Dentistry Review最新文献

Gingival recession is a prevalent mucogingival deformity and condition associated with teeth, often occurring in patterns involving multiple adjacent sites. This presentation by the patient is frequently framed as an aesthetic concern, because of the imbalance in white and pink esthetic proportions, or related to a complaint of dentin hypersensitivity. The clinician is required to understand the etiologic factors specific to this recession pattern. Modification or management of these factors contributing to multiple adjacent gingival recession should be included as part of the overall treatment plan to increase efficacy of surgical root coverage procedures. The current treatment options for multiple gingival recession include tunneling and coronally advanced flap techniques with varying technical modifications. The aim of this narrative review is to explore the development of these procedures utilized to manage patients presenting with multiple adjacent gingival recession.

This review assesses evolving landscape of mucogingival surgery for treatment of gingival recession and peri-implant mucosal defects, highlighting an increased awareness of the role of soft tissue and advancements in treatment modalities. In response to diverse mucogingival defects, various treatment approaches have been proposed, with ongoing updates in considerations, prognostic factors, as well as the introduction of novel techniques. A comprehensive and up-to-date exploration of the existing literature is therefore required to consolidate the current understanding of mucogingival surgery.

Among all treatment modalities, coronally advanced flap (CAF) and tunneling (TUN) techniques were evaluated for treating gingival recessions and peri-implant mucosal defects, acknowledging challenges due to limited direct comparisons and heterogeneous study groups. While some evidence favored CAF for achieving higher complete root coverage, recent meta-analyses suggest comparable outcomes for both techniques, underscoring the need for better-designed studies.

In conclusion, both CAF and TUN exhibit versatility in mucogingival surgery, with considerations for specific clinical scenarios. Future studies should explore surgical duration, post-operative experiences, and comprehensive outcomes such as patient satisfaction, long-term stability, and esthetic results for a more thorough evaluation of these techniques.

Objective

To assess the correlation between patients with type 1 diabetes mellitus (T1DM) and dental caries outcomes, including missing teeth, missing surface, filling teeth, filling surface, plaque index, gingival index, and calculus index.

Methods

A comprehensive search was performed across EMBASE, Medline/Pubmed, and Web of Science databases from inception until February 20, 2023. Observational and interventional studies reporting dental caries outcomes in patients with T1DM were included. A random effects meta-analysis was performed to estimate the pooled effect sizes and 95 % confidence intervals.

Results

Thirty-three studies met the criteria for inclusion in the meta-analysis, which revealed that patients with T1DM had a reduced risk of missing teeth in comparison to those without diabetes (control group), with a mean difference (MD) of -0.03, CI 95 % [-0.03, -0.03]. No significant differences were found in missing surface, filling teeth, filling surface, or calculus index between T1DM and non-diabetic groups. However, patients with T1DM had a significantly higher plaque index (MD: 0.47, CI 95 % [0.06, 0.89]) than the non-diabetic group. The overall MD in DFMT between the DM and non-DM groups was 0.47 (95 % CI: 0.13, 0.82). The gingival index showed no significant difference between the groups.

Conclusion

This meta-analysis suggests that patients with T1DM have a higher plaque index than the non-diabetic group, whereas no significant differences were observed in other dental caries outcomes. Because of the considerable variability identified in certain analyses, additional research employing more extensive sample sizes and rigorous methodologies is required to validate these results.

This article provides a comprehensive exploration of critical factors influencing optimal outcomes in single-implant restorations in the anterior maxilla. The review delves into key considerations, including peri‑implant mucosal thickness, restorative materials, abutment height, emergence profile, 3-D implant position, and provisionalization timing. It highlights the importance of meticulous planning, from accurate diagnosis to precise implant positioning, while addressing advancements in computer-guided surgery. The present article emphasizes the complex interaction of surgical and prosthetic considerations and the need for a comprehensive approach to achieve success in implant dentistry.

This review highlights the use of optical scanning-based digital technologies in assessing volumetric changes following root coverage therapy. A comprehensive search was conducted in different databases to identify interventional studies reporting on volumetric changes after root coverage surgery using various approaches. 12 articles from 10 studies meeting the inclusion criteria were included in the qualitative synthesis. The documented volumetric outcomes encompassed changes in volume (Vol) measured in mm³, mean distance between surfaces (ΔD) in mm, and linear dimensional changes (LD) in mm. A notable divergence was observed in determining the Region of Interest (ROI). The observed variability in methodologies and outcomes underscores the necessity for standardized approaches and reporting guidelines, enabling volumetric comparisons across different studies and treatments.

Ultrasonography (USG) is a diagnostic imaging technique based on the application of ultrasound waves with a frequency greater than 20.000 Hz, corresponding to the upper limit of audible human sound. The frequencies used in ultrasound imaging typically range from 1 MHz to 16 MHz. The principles and applications of this type of waves were first described by the Curie brothers and despite the time that has passed, their use in dentistry has not currently become widespread. The generation of images in USG is the result of the relationship and behavior experienced by different bodies and structures before the application of ultrasound pulses. Ultrasound imaging and its different modes have been used in different areas of dentistry, surgery, and maxillofacial aesthetics, in the description of cysts and tumors, identification of caries, dental fractures or cracks, periodontal bone defects, maxillofacial fractures, temporomandibular disorders, evaluation of periodontal and peri‑implant tissues, in addition to the identification of anatomical structures in the facial region. Although USG in dentistry offers considerable advantages over other frequently used diagnostic imaging techniques, further research is still required in relation to the equipment used for the study of the maxillofacial area, the different tissues and anatomical spaces that are part of it.

Purpose

The bar-clip retention system is the most retentive; however, the best material choice is questionable. So, this review aimed to answer “How does the material used for overdenture bars influence the results?”.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered in the Open Science Framework. A personalized search strategy was applied in four databases and grey literature. The selection process was carried out in two stages independently by two reviewers according to the eligibility criteria, in vitro or in vivo experimental articles that evaluated the influence of bar material on the results. The risk of bias was analyzed using a checklist of important parameters.

Results

Three hundred and sixty-one articles were found, and after the removal of duplicates, 308 were evaluated, of which six met the eligibility criteria, and all had a low risk of bias. The qualitative analysis was subdivided into stress distribution, bar deformation, clip retention, esthetic, and hygiene.

Conclusion

1) PEEK and BioHPP when compared to metallic alloys, are promising materials for the bar because they have a lower modulus of elasticity, low affinity for bacterial adhesion, and greater esthetic; 2) Clinical studies with longer follow-up times are required to evaluate the biomechanical performance of zirconia bars (ZrO₂) because their stiffness and hardness can lead to increased stress concentration and replacement of the plastic clip, although they are associated with high esthetic and low affinity for bacterial adhesion.

Background

Chronic periodontitis (CP) is a chronic inflammatory disease, primarily caused by microbial infections and characterized by immune system dysfunction. The latter ultimately leads to the progressive destruction of the alveolar bone supporting the teeth in the jawbones. Chronic migraine (CM) is a complex disorder characterized by repetitive episodes of moderate to severe headaches that unfold over hours to days. The episodes are usually unilateral and generally associated with nausea and light and/or sound stimuli sensitivity. The disease is a common cause of disability and loss of working hours, as it significantly burdens the patient's daily life. CP and CM association is clinically relevant as both involve inflammatory mechanisms and immune dysfunction.

Aim

To systematically review the literature on the epidemiological association between CP and CM in adults.

Methods

The study protocol followed the PRISMA 2020 statement. The design of the study adhered to the Cochrane methodology. A comprehensive literature search was conducted in PubMed, Scopus, and Cochrane databases, as well as a manual search and evaluation of gray literature sources. The Review Manager (RevMan) 5.4 software was used for the meta-analysis. The effect size of the outcome was expressed as odds ratio (OR) with a 95 % confidence interval (CI), providing a measure of the association between CP and CM. The Chi-square test and I² statistic were employed to assess heterogeneity among the included studies. The inclusion criteria were English language, observational (case-control) design, and report of the diagnostic criteria for CP and CM. Duplicate entries were excluded. The reliability and quality of the included studies were assessed using the Newcastle-Ottawa Scale (NOS) and GRADE tools. Two independent reviewers performed all evaluations and a third resolved discrepancies.

Results

The meta-analysis included three observational studies with 522 participants. CM patients were 2.82 times more likely to be diagnosed with CP compared with healthy controls. This association was statistically significant (OR 2.82, 95 % CI 1.96–4.05, p < 0.0001); however, the external generalizability is limited because of the examination of data originating from populations with specific ethnic backgrounds.

Conclusion

A high prevalence of CP was found among patients with CM compared with healthy controls. Healthcare professionals should be aware of the correlation between these pathological conditions to provide patients with high-quality care through an effective and comprehensive diagnostic and therapeutic approach.

The oral health needs of patients who have received bariatric surgery are often overlooked. Although bariatric surgery is an effective modality for treating obesity, detrimental oral health sequelae are frequently observed and often neglected. Nutrient deficiencies, changes in salivary pH, gastroesophageal reflux, erosion, xerostomia, caries, wear, and hypersensitivity are all post-operative consequences seen in this patient population. These complications can lead to an accelerated deterioration of the oral cavity and subsequent extensive dental treatment. In some cases, the accelerated deterioration lends them with a terminal dentition. Pre-operative patient education and clearance in conjunction with multidisciplinary care is essential for these patients. In patients with post-operative complications, however, proper prosthodontic management is crucial. This review presents the prosthodontic management and rehabilitation considerations of patients who have received bariatric surgery.

Objective

This study aimed to examine marginal bone loss (MBL) around immediately placed platform-switched implants (PS) compared to platform-matched (PM) implants; and to critically appraise the available literature on this topic.

Materials and Methods

Randomized control trials (RCTs), non- randomized control trials (NRCT) and case series of immediate placement platform-switched and platform-matched implant, published in English were included in the study. Two databases, namely Medline and PubMed covering the period between July 1966 and July 2023 were searched. A total of five case series, five RCTs and one NRCT were included in this systematic review by using pre-defined study selection criteria and following the PRISMA protocol. A critical appraisal of the selected studies was completed using standardized appraisal checklists, including CASP tool for critical appraisal of RCTs, the Downs and Black checklist for NRCT, and the CEBMa checklist for case series studies.

Results

Five studies showed a statistically significant difference in MBL (PS: 0.18–0.78 mm, PM 0.51–1.19 mm). The studies featured a small sample size, and substantial methodological variability in patients’ selection criteria, implant and abutment designs, connection types and surgical protocols. A high risk of bias was identified, especially in case series studies.

Conclusion

The use of PS implants in immediate placement protocols can lead to a statistically significant reduction in MBL compared to PM implants. However, the results need to be interpreted with caution, given the numerous confounding variables and clinical heterogeneity existing between the studies.