Dentistry Review最新文献

Predictable three-dimensional repair of the lost periodontal tissues due to disease remains to be the goal of periodontal therapy. The dynamic process of periodontal regeneration uses particulate bone graft from various sources that function as scaffolds facilitating attachment, induction, and regeneration. Historical reports have documented the use of bone grafts with or without barrier membranes to achieve positive outcomes for periodontal regeneration and reconstruction of alveolar ridge prior to implant placement. Particulate bone grafts can be defined based on their source of obtainment as autografts, allografts, xenografts and alloplasts. Autografts and allografts have human origins, where autografts are tissues transplanted within the same individual from one part of the body to another and allografts are those that are surgically transplanted from one individual to another. Xenografts are tissues that are transplanted from one species to another. Alloplasts on the other hand are synthetic/ man-made and are manufactured from various materials to facilitate guided tissue and bone regeneration. This narrative review focuses on particulate bone grafts and bone substitutes used in regenerative and reconstructive surgical dental therapies with supporting case presentations.

Objetive

This systematic review aimed to evaluate whether the use of HA could be considered an effective treatment approach for the restoration of papillary defects.

Material and methods

This study was registered on the PROSPERO. A systematic search was performed on five electronic databases for articles published up to May 2022. The meta-analysis was performed using the R program. The risk of bias and quality was assessed using the RoB 2.0 and National Institutes of Health, respectively.

Results

Eighteen studies were included with a total of 213 participants with 696 interdental papillary defects. All included studies reported promising results on the reconstruction of the deficient interdental papilla after injection of HA. Single-arm meta-analysis indicated a proportion of 47% (confidence interval [CI]:35–59%) of sites evaluated with complete interdental papilla reconstruction (100% of reconstruction). Partial interdental papilla reconstruction (range from: 2.1% to 96% reconstruction) was reported by 49% (CI:40–59%) of sites evaluated. Five studies evaluated patient-reported outcome measures. An increased satisfaction was observed after the injection of HA without significant pain after the evaluation periods. Randomized controlled trials (RCT) studies presented a low and unclear risk of bias, while uncontrolled studies were classified as having good quality.

Conclusion

The short-term analysis indicated that the injection of HA for the treatment of papillary defects is considered a feasible treatment achieving esthetic satisfactory results with minimum pain. However, further well-conducted RCT studies with standardized parameters and long-term follow-up should be recommended.

Alzheimer's disease (AD) is one of the most prevalent progressive neurodegenerative disorders and among the leading causes of mortality globally. AD is characterized by continued cognitive and behavioral impairments associated with memory loss, difficulty with reasoning, and language impairment. In parallel, periodontal disease (PD) is a prevalent chronic disease, affecting one in two adults, with associations to various systemic disease. Recently, pre-clinical and clinical studies have elucidated associations between PD and AD. The most recent evidence suggests a bi-directional relationship between both disease entities. However, a causal relationship between PD and AD has yet to be established. In this review, we aim to provide an overview of the pathogenesis of PD and AD, and present the main theories behind the link between PD and AD, the role of periodontal pathogenic bacteria on the onset and progression of AD, and emerging clinical evidence on the relationship between PD and AD.

Objectives

To collate and summarize existing evidence for the use of cannabis and cannabinoids to treat chronic orofacial pain (COP) by oral and maxillofacial surgeons (OMFS), oral medicine specialists (OMS), and orofacial pain specialists (OPS).

Data

We systematically screened for sources including a measure of effect of a cannabinoid compound on pain in COP patients that might be treated by our target specialists. Sources were selected by two authors independently. Sources were summarized by country, publication date, objective(s), COP condition(s) studied, cannabinoid(s) studied, methods, results, limitations, and conclusions. A thematic analysis and word cloud were conducted to elucidate commonalities, emphases, and gaps amongst identified sources.

Sources

Retrieved from MEDLINE, EMBASE, Web of Science Core Collections, Dentistry and Oral Sciences, DARE, CCRCT, and US National Institute of Health and Controlled Trials Register.

Study Selection

Of 705 retrieved titles, 8 met inclusion/exclusion criteria and were included for review. Included sources dealt with COP attributed to: head and neck cancer (3), multiple sclerosis-related trigeminal neuralgia-like symptoms (2), post-herpetic neuralgia (1), temporomandibular dysfunction (1), and primary burning mouth syndrome (1). Cannabinoids studied included: self-administered cannabis (3), topical N-palmitoyle-thanolamine (1), topical cannabis extract (1), cannabis sativa oil (1), nabiximols oromucosal spray (1), and nabilone (1).

Conclusions

Most sources concluded their respective cannabinoid treatments to provide some therapeutic benefit for COP (6 of 8) and all concluded their treatments to be safe. Current research is wholistically focused, recording outcome measures for pain, anxiety, depression, quality of life, functional disability. Cannabinoids are most often studied as adjunctive and palliative treatments.

Clinical significance

Cannabinoids are becoming increasingly accessible and might benefit many COP patients. Patients and clinicians require more and higher quality evidence to make confident and informed decisions regarding treatment of COP with cannabis or cannabinoids. This review summarizes current evidence for patients, clinicians, and future researchers.

Objective

The purpose of this scoping review is to show the evidence available in the literature and provide an overview of the antimicrobial-containing mouthwashes for reducing viral load in order to group the most up-to-date information and make it more accessible to dentists.

Design

A structured electronic search in PubMed (Medline), LILACS, EMBASE and EBSCO without temporal restriction was performed. The studies were selected based on their title, abstract and full reading following a pre-established order based on the inclusion and exclusion criteria. The included studies were those that analyzed the effect of viral load reduction by mouthwashes, primary studies, no reviews and in Spanish, English or Portuguese.

Results

The search resulted in 1881 articles, at the end of the exclusion of duplicates and selection, 71 articles were included in this scoping review. The substances most commonly found were chlorhexidine (CHX), povidone-iodine (PVP-I), essential oils (EO), cetylpyridinium chloride (CPC), hydrogen peroxide (H2O2) and other substances (OTHERS).

Conclusion

Of all the mouthwashes analyzed, the Essential oils, Cetylpyridinium Chloride and Povidone-iodine, showed antiviral potential against common viruses present in the oral cavity, with no significant side effects in short-term use, and are viable options for use as a pre-procedure in clinical routine against SARS-CoV-2 and other types of viruses. The other solutions need further studies to determine their effect and confirm their clinical use.

Dental treatment after endodontic therapy is quite challenging in clinical practice. While multiple post-and-core systems emerged and disappeared in the dental field, the historical process was laborious and still requires several up to date scientific evidence. Furthermore, once considered the gold standard, rigid metallic post-and-cores might be considered a limited option. Moreover, the development of glass-fiber posts and the biomechanical principles for root preparation bring multiple advantages, but also raise concerns over guidelines and indications. This review examined the classic literature so that clinicians may understand the concepts behind post endodontic restorative treatments and the doubts that still remain in the daily practice before performing this restorative modality.

Objectives

Functional and esthetic crown lengthening surgery (CLS) is one of the most common surgical procedures in periodontal practice. The healing time necessary to achieve stable periodontal tissues, including the supracrestal gingival tissue (SGT) dimensions, biologic width, and gingival margin position following CLS has been investigated, although conflicting results have been reported. The positional stability of the periodontal tissues may be influenced by anatomical factors such as the periodontal phenotype and variability in the biologic width, in addition to factors related to surgical technique such as the ostectomy approach and the postoperative position of the flap margin. In this review, we have attempted to answer a number of research questions related to the recovery time and stability of the periodontal tissues after CLS.

Data, sources and study selection

Randomized controlled trials and clinical observational studies with a minimum follow-up of three months to assess the periodontal tissues after CLS were included. In vitro studies, animal studies, and case report were excluded. Searches were performed using PubMed, SCOPUS, Web of Science, and Google Scholar electronic databases for articles published until April 1, 2022.

Conclusions

Significant coronal rebound of the gingival margin can occur after CLS. The periodontal phenotype affects both gingival margin rebound and the healing time, while the surgical technique affects the short-term results and procedure-related morbidity. The amount of osseous resection must be determined on the basis of the individual's baseline SGT dimensions. An adequate healing time (≥3 months) after CLS with ostectomy should be respected to achieve stable and predictable results before placement of the permanent restoration.

Clinical significance

The positional stability of the gingival margin after crown lengthening surgery is affected by factors related to the periodontal anatomy and surgical technique, and stable and predictable positions can be achieved by allowing an appropriate healing time of at least 3 months.

Objective

This review aims to collate the current knowledge in the field of antimicrobial surfaces on dental implant materials, focusing on microbial population and functional responses, predominantly from omics-based studies.

Design

Extensive searching of Scopus and Pubmed databases informed a narrative review on the antimicrobial impact of implant surfaces on the complex oral microbiome.

Results

The awareness of this issue has led to considerable research resources being directed towards the augmentation of implant surfaces to counteract microbial colonization. Whilst the implant material itself has a direct influence on bacterial adhesion and viability, the surface finish and putative antimicrobial coatings are critical to countering early biofilm formation. Multiple modes of surface modification have been developed to counteract early colonization, including direct physical contact effect, such as anti-adhesion strategies and extract effects, through antimicrobial release chemistry or material leaching. These concepts deploy different techniques, including nano-texturing, surface chemistry alteration and controlled release, each with a diverse set of benefits and drawbacks. Novel surface finishes and coatings require investigation with regards to their influence on oral biofilms, whether on individual bacterial species or against mature biofilms.

Conclusion

The search for optimal implant surfaces is necessary for the reduction of the peri-implantitis burden and the longevity of dental implants. To date, next generation sequencing methodologies, enabling a greater depth of understanding of the complex interactions between oral microorganisms, host response, and implant surface coatings are under used in this area of research.

Purpose

To summarize the effectiveness of non-invasive and minimally invasive root caries preventive interventions in older adults.

Methods

An electronic search was conducted in PubMed up to February 18, 2021. Only randomized controlled trials (RCTs) published in English language with root caries outcomes measured on older adults were included in this review. Studies were eligible if assessing the efficacy of either topical fluoride varnish/gel, chlorhexidine (CHX), atraumatic restorative treatment (ART), or silver diamine fluoride (SDF) to prevent and/or arrest root caries in older adults.

Results

A total of 16 RCTs were included in this review. No significant differences were found between conventional therapy with rotary instruments and ART with hand instruments in survival rates of restorations in four studies. 1% CHX varnish (every 3 months), 5% sodium fluoride (NaF) varnish (every 3 months) and 38% SDF solution applied annually in addition to OHI were more effective preventing new root caries than OHI alone over a period of 3 years (with no differences between the 3 interventions). A 0.2% neutral NaF mouth rinse used daily reduced the incidence of caries among elders in long-term facilities and performed better than 0.12% CHX. The number of new lesions in the 1.2% acidulated phosphate fluoride (APF) gel group was significantly lower than in the placebo rinse group (P < 0.05), however the fluoridated mouth rinse group had more reversed root lesions. 38% SDF solution applied annually in combination with oral health education (OHE) every 6 months was efficacious in arresting and preventing root caries among older adults. The combination of Cervitec™ (1%CHX/1% thymol varnish) and fluoride varnish was successful in arresting exisiting root caries in a group of frail older adults compareed to fluoride varnish alone.

Conclusions

Multiple minimally invasive interventions showed significant improvements in arresting and preventing root carious lesions in older adults compared to control groups, including the use of 0.2% neutral NaF mouth rinse, 1% CHX varnish, Cervitec™, APF gel and annual application of SDF combined with oral health education. However, further studies are needed to confirm these results as few studies could be found for each intervention.