Clinical, Cosmetic and Investigational Dentistry最新文献

Purpose: Dental magnifying loupes (DMLs) allow better visualization of the operative field and operator's seating postures. This study aimed to investigate factors influencing the usage and selection of DMLs among dentists and determine the self-reported musculoskeletal pain and perception regarding DMLs usage.

Methods: A validated self-reported questionnaire of 19 items assessing participant's characteristics and DMLs usage was distributed to individuals who fit the inclusion criteria: practicing general dentists/dental intern and resident/specialized dentist in various dental specialties. The data were collected and then statistically analyzed using comparisons tests (chi-square/Fisher's exact test) and logistic regression with significance level (p-value) below 0.05.

Results: The response rate for this study's questionnaire was 97.33%. There is a significant association between the use of DMLs and training using them in dental school (p < 0.002). Using DMLs in endodontic treatment is significantly associated with the general dentist professional classification. Specialized dentists are 1.94-times more likely to use DMLs than general dentists (p < 0.001). The majority (50%) of DML users believe that DMLs are best used during undergraduate training. Using DMLs for "better vision" was the most selected (63.64%) option by DMLs users, followed by "increased clinical efficacy" (61.36%), "improved patient care" (50%), and "better ergonomics" (47.73%). Of dentists who did not use DMLs, 66.90% reported that DMLs being expensive was a limitation to their usage. Almost 91% dentists who have neck and shoulder discomfort (n = 219) do not use DMLs.

Conclusion: DMLs are under-utilized by dentists. The major factors limiting their use are the high cost and lack of training regarding their use in dental school. Addressing these two factors may contribute to a positive shift in the utilization of DMLs by a larger number of dentists.

Background: Improved Lithium Disilicate Ceramic has been highly valued in dentistry for over two decades, owing to its durability and aesthetic qualities, making it a preferred choice for both anterior and posterior crowns.

Objective: This study aimed to evaluate the flexural strength of two types of lithium disilicate blocks post-chewing simulation.

Materials and methods: Seventy-six lithium disilicate specimens were utilized in this study. They were divided into two primary groups (n=38) based on two brands: IPS Emax CAD LT (Ivoclar Vivadent) designated as (E), and Initial Lisi LT/B1 (GC America) designated as (L). Each primary group was further split into two subgroups (n=19) based on surface treatment: group E into (E0 & E1) and group L into (L0 & L1). Half of the specimens were subjected to flexural testing without chewing simulation cycles and designated as (E0 and L0), while the remainder were tested after 24×10⁴ cycles of chewing simulation and designated as (E1 and L1). The ceramic surfaces were examined using SEM before and after loading.

Statistical analysis: Data were gathered, organized, and subjected to Shapiro-Wilk's and Levene's tests (p-value < 0.05), followed by analysis with Brown-Forsythe two-way ANOVA and Tamhane's post hoc tests to assess group differences (p-value <0.05).

Results: There were significant statistical differences in the flexural strength values between the different brand groups before and after chewing simulation (p-value < 0.05). The IPS Emax CAD group showed values approximately twice that of the Initial Lisi group (307.2-310.5 MPa ± 48.5-67 vs 148.1-158.5 MPa ± 24.6-25.6).

Conclusion: Within the limitation of the current study, the following may be concluded: 1. The study's findings suggest that Initial Lisi blocks should not be used for posterior teeth restorations. 2. This study can provide valuable insights for dental professionals to make informed decisions about which material is most appropriate for various clinical situations.

Purpose: This study evaluated senior dental students' confidence in their knowledge and clinical skills in performing pulpotomy procedures on primary molars based on the number of procedures performed on pediatric patients and/or extracted primary teeth.

Methods: An electronic survey was validated and modified from the National League of Nursing (NLN) questionnaire and was used to assess the student's satisfaction with past learning and self-confidence in performing pulpotomy on pediatric patients and primary extracted teeth. The questionnaire comprised 29 questions across six sections outlining various clinical experience and knowledge acquisition aspects. The target sample was senior dental students enrolled at a governmental dental school during the 2023-2024 academic year, which were 369 students who were recruited for this study. The association between knowledge and clinical experience of performing pulpotomies and self-confidence was analyzed using a chi-square test. The association between knowledge and practical/clinical experience and the competency grade was performed using an independent sample t-test and ANOVA (α = 0.05).

Results: Of the targeted subjects, 215 responded to the questionnaire, yielding a response rate of 66.3%. A significant association was found between the number of procedures performed on pediatric patients and students' confidence levels (p<0.001), as well as between competency grades and confidence levels (p<0.001). In contrast, the number of times they practiced pulpotomy on extracted teeth did not significantly affect their confidence level (p=0.381). No significant association existed between knowledge scores and confidence levels (p=0.869). Those who reported better learning experiences were more likely to report higher confidence levels (p<0.001).

Conclusion: The number of pulpotomy procedures performed on pediatric patients significantly impacted students' confidence levels, while knowledge scores showed no correlation with confidence. A positive relationship between competency grades and confidence. These findings underscore the importance of practical training in enhancing both clinical skills and confidence in performing clinical procedures.

Background: Early Childhood Caries (ECC) is a major dental health issue that affects children worldwide. The prevalence of ECC can vary between regions, and understanding these differences is essential for targeted public health interventions. This study aimed to compare the prevalence of ECC in children aged 2-6 years from the highland and lowland areas of West Java.

Methods: The research method used a cross-sectional study. Data collection was conducted in Rancabali District, Bandung Regency as a highland with an altitude of 1600 masl and Cijulang District, Pangandaran Regency as a lowland with an altitude of 30 masl. Sampling was determined using purposive sampling technique with a total sample of 201 children consisting of 98 children in the highlands and 103 children in the lowlands. Data were analysed using the Chi-Square test.

Results: The prevalence of early childhood caries in children aged 2-6 years in Bandung Regency was 91.8% with a mean def-t index of 10.03 and in children aged 2-6 years in Pangandaran Regency was 96.1% with a mean def-t index of 10.74. The mean value of the def-t index in both regions is in the very high category according to WHO. Chi-square test results with a p-value >0.05, namely 0.201, showed that there was no significant difference between the prevalence of ECC in children aged 2-6 years in Bandung Regency and Pangandaran Regency.

Conclusion: There is no difference in the prevalence of early childhood caries in children aged 2-6 years in the highlands and lowlands of West Java.

Purpose: Guided access cavity preparation (GACP) is an endodontic procedure utilizing stents, guide sleeves, or dynamic guides to facilitate the proper formation of access cavities. This paper aims to evaluate the significance of research on guided access cavity preparation in endodontic treatment concerning dentin preservation. In the context of dentin preservation, this paper provides a thorough scoping review of a variety of methodologies for evaluating the accuracy of guided access cavity preparation.

Materials and methods: Article searches were conducted using Tthe keywords "Guide Access Cavity Preparation" AND "Static Guide OR 3D Printing Template" AND "Dynamic Guide through digital databases including PubMed, Scopus, Cochrane Library, Science Direct, and Google Scholar. Research articles published in English within the past five years (2019-2024) and in accordance with the PCC (Population, Concept, and Context) framework were also included in the study. Articles from the meta-analysis or systematic review study type, those that were not accessible in full text or in a paid format, and those that did not assess the use of guided endodontics in endodontic surgery were excluded. This scoping review adheres to the Preferred Reporting Items for Systematic Reviews without Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) criteria.

Results: A total of 12 articles were reviewed, encompassing various locations, designs, type, and samples, which demonstrated the use of guided access cavity preparation has significant clinical applications and can provide accurate results in endodontic therapy.

Conclusion: Article searches were conducted using the keywords "Guide Access Cavity Preparation" AND 'Static Guide OR 3D Printing Template' AND" Dynamic Guide through digital databases including PubMed, Scopus, Cochrane Library, Science Direct, and Google Scholar. Research articles published in English within the past five years (2019-2024) and in accordance with the PCC (Population, Concept, and Context) framework were also included in the study. Articles from the meta-analysis or systematic review study type, those that were not accessible in full text or in a paid format, and those that did not assess the use of guided endodontics in endodontic surgery were excluded. This scoping review adheres to the Preferred Reporting Items for Systematic Reviews without Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) criteria. Studies show that advanced technologies in guided access cavity preparation endodontic treatment can improve dentin preservation, improve accuracy and predictability, particularly for root canal anomalies and difficult teeth, but clinicians must consider limitations and clinical applications. Clinicians must evaluate the limitations and clinical applications of guided endodontic access prior to its implementation.

Background: Facial bone fractures represent a significant clinical challenge due to their prevalence and the complexity of treatment required. Understanding the demographic patterns, causes, and treatment outcomes of these injuries is crucial for improving patient care and developing targeted prevention strategies.

Objective: This study aims to analyze the demographic characteristics, etiological factors, anatomical distribution, and treatment modalities of patients presenting with facial bone fractures at Stomatology National and Specialized Hospital in Kabul, Afghanistan, during 2022.

Methods: A retrospective analysis was conducted on 463 patients with facial bone fractures treated at the hospital. Data collected included patient demographics, causes of trauma, fracture location, and treatment methods. Statistical analysis was performed to identify patterns and correlations.

Results: The study included 463 patients (378 males and 85 females), aged between 3 and 88 years, with a mean age of 26.34 years. The primary causes of trauma were road traffic accidents (RTAs) (29.6%), interpersonal violence (26.1%), and falls (23.3%). The mandible was the most commonly fractured bone (74.1%), with the parasymphysis being the predominant site of injury. Treatment predominantly involved closed reduction (54.9%), with a significant portion of patients undergoing open reduction and internal fixation (ORIF) (45.1%).

Conclusion: The findings highlight RTAs, interpersonal violence, and falls as the leading causes of facial bone fractures. The mandible is the most frequently affected bone. Closed reduction remains the most common treatment modality. These insights underline the need for enhanced preventive measures, including stricter enforcement of traffic regulations and targeted interventions to address interpersonal violence and fall prevention.

Purpose: Thyroid hormones have a catabolic effect on bone mineral homeostasis. Hypothyroid patients have shown changes in bone mineral density with increased risk for osteoporosis and bone fractures. Radiomorphometric parameters on panoramic images are good indicators of bone mineral density. The aim of the study was to compare the radiomorphometric parameters in dental panoramic images of patients diagnosed with hypothyroidism with age- and gender-matched control populations.

Methods: Panoramic radiographs of 47 patients diagnosed with hypothyroidism were measured for radio morphometric indices like mental index (MI), The inferior panoramic mandibular index (PMI), antegonial index (AGI), gonial Index (GI) and mandibular cortical Index (MCI). The measurements were compared with age and gender matched 50 healthy controls.

Results: The mean values of MI (3.11), PMI (0.28), and GI (1.38) were lower in hypothyroidism than in 50 healthy controls which was 3.17, 0.30 and 1.33, respectively. However, only AGI (3.14) showed statistically significant differences (p = 0.03).

Conclusion: This study showed radiomorphometric parameters like MI, PMI, GI and AGI are valuable indicators of bone changes in mandible of patients with systemic diseases like hypothyroidism. Although statistically significant difference was seen only in AGI compared to healthy controls. Further studies with larger samples can provide substantial data. Applying newer technologies like machine learning can also help us determine whether mandibular morphometric parameters can predict changes in bone mineral density in hypothyroid cases.

Objective: This study aimed to evaluate the in vitro effects of coffee exposure on the color and roughness of conventional and bulk-fill resin composites, with and without surface pre-reacted glass-ionomer (S-PRG) filler.

Methodology: Forty-eight cylindrical samples (Ø6 mm × 2 mm) were prepared and categorized as follows (n = 12 per group): conventional nano-hybrid (Tetric N-Ceram, Ivoclar); nano-hybrid with S-PRG filler (Beautifil II, Shofu); bulk-fill (Tetric N-Ceram Bulk Fill, Ivoclar); and bulk-fill with S-PRG filler (Beautifil Bulk Restorative, Shofu). The samples were assessed for surface roughness (Ra, μm), color coordinates (CIE Lab), and overall color change (ΔE_ab, ΔE₀₀). Measurements were taken at baseline and after 7 days of coffee immersion (pH = 4.95). Data were analyzed using generalized linear models, Kruskal-Wallis, Dunn, and paired Wilcoxon tests (α = 0.05).

Results: After the coffee exposure, all resin composites exhibited a significant decrease in L* (towards black), an increase in a* (towards red), an increase in b* (towards yellow), and a higher Vita color score (p < 0.05). Tetric N-Ceram demonstrated the lowest roughness values post-exposure; however, a significant increase in roughness over time was observed only for Tetric N-Ceram Bulk Fill (p < 0.05). For ΔE_ab, Beautifil Bulk Restorative and Tetric N-Ceram showed higher values compared to Beautifil II. For ΔE₀₀, a significant difference was noted between Beautifil Bulk Restorative and Beautifil II (p < 0.05).

Conclusion: Resin composites with S-PRG fillers exhibited similar pigmentation dynamics to conventional composite but showed greater surface roughness after exposure to coffee. Considering the S-PRG materials, the bulk-fill version is more susceptible to staining.

Purpose: The study aimed to measure the distance from the cementoenamel junction (CEJ) to the alveolar bone crest on both the buccal and lingual sides of the anterior mandibular teeth utilizing cone beam computed tomography (CBCT).

Materials and methods: Cone-beam computed tomography (CBCT) was utilized to measure the distance between CEJ and the alveolar bone crest on both the buccal and lingual sides of the mandible's anterior teeth.

Results: The mean of the distance on buccal side for the central, lateral, and canine teeth were (1.6 mm), (1.6 mm), and (1.5 mm) respectively. On the lingual side, the mean for all teeth (central, lateral, and canine) was 1.7 mm. The study demonstrated a significant difference in distance across age groups (<30 and ≥30 years) for all teeth on both the buccal and lingual sides, except for the canine on the buccal side.

Conclusion: The distance from the CEJ to the bone crest on both the buccal and lingual sides varies significantly by age group. This data is essential for developing orthodontic, implant, and periodontal therapies.