Clinical, Cosmetic and Investigational Dentistry最新文献

Background: Temporary restorations play a crucial role in oral rehabilitation. The development of CAD/CAM technology and 3D printing has expanded the use of polymethyl methacrylate (PMMA) and polyetheretherketone (PEEK) in the fabrication of provisional restorations. While both materials are widely used, their mechanical behavior under simulated long-term clinical conditions remains largely ununderstood.

Aim: This study aims to compare the flexural strength of CAD/CAM milled PMMA and CAD/CAM 3D-printed PEEK provisional crowns that were subjected to thermocycling and cyclic loading, simulating the aging protocols designed to replicate long-term clinical use.

Materials and methods: A total of 54 provisional crowns (n = 27 per group) were fabricated from PMMA and PEEK. All specimens underwent an aging protocol consisting of 2500 thermal cycles (5°C-55°C) and 600,000 mechanical loading cycles (50 N, 1.6 Hz). Flexural strength was assessed using a universal testing machine. Fracture load values were analyzed using descriptive statistics and compared using the Mann-Whitney U-test (p < 0.05).

Results: PEEK crowns exhibited significantly higher mean fracture load values (2.441 ± 0.573 kN) than PMMA (1.860 ± 0.517 kN), with a statistically significant difference (p = 0.0004). PEEK specimens demonstrated consistent mechanical performance and ductile failure patterns, while PMMA crowns showed brittle fractures and greater variability.

Conclusion: 3D printing PEEK provisional crowns demonstrated superior flexural strength compared to milled PMMA under simulated aging conditions. PEEK represents a promising material for long-term provisional use, particularly in high-load clinical scenarios.

Background: Significant maxillary atrophy poses a considerable obstacle for oral restoration with standard dental implants because of insufficient bone supply. Zygomatic implants provide alternative treatments without a graft by being secured into the sturdy zygomatic bone, enabling support for prosthetic restoration. Thus, zygomatic implants were proposed in this case report as a substitute for costly and lengthy grafting techniques for rehabilitating patients with insufficient bone.

Case presentation: We describe a 62-year-old male who was diagnosed with maxillary atrophy and who underwent a rehabilitation protocol involving zygomatic implants. Two bilateral zygomatic implants were planned as free-hand surgical procedures because of the lack of a supporting structure to stabilize the surgical template. Prostheses were then placed after 48 hours, and a radiographic follow-up occurred at 24 months. Regular check-ups and proper oral hygiene were maintained. The clinical data and radiographs for the control treatment were obtained throughout the two years following treatment. Patients achieved functional and aesthetic rehabilitation with no major complications reported during the follow-up period. High levels of patient satisfaction and prosthetic function were observed.

Conclusion: This case report highlights the effective rehabilitation of a severely atrophic maxilla using quad zygomatic implants, achieving immediate function and aesthetics with no major complications over two years. Compared with traditional bone grafting, the graftless approach is less invasive, leading to faster recovery and greater patient satisfaction.

Aim: Periodontitis, a highly prevalent chronic inflammatory disease, progressively destroys tooth-supporting tissues, ultimately leading to tooth loss, and significantly increases systemic risks such as cardiovascular disease and diabetic complications. Current mechanical therapies effectively control clinical symptoms but fail to eradicate pathogenic microenvironments or restore periodontal homeostasis. Mitochondrial dysfunction is a critical driver of periodontitis progression; however, the regulatory mechanisms of mitochondria-related genes remain poorly defined.

Materials and methods: This study integrated bulk transcriptome sequencing (bulk RNA-seq) and single-cell RNA-seq (scRNA-seq) analyses to identify mitochondrial dysfunction-associated immune cell alterations in periodontitis. Key mitochondria-related genes inducing disease progression were pinpointed through non-negative matrix factorization (NMF) and weighted gene coexpression network analysis (WGCNA). By integrating ten machine learning algorithms with experimental validation using real-time quantitative polymerase chain reaction (qPCR) and immunofluorescence, peroxiredoxin 4 (PRDX4) was identified as the most crucial hub gene governing mitochondrial homeostasis in periodontitis.

Results: Patient stratification based on PRDX4 expression revealed upregulated B cell-related pathways. Pseudotime analysis demonstrated a synchronized upregulation of PRDX4 and B cell signature genes during late-stage disease progression. scRNA-seq and immunofluorescence confirmed PRDX4 upregulation in B cells, particularly in plasma cells and memory B cells, and indicated its involvement in B cell differentiation. Experiments in a mouse model further validated the conserved functional role of PRDX4 in regulating B cells during periodontitis. Finally, we screened traditional Chinese medicinal compounds and identified aloe as a potential PRDX4 inhibitor.

Conclusion: These findings establish PRDX4 as a key regulatory node linking mitochondrial dysfunction to periodontitis pathogenesis, providing insights into mitochondria-related genes and potential therapeutic strategies.

Purpose: Pulp canal obliteration (PCO) narrows the root canal, complicating access and increasing treatment risks. This study aims to evaluate the accuracy of static guided endodontic access (SGEA) using custom sleeves of different materials and heights compared to conventional freehand access (FHA) in pulp canal obliteration.

Methods: An in vitro experimental study was conducted using 48 resin maxillary incisors modeled to simulate pulp canal obliteration via CBCT, intraoral scanner, and 3D printing. The samples were divided into eight groups (n=6): a negative control (freehand access-FHA), a positive control (Titanium Steco 5 mm sleeve), and six static guided endodontic access (SGEA) groups using custom inner sleeves made of Chrome-Cobalt (CoCr) and Zirconia at three heights (3 mm, 5 mm, and 7 mm). Coronal and sagittal deviations between pre- and postoperative CBCT scans were analyzed using one-way ANOVA and Bonferroni post hoc tests (α=0.05).

Results: All SGEA groups demonstrated significantly lower deviation values compared to freehand access (p < 0.05). The mean coronal deviation ranged from 1.83° to 6.90°, with the lowest value observed in the Zirconia 7 mm sleeve group (1.83°±1.84°). Sagittal deviation ranged from 2.48° to 30.08°, also lowest in the Zirconia 7 mm group (2.48°±2.43°) and highest in the freehand access group (30.08°±5.93°). Increased sleeve height improved angular precision, and zirconia demonstrated superior dimensional stability compared to chrome-cobalt and titanium.

Conclusion: The SGEA technique provided higher accuracy than freehand access in controlling drilling deviation. Among the tested parameters, the custom 3D-printed zirconia sleeve with a 7 mm height yielded the best precision, supporting its potential use in minimizing iatrogenic risk during endodontic access of obliterated canals. This in vitro study on resin models requires further in vivo validation for clinical application.

Purpose: This research evaluated the effectiveness of sonic, ultrasonic, and diode laser irrigation techniques with a final irrigation protocol of 3% NaOCl, 17% EDTA, and 2% CHX in eliminating Fusobacterium nucleatum (F. nucleatum) from dentinal tubules.

Materials and methods: The research method utilized 38 human lower premolar teeth inoculated with F. nucleatum, which were divided into four groups: conventional needle irrigation (positive control), sonic irrigation (EDDY^® tips), ultrasonic irrigation (IrriSafe™), and diode laser (SOLASE, 976 nm). Bacterial viability was assessed using confocal laser scanning microscopy with the LIVE/DEAD™ BacLight™ Bacterial Viability Kits. Data were analyzed using the Kruskal-Wallis and post-hoc Mann-Whitney tests.

Results: The results demonstrated that the diode laser irrigation technique achieved the highest effectiveness, with an average penetration depth of 1045.55 (740.00-1420.00) µm, significantly outperforming sonic (751.11 [480.00-1170.00] µm; p-value = 0.024) and ultrasonic (617.77 [450.00-1090.00] µm; p-value = 0.002) irrigation techniques. The control group exhibited the lowest effectiveness (243.33 [150.00-330.00] µm).

Conclusion: Diode laser irrigation with the final irrigation protocol provided the highest efficacy against F. nucleatum in dentinal tubules, highlighting its superiority over other irrigation techniques for disinfection in endodontic treatment.

Background: Gingival health is considered an important concern in dentistry and can affect people, especially females. Depression plays a crucial role in the gingival state.

Aim of the study: This study aimed to test the consequences of a depressive state on gingival health status in women in association with C-reactive protein in saliva.

Materials and methods: A cross-sectional study was conducted using a sample of 500 randomly selected women. All chosen females in the sample suffered from depression, but in different grades, and this was achieved using Beck's Depression Inventory II questionnaire. Plaque and gingival indices were used to assess the oral health. Salivary flow rate and C-reactive protein levels were examined in the high- and low-depression subsamples.

Results: Participants were divided into three grades based on the depression scale (mild, moderate, and severe). The severe depression grades had higher plaque and gingival indices, and the mean C-reactive protein concentration was higher in the severe depression grade, with a highly significant difference (P =0.000).

Conclusion: Depression has an actual biological relationship with the health of the oral cavity; it increases gingival inflammatory illnesses and similarly disturbs typical salivary constituents. Increased C-reactive protein levels correlate with psychosomatic depressive illnesses.

Background: Edentulism is a major global burden that contributes to disability and impairment. Globally, edentulous patients frequently receive removable complete dentures because they are still a preferred treatment modality. However, effective adaptation to removable complete dentures remains challenging. This study explored the post-insertion challenges patients present to dental practitioners after receiving and wearing removable complete dentures.

Methods: This was a qualitative exploratory study conducted at Makerere University Dental Hospital in Kampala, Uganda. Twenty-five key informant interviews were conducted with dental surgeons and dental technologists, who were purposively selected based on their training, years of practice and roles in removable complete denture fabrication and fitting. Audio recordings were transcribed verbatim. Data were analyzed using inductive thematic analysis. The analysis was managed using NVivo software.

Results: Dental technologists and dental surgeons revealed that patients commonly reported substantial post-insertion challenges like pain and discomfort, drooling, difficulty speaking, eating, oral hygiene and salivating. They also noted that patients' confidence and self-esteem were severely influenced by their displeasure with the way their dentures looked. Furthermore, they stated that patients frequently experienced denture instability. Dental technologists and dental surgeons reported providing post-insertion advice on hygiene, oral care adaptation. They encouraged patients to keep wearing their dentures despite all inconveniences and assured them that they would eventually get used and become comfortable with wearing the dentures.

Conclusion: Patients presented several post insertion challenges relating to pain, discomfort, speech, drooling, salivating and hygiene which consequently affected their self-esteem. Post insertion advice and assurance was key in restoring confidence to patients to adapt to the removable complete dentures.

Introduction: Dental esthetics play a significant role in perceived facial attractiveness. This study aimed to assess and compare smile characteristics, smile perception and satisfaction with smile appearance among young adult populations in Latvia (Northern Europe) and Uzbekistan (Central Asia).

Methods: A total of 200 participants (100 Latvian and 100 Uzbek), aged 20-35 years, were divided into two groups. In the first group, photographs of the smiles of 50 Latvian and 50 Uzbek participants were analyzed for smile characteristics (smile type, smile symmetry, number of teeth displayed in a smile, position of maxillary incisor edge relative to the lower lip, smile arc, dental midline). In the second group, a self-administered questionnaire was distributed electronically to 50 respondents from each country to evaluate smile perception and satisfaction with smile appearance. The Wilcoxon-Mann-Whitney test, Spearman test, and Pearson Chi-Square test were used for statistical analyses.

Results: Statistically significant differences were found between Latvian and Uzbek participants in smile type (p = 0.009) and the number of teeth displayed in a smile (p = 0.05). Satisfaction with smile appearance was significantly higher among Uzbek participants compared to Latvians (p = 0.004). The average smile line and parallel smile arc were the most preferred designs in both countries.

Conclusion: Differences in smile characteristics and satisfaction with smile appearance exist between Latvian and Uzbek populations, while smile perception is largely similar. These findings highlight the influence of cultural backgrounds on self-perception of the smile and emphasize the importance of culturally informed dental treatment planning.

Background: This retrospective observational clinical study designed to assess the clinical performance and outcomes of cemented one-piece molar endocrowns (ECs) using the United States Public Health Service (USPHS) criteria at various time intervals. Additionally, patient satisfaction for cemented ECs was measured using the Visual Analog Scale (VAS).

Methods: Clinical data were collected from 29 participants (mean age 26.34 ± 6.99 years) who received ECs at a specialist dental center. Twenty-four ECs were constructed from lithium disilicate glass-ceramic (LDGC) and five from multilayered zirconia. All patients were analyzed at each follow-up (baseline, 6, 12, 24, and 36 months). Clinical performance was evaluated using modified USPHS criteria, and patient satisfaction was measured with a VAS. Statistical analyses included ANOVA and McNemar tests, with significance set at p ≤ 0.05.

Results: After 36 months most LDGC restorations retained "Alpha" (clinically excellent) scores for marginal adaptation, color match, anatomical form, restoration integrity and retention; zirconia restorations showed a mix of Alpha and Bravo scores. Significant differences between the materials were found for color at baseline (p=0.001) and at 36 months (p=0.018) and for retention at 36 months (p=0.001). Overall patient satisfaction by VAS remained high across groups.

Conclusion: Despite the limitations of a small zirconia sample, LDGC ECs showed better color matching and retention than zirconia. Zirconia is still a viable option where strength is essential. Material selection should consider esthetic demands and occlusal load. Long-term studies with larger cohorts are needed for validation.

Dental caries remains a global public health challenge, traditionally managed through fluoride-based strategies that enhance enamel remineralization and inhibit demineralization. However, concerns regarding fluoride resistance, fluorosis, and the growing demand for minimally invasive alternatives have stimulated interest in bioactive, plant-derived compounds. Galla chinensis extract (GCE), rich in polyphenols and tannins, has emerged as a promising candidate with dual effects on hard tissue repair and microbial control. This scoping review aimed to assess the evidence on Galla chinensis extract (GCE) as a non-fluoride agent for enhancing enamel and dental hard tissue remineralization and preventing dental caries. A structured search of available literature was conducted, focusing on experimental, in vitro, in vivo, and clinical studies evaluating GCE's biological properties, mechanisms of action, and translational potential in dentistry. Our findings indicate that GCE consistently promotes mineral deposition and enhances enamel surface microhardness, effectively inhibiting demineralization processes. In addition, GCE exhibits strong antimicrobial activity against cariogenic biofilms, particularly Streptococcus mutans, highlighting its potential to reduce caries risk by modulating the oral microbiome. Preliminary clinical studies show favorable outcomes, although the available evidence is limited in scale and duration. Collectively, these results demonstrate a dual action of GCE: supporting enamel repair while concurrently suppressing cariogenic activity. This suggests that GCE may serve as a promising adjunct or alternative to conventional fluoride-based strategies within minimally invasive dentistry. However, further well-designed clinical trials are necessary to confirm its efficacy, safety, and long-term benefits in caries management.