Clinical Oral Investigations最新文献

Objectives: To quantitatively evaluate the progression of non-carious cervical lesions (NCCLs), gingival recession (GR), and occlusal tooth wear (OTW) over 25 years.

Methods: This observational, retrospective study involved 33 dental students who completed a questionnaire regarding their oral habits, diet, and health information. Impressions from the baseline and the 25-year follow-up were used to create digital casts, which were analyzed with 3D software (Geomagic Control; 3D Systems) to measure the progression of NCCLs, GR, and OTW. Occlusal analysis from Phase I, using the T-Scan system (Tekscan), was also included to evaluate occlusal interferences.

Results: NCCL dimensions (area, height, and width) showed moderate associations with GR and only weak correlations with OTW. Multivariate regression analyses identified significant factors associated with NCCL progression. For NCCLs, visible plaque, vigorous toothbrushing, occlusal interferences, dentin hypersensitivity, alcohol consumption, smoking, and frequent exposure to acidic or cariogenic diets were associated with increased NCCL progression. For GR, was significantly associated with occlusal contact, dentin hypersensitivity, alcohol consumption, and smoking. For OTW, unilateral mastication, long-term orthodontic treatment, and smoking were positively correlated with wear progression.

Conclusions: Mechanical and behavioral factors-particularly vigorous toothbrushing, occlusal interferences, and lifestyle habits such as smoking and alcohol consumption-significantly influenced the long-term progression of NCCLs, GR, and OTW. Mandibular molars and premolars were the most frequently affected teeth.

Clinical significance: The use of digital three-dimensional analysis allows accurate monitoring of NCCLs, GR, and OTW. Preventive measures should prioritize controllable risk factors, including brushing habits, smoking, alcohol consumption, and occlusal imbalances.

Objectives: To evaluate angular and linear tooth movements following orthodontic treatment for correction of moderate to severe crowding using clear aligner therapy (CAT).

Materials and methods: This retrospective study included 46 patients treated with clear aligners in permanent dentition for correction of moderate to severe crowding. Twenty-three patients (6 males, 17 females; mean age 20.0 years) were treated with premolar extractions and 23 patients (8 males, 15 females; mean age 17.3 years) were treated without premolar extractions. Three-dimensional tooth linear and angular displacements were quantified in the pre- and post-treatment digital dental models superimposed using the Slicer Automated Dental Tools module of 3D Slicer software ( www.slicer.org ). Generalized estimation equations were used for group comparisons (p < 0.05).

Results: CAT correction of moderate to severe crowding with premolar extraction led to significant retroclination of upper and lower incisors (upper: -6.71° ±7.79, P < 0.001 and lower: -5.11° ±8.49, P < 0.001). Anchorage control in extraction cases was limited, with approximately equal molar mesialization and incisor lingualization. In non-extraction cases, crowding was corrected through arch expansion with flaring of incisors. Vertical changes were similar between groups.

Conclusions: CAT of moderate to severe crowding without extraction led to arch expansion and proclination of incisors. In contrast, premolar extraction cases often presented incisor retroclination and molar mesial tipping, requiring careful biomechanical management.

Clinical relevance: These findings help clinicians plan treatments, manage patient expectations, and anticipate side effects, enabling the use of proper strategies and resources to optimize outcomes in both extraction and non-extraction cases.

Objectives: To evaluate the efficacy of ozone therapy on pain reduction, trisma and number of analgesic tablets taken following surgical removal of impacted mandibular third molar.

Methods: A split-mouth randomized clinical trial was conducted in 54 patients in need of bilateral impacted mandibular third molars (Pell-Gregory class II-B) extraction. Test sites were treated with adjunctive ozone therapy to the surgical extraction, while controls underwent surgical intervention only (time between surgeries: 3 weeks). Study primary outcome measure was the difference in perceived pain recorded using a Numerical Rating Scale (NRS) at 7 days after surgery. In addition, functional limitation in mouth opening (mm), number of analgesic tablets taken within one week after surgery as well as the patient's perceived quality of life (Oral Health Impact Profile (OHIP-14) were evaluated.

Results: Fifty patients (20 males and 30 females; median age: 21 years; all non-smokers) completed the study. Mean reported perceived pain decrease from 5.06 to 0.58 (test group) and from 5.62 to 1.08 (control group) between day 1 and 7. No statistically significant differences were detected between the two groups at any time points (p > 0.05). At day 7, mean mouth opening value was 40.8 vs. 36.6 mm in test and control group respectively (mean difference: 4.24 mm; p < 0.001; 95% CI: 6.55-1.93). The same trend was detected for the of number of analgesic tablets taken (median: 4 vs. 7; p = 0.01). Finally, OHIP-14 values did not differ between groups (p > 0.05).

Conclusion: Ozone therapy had a beneficial clinical effect in terms of mouth opening and in the number of analgesic tablets intake at 7 days after surgical removal of impacted mandibular third molar, despite the lack of adjunctive benefit on patients perceived pain reduction.

Clinical relevance: The clinical use of ozone therapy as adjunct to surgical removal of impacted mandibular third molar might be considered in light of the promising positive reported results in terms of mouth opening reduction and analgesic intake.

Clinical trial registration number: NCT05949476.

Objective: To examine the transdentinal response of odontoblast-like cells (MDPC-23), dental pulp stem cells (DPSC), and macrophages to flavonoid-based primers applied to caries-affected dentin.

Materials and methods: Primers were prepared from 20 mM of Naringin, Kaempferol, or Baicalein in 20% ethanol. Caries-affected dentin discs (N = 56) were produced using a microcosm biofilm model and mounted in artificial pulp chambers with MDPC-23 cells seeded on the pulp side. Occlusal surfaces (n = 8) were etched with 35% phosphoric acid, rinsed, and blot-dried, followed by application of ultrapure water (negative control, NC), 20% ethanol (solvent control, SC), flavonoid primers, or 29% hydrogen peroxide (positive control, PC). After 24 h, cell viability and morphology (scanning electron microscopy, SEM) were evaluated. Extracts obtained by transdentinal diffusion were applied to DPSC and MDPC-23 cells for up to 7 days to assess cell viability and mineralization, and to macrophages (RAW 264.7) for reactive oxygen species (ROS) production. Data were analyzed using ANOVA and Sidak's test (α = 5%).

Results: None of the flavonoid primers reduced MDPC-23 viability, while PC and phosphoric acid showed significant differences from NC. SEM images revealed altered cell morphology in acid-etched groups. After 7 days, primers slightly increased DPSC viability, maintained MDPC-23 viability, promoted mineralization, and reduced ROS.

Conclusions: Flavonoid-based primers applied to caries-affected dentin were non-cytotoxic, stimulated mineralization in pulp cells, and lowered oxidative stress in macrophages.

Clinical relevance: Flavonoid primers could support pulp health during dentin pretreatment, providing a conservative strategy for managing caries-affected dentin and reducing the risk of pulp irritation.

Objectives: To develop a cycling protocol for the evaluation of enamel erosion and to evaluate the effect of fluoride mouthrinses containing micrometric (TMPm) or nano-sized (TMPn) trimetaphosphate on enamel erosion using an artificial mouth apparatus.

Materials and methods: Fifty-three volunteers with high frequency of acid drink consumption were evaluated for duration and interval between sips, as well as the total drinking time. After standardizing the protocol, bovine enamel blocks (n = 120) were subjected to erosive cycles three times a day and treated with mouthrinses twice a day (1 min): placebo, 100 ppm F, 225 ppm F, 100 ppm F + 0.2% micrometric TMP (100F+TMPm) and 100 ppm F + 0.2% nano-sized TMP (100F+TMPn). The blocks were analyzed by profilometry (µm), surface hardness (KHN) and cross-sectional hardness (ΔKHN) after 1 or 3 days. Data were submitted to two-way ANOVA, followed by Student-Newman-Keuls' test, and Pearson correlation (p < 0.05).

Results: Most volunteers were women (74.4%) with a mean age of 21 years. Among all volunteers, 35.9% preferred to consume juices. Median sip time was 3.4 s, with a pause of 6.4 s and a total drinking time of 1 min and 10 s. Mouthrinses containing TMP maintained significantly higher SH (p < 0.001), with 100F+TMPn showing the lowest ΔKHN among all groups (p < 0.05). After 3 days, placebo produced the greatest enamel wear, SH loss, and ΔKHN, whereas 100F+TMPn achieved the lowest values (p < 0.05).

Conclusions: The protocol developed using an artificial mouth is informative and suitable for studying erosive tooth wear under in vitro conditions. Treatment with mouthrinses containing TMP significantly reduced enamel erosive wear and mineral loss.

Clinical relevance: TMP supplementation in mouthrinses significantly enhances their protective effect against erosive enamel wear.

Objectives: "The objective of this randomized control trial is to compare the marginal bone loss (MBL) in single implant-retained mandibular overdentures (SIRMO) retained by two different types of attachments using two healing protocols after a 2-year follow-up.

Materials & methods: SIRMOs were constructed for eighty completely edentulous patients. The latters were randomized based on the healing protocol and the used attachments into 4 equal groups: Submerged healing with ball attachment (BS), submerged with CM-LOC attachment (CS), non-submerged with ball attachment (BN), and non-submerged with CM-LOC (CN). Standardized peri-apical radiographs at baseline, 12 and 24 months were recorded to measure MBL. Comparisons for numerical data were performed using either Mann Whitney-U or Kruskal Wallis tests. Binary and categorical data were compared using chi square test. Significance level was set at p < .05.

Results: During the healing period, 6 implants failed, and 4 drop-outs were recorded. At the second year, 27/34 ball groups and 28/36 CM-LOC groups were recalled, no significant difference between B (0.28 ± 0.44) and C (0.38 ± 0.46) favoring B group (p = .3), and N (0.27 ± 0.39) and S (0.43 ± 0.51) favoring N group (P = .6). MBL revealed no significant difference neither between B and C groups nor between N and S groups.

Conclusion: Both attachments showed physiologically accepted limits of MBL, favoring the non-submerged healing protocol after a 2-year follow-up period.

Clinical relevance: Submerged (S) and Non-submerged (N) protocols could be used for a SIMOR, favoring the N protocol after a 2-year follow-up.

Trial registration number: PACTR20183003085193.

Aim: This in vitro study aimed to compare the direct (visual exam) versus indirect (3D-colored digital images exam) assessments of ICDAS (dental caries), BEWE (erosive tooth wear), and TF (enamel fluorosis lesions) indices performed on the occlusal surfaces of extracted human teeth for the detection and severity differentiation of dental caries, erosive tooth wear, and enamel fluorosis lesions.

Materials and methods: A total of 453 occlusal surfaces from extracted human teeth were mounted on 28 typodont models. Surfaces were examined directly (visual) and indirectly using 3D-coloured intraoral scans (TRIOS 4, 3Shape). Three indices were assessed: International Caries Detection and Assessment System (ICDAS; caries), Basic Erosive Wear Examination (BEWE; erosive tooth wear), and Thylstrup-Fejerskov (TF; fluorosis). Agreement between methods was analysed using weighted kappa statistics and percentage agreement.

Results: Substantial agreement was observed between direct and indirect methods: ICDAS (κ = 0.72, 64%), BEWE (κ = 0.70, 73%), and TF (κ = 0.75, 86%). Early lesions (ICDAS 1-2, BEWE 1) were more frequently misclassified.

Conclusions: 3D-coloured intraoral scanner imaging shows substantial agreement with visual examination for detecting and grading caries, erosive tooth wear, and fluorosis.

Clinical significance: This study supports the use of intraoral scanners as a practical adjunct to visual examination for documentation, education, and potentially remote consultations. Further clinical validation is warranted.