Clinical, Cosmetic and Investigational Dentistry最新文献

Background: Endodontic treatment outcomes may change over time. Factors such as compromised coronal seal and inadequate obturation can lead to canal reinfection and often periapical infection, thus developing into periapical lesions. Biofilm occupying the surface of the root tip can cause failure of conventional endodontic treatment or retreatment. Healing is achievable depending on the success of efforts to eradicate the biofilm layer from the site. Tooth discoloration after a root canal treatment can also be concerning, with several causes and treatment options. One of the minimally invasive aesthetic treatment options for discolored anterior teeth is dental bleaching or direct composite veneers.

Case report: A 22-year-old patient experienced pain in the right maxillary lateral and central incisors with a history of trauma at the age of six. Both teeth have undergone root canal treatment at the age of ten years. Clinically, the teeth were discolored with visible old composite restorations. Radiological finding shows radiolucency in the periapical and compromised apical structure. Endodontic retreatment and periapical microsurgery were performed to remove the periapical lesion, followed by internal-external bleaching and direct composite veneer to restore the aesthetics.

Results: The procedure was successful, and a one-year follow-up recall revealed bone regeneration around their apices and esthetic outcomes that satisfied the patient.

Conclusion: The technique described is an excellent approach in conserving the tooth with periapical lesions and compromised apical structure due to root resorption and internally stained teeth.

Background and objective: With increasing life expectancy, the incidence of degenerative and inflammatory joint diseases continues to rise. These conditions are major indications for orthopedic prostheses, which pose risks of postoperative complications, particularly infections of orthopedic prostheses (IPO). Dental infections have been considered a potential source of these infections, and recommendations regarding the use of antibiotic prophylaxis (AP) during dental procedures have evolved over time. Current guidelines discourage the routine use of AP. This study aims to assess the knowledge, attitudes, and practices (KAP) of private-sector dentists in the cities of Rabat, Temara, and Salé (Morocco) regarding the dental management of patients with orthopedic prostheses, particularly the use of AP.

Methodology: An anonymous 21-question survey was distributed to 310 dentists practicing in these cities. The collected responses were analyzed using JamoviR software (version 2.3.25), with a significance threshold set at p < 0.05. Chi-square and Fisher's exact tests were employed to compare different groups.

Results: Out of 310 distributed questionnaires, 102 valid responses were retained (response rate: 32.9%). Among respondents, 53.9% considered patients with joint prostheses at risk of infection, yet only 47.1% reported prescribing AP. Female practitioners and those with over 20 years of experience were significantly more likely to prescribe AP (p=0.047 and p=0.002, respectively). Dentists who did not consult guidelines or attend professional conferences were also more prone to prescribing AP during endodontic procedures (p=0.017 and p=0.018).

Conclusion: This study reveals inconsistent knowledge and practices among dentists regarding AP use for patients with joint prostheses. Given the misalignment with current guidelines and the influence of outdated sources of information, targeted educational interventions and updated clinical guidelines are urgently needed to promote evidence-based practices. Clear, standardized guidelines are also essential to prevent the unjustified overprescription of antibiotics and to address the growing concern of antimicrobial resistance.

This report presents a two-stage approach for crestal sinus elevation using the osseodensification technique in a case of severe vertical bone deficiency (<3 mm). Traditional approaches to maxillary sinus elevation with less than 3 mm of residual bone height typically require a lateral window technique. A 55-year-old male patient presented with a missing maxillary right first molar with residual bone height of 2 mm. The treatment involved: Stage 1: Crestal sinus elevation using osseodensification with Versah burs and allograft placement. Stage 2: After 6 months of healing, placement of a Straumann Bone Level Tapered implant (4.1 × 10mm) with 35 Ncm insertion torque and final prosthetic restoration was started 4 months after implant placement. Then, follow-up at 12 months demonstrated stable peri-implant tissues, maintained bone levels, and excellent patient satisfaction. Radiographic evaluation showed uniform bone formation around the implant and maintained sinus floor elevation. The case demonstrates that osseodensification can provide a predictable alternative to lateral window approaches even in cases with severe vertical bone deficiency (<3 mm), offering reduced invasiveness with enhanced bone density and favorable clinical outcomes.

The rapid advancement of digital technologies and the introduction of new ceramic materials have largely attributed to the notable transition from metal-ceramic to all-ceramic implant restorations bonded to Ti-bases. The purpose of this review was to evaluate all clinical studies reporting on the bond stability between CAD-CAM implant-supported all-ceramic restorations and Ti-bases. The review was directed according to the PRISMA guidelines to answer the focused question "How much is the stability and durability of the resin bond between implant-supported fixed CAD-CAM ceramic restorations and Ti- bases clinically?". The PubMed, Google Scholar, and Cochrane databases were investigated to identify related clinical studies. Human studies assessing at least 10 patients restored with implant-supported fixed CAD-CAM ceramic restorations luted to prefabricated Ti-bases with a mean follow-up of at least 1 year and published in an English-language up to Sep. 2024 were included. The restorations could be single crown, fixed dental prosthesis, or full-arch fixed prosthesis. The search yielded 5,190 records; of these, 59 full-text articles were evaluated based on eligibility criteria. Ultimately, 40 studies were included. All 40 studies demonstrated low debonding rates from Ti-bases for single copings, multi-unit fixed dental prostheses, and full arch zirconia prostheses. Based on the limited evidence available, different factors were blamed for the debonding incidence, such as Ti-base height, geometry, luting agent, inadequacy of passive fit and biomechanical patient- and prosthesis-related factors. CAD-CAM implant-supported all-ceramic restorations bonded to Ti-bases demonstrated relatively high bond stability during observation period ranging from 1 to 7.5 years. More well-designed clinical research with long-term observation periods is highly recommended.

Background: The objective of this study was to assess the quality of post and core restorations carried out by general dentists in the Hail region of Saudi Arabia using periapical radiographs. Additionally, the assessment included the examination of periapical lesions.

Methods: A comprehensive analysis was conducted on 301 periapical digital radiographs to assess various factors including the type of post, type of coronal restoration, post length in relation to crown and root length, presence of any abnormalities in the post space, condition of the remaining gutta-percha (GP), gap between the end of the post and the GP, and the presence of apical lesions. Analysis was conducted to determine the frequency distribution and cross-tabulation of the variables.

Results: Prefabricated metallic posts were most commonly used (62.1%), followed by metal posts which were found in 28.9% of the cases, and fiber posts which were used in 9.0% of the cases. The length of the posts in relation to the tooth were 2:1 in 32.6%, followed by 1:1 (27.9%) and 1:2 (23.6%). Parallel posts were used in 54.2% of cases, while the remaining 45.8% used tapered posts. Smooth posts were utilized in 77.1% of the cases, while serrated posts were utilized in 22.9%. Approximately 54.2% of the cases exhibited remaining GP of more than 5 mm, whereas 35.2% demonstrated adequate GP between 3-5 mm and 8.0% with remaining GP less than 3 mm. According to the study's findings, 65.1% of the samples under investigation had full coverage indirect restorations placed.

Conclusion: It was found that the post and core procedures' quality was comparable to earlier epidemiological studies. However, a significant proportion of posts were deemed to have poor technical quality, and apical periodontitis was seen in slightly more than one-third of the cases.

Purpose: This study evaluated the effectiveness of novel, inexpensive saliva substitute formulas (Rangsit University (RSU) preparation) in maintaining mucosal wetness compared with commercial products.

Materials and methods: In vitro experiments were conducted using swine tongues to assess the wetness of various RSU saliva substitute solutions and gels, with four flavors each (sweet mint, sweet vanilla, sweet-sour mint, and sweet-sour lemon), compared with water, hospital-based mouth rinse from a government dental school, and commercial products (Biotene^® mouthwash and GC Dry Mouth Gel^®). The wetness was measured at baseline and at 0, 10, 20, 30, 60, and 120 minutes using a digital moisture analyzer.

Results: All saliva substitutes consistently maintained a higher relative wetness than water, particularly beyond 60 minutes (p < 0.001). RSU solutions with a sour flavor (sweet-sour mint and sweet-sour lemon) had a similar wetness to commercial saliva substitute mouthwash at all times. These solutions were more effective in maintaining higher relative wetness over time than those without a sour flavor (sweet mint and sweet vanilla) (p < 0.05) and provided more wetness than the hospital-based mouth rinse at 120 minutes. The RSU solution formula also provided comparable wetness to RSU gel preparation at every time point. While RSU gel formulas initially provided comparable wetness to water, they maintained significantly higher wetness at 60 minutes (p = 0.029) and 120 minutes (p = 0.002). These results were similar to those of commercial saliva substitute gel, which maintained stable wetness since application up to 120 minutes (p = 0.052).

Conclusion: Our novel saliva substitute formulas show similar effectiveness to commercial products in maintaining mucosal wetness. These inexpensive products could be a viable alternative for patients with dry mouth who cannot afford commercial formulations.

Background: Periodontitis is an inflammatory disease, and contributes to several inflammatory conditions, such as cancer. The relationship between periodontal disorders and different human malignancies is not well understood. The purpose of this study is to assess the association of periodontitis severity with cancers in the oral cavity, oropharyngeal and parapharyngeal regions.

Methods: The sample comprised 300 participants divided into four case groups: 75 oral, oropharyngeal, or parapharyngeal cancer patients with periodontitis (CA-with-P); 75 oral, oropharyngeal, or parapharyngeal cancer patients without periodontitis (CA-without-P); 75 periodontitis (P) patients without cancers; and a control (C) group of 75 healthy individuals. All participants were subjected to a periodontal examination that considered parameters such as bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment loss (CAL). The type of tumours was identified via a histological analysis of a biopsy sample. Saliva samples were also collected, and an enzyme-linked immunosorbent assay (ELISA) kit was used to determine interleukin 8 (IL-8) and nuclear factor kappa B (NF-κB) levels.

Results: The research findings indicated a significant increase in the number of sites with clinical observations of BOP (85.11,73.84), PI (87.23.88.14), PPD (8.03,6.82), and CAL (8.67,7.34) in groups CA-with-P and P. The CA-with-P, CA-without-P, and P groups had higher levels of salivary IL-8 (192.03, 121.89,89.22) and NF-κB (10.242, 8.172, 6.324) than the C group. Moreover, there was a significant correlation between the severity of periodontitis and the malignancies in the oral, oropharynx, and parapharyngeal regions.

Conclusion: This study assessed the mechanisms underlying the correlation between these two disorders, as elucidated by higher levels of salivary IL-8, NF-κB and an increase in clinical periodontal parameters. Periodontal bacteria, which contributes to the development of periodontal disorders, could have a major impact on the onset of oral cancers.

Background: Instagram has gained ground over the past few years and is a significant health (mis)information source. Instagram posts significantly contribute to the increased demand for dental cosmetic procedures among patients in Arab countries. However, it is critical to assess the quality of these posts to ensure the dental information's reliability and accuracy.

Aim: This study aimed to assess the quality and engagement of Instagram posts related to aesthetic dentistry among Arabic-speaking users.

Materials and methods: This cross-sectional observational study analyzed publicly available Instagram posts using 15 popular Arabic hashtags related to smile alteration and Hollywood smiles. The data collected included post type, poster role, content theme, and claim accuracy. After that, the collected data were analyzed using non-parametric statistical tests.

Results: The study analyzed 150 Instagram posts, predominantly shared by patients (49.3%) and dentists (32.7%). Marketing posts dominated, with 69.3% focusing on promotions. A concerning 84.0% of posts contained non-factual information. Patient-generated posts received the highest engagement but often lacked professional accuracy.

Conclusion: While Instagram is a powerful platform for marketing and patient engagement, the prevalence of misinformation is a significant concern. It is crucial for healthcare professionals to actively participate on social media to ensure the dissemination of accurate information and to counteract misinformation.

This case report describes the endodontic treatment of a lower right second molar with a C-shaped root canal in a 49-year-old woman exhibiting severe loss of coronal structure. Clinical examination revealed a cavity with temporary filling on tooth 47, which tested negative to cold stimuli but was positive to percussion and bite tests. Cone beam computed tomography (CBCT) scan revealed a C-shaped canal morphology with associated periapical radiolucency, graded as CBCT-PAI score 4. The canal was classified as C3 subdivision III (Melton et al), C3 type II (Fan et al), and ²47 M^2-2D^2-1 (Ahmed et al's). A non-surgical endodontic procedure was performed using metallurgically gold heat-treated files, passive ultrasonic irrigation, and warm hydraulic condensation obturation. Post-endodontic restoration included a post and core build-up with the wallpapering technique and a zirconia overlay. This case highlights the importance of CBCT imaging for diagnosis and treatment planning, careful selection of endodontic instruments and technique, and the use of advanced restoration methods to improve the outcome of challenging C-shaped canal treatments with extensive cavity involvement.

Introduction: As the demand for comprehensive patient records grows, dental practices increasingly adopt Electronic Dental Records (EDRs). This study evaluates the usability of the Salud EDR application implemented at the College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, focusing on potential users without prior experience using the application to identify usability challenges and areas for improvement. Theoretical frameworks such as the Technology Acceptance Model (TAM) and Diffusion of Innovation (DOI) were employed to contextualize the findings.

Methods: A cross-sectional study design was employed, integrating both qualitative and quantitative methods. Think-Aloud sessions captured participants' cognitive processes during task completion, while semi-structured Exit Interviews provided insights into their overall experience and feedback. The System Usability Scale (SUS) questionnaire measured satisfaction, and navigation pathways were analyzed to compare task performance between potential users and an experienced user.

Results: Potential users required significantly more clicks to complete tasks than experienced users, indicating navigation challenges. The SUS questionnaire yielded a mean score of 31.1, categorized as "not acceptable", reflecting low Perceived Usefulness and Ease of Use as outlined by TAM. DOI attributes such as high Complexity and low Compatibility were also evident in user feedback. Exit Interviews revealed that participants found the interface complex, with design issues such as unclear icons and terminology further complicating navigation.

Discussion: The findings underscore the need for interface design improvements, including clearer icons, terminology, and navigation pathways, to enhance usability and satisfaction. The application of TAM and DOI frameworks provided a structured lens to interpret usability challenges and inform targeted recommendations. This study demonstrates the importance of usability testing in identifying and addressing challenges in EDR systems, contributing to better user experiences and more effective adoption.