Clinical, Cosmetic and Investigational Dentistry最新文献

Aim: In patients with fixed orthodontic appliances, the effectiveness of mechanical cleaning is compromised due to difficulties in accessing all areas of the mouth.

Purpose: Aimed to evaluate the antimicrobial effectiveness and periodontal actions of sugar-free chewing gums in patients with fixed orthodontics through a systematic review of randomized clinical trials.

Materials and methods: A bibliographic search was conducted in digital databases for articles published up to 2024 in accordance with the PICO question. This review followed the PRISMA methodology and was registered in PROSPERO (CRD42023444472), while the Cochrane RoB 2 tool used to assess the risk of bias and GRADE employed to evaluate the certainty of evidence for each outcome.

Results: Five studies were included. A significant reduction Streptococcus mutans in saliva was observed in two studies (-17%-33% saliva, -20%-29% dental plaque, p<0.05), with xylitol gum and it's mixture with sorbitol exerting the best effect after one month of consumption (GRADE high). An effective decrease in the plaque index was observed in two studies of xylitol gum (-43% -47%, p<0.05) after one month of consumption, as well as studies of essential oil gum (10 days) and sorbitol gum (three months) (GRADE low). Chlorhexidine, sorbitol, and essential oil gums effectively reduce gingival bleeding, and xylitol gum increases the salivary pH, more than 50% presented a high risk of bias, and less than 25% were at low risk of bias (GRADE low).

Conclusion: The different types of chewing gum significantly improved the oral health of patients with fixed orthodontics, the quality of evidence suggests that chewing gums could decrease the level of SM in saliva (4:1 xylitol and sorbitol mix or xylitol). However, the heterogeneity of the studies limits the generalization to other outcomes which highlights the need for larger and longer clinical trials to confirm their efficacy.

Background & objectives: The Greater Palatine Foramen (GPF), is a vital anatomical landmark for palatal nerve blocks. Hence imaging of this structure to understand its anatomy is important. Our study aimed to explore the radiomorphometric parameters of the greater palatine canal and pterygopalatine fossa using CBCT images in different age groups and gender.

Subjects materials and methods: 100 CBCT images showing both right and left maxillary sinus region were analysed for length of the greater palatine canal, the upper and lower opening diameters, and the intra-canal curvature. The recorded values were statistically analysed.

Results: The right greater palatine canal length was significantly shorter in individuals >25 years (Mean = 31.72 mm, SD = 4.30 mm, p-value = 0.021). The left upper opening diameter increased significantly with age (Mean = 5.90 mm, SD = 1.47 mm, p-value = 0.006). Males exhibited longer canals (Avg. length mean = 33.23 mm, SD = 4.19 mm, p-value = 0.095). And larger lower opening diameters (Avg. mean = 5.69 mm, SD = 1.18 mm, p-value = 0.073) than females. Canal curvature was predominantly curved across both the age groups, but age group 18-25 years showed a significantly higher prevalence of curved canals on both sides.

Conclusion: The present study showed significant variations in the morphology of the greater palatine foramen and canal curvature with respect to age and sex. Variations in GPC length, diameter, and curvature can influence the success of palatal nerve blocks, that reduce the risk of injury to the greater palatine nerve. Recognizing these differences through preoperative CBCT enables accurate anesthesia delivery, safer flap design, and precise osteotomy planning.

Purpose: End-stage chronic kidney disease (CKD) and its treatment by hemodialysis represent a public health issue especially in Morocco. This study aimed to assess the impact of chronic renal failure on oral health in patients undergoing renal dialysis.

Materials and methods: A cross-sectional study was conducted among patients undergoing dialysis. The variables recorded were DMFT (Decayed, Missing, and Filled Teeth) index and pH salivary. The correlation between oral health and the duration of dialysis was assessed.

Results: A total of 46 adult hemodialysis was evaluated, among them 52.2% were males, the mean age was 58.72 ± 12.4 years. All the patients in the sample underwent three dialysis sessions per week. Half of the patients brushed their teeth once a day. The average DMFT index was 15.41 ± 6.04. Xerostomia was noted in 84.8% of the sample. This health situation analysis showed that dental care of the dialysis patients was not favorable, highlighting a great need for dental treatment.

Conclusion: CKD cases should be made aware of the oral problems and their potential effect on overall health. A multidisciplinary approach with the involvement of different specialties is recommended.

Purpose: Mouth breathing is an associated or characteristic feature of sleep-disordered breathing (SDB), not a direct cause. This study aims to investigate whether mouth-breathing children in Indonesia have a higher risk of SDB, as assessed by the Pediatric Sleep Questionnaire (PSQ) questionnaire.

Patients and methods: A cross-sectional study was conducted in three public elementary schools in Bandung (SDN 001 Merdeka, SDN 062 Ciujung, and SDN 054 Tikukur), involving 343 children aged 8-9 years (193 boys, 150 girls). Clinical examinations were performed to identify mouth breathing habits, followed by administration of the PSQ questionnaire completed by parents. Prior to questionnaire completion, parents received standardized guidance via standardized online briefing sessions.

Results: Mouth breathing was observed in 95 children (27.7%). PSQ scores were significantly higher in mouth breathers compared to non-mouth breathers (mean: 25.45% vs 7.93%; median: 19.05% vs 4.54%; range: 4.54-58.82 vs 0.0-45.46; p < 0.001). Furthermore, 41.1% of mouth-breathing children were identified as having SDB, in contrast to 9.7% of non-mouth breathers. The relative risk (RR) for SDB in mouth breathers was 4.24 (95% CI: 2.70-6.65; p < 0.001).

Conclusion: Mouth breathing in school-aged children is significantly associated with a higher risk of developing sleep-disordered breathing. These findings highlight the importance of early screening and timely intervention to prevent adverse health outcomes linked to SDB.

Aim: The aim of this study was to determine the impact of different nanoparticle concentrations with endodontic bioceramic sealer. It was assessed the combination by analyzing the correlation between the degree of conversion (DC) and antibacterial efficacy. And assess the penetration depth into the lateral canals.

Materials and methods: The AH Plus bioceramic sealers were mixed with silver nanoparticles (Ag) at different concentrations (2.5%, 5%, 10%). The antibacterial efficacy against Enterococcus faecalis was evaluated utilizing the direct contact test (DCT) at multiple time intervals (immediately, 30 minutes, 1 day, 2 days, and 7 days). The conversion degree was evaluated by FTIR. The penetration depth was evaluated using X-ray examination.

Results: The antibacterial activity increased with higher concentrations of nanoparticles, with silver nanoparticles demonstrating a pronounced effect on E. faecalis. The conversion degree increased with high quantities of silver nanoparticles. Positive, strong relation between the degree of conversion and antimicrobial activity. The penetration depth decreased as nanoparticle concentration increased. A statistically significant difference was seen between the antibacterial activity values and the degree of conversion at different time intervals (P = 0.05).

Conclusion: The highest nanoparticles concentration (10%) has the greatest effect on the antibacterial activity and degree of conversion, the highest nanoparticles concentration decreased the penetration depth into the lateral canals.

Titanium is widely used for dental implant abutments due to its mechanical strength, biocompatibility, and corrosion resistance; however, its gray coloration can compromise esthetic outcomes, particularly in patients with thin or translucent gingival biotypes. Anodization, a surface modification technique altering the titanium oxide layer, has been proposed to improve soft tissue aesthetics by producing abutments with warmer tones (eg, pink or gold) that harmonize with the surrounding gingiva. This systematic review aimed to evaluate the clinical and aesthetic outcomes of anodized titanium abutments compared to non-anodized titanium and other materials, with a focus on peri-implant soft tissue health and visual integration. Following PRISMA 2020 guidelines, a comprehensive search was conducted in Scopus, PubMed, and ScienceDirect for Randomized Controlled Trials (RCTs) published between 2013 and 2024. Eligibility followed the PICOS framework. Nine RCTs with parallel or split-mouth designs and follow-ups from six weeks to two years were included. Esthetic outcomes were assessed using CIELab spectrophotometry and the Pink Esthetic Score (PES), while clinical parameters included mucosal recession, probing depth, plaque accumulation, gingival inflammation, and bleeding on probing. Study quality was appraised using the Cochrane Risk of Bias 2.0 tool. Anodized titanium abutments demonstrated enhanced aesthetic outcomes, especially in thin gingival biotypes, by improving colour harmony and reducing grayish shine-through. Pink-anodized abutments also showed better soft tissue integration compared to controls. However, clinical improvements such as reductions in inflammation, plaque, or recession were modest, inconsistent, and often statistically insignificant across studies. While anodization appears safe and beneficial for visual outcomes, its functional clinical advantages remain uncertain. These findings call for cautious interpretation and highlight the need for further well-powered, standardized long-term RCTs to validate the broader clinical relevance.

Introduction: Many dental students lack sufficient knowledge to manage dental trauma. Traditional lectures usually involve one-way communication from the instructor to the students. Game-based learning strategies can increase student engagement, offer hands-on experiences, and promote a deeper interest in learning.

Objective: To compare the knowledge and satisfaction of dental interns participating in game-based learning versus traditional learning method on traumatic dental management at KAUFD.

Methods: An experimental study conducted at the Faculty of Dentistry at King Abdulaziz University involved a sample size of 88 dental interns. The interns were divided into a game-based learning group (game group) and a traditional lecture group (lecture group). The game group participated in a game-based learning session, engaging in an educational game focused on managing permanent teeth trauma. Meanwhile, the lecture group attended a traditional lecture covering the same topic. Both groups took part in pre- and post-quizzes before and after the sessions and completed a satisfaction survey distributed after the sessions.

Results: Both lecture formats significantly enhanced knowledge retention. Post-intervention scores were comparable between the groups (p = 0.393), The mean post-intervention correct score for the lecture group was 12.72 (SD = 1.33; 95% CI: 12.32-13.13), while the mean score for the game group was 12.62 (SD = 1.56; 95% CI: 12.15-13.09). showing no significant difference in score improvements (p = 0.315). The post-intervention satisfaction survey indicated positive responses in both groups, with no significant differences in satisfaction levels.

Conclusion: The findings indicate that both game-based learning and traditional lectures are equally effective in enhancing knowledge and ensuring high satisfaction among dental interns. Given the similar results, it is recommended to incorporate both approaches in educational settings. Future research should investigate the impact of new content and more complex game designs to understand their potential benefits better.

Introduction: Aesthetic outcomes are increasingly vital in dental care, especially in achieving harmony between facial and dental features. Traditional smile design methods rely heavily on clinician judgment, which introduces subjectivity and variability. Digital Smile Design (DSD) offers an eco-friendly and standardized alternative, promoting improved aesthetic outcomes with reduced environmental impact. This systematic review aims to synthesize current evidence regarding the effectiveness and sustainability of DSD in enhancing dental aesthetics and patient satisfaction compared to conventional approaches.

Methods: A systematic review was conducted following PRISMA guidelines. Articles were retrieved from PubMed, Scopus, EBSCO, and ScienceDirect using pre-defined keywords and MeSH terms. Eligible studies included randomized controlled trials and experimental studies published between 2019 and 2024. This review synthesizes evidence regarding the clinical effectiveness and eco-friendly implications of Digital Smile Design (DSD) compared to conventional smile planning, focusing on aesthetic outcomes, patient satisfaction, and environmental sustainability. Quality assessment was performed using the Joanna Briggs Institute (JBI) critical appraisal tools.

Results: Twelve studies met the inclusion criteria. Overall, DSD consistently improved smile aesthetics through enhanced alignment, tooth shape harmony, and lip symmetry. Patient satisfaction was also generally higher with DSD due to its precision, reduced chair time, and less invasive procedures. Many studies also emphasized the eco-friendly benefits of DSD, such as minimized material waste and reduced need for multiple visits.

Conclusion: DSD is an effective and sustainable approach for enhancing dental aesthetics and patient experience. Its adoption in clinical practice may support a shift toward more precise, patient-centered, and environmentally conscious dentistry. However, variations in study design and reporting highlight the need for further standardized research.

Introduction: Metal allergies can cause mucosal inflammation when triggered by dental materials. Oral lichen planus (OLP) is a chronic inflammatory disorder with multiple causes, including autoimmune factors, stress, and allergic reactions to dental metals. Differentiating between OLP and metal allergies in the oral cavity can be clinically challenging. This report presents a case initially suspected to be metal allergy but later confirmed as OLP.

Patients and methods: A 55-year-old female presented with redness and pain near the buccal gingiva of the right mandibular first molar, along with white lace-like patches. Intraoral examination revealed multiple metal restorations, and element analysis identified Zn and Co in several crowns. Based on these findings, a metal allergy was diagnosed. All metal crowns were replaced with zirconia. However, symptoms persisted. A biopsy later confirmed OLP, and steroid therapy was initiated.

Results: Despite removal of the suspected allergenic metals, the inflammation did not resolve, suggesting metal allergy was not the primary cause. Subsequent treatment with steroids led to gradual resolution, supporting the diagnosis of OLP as the primary condition.

Conclusion: This case highlights the diagnostic difficulty in differentiating between metal allergy and OLP. Clinicians should consider OLP when symptoms persist despite metal replacement. A multidisciplinary approach is essential to achieve accurate diagnosis and effective treatment.

Background: Oral squamous cell carcinoma (OSCC) is a prevalent malignancy of the head and neck, often only diagnosed at advanced stages due to the limitations of conventional diagnostic tools. Early detection is crucial for improving survival rates, minimising treatment-related morbidity, and enhancing patient outcomes. Immunohistochemical (IHC) markers have emerged as potential tools for identifying early molecular changes associated with malignant transformation in oral epithelial cells.

Objective: This systematic review aims to evaluate the diagnostic performance of IHC markers in the early detection of OSCC, focusing on their sensitivity, specificity and clinical applicability.

Methods: A systematic literature search was conducted for relevant studies published between 2015 and 2025. After removing duplicates using Mendeley Software, 412 studies were identified. A total of 168 studies were excluded following title screening, and 181 were excluded based on abstract screening. Sixty-three full-text articles were reviewed for eligibility. An additional 20 studies were identified through reference list screening. After applying the inclusion and exclusion criteria, 6 studies were included in the final analysis.

Results: The review identified several IHC markers, including p53, Ki-67, EGFR, and p16, as frequently associated with early dysplastic changes and malignant transformation in the oral mucosa. While many markers showed high sensitivity and specificity, variability in study design, antibody clones, interpretation criteria, and staining protocols limited the generalisability of the findings.

Conclusion: IHC markers demonstrate considerable potential for the early identification of OSCC. However, standardised protocols, large-scale multicentre validation studies, and integration with molecular diagnostics are needed to establish their clinical utility. The findings of this review support the incorporation of IHC markers into evidence-based diagnostic approaches to improve early detection and patient prognosis in OSCC.