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An Investigation Into Contaminated Waste Composition in a University Dental Clinic: Opportunities for Sustainability in Dentistry 大学牙科诊所污染废物成分调查:牙科可持续发展的机遇。
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-29 DOI: 10.1002/cre2.70015
Samuel Yeoh, Yani Bourdamis, Adam Saker, Noah Marano, Liam Maundrell, Poornima Ramamurthy, Dileep Sharma

Objectives

Many international dental organizations have been advocating for sustainable practices in dentistry, whereby significant reductions in environmental impacts are needed. The aim of this study was to analyze dental clinical waste in a university clinic setting to explore opportunities for sustainable practices.

Material and Methods

Fifty dental units (chairs) that are routinely used in delivery of dental treatment and involved supervising clinicians, dental students, and patients were randomly selected, and the clinical waste generated was collected, segregated, and weighed. Statistical analysis was performed to analyze differences in waste production based on treatment performed.

Results

The mean waste production generated by each chair was 81.4 g of aprons, 56.2 g of gloves, 17.2 g of masks, 24.0 g of sterile wrappings, 48.8 g of other plastics, 100.8 g of cellulose-based items, and 25.8 g of miscellaneous items. Higher waste was generated from the chairs performing endodontic procedures when compared with examinations. A potential annual greenhouse gas saving of approximately 10 kg CO2e per year (when one patient is treated daily) can be achieved if sterile wrapping plastics were to be recycled.

Conclusions

Simple yet achievable opportunities for efficient clinical waste management at university clinics exist, which in turn will increase environmental sustainability in the post-COVID-19 era. Increased awareness and incentives for sustainable measures could potentially enhance the possibility of wider adoption of ecofriendly approaches.

目的:许多国际牙科组织一直在倡导牙科的可持续实践,即需要大幅减少对环境的影响。本研究旨在分析一所大学诊所的牙科临床废物,以探索可持续实践的机会:随机抽取了 50 个牙科诊室(椅),这些诊室在提供牙科治疗时经常使用,涉及临床医生、牙科学生和患者,并对产生的临床废物进行了收集、分类和称重。进行了统计分析,以分析根据所进行的治疗而产生的废物量的差异:结果:每台牙科治疗椅产生的平均废物量为 81.4 克围裙、56.2 克手套、17.2 克口罩、24.0 克无菌包装材料、48.8 克其他塑料、100.8 克纤维素类物品和 25.8 克杂项物品。与检查相比,牙髓治疗椅产生的废物较多。如果对无菌包装塑料进行回收利用,每年可减少约 10 千克 CO2e 的温室气体排放(每天治疗一名患者):结论:在大学诊所进行有效的临床废物管理存在着简单而可行的机会,这反过来又将提高后 COVID-19 时代的环境可持续性。提高对可持续发展措施的认识并采取激励措施,有可能促进更广泛地采用生态友好型方法。
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引用次数: 0
The Accuracy of the CBCT-Based 3-Dimensional Replica of the Donor Tooth in Autotransplantation 自体牙移植中基于 CBCT 的供体牙三维复制品的准确性。
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-29 DOI: 10.1002/cre2.70032
Jessica Juslin, Tuija Teerijoki-Oksa, Päivi Jääsaari, Marja Ekholm, Pekka Vallittu, Lippo Lassila, Hanna Thorén

Background

This study evaluated the accuracy of the CBCT reconstruction model compared to the natural tooth and the accuracy of the replica tooth compared to the natural tooth.

Objective

The hypothesis was that a replica tooth could be used as a surgical guide in autotransplantation.

Methods

Three teeth were chosen and a CBCT reconstruction model was formed from each tooth. STL-data was transferred to a milling machine and replica teeth were milled from PEEK. A digitized surface model was prepared from the natural and the replica teeth by a stereophotogrammetry scanner. The surface model from the optical scan of the natural tooth was compared to the CBCT reconstruction model and the surface model of the replica tooth. The models were matched on each other, and surface-based rigid registration was performed between the surface models. Distances were calculated and visualized by MATLAB.

Results

The CBCT reconstruction model and the natural tooth were compared. The largest euclidean distance was found at the root tip in the premolar (0.93 mm) and at the furcation area in the molar (2.3 mm). When the natural tooth and the replica tooth were compared, the largest euclidean distance was found at the root tip in the premolar (1.5 mm) and at the furcation area in the molar (1.9 mm).

Conclusion

A CBCT scan maintains sufficient image quality for tooth autotransplantation planning. The replica tooth corresponded in size and shape to the natural tooth in terms of clinically expected need of precision.

背景:本研究评估了 CBCT 重建模型与天然牙相比的准确性,以及复制牙与天然牙相比的准确性:本研究评估了CBCT重建模型与天然牙相比的准确性,以及仿制牙与天然牙相比的准确性:方法:选取三颗牙齿,将其 CBCT 重建模型与天然牙齿进行对比,并对其准确性进行评估:方法:选取三颗牙齿,并根据每颗牙齿制作 CBCT 重建模型。将 STL 数据传输到铣床,用 PEEK 材料铣出仿制牙。用立体摄影测量扫描仪从天然牙和仿制牙上制作数字化表面模型。将天然牙齿光学扫描的表面模型与 CBCT 重建模型和仿制牙齿的表面模型进行比较。模型相互匹配,表面模型之间进行基于表面的刚性配准。结果:结果:CBCT 重建模型与天然牙齿进行了比较。最大的欧氏距离出现在前臼齿的根尖(0.93 毫米)和臼齿的沟区(2.3 毫米)。将天然牙和复制牙进行比较,发现前磨牙根尖(1.5 毫米)和臼齿沟区(1.9 毫米)的欧氏距离最大:结论:CBCT 扫描为牙齿自动移植规划提供了足够的图像质量。就临床预期的精度要求而言,复制牙齿的大小和形状与天然牙齿一致。
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引用次数: 0
Combined Phase 1/2a Initial Clinical Safety Trials and Proof-of-Concept Assessment of a Novel Antimicrobial Peptide KSL-W Anti-Plaque Chewing Gum 新型抗菌肽 KSL-W Anti-Plaque 嚼胶的 1/2a 期初步临床安全性联合试验和概念验证评估。
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-28 DOI: 10.1002/cre2.943
J. Brett Ryan, Brian J. Kirkwood, Kai P. Leung

Objectives

The effective control of dental plaque is crucial for oral health, given that pathogenic bacteria in plaque are the primary cause of dental caries. Current antimicrobial agents, although effective, disrupt the oral microbiome and lead to oral dysbiosis, hindering efforts to curb dental caries. Novel antimicrobial peptides offer a promising solution due to their selective bactericidal activity against cariogenic bacteria. This study explores the initial safety and efficacy of KSL-W formulated into chewing gum through a Phase 1 and 2a clinical trial.

Methods

The combined trial, approved by the FDA, follows a double-blind, randomized, placebo-controlled design. Phase 1 assessed safety with single doses (2−100 mg), whereas Phase 2a explored both safety and proof of concept in reducing oral bacteria with multiple doses (4−75 mg). Besides adverse events (Phase 1), outcome measures included whole-mouth plaque and gingival index scores and bleeding on probing (Phase 2a).

Results

KSL-W demonstrated safety in both phases, with no severe adverse events. The proof-of-concept analysis revealed a decrease in plaque and gingival inflammation, particularly at doses ≥ 20 mg. The 30 mg dose appeared to yield optimal effects without any adverse reactions in subjects.

Conclusions

Results from this study indicate that KSL-W is safe for use in humans and provides initial evidence of its potential efficacy in reducing plaque and gingival inflammation. Further research is essential to determine optimal usage and ultimate safety, and to assess its potential in diverse populations.

Trial Registration

The trial is registered with the FDA (Trial Registration Number: NCT01877421). The clinical trials were registered in the clinicaltrials.gov database under the title “Safety and Tolerability of Antiplaque Chewing Gum in a Gingivitis Population” and the identifier number is NCT01877421. The URL for accessing the study in clinicaltrials.gov is https://clinicaltrials.gov/study/NCT01877421?intr=Antiplaque%20chewing&rank=1.

目的:有效控制牙菌斑对口腔健康至关重要,因为牙菌斑中的致病菌是导致龋齿的主要原因。目前的抗菌剂虽然有效,但会破坏口腔微生物群,导致口腔菌群失调,阻碍遏制龋齿的努力。新型抗菌肽对致癌细菌具有选择性杀菌活性,因此是一种很有前景的解决方案。本研究通过 1 期和 2a 期临床试验,探讨了将 KSL-W 配制成口香糖的初步安全性和有效性:经美国食品及药物管理局批准,该联合试验采用双盲、随机、安慰剂对照设计。第 1 期评估了单剂量(2-100 毫克)的安全性,而第 2a 期则探讨了多剂量(4-75 毫克)的安全性和减少口腔细菌的概念验证。除了不良反应(1期),结果指标还包括全口牙菌斑和牙龈指数评分以及探诊出血(2a期):结果:KSL-W 在两个阶段都表现出安全性,没有出现严重的不良反应。概念验证分析显示,牙菌斑和牙龈炎症有所减轻,尤其是剂量≥20毫克时。30毫克的剂量似乎产生了最佳效果,受试者没有出现任何不良反应:本研究结果表明,KSL-W 可安全用于人体,并初步证明了其在减少牙菌斑和牙龈炎症方面的潜在功效。进一步的研究对于确定最佳用法和最终安全性以及评估其在不同人群中的潜力至关重要:该试验已在美国食品和药物管理局注册(试验注册号:NCT01877421)。临床试验已在 clinicaltrials.gov 数据库中注册,标题为 "Antiplaque 嚼胶在牙龈炎人群中的安全性和耐受性",标识号为 NCT01877421。在 clinicaltrials.gov 中访问该研究的网址是 https://clinicaltrials.gov/study/NCT01877421?intr=Antiplaque%20chewing&rank=1。
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引用次数: 0
Effects of Adding Tricalcium Silicate Nanoparticles to the Universal G2 Bond Adhesive as Self-Etch Mode on the Shear Bond Strength to the Orthodontic Bracket 在通用 G2 粘接剂中添加纳米硅酸三钙颗粒作为自蚀模式对正畸托槽剪切粘接强度的影响
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-25 DOI: 10.1002/cre2.948
Yasir R. Al-Labban, Mehdi Alrubayee, Syed Jaffar Abbas Zaidi, Shakeel Kazmi

Objective

This study investigated the effects of adding tricalcium silicate nanoparticles (TCSNp) to the universal G2 bond adhesive (G2BU) in self-etch (SE) mode on shear bond strength (SBS) to orthodontic brackets, cytotoxicity, and degree of conversion (DC).

Material and Methods

A total of 176 human teeth were divided into four groups based on TCSNp concentration in G2BU adhesive: 0% (control), 1%, 3%, and 5%. The G2BU adhesive consists of a hydrophilic primer (P) and a hydrophobic bonding agent (2B). TCSNp were added to the 2B component by mixing 0.1, 0.3, and 0.5 g of TCSNp with 9.9, 9.7, and 9.5 g of 2B, respectively. SBS was assessed after 24 h of water storage and 5000 thermocycles using a universal testing machine. Cytotoxicity was evaluated using the MTT assay on rat embryo fibroblast cells, and DC was measured using fourier-transform infrared spectroscopy. Statistical analysis included one-way ANOVA and Tukey's post-hoc test, with significance set at p < 0.05.

Results

After 24 h, mean SBS values were 15.58 MPa (control), 13.66 MPa (1% TCSNp), 15.99 MPa (3% TCSNp), and 12.04 MPa (5% TCSNp). After 5000 thermocycles, SBS values decreased to 12.91 MPa (control), 12.42 MPa (1% TCSNp), 11.11 MPa (3% TCSNp), and 10.21 MPa (5% TCSNp). ANOVA showed significant differences between groups (p < 0.05), except between the control and 3% TCSNp groups. Cell viability increased with higher TCSNp concentrations, with significant differences at 72 h between control and 5% TCSNp groups (p = 0.014). Mean DC values were 51.66% (control), 49.33% (1% TCSNp), 49.66% (3% TCSNp), and 48% (5% TCSNp). ANOVA indicated no significant differences between groups.

Conclusions

Adding TCSNp to G2BU in SE mode maintains clinically acceptable SBS levels and enhances cytocompatibility. Higher TCSNp concentrations may reduce SBS and DC slightly. Further studies are needed to evaluate long-term effects.

研究目的本研究探讨了在通用 G2 粘接剂(G2BU)中添加纳米硅酸三钙颗粒(TCSNp),在自酸蚀(SE)模式下对正畸托槽剪切粘接强度(SBS)、细胞毒性和转换度(DC)的影响:根据 G2BU 粘合剂中 TCSNp 的浓度将 176 颗人类牙齿分为四组:0%(对照组)、1%、3% 和 5%。G2BU 粘合剂由亲水性底漆(P)和疏水性粘接剂(2B)组成。将 0.1、0.3 和 0.5 克 TCSNp 分别与 9.9、9.7 和 9.5 克 2B 混合后添加到 2B 组份中。经过 24 小时的水储存和使用万能试验机进行 5000 次热循环后,对 SBS 进行了评估。细胞毒性采用 MTT 法对大鼠胚胎成纤维细胞进行评估,DC 采用傅立叶变换红外光谱法进行测量。统计分析包括单因素方差分析和 Tukey 的事后检验,显著性以 p 为标准:24 小时后,平均 SBS 值分别为 15.58 兆帕(对照组)、13.66 兆帕(1% TCSNp)、15.99 兆帕(3% TCSNp)和 12.04 兆帕(5% TCSNp)。经过 5000 次热循环后,SBS 值分别降至 12.91 兆帕(对照组)、12.42 兆帕(1% TCSNp)、11.11 兆帕(3% TCSNp)和 10.21 兆帕(5% TCSNp)。方差分析显示各组之间存在明显差异(p 结论:TCSNp 和 TCSNp 在 GBS 中的比例为 1:1:在 SE 模式下向 G2BU 中添加 TCSNp 可保持临床可接受的 SBS 水平并增强细胞相容性。较高浓度的 TCSNp 可能会略微降低 SBS 和 DC。需要进一步研究以评估长期效果。
{"title":"Effects of Adding Tricalcium Silicate Nanoparticles to the Universal G2 Bond Adhesive as Self-Etch Mode on the Shear Bond Strength to the Orthodontic Bracket","authors":"Yasir R. Al-Labban,&nbsp;Mehdi Alrubayee,&nbsp;Syed Jaffar Abbas Zaidi,&nbsp;Shakeel Kazmi","doi":"10.1002/cre2.948","DOIUrl":"10.1002/cre2.948","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the effects of adding tricalcium silicate nanoparticles (TCSNp) to the universal G2 bond adhesive (G2BU) in self-etch (SE) mode on shear bond strength (SBS) to orthodontic brackets, cytotoxicity, and degree of conversion (DC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>A total of 176 human teeth were divided into four groups based on TCSNp concentration in G2BU adhesive: 0% (control), 1%, 3%, and 5%. The G2BU adhesive consists of a hydrophilic primer (P) and a hydrophobic bonding agent (2B). TCSNp were added to the 2B component by mixing 0.1, 0.3, and 0.5 g of TCSNp with 9.9, 9.7, and 9.5 g of 2B, respectively. SBS was assessed after 24 h of water storage and 5000 thermocycles using a universal testing machine. Cytotoxicity was evaluated using the MTT assay on rat embryo fibroblast cells, and DC was measured using fourier-transform infrared spectroscopy. Statistical analysis included one-way ANOVA and Tukey's post-hoc test, with significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 24 h, mean SBS values were 15.58 MPa (control), 13.66 MPa (1% TCSNp), 15.99 MPa (3% TCSNp), and 12.04 MPa (5% TCSNp). After 5000 thermocycles, SBS values decreased to 12.91 MPa (control), 12.42 MPa (1% TCSNp), 11.11 MPa (3% TCSNp), and 10.21 MPa (5% TCSNp). ANOVA showed significant differences between groups (<i>p</i> &lt; 0.05), except between the control and 3% TCSNp groups. Cell viability increased with higher TCSNp concentrations, with significant differences at 72 h between control and 5% TCSNp groups (<i>p</i> = 0.014). Mean DC values were 51.66% (control), 49.33% (1% TCSNp), 49.66% (3% TCSNp), and 48% (5% TCSNp). ANOVA indicated no significant differences between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adding TCSNp to G2BU in SE mode maintains clinically acceptable SBS levels and enhances cytocompatibility. Higher TCSNp concentrations may reduce SBS and DC slightly. Further studies are needed to evaluate long-term effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10203,"journal":{"name":"Clinical and Experimental Dental Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Comparison Between Three Types of Scaffolds for Pulp Regeneration: A Histological Study on Dogs 三种牙髓再生支架的比较:狗的组织学研究
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-23 DOI: 10.1002/cre2.70031
Aliaa Alshahhoud, Mhd. Salem Rikab, Nizar Issa, Ahmad Manadili, Yasser Alsayed Tolaibah

Objectives

This study aims to compare the application of three types of normal scaffolds—native chitosan, enzymatically modified chitosan, and blood clot (BC)—on pulp regeneration in the teeth of experimental dogs through histological examination, to determine the quantity and type of new tissues formed within the root canal.

Materials and Methods

The research sample consisted of 32 root canals from 20 premolars of two male local experimental dogs. The sample was randomly divided into a control group, in which no intervention was performed on the teeth, and three experimental groups based on the type of scaffold used: the BC group, the native chitosan combined with BC (NCS + BC) group, and the enzymatically modified chitosan combined with BC (EMCS + BC) group. Mechanical and chemical cleaning of the canals was performed, followed by the application of the studied scaffolds within the root canals. After 3 months, the teeth were extracted and prepared for histological study, where two variables were studied: the percentage of total vital tissue (soft and hard; VT%) and the percentage of soft vital tissue only (ST%). A one-way ANOVA and Bonferroni tests were used to determine significant differences between the groups at a 95% confidence level.

Results

The VT% values were significantly higher in the EMCS + BC group compared to both the NCS + BC and BC groups. The ST% values were also significantly higher in the EMCS + BC group compared to the BC group. However, no significant differences in ST% values were observed between the NCS + BC group and either the BC or EMCS + BC groups.

Conclusions

Within the limitations of this study, we conclude that the application of enzymatically modified chitosan scaffolds combined with BC yields superior results in pulp regeneration, which contributes to the formation of pulp-like tissue and cells resembling odontoblasts, as well as apex closure with tissue resembling bone tissue.

研究目的本研究旨在通过组织学检查比较三种普通支架--原生壳聚糖、酶改性壳聚糖和血凝块(BC)--在实验犬牙齿牙髓再生中的应用,以确定根管内形成的新组织的数量和类型:研究样本包括两只雄性本地实验犬 20 颗前臼齿的 32 个根管。样本随机分为对照组和三个实验组,对照组不对牙齿进行任何干预,实验组则根据所用支架的类型分为 BC 组、天然壳聚糖与 BC 结合(NCS + BC)组和酶改性壳聚糖与 BC 结合(EMCS + BC)组。先对根管进行机械和化学清洗,然后在根管内应用所研究的支架。3 个月后,拔出牙齿并准备进行组织学研究,其中研究了两个变量:总活力组织的百分比(软和硬;VT%)和仅软活力组织的百分比(ST%)。在 95% 的置信水平下,采用单因素方差分析和 Bonferroni 检验来确定组间的显著差异:结果:EMCS + BC 组的 VT% 值明显高于 NCS + BC 组和 BC 组。与 BC 组相比,EMCS + BC 组的 ST% 值也明显更高。然而,NCS + BC 组与 BC 组或 EMCS + BC 组之间的 ST% 值无明显差异:在本研究的局限性范围内,我们得出结论:应用酶改性壳聚糖支架结合 BC 在牙髓再生方面产生了卓越的效果,有助于形成牙髓样组织和类似牙本质细胞的细胞,以及具有类似骨组织的组织的牙尖闭合。
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引用次数: 0
Tumor Metastasis to the Oral Soft Tissues and Jaw Bones: A Retrospective Study and Review of the Literature 肿瘤转移至口腔软组织和颌骨:回顾性研究与文献综述
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-17 DOI: 10.1002/cre2.70011
Atessa Pakfetrat, Zohreh Dalirsani, Nasrollah Saghravanian, Kazem Anvari, Sajede Asalian, Armaghan Salehi, Mahboobeh Taherizadeh

Objectives

Metastasis to the oral soft tissues and jaw is rare and accounts for 1%–3% of maxillofacial malignancies. These lesions usually occur in the context of an extensive malignant tumor with a poor prognosis.

Materials and Methods

Archived cases from the Oral and Maxillofacial Pathology Department of the Faculty of Dentistry and two hospital centers of Mashhad University of Medical Sciences were examined. Inclusion criteria were cases with available records of pathologically confirmed metastatic lesions of the oral cavity with or without diagnosed primary malignancy.

Results

Metastatic lesions in the oral cavity and jaw were found in 18 patients, including seven women and 11 men, with a mean age of 49.5 years. Metastatic lesions were more common in the jaw (66%) and particularly in the mandible (38%) than elsewhere. In the case of soft tissue metastases, the gingiva was more affected than other sites. The primary tumor was most commonly in the kidney in men and in the breast in women (36%–28%). In addition, the diagnosis of a metastatic lesion led to the detection of the primary tumor elsewhere in six out of 18 cases (33.3%).

Conclusions

Early diagnosis of the lesions is challenging, given the absence of specific signs or symptoms, which, in some cases, nonetheless resemble inflammatory, benign, reactive lesions. Therefore, dentists play a crucial role in diagnosing such lesions, as they lead to the discovery of hidden distant primary tumors. Biopsy should always be considered for suspicious lesions, even if the probability is very low.

目标 转移到口腔软组织和颌骨的情况很少见,占颌面部恶性肿瘤的 1%-3%。这些病变通常发生在预后不良的广泛恶性肿瘤中。 材料与方法 研究对象为马什哈德医科大学牙科学院口腔颌面病理系和两个医院中心的存档病例。纳入标准为有病理证实的口腔转移性病变病例,无论是否确诊为原发性恶性肿瘤。 结果 在 18 名患者中发现了口腔和颌骨转移性病变,包括 7 名女性和 11 名男性,平均年龄为 49.5 岁。与其他部位相比,转移病灶更常见于颌骨(66%),尤其是下颌骨(38%)。在软组织转移病例中,牙龈的受影响程度高于其他部位。原发肿瘤最常见的部位是男性的肾脏和女性的乳房(36%-28%)。此外,在 18 个病例中,有 6 个病例(33.3%)在诊断出转移病灶后发现了其他部位的原发肿瘤。 结论 由于没有特异性体征或症状,病变的早期诊断具有挑战性,在某些病例中,病变类似于炎症、良性和反应性病变。因此,牙医在诊断这类病变方面起着至关重要的作用,因为他们可以发现隐藏的远处原发肿瘤。对于可疑病变,即使可能性很低,也应考虑进行活组织检查。
{"title":"Tumor Metastasis to the Oral Soft Tissues and Jaw Bones: A Retrospective Study and Review of the Literature","authors":"Atessa Pakfetrat,&nbsp;Zohreh Dalirsani,&nbsp;Nasrollah Saghravanian,&nbsp;Kazem Anvari,&nbsp;Sajede Asalian,&nbsp;Armaghan Salehi,&nbsp;Mahboobeh Taherizadeh","doi":"10.1002/cre2.70011","DOIUrl":"https://doi.org/10.1002/cre2.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Metastasis to the oral soft tissues and jaw is rare and accounts for 1%–3% of maxillofacial malignancies. These lesions usually occur in the context of an extensive malignant tumor with a poor prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Archived cases from the Oral and Maxillofacial Pathology Department of the Faculty of Dentistry and two hospital centers of Mashhad University of Medical Sciences were examined. Inclusion criteria were cases with available records of pathologically confirmed metastatic lesions of the oral cavity with or without diagnosed primary malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Metastatic lesions in the oral cavity and jaw were found in 18 patients, including seven women and 11 men, with a mean age of 49.5 years. Metastatic lesions were more common in the jaw (66%) and particularly in the mandible (38%) than elsewhere. In the case of soft tissue metastases, the gingiva was more affected than other sites. The primary tumor was most commonly in the kidney in men and in the breast in women (36%–28%). In addition, the diagnosis of a metastatic lesion led to the detection of the primary tumor elsewhere in six out of 18 cases (33.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early diagnosis of the lesions is challenging, given the absence of specific signs or symptoms, which, in some cases, nonetheless resemble inflammatory, benign, reactive lesions. Therefore, dentists play a crucial role in diagnosing such lesions, as they lead to the discovery of hidden distant primary tumors. Biopsy should always be considered for suspicious lesions, even if the probability is very low.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10203,"journal":{"name":"Clinical and Experimental Dental Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cre2.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142449175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Australian Dentists' Knowledge of the Consequences of Interpretive Errors in Dental Radiographs and Potential Mitigation Measures 澳大利亚牙医对牙科 X 射线照片判读错误后果的认识及潜在缓解措施
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-17 DOI: 10.1002/cre2.70027
Shwetha Hegde, Shanika Nanayakkara, Stephen Cox, Rajesh Vasa, Jinlong Gao

Objectives

Dental radiographs, typically taken and interpreted by dentists, are essential for diagnosis and effective treatment planning. Interpretive errors in dental radiographs, stemming from failures of visual and cognitive processes, can affect both patients and clinicians. This survey aimed to assess the dental practitioners' perceptions of the consequences of these errors and potential measures to minimize them.

Materials and Methods

This online anonymized survey assessed Australian dental practitioners' perceptions of the consequences of these errors and potential mitigation measures using ranking, Likert scale, and open-ended questions. The data were analyzed using descriptive statistics and bivariate analysis.

Results

Participants identified undertreatment (72%) and legal implications (82%) as the most significant consequences of interpretive errors, whereas severe harm to patients was deemed the least likely. Dental practitioners placed a greater emphasis on maintaining a high level of competence and the well-being of their patients. Utilizing high-quality images (63.9%) and appropriate radiographs (59.7%) were identified as the most effective measures to minimize interpretive errors. Participants showed hesitancy regarding the reliance on machine learning as a clinical decision-making tool.

Conclusions

The survey provides valuable practical insights into the consequences and targeted measures to minimize the occurrence of interpretive errors. Efforts to minimize interpretive errors should address patient safety and practitioners' concerns about professional reputation and business viability. The study also suggests further research into the role of machine learning algorithms in reducing interpretive errors in dentistry.

目的 牙科 X 光片通常由牙科医生拍摄和判读,对于诊断和有效的治疗计划至关重要。由于视觉和认知过程的失误而导致的牙科 X 光片判读错误会对患者和临床医生造成影响。本调查旨在评估牙科医生对这些错误后果的看法以及减少这些错误的潜在措施。 材料与方法 该在线匿名调查采用排序、李克特量表和开放式问题的方式,评估了澳大利亚牙科医生对这些错误的后果和潜在缓解措施的看法。采用描述性统计和双变量分析法对数据进行了分析。 结果 参与者认为治疗不足(72%)和法律影响(82%)是解释性错误最主要的后果,而对患者造成严重伤害的可能性最小。牙科医生更重视保持高水平的能力和患者的健康。使用高质量的图像(63.9%)和适当的射线照片(59.7%)被认为是减少判读错误的最有效措施。参与者对依赖机器学习作为临床决策工具表示犹豫。 结论 该调查提供了宝贵的实用见解,帮助人们了解最大限度减少判读错误发生的后果和有针对性的措施。尽量减少解释性错误的努力应解决患者安全问题以及从业人员对专业声誉和商业可行性的担忧。这项研究还建议进一步研究机器学习算法在减少牙科口译错误中的作用。
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引用次数: 0
Association of Periodontal Condition With Impaired Glucose Tolerance: Results of a 15-Year Follow-Up Study 牙周状况与葡萄糖耐量受损的关系:15 年随访研究结果
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-13 DOI: 10.1002/cre2.70023
Ville Myllymäki, Pekka Ylöstalo, Anna Liisa Suominen, Matti Knuuttila, Ulla Rajala, Sirkka Keinänen-Kiukaanniemi, Sirpa Anttila, Tuomas Saxlin

Objectives

The aim of this study was to investigate whether periodontal condition is associated with the development of impaired glucose tolerance (IGT).

Material and Methods

This study was based on a subpopulation of a cohort of persons born in 1935 and living in Oulu, Finland, on October 1, 1990. The participants were normoglycemic (no previously diagnosed diabetes mellitus and a 2-h oral glucose tolerance test [OGTT] blood glucose < 7.8 mmol/L) in the baseline examinations (1990–1992) and had fasting blood glucose < 7.0 mmol/L in the follow-up examinations (2007–2008) (n = 225). The outcome was IGT on follow-up, measured by a blood glucose level of ≥ 7.8 mmol/L after OGTT. The exposure was the periodontal condition at baseline categorized into four groups: 0, 1–6, ≥ 7 sites with deepened (≥ 4 mm) periodontal pockets, and edentulousness.

Results

A total of 23% of the participants developed IGT. The adjusted incidence rate ratios with 95% confidence intervals (CI) for dentate participants with 1–6 sites and ≥ 7 sites with deepened periodontal pockets, and edentate participants (reference category dentate participants without deepened periodontal pockets) were 1.5 (95% CI, 0.6–4.0), 1.8 (95% CI, 0.7–4.4), and 1.6 (95% CI, 0.6–4.0), respectively.

Conclusions

Poor periodontal condition may predispose individuals to IGT; however, further studies on this matter are warranted.

目的 本研究旨在探讨牙周状况是否与糖耐量受损(IGT)的发生有关。 材料与方法 本研究的对象是 1935 年出生、1990 年 10 月 1 日居住在芬兰奥卢的人群中的一个亚群。参与者在基线检查(1990-1992 年)中血糖正常(既往未确诊糖尿病,2 小时口服葡萄糖耐量试验 [OGTT] 血糖为 7.8 mmol/L),在随访检查(2007-2008 年)中空腹血糖为 7.0 mmol/L(n = 225)。随访结果为 IGT,测量指标为 OGTT 后血糖水平≥ 7.8 mmol/L。暴露是基线时的牙周状况,分为四组:0、1-6、≥ 7 个部位牙周袋加深(≥ 4 毫米)和无牙缝。 结果 共有 23% 的参与者患上了 IGT。牙周袋加深 1-6 个部位和≥ 7 个部位的无牙者和无牙齿者(参照类别为无牙周袋加深的无牙者)的调整后发病率比(95% 置信区间)分别为 1.5(95% CI,0.6-4.0)、1.8(95% CI,0.7-4.4)和 1.6(95% CI,0.6-4.0)。 结论 牙周状况不佳可能会导致胰岛素抵抗,但还需要进一步研究。
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引用次数: 0
Periodontal Evaluation for a New Alkasite Restorative Material in Noncarious Cervical Lesions: A Randomized-Controlled Clinical Trial 新型 Alkasite 修复材料对非龋性牙颈部病变的牙周评估:随机对照临床试验
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-10-13 DOI: 10.1002/cre2.70025
Khattab Mustafa, Ghaith Alfakhry, Hussam Milly

Objectives

This study aims to evaluate the periodontal condition adjacent to Cention N (CN) restorations applied for noncarious cervical lesions (NCCL) compared with resin-modified glass ionomer cement (RM-GIC) restorations in terms of plaque accumulation, attachment loss, and gingival inflammation.

Materials and Methods

This is a double-blind split-mouth three-armed randomized-controlled clinical trial. The study arms are RM-GIC (FUJI II LC), CN + adhesive system, and CN + retentive groove. The study included 25 restorations per arm. Follow-ups were performed at 1 week, 3, 6, and 9 months after the application of the restorations. The periodontal condition was evaluated using the plaque index (PI), the bleeding on probing index (BOP), and the probing depth (PD). Appropriate tests were used to perform statistical analyses (α = 0.05).

Results

There was no significant difference between Cention N and RM-GIC regarding the studied variables. However, after the application of the restorations, it was noted that the PI and the PD mean values increased. The average increase after 9 months was 0.06 and 0.34 for PI and PD, respectively, with that of PD being significant. It was also noted that the percentage of positive BOP sites increased at the 1-week follow-up for all study groups and afterward dropped to near preintervention values at the 3-month and later follow-ups.

Conclusions

The two ion-releasing materials Cention N and RM-GIC have a comparable and clinically acceptable effect on the gingival tissue when restoring NCCLs. The combined effect of the gingival retraction cord and the rubber dam clamp on the periodontal tissues might be more important to consider, especially in relation to the probing depth. Future long-term studies are needed to evaluate the effect of Cention N on the subgingival biofilm in comparison with nonion-releasing restorative materials, and subsequently, its effect on gingival inflammation.

Clinical Trial Registration

This clinical trial was registered in clinicaltrial.gov clinical registry under protocol #NCT05593159.

目的 本研究旨在从菌斑累积、附着丧失和牙龈炎症等方面评估用于治疗非龋性颈椎病(NCCL)的 Cention N(CN)修复体与树脂改性玻璃离子水泥(RM-GIC)修复体的邻近牙周情况。 材料和方法 这是一项双盲分口三臂随机对照临床试验。研究臂为 RM-GIC(富士二代 LC)、CN + 粘接系统和 CN + 固位槽。每组包括 25 个修复体。在使用修复体后的 1 周、3、6 和 9 个月进行随访。使用牙菌斑指数(PI)、探诊出血指数(BOP)和探诊深度(PD)对牙周状况进行评估。使用适当的检验进行统计分析(α = 0.05)。 结果 Cention N 和 RM-GIC 在研究变量方面没有明显差异。然而,在使用修复体后,我们注意到 PI 和 PD 的平均值有所增加。9 个月后,PI 和 PD 的平均值分别增加了 0.06 和 0.34,其中 PD 显著增加。同时还注意到,在 1 周的随访中,所有研究组的 BOP 阳性点的百分比都有所增加,之后在 3 个月和更长时间的随访中,BOP 阳性点的百分比下降到接近干预前的数值。 结论 Cention N 和 RM-GIC 这两种离子释放材料在修复 NCCL 时对牙龈组织的效果相当,临床上可以接受。牙龈牵引带和橡胶坝夹对牙周组织的综合影响可能更值得考虑,尤其是与探诊深度有关的影响。今后还需要进行长期研究,评估 Cention N 与非离子释放修复材料相比对龈下生物膜的影响,以及对牙龈炎症的影响。 临床试验注册 该临床试验已在 clinicaltrial.gov 临床注册中心注册,注册号为 #NCT05593159。
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引用次数: 0
Toward Wearables for Bruxism Detection: Voluntary Oral Behaviors Sound Recorded Across the Head Depend on Transducer Placement 开发用于检测磨牙症的可穿戴设备:通过头部记录的自愿口腔行为取决于传感器的位置。
IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-22 DOI: 10.1002/cre2.70001
Mohammad Khair Nahhas, Jens Christoph Türp, Philippe Cattin, Nicolas Gerig, Elisabeth Wilhelm, Georg Rauter

Objectives

Bruxism is a parafunctional orofacial behavior. For diagnosis, wearable devices that use sounds as biomarkers can be applied to provide the necessary information. Human beings emit various verbal and nonverbal sounds, making it challenging to identify bruxism-induced sounds. We wanted to investigate whether the acoustic emissions of different oral behaviors have distinctive characteristics and if the placement of the transducer has an impact on recording the sound signals.

Material and Methods

Sounds from five oral behaviors were investigated: jaw clenching, teeth grinding, reading, eating, and drinking. Eight transducers were used; six were attached to the temporal, frontal, and zygomatic bones with the aid of medical tape, and two were integrated into two commercial earphones. The data from 15 participants were analyzed using time-domain energy, spectral flux, and zero crossing rate (ZCR).

Results

In summary, all oral behaviors showed distinct characteristic features except jaw clenching, though there was a peak in the recording, possibly due to tooth tapping, before its expected onset. For teeth grinding, the transducer placement did not have a significant impact (p > 0.05) based on energy, spectral flux, and ZCR. For jaw clenching, the transducer placement had an impact with regard to spectral flux (p < 0.01). For reading and eating, the transducer placement had a significant impact with regard to energy (p < 0.05 for reading, p < 0.01 for eating), spectral flux (p < 0.001 for reading, p < 0.01 for eating), and ZCR (p < 0.001 for both reading and eating). For drinking, the transducer placement only had a significant impact with regard to ZCR (p < 0.01).

Conclusions

We were able to record the sounds of various oral behaviors from different locations on the head. However, the ears were an advantageous location to place the transducer, since they could compensate for various head movements and ear devices are socially tolerable.

目的:磨牙症是一种副功能性口颌行为。在诊断时,可将声音作为生物标记的可穿戴设备可提供必要的信息。人类会发出各种语言和非语言的声音,因此识别磨牙症引起的声音具有挑战性。我们希望研究不同的口腔行为发出的声音是否具有不同的特征,以及传感器的位置是否会对声音信号的记录产生影响:我们调查了五种口腔行为发出的声音:下颌紧咬、磨牙、阅读、进食和饮水。共使用了八个换能器,其中六个用医用胶带粘贴在颞骨、额骨和颧骨上,另外两个集成在两个商用耳机中。使用时域能量、频谱通量和过零率(ZCR)对 15 名参与者的数据进行了分析:总之,除下颌紧握外,所有口腔行为都表现出明显的特征,但在其预期开始前,记录中出现了一个峰值,可能是由于牙齿敲击造成的。对于磨牙,根据能量、频谱通量和 ZCR,换能器的位置没有显著影响(p > 0.05)。对于下颌紧咬,换能器的位置对频谱通量有影响(p 结论:对于下颌紧咬,换能器的位置对频谱通量有影响:我们能够从头部的不同位置记录各种口腔行为的声音。不过,耳朵是放置传感器的一个有利位置,因为耳朵可以补偿头部的各种运动,而且耳部装置在社会上是可以容忍的。
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引用次数: 0
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Clinical and Experimental Dental Research
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