Clinical, Cosmetic and Investigational Dentistry最新文献

Aim: This study evaluated the color stability and surface roughness of two universal-shade compared to two nanohybrid composites after staining and external bleaching with 40% hydrogen peroxide.

Methods: Two universal shade resin-based composites and two nanohybrid composites were tested. Twenty disc-shaped specimens from each material were fabricated and divided into two subgroups: one group was stained and bleached (staining group) and the other received bleaching treatment only (control group). The staining group was stained with coffee solution for 24 h. Subsequently, each sample of all four materials was bleached using an in-office bleaching gel using 40% hydrogen peroxide. Color measurements were performed using a spectrophotometer to obtain the International Commission on Illumination parameters, L*; a*; and b* for each of the following periods: baseline, after bleaching, and two weeks after bleaching for the control group. The staining group was examined at baseline, after staining, after bleaching, and two weeks after bleaching. Surface roughness (Ra) of all the materials after each treatment step were also recorded. The data was statistically analyzed using SPSS 26.0 statistical software. Changes were considered statistically significant at P = 0.05.

Results: Descriptive statistics (means and standard deviations) were used to describe color measurements and surface-roughness values. Two-analysis of variance and one-way analysis of variance were used to compare the mean values of surface roughness, L*a*b*and ΔE₀₀ values. Statistically significant differences and clinically acceptable ΔE₀₀ were observed between all materials during the different stages in color measurements, whereas the surface roughness was significantly different for each study material and treatment mode.

Conclusion: Staining with coffee solution and external bleaching produced acceptable color changes for all materials tested. Staining and bleaching increased the surface roughness values of the tested resin-based composites.

The tight junction (TJ), a type of cell-cell junction, regulates the permeability of solutes across epithelial and endothelial cellular sheets and is believed to maintain cell polarity. However, recent studies have provided conflicting views on the roles of TJs in epithelial polarity. Membrane proteins, including occludin, claudin, and the junction adhesion molecule, have been identified as TJ components. TJs are predominantly found at the stratum granulosum and stratum corneum. Although it remains unclear whether the disruption of TJs is the cause or consequence of certain dental diseases, evidence suggests that TJ dysfunction may be a crucial factor in gingival epithelial barrier impairment and the progression of oral diseases. Bacterial infection is among the most specific factors we found that may contribute to the breakdown of the epithelial barrier formed by TJs in dental diseases. Bacteria and their products may weaken the epithelial barrier by directly destroying intercellular junctions or altering the expression of junctional proteins. Additionally, they may induce the production of inflammatory cytokines, which could lead to the downregulation of TJ proteins and, consequently, impair the epithelial barrier. This review introduces a novel perspective by exploring, for the first time, the role of TJs dysfunction in the breakdown of the oral epithelial barrier and its potential link to the progression of dental diseases such as gingivitis, periodontitis, Sjӧgren syndrome, and oral squamous cell carcinoma.

Background: Globally, there is growing concern regarding mouth sores, occlusion, cost, ridge resorption, and retention, in the delivery of removable complete dentures fabrication services brought about by the aging of the population and poor oral healthcare. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design/computer-aided manufacturing (CAD/CAM). In Uganda, the therapy for edentulous patients has predominantly been realized through the use of conventional removable complete dentures. There has been a discernible difference in the number of visits and remake rate between removable complete dentures that were made conventionally and digitally. This present study, therefore, aimed to explore dental clinicians' and technologists' experiences and perspectives on removable complete denture fabrication services.

Methods: The study employed a qualitative design, 25 in-depth interviews were conducted with dental clinicians and technologists at Makerere University Dental Hospital. Both practicing dental technologists and clinicians were purposively selected after providing written informed consent. Interviews' audios were transcribed verbatim, coded in NVivo 14 and data were analyzed thematically.

Results: Clinical and socio-demographic assessments like age, oral hygiene, ridge level, underlying health conditions, and mental stability of the patient were done by dental clinicians before removable complete denture fabrication. Dental technologists and clinicians mentioned patients having a lot of expectations relating to being able to eat whatever they like and improving physical appearance. However, the patients also had fears and concerns about discomfort, and some worried that they would swallow the dentures.

Conclusion: Prior assessments were the basis for planning for complete denture therapy. Patients' fears and expectations can effectively be addressed in the consent process since adequate information can be shared and the patients can be psychologically prepared to receive the denture treatment.

Purpose: The present study aimed to evaluate the appropriate protocol to be followed in the maxillary esthetic zone involving single dental implants by comparing three implant placement protocols: immediate implant placement (IIP) with and without the socket shield technique (SST) and delayed implant placement (DIP) in terms of dynamic alterations in hard and soft tissues and patient-related outcome measures (PROMS).

Materials and methods: A total of 75 patients were recruited for the study and randomly allocated to the SST, IIP, and DIP groups (25 each). They were subjected to Cone Beam Computed Tomography (CBCT) assessment pre-operatively, 6 and 12 months post-operatively to evaluate changes in Crestal Bone Thickness (CBT). Soft tissue changes were evaluated using the pink aesthetic score (PES) and visual analogue scale (VAS) to assess the pain threshold and patient satisfaction.

Results: There was a statistically significant difference in the mean reductions in crestal bone thickness (CBT) between and among the groups. The SST group demonstrated a significantly lower reduction in CBT (0.09) than the IIP and DIP groups, which showed a mean reduction in CBT of 0.18 and 0.50 at (p<0.01), respectively, at the end of 12 months. However, when the mean differences in PES between the groups were compared, there was a statistically significant difference for SST 13(2), IIP 10(2), and DIP 9(2) (p<0.01).

Conclusion: Socket shield technique could be technique of choice for IIP when buccal bone thickness is <1mm as demonstrated by less reduction in CBT and better PES at the end of 12 months than the IIP and DIP groups.

Background: Platelet-rich fibrin (PRF) blood concentrates are used in oral implantology and defect surgery to promote osteoneogenesis in Bone Marrow Defects in Jawbone (BMDJ), according to the morphology of fatty-degenerative osteonecrosis also called FDOJ.

Question: Can the benefit of PRF on alveolar osteoneogenesis be confirmed by cytokine analysis?.

Methods: The cytokine expressions of the PRF samples in 26 patients undergoing BMDJ/FDOJ surgery in the same session were analysed for seven cytokines (RANTES/CCL5; FGF-2; IL-1RA; Il-6; IL-8; MCP-1; TNF-a) by multiplex (Luminex). The FDOJ samples of these 26 BMDJ/FDOJ patients were analysed for the RANTES/CCL5 expression only.

Results: Cytokine expression in PRF is compared to reference values for healthy medullary bone of the jaw and BMDJ/FDOJ and shows that the cytokine expressions of the PRF samples do not compensate or counteract prima vista for the cytokine dysregulations present in the BMDJ/FDOJ areas.

Discussion: To define the aid of cytokines studied in PRF in the restoration of the immunological dysregulation in areas of BMDJ/FDOJ, literature is reviewed comparing RANTES/CCL5, IL-1ra, TNF-α and MCP-1/CCL2 expression in PRF and BMDJ/FDOJ. Immunoregulatory properties of PRF in alveolar bone restoration are evaluated.

Summary: PRF was mistakenly thought to be a cure for bone healing, which is here shown to be incorrect. Enoral Ultrasound Sonography of bone density is available for the clinical measurement of individually developed osteoneogenesis by PRF.

Conclusion: The multiplex analysis of PRF shows a dynamic and cytokine-based interaction with osteoneogenesis that is not yet fully clarified.

Background: Despite the great effort between the dentist and dental technician in prosthesis fabrication, there is a lack of proper communication. According to the laboratory prescription, the communication process must include all the essential elements to complete the prosthesis fabrication correctly. The digital revolution in dentistry suggested using information technology system prescriptions instead of traditional prescriptions.

Aim: To explore the association between the application of ITS and the communication process between dental laboratories and dental clinics in a developing country setting.

Methods: The current study used a quasi-experimental design (posttest only). A convenience sample of 600 subjects was divided into two subsamples of 300 subjects each. The data from the first subsample was collected from traditional (paper-based) prescriptions, and the data from the second subsample was collected from the Information Technology System (ITS).

Results: It was associated with a statistically significant commitment to recording the most essential information in the dental lab prescription. The time spent completing and delivering the work was faster, and the need for recommunication was less common among those using ITS than those using traditional systems. Regarding the quality of the prosthesis, the need for modification or redo due to improper shade, inappropriate charting of teeth, or lack of additional information in the dental lab prescription was less among users of the ITS system compared to the traditional system (P < 0.05).

Conclusion: Using ITS instead of a traditional system can enhance the communication process and the amount filled in the laboratory prescription in multiple aspects, including the completeness of essential information in the dental lab prescription, the time needed to complete the cases, the need to re-communicate less frequently with the dentist, and improved the quality of the prosthesis.

Purpose: This study aims to investigate the biomimetic effect of agarose hydrogel loaded with enamel matrix derivative (EMD-agarose) alone or in combination with nano-hydroxyapatite (n-HA-EMD-agarose) on the remineralization of human demineralized enamel.

Methods: Extracted human mandibular third molars were sectioned into 54 buccal and lingual halves. Acid-resistant nail varnish was applied to each half, except for two enamel windows. Enamel surface microhardness, energy-dispersive X-ray spectroscopy (EDX), and scanning electron microscopy (SEM) analyses were conducted to evaluate enamel surfaces at baseline, following demineralization with 37% phosphoric acid, and after each hydrogel application and remineralization for two, four, and six days. Remineralization was performed using a phosphate solution at 37°C.

Results: At day 6 following remineralization, a statistically significant higher mean microhardness was recorded in n-HA-EMD-agarose hydrogel (260.87 ± 3.52) as compared to EMD-agarose hydrogel (244.63 ± 2.76) (p = 0.027). Similarly, n-HA-EMD-agarose hydrogel showed a higher mean calcium (46.31 ± 2.78), phosphorous (24.92 ± 0.826), and fluoride (0.909 ± 0.053) weight percentage compared to EMD-agarose hydrogel calcium (19.64 ± 1.092), phosphorous (19.64 ± 1.092), and fluoride (0.7033 ± 0.0624) weight percentage (p < 0.05). Further, SEM analysis revealed a substantial deposition of n-HA following the application of the n-HA-EMD-agarose hydrogel, whereas the EMD-agarose exhibited a relatively smooth enamel surface with less visible enamel rods due to mineral deposition.

Conclusion: The combined n-HA-EMD-agarose hydrogel demonstrated improved surface microhardness of the remineralized enamel and enhanced mineral content deposition, indicating its potential as a biomimetic approach for dental enamel repair.

Objective: : Children with Intellectual Disabilities (ID) have a higher rate of untreated caries and often progress to caries with pulpal involvement or odontogenic infections. This can be assessed using the Caries Assessment Spectrum and Treatment (CAST) index and the Pulp Ulcer Fistula Abscess (PUFA) index. Dental problems often have an impact on quality of life, so Oral Health-Related Quality of Life (OHRQoL) assessment is needed for ID children.

Purpose: To identify and analyze the correlation between odontogenic infection, the total spectrum of caries, and OHRQoL in ID children.

Methods: : The subjects of the research were 70 ID children who attended Special Needs Schools (SNS) Type D of the Foundation for the Development of Disabled Children (FDDC). This research uses an analytical survey using questionnaires and interviews to assess OHRQoL. The sampling technique, namely Total Sampling, obtained 43 ID child subjects who met the inclusion criteria. The data were tested statistically using the Spearman Correlation non-parametric test and the t-test.

Results: : The average value of odontogenic infection in the population was 1.79, including in the poor category, and the total spectrum of dental caries was 51.16%, including severe morbidity. Multivariate analysis showed a significant correlation between odontogenic infection, total spectrum of caries, and OHRQoL; odontogenic infection with total dental caries spectrum was significantly associated with each p-value = 0.0000, while the correlation between OHRQoL and both odontogenic infection and total caries spectrum had p-values > 0.05, respectively, so it is considered not significant.

Conclusion: : Odontogenic infection in ID children is a poor category. The total spectrum of dental caries in ID children mostly includes severe morbidity. There is a correlation between odontogenic infections, the total spectrum of dental caries, and OHRQoL, as well as between odontogenic infections and the total spectrum of dental caries.

Purpose: The aim of this pilot study was to assess the knowledge and perceptions surrounding the use of fake snap-on veneers, as well as to evaluate the experiences of individuals who have used them.

Materials and methods: This study was conducted between October 2021 and January 2022. A questionnaire was distributed through social media platforms to individuals aged >18 years in Saudi Arabia, which assessed their personal and sociodemographic information and perceptions and experiences with fake snap-on veneers. The statistical analyses included descriptive statistics, bivariate analyses, and multiple logistic regressions.

Results: The study included 466 participants, with the majority being young adults, with an almost equal sex distribution. The study highlighted a general reluctance to use these veneers because of concerns about dental damage and esthetics. Women and younger individuals showed higher awareness, and regional variations indicated potential cultural influences on the perception of these dental devices. Most users experienced discomfort and did not recommend the fake snap-on veneers.

Conclusion: This study sheds light on a cautious approach toward fake snap-on veneers, despite their esthetic appeal. This underscores the need for strict regulations, public awareness campaigns, and ethical dental practices to ensure informed decision-making and safeguard dental health. The concept of an ideal smile has led to various cosmetic dental procedures. Snap-on veneers offer a pain-free and affordable solution, but fake versions raise concerns about discomfort, unrealistic results, and oral health issues. User complaints emphasize the need for strict regulations and public awareness campaigns to ensure informed decisions.

Background: The mandible, a key bone in the lower face, is prone to trauma. Although mandibular fractures are widely recognized as common and costly, there is a research gap on this topic in Afghanistan. This study explores the causes of lower jaw fractures and their link to demographic factors in the Afghan population.

Materials and methods: A retrospective analysis of 535 medical records from a Kabul tertiary hospital (March 2021 to March 2022) examined lower jaw fractures, patient demographics (age, sex), and injury causes. Statistical methods, including chi-square tests and Pearson's contingency coefficient, were employed to explore correlations between mandibular fractures and demographic factors.

Results: In this study, we analyzed 579 mandibular fractures in 535 patients, with road accidents (33.08%), falls (22.61%), and interpersonal conflicts being the leading causes. Most patients were aged 21-30, with single fractures being the most common (92.3%) and parasymphyseal fractures being the most prevalent (28.5%). Although certain fracture types were significantly correlated with age, no notable association was found between age and injury cause.

Conclusion: This study reveals that road accidents, falls, and interpersonal conflicts are the main causes of lower jaw fractures in Kabul, with the highest incidence in individuals aged 21-30. These findings highlight the necessity for targeted public health interventions, such as improved road safety campaigns and stricter traffic regulation enforcement, to lower injury rates. Incorporating these insights into clinical practice can also help healthcare providers more effectively manage lower jaw fractures in affected populations.