Clinical and Experimental Dental Research最新文献

Objectives

Chronic kidney disease (CKD) is relatively common in patients with rheumatoid arthritis (RA). Periodontitis and periodontopathic Porphyromonas gingivalis are risk factors for CKD. However, the association of serum immunity to P. gingivalis and its peptidylarginine deiminase (PPAD), as well as periodontitis severity, with CKD in relation to RA has not been elucidated. The present study evaluated whether or not serum immunoglobulin G (IgG) titers against P. gingivalis and PPAD and periodontitis severity are associated with CKD in patients with RA and periodontitis.

Methods

Demographic, comorbidity, rheumatologic, and periodontal data were collected from 127 patients with RA and periodontitis in a retrospective cohort study. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or proteinuria of ≥ 3 months’ duration. Serum IgG titers against P. gingivalis and PPAD were determined using an electrochemiluminescence immunoassay.

Results

Twenty patients showed an eGFR < 60 mL/min/1.73 m², while no patients had proteinuria. The 20 CKD patients were significantly older (p = 0.002), had higher percentages of former smokers (p = 0.01), had more sites with probing depth and clinical attachment level ≥ 4 mm (p = 0.03 and p = 0.02), and had higher levels of serum creatinine and eGFR (p < 0.001 for both) and anti-P. gingivalis IgG titers (p = 0.04) than the 107 non-CKD patients. A significant association was observed between anti-P. gingivalis IgG titers and eGFR (p < 0.001 for both) by bivariate and multivariate analyses and between anti-P. gingivalis IgG titers and CKD (p < 0.001) using a multiple logistic regression analysis after adjusting for age, gender, smoking status, comorbidity, RA condition, and RA-related drugs.

Conclusions

These results suggest that serum IgG titers against P. gingivalis, but not against PPAD, are associated with CKD in patients with RA and periodontitis.

Purpose

The objective of this study was to biomechanically compare the All-on-Four and All-on-Six implant configurations combined with various framework materials by assessing stress distribution in peri-implant bone, implants, and prosthetic structures using finite element analysis (FEA).

Materials and Methods

This study investigated the biomechanical behavior of six different framework materials titanium, zirconia, PEEK, PEKK, Trilor and Trinia in full-arch, implant-supported fixed prostheses using the All-on-Four and All-on-Six concepts in a total edentulous mandible. A three dimensional finite element model of the mandible, incorporating cortical and trabecular bone as well as mucosal tissue, was developed based on CBCT data. In the All-on-Four configuration, two anterior implants were placed axially and two posterior implants were tilted distally at 30°. The All-on-Six model featured axially placed anterior implants, with posterior implants angled at 15° in the premolar and 30° in the molar regions. Multi-unit abutments were used for all implants. Frameworks were digitally designed in a Toronto prosthesis configuration using each material, and a monolithic zirconia superstructure was applied as the veneering material. All models were subjected to a simulated vertical masticatory load of 150 N. Maximum principal stress values were assessed in the peri-implant bone, while von Mises stress distributions were analyzed in the framework, implants, and fixation screws.

Results

The highest stress accumulation was observed in the All-on-Four configuration, particularly around the cantilever region and distal implants. Materials with low elastic modulus (PEEK and PEKK) caused higher stress transmission to peri-implant bone and connection components. In contrast, rigid materials (titanium and zirconia) provided a more balanced load distribution and resulted in lower stress concentrations. Glass fiber-reinforced composite frameworks (Trilor and Trinia) remained within clinically acceptable biomechanical limits.

Conclusion

The findings of this study indicated that both implant configuration and framework material properties play a critical role in the biomechanical performance and long-term success of the prosthesis.

Objectives

The aim of this systematic review and meta-analysis was to evaluate the impact of open proximal contacts on peri-implant tissue changes, specifically marginal bone levels, probing pocket depth, and the incidence of peri-implant diseases.

Methods

Electronic databases were searched to identify non-randomized observational studies comparing open and closed proximal contacts. Risk of bias was assessed using the Cochrane Collaboration's tool and data were analyzed with a statistical software.

Results

Out of 276 studies initially identified, five met the inclusion criteria, involving 4882 dental implants. Meta-analysis indicated that open proximal contacts were associated with greater, but not statistically significant, marginal bone changes (mean difference (MD) 0.07; 95% confidence interval (CI) −0.09 to 0.24; p = 0.38); probing pocket depths (MD 0.11; 95% CI −0.29 to 0.51; p = 0.59) and a higher incidence of peri-implantitis (relative risk (RR) 1.63; 95% CI 0.88–3.02; p = 0.12) compared to closed contacts. Open proximal contact was associated with a significant increase in incidence of peri-implant mucositis (RR 1.74; 95% CI 1.06–2.86; p = 0.03).

Conclusions

Open proximal contacts are associated with increased probing pocket depths and marginal bone changes and could be a risk indicator for peri-implant mucositis. Further research is needed to assess long-term effects and to develop preventive measures.

Objectives

This RCT study aimed to investigate the clinical performance of IPS e.max endocrowns as an alternative option compared to conventional crowns to restore damaged molar teeth after an 18-month follow-up.

Materials and Methods

A sample of 30 patients with 40 molars, who needed a single-tooth restoration, was enrolled to receive either a conventional crown (n = 20) or an endocrown (n = 20). After molar preparation, all crowns were manufactured with the IPS e.max press system, then cemented using dual-cure resin. All crowns were assessed using the modified United States Public Health Service criteria (USPHS) at baseline, 6, 12, and 18 months following placement. Patient satisfaction was evaluated using a questionnaire. Statistical analyses were performed using Mann-Whitney U and Friedman tests (95% confidence interval).

Results

All teeth in the conventional crown group and endocrown group showed 100% clinical success with no failure at 6, 12, and 18 months after placement in terms of marginal adaptation, contact points, and surface texture. No significant difference was found between endocrowns and conventional crowns in adhesive failure at 6 months (p = 0.075), 12 months (p = 0.317), and 18 months (p = 1.000). 100% of patients were very satisfied with the esthetics and comfort of the prosthesis. The function percentage was 93.3%.

Conclusions

Both restorative options are durable and maintain their integrity. Adhesive failure occurred in a notable number of cases in the endocrown group compared to the conventional crown group. Patient satisfaction was high with both restoration types.

Objectives

In craniofacial disorders (CD) like cleft lip and/or palate (CL/P), Robin sequence (RS) or Down syndrome (DS), an early orthodontic intervention with different palatal plate devices is often applied. However, there are no data on complications such as mucosal ulcerations (MU).To determine the frequency and location of MU and evaluate associations with potential risk factors such as CD type, sex, appliance type, cleft location, underlying syndrome, and anatomical cleft morphology.

Materials and Methods

In a retrospective analysis, we searched our electronic patient records of newborn patients with CD admitted 01/2020-12/2022 for documented MU. For comparisons, Pearson's Chi-square or Fisher's Exact test were used, statistical significance was set at p < 0.05.

Results

A total of 248 patients (132 female, age range: 0–580 days) receiving 510 palatal plates were treated (51% CL/P, 26% RS; 24% DS); 81/248 (33%) infants had MU, occurring with 112/510 appliances (22%). MU were most common in RS patients (61/69; 88%), followed by CL/P (21/111; 19%). No MU were found in DS. MU occurrence differed significantly by type of orthodontic palatal plate (p < 0.0001). There was no significant association between sex, cleft location, presence of an underlying syndrome or cleft morphology and the occurrence of MU.

Conclusions

MU are common during palatal plate therapy. Our findings suggest that MU are correlated with both, the device's function and the mucosal load it applies. Parental training in device use and oral inspection, along with regular clinical check-ups, is advised to identify MU early, increase appliance quality and patient comfort.

Objectives

This study aimed to investigate the effect of erythritol air-polishing on implant surface topography and bacterial colonization, and to determine the antimicrobial activity of erythritol powder.

Materials and Methods

Titanium implants, with machined/acid-etched hybrid design, were divided into three groups: erythritol air-polishing for 1 min (E1), 5 min (E5), and untreated control. Surface analysis was performed using a stylus profilometer and scanning electron microscope (SEM). To test the ability to prevent biofilm formation, four bacteria strains (Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus mutans, Streptococcus sanguinis) were separately cultured on five implants per group and colony counting was performed. The intrinsic erythritol antibacterial activity was investigated by means of minimum inhibitory concentration against the same strains.

Results

At SEM analysis implant surfaces appeared unaltered by air-polishing and presented increasing amount of residues depending on the treatment duration. Machined surfaces exhibited no significant differences in roughness parameters between the groups. On acid-etched surfaces, E5 presented significantly lower Ra (vs. E1 and control) and Rz (vs. control). The count of colonies was significantly lower for all bacterial strains on treated implants as compared to control, with E1 and E5 being equally capable to reduce by 1.5 log bacteria growth. Erythritol antimicrobial activity against all tested bacterial strains was confirmed.

Conclusions

The proposed erythritol air-polishing protocols did not alter implant surfaces and the antimicrobial properties of erythritol are conserved by the titanium implant surfaces.

Clinical Relevance

Erythritol air-polishing could be repeatedly used in supportive peri-implant care programmes.

Background

The articular eminence is essential for the proper functioning of the temporomandibular joint (TMJ), guiding the movement of the mandibular condyle along its posterior slope. Changes in the inclination of the articular eminence (AEI) can occur as a result of tooth loss or aging. The objective of this study was to investigate the association between the AEI and the Eichner Index.

Materials and Methods

The study analyzed 162 cone beam computed tomography (CBCT) images from patients with TMJ dysfunction. These images were categorized into three groups (A, B, and C) according to the Eichner Index. The posterior surface of the AEI was measured using the top-roof line method. An ANOVA test was conducted to assess the relationship between the Eichner Index and AEI.

Results

A statistically significant relationship has been found between the AEI and the Eichner Index (p = 0.005). Class C had a significantly lower inclination than Classes A and B.

Conclusion

This study revealed that tooth loss impacts the AEI, with patients who have more missing teeth exhibiting a significantly flatter AEI. To prevent morphological changes and potential future issues in the TMJ, it is essential to ensure proper dental care and maintain occlusal support for these patients.

Objective

To assess how chronotherapy influences recovery after bilateral third molar extraction when Dexketoprofen is administered as an anti-inflammatory agent.

Material and Methods

A randomized cross-over controlled trial with 10 patients with bilateral impacted third molar extraction was enrolled. For 7 days after the surgery, the chronotherapy group was prescribed one dose of Dexketoprofen (25 mg) limited to daytime, while the control group were given two doses per day (every 12 h). Pain intensity was recorded at baseline, 24, 48, and 72 h, while facial swelling parameters were evaluated at baseline, 24, 72, and 168 h (Day 7) postoperatively. Also, the inflammatory profile was analyzed for each patient by blood samples at baseline, 72 and 168 h. The concentrations of IL-1β, IL-1a, IL-2, IL-4, IL-6, IL-7, IL-10, and IL-13 were measured using high-sensitivity multiplex map human immunoassays.

Results

No significant differences in postoperative VAS pain, swelling, and mouth opening (trismus) measures were observed between the two groups. However, the chronotherapy group had reduced overall postoperative complications compared to the control group. Regarding postoperative recovery, pain intensity scores in the chronotherapy group at 24, 48, and 72 h indicated a faster recovery than the control group. Blood samples analysis showed no statistical differences between the different inflammatory markers studied at 72 h or Day 7 in both groups.

Conclusions

Daytime administration of NSAIDs might be sufficient to manage postoperative pain after third molar extraction, and complications were similar between both groups.

Clinical Trial Registration: clinicaltrials. gov, Identifier database: NCT05176158.

Purpose

Guided endodontics allows precise access in challenging cases such as calcified canals; however, drilling can generate temperature increases that risk damaging periradicular tissues. This study aimed to evaluate the influence of different sleeve materials—zirconia, cobalt-chromium (CoCr), and titanium—on temperature changes during guided endodontic access using finite-element analysis (FEA).

Materials and Methods

High-resolution three-dimensional (3D) models of a human central incisor and titanium sleeve were developed using micro-computed tomography (micro-CT), 3D Slicer, Meshmixer, and SolidWorks. FEA simulations were conducted in Abaqus under a 2° deviation and 700 rpm drilling, with thermal properties based on literature. Experimental validation employed thermocouples to determine the temperature changes under identical conditions.

Results

Results showed that zirconia sleeves produced the lowest temperature elevation (< 10°C) with localized concentration, while CoCr and titanium allowed more even heat dissipation.

Conclusion

Zirconia is an effective insulator due to its thermal conductivity properties. CoCr has emerged as a promising alternative to titanium, offering more favorable thermal and mechanical characteristics.