survey comprised of 35 questions related to personal information, frequency of endodontic treatment, endodontic procedures and treatment principles was distributed electronically to 187 dentists in PDS in two counties of Western Norway. Results: The response rate was 74%, and 130 dentists participated. Among them, 57.0% had completed their education less than 13 years ago, and almost all were below 39 years old (95%). The majority (81.0%) had graduated in Norway. Stepwise caries excavation in primary and permanent teeth and direct pulp capping in primary teeth were more frequently performed by dentists with less than 13 years from graduation. Routine use of rubber dam was high among the responders (87%). However, use of rubber dam and master-cone radiograph uptakes were more frequent among the younger dentists. The majority used rotary instrumentation systems, and almost all participants followed the current guidelines for use of antibiotics in endodontics. Conclusions: In general, dentists in PDS follow the current endodontic treatment guidelines. However, it seems that the more recently graduated dentists perform more endodontic procedures and tend to adhere more to the taught principles regarding rubber dam use and radiograph uptakes.

This study aims to evaluate fracture resistance of simulated immature teeth after treatment with regenerative endodontic procedure (REP) using tricalcium silicate cements (TSCs) as cervical plugs. Bovine incisors were sectioned to standard crown/root ratio. Pulp tissue was removed and canals were enlarged to a standardized diameter. Teeth were then treated with a REP protocol consisting of NaOCl and EDTA irrigation, intracanal medication with triple-antibiotic paste for 14 days followed by a TSC cervical seal and composite restoration. Teeth were divided into groups according to the material used; Mineral-Trioxide-Aggregate (MTA), Biodentine, TotalFill. Teeth filled with guttapercha (GP) and intact teeth served as controls. All teeth subjected to an increasing compressive force (rate of 0.05 mm/s at a 45° angle to the long axis of the tooth) until fracture. All treated teeth exhibited significantly lower resistance to fracture compared to the intact teeth but no difference was found between the TSC groups (Kruskal-Wallis, Dunn’s multiple comparison, p < .05). TSCs applied at the cervical area of simulated immature teeth treated with REP did not reinforce fracture resistance.