Clinical Oral Investigations最新文献

Objective: This randomized controlled trial compared the 1-year clinical efficacy of Scotchbond Universal Adhesive Plus (SBU+) with that of its predecessor Scotchbond Universal Adhesive (SBU) to restore Class I and Class II preparations using the self-etch strategy in adult patients.

Materials and methods: Fifty-one subjects participated in this study. Two posterior teeth in each subject were randomized to a restoration with SBU+ or to a restoration with SBU (control) using the self-etch strategy. Teeth were restored with Filtek Universal Restorative. Restorations were evaluated at baseline, 6 months and 1 year using the FDI criteria. The Wilcoxon signed-rank test was used to compare outcomes.

Results: No restorations were graded as "Insufficient/Unsatisfactory" or "Poor" for any of the FDI criteria at the baseline, 6-month, or 1-year visits. At 1 year the retention rate was 100% for both SBU+ and SBU. For fracture of the restorative material 42/44 SBU+ restorations (95%) and 44/44 SBU restorations (100%) were graded "Excellent/Very Good" (p > 0.05). All restorations were clinically acceptable for marginal adaptation at 1 year with no statistical differences between the two adhesive materials. There were no recurrent caries lesions at the 1-year visit.

Conclusions: The clinical efficacy of the SBU+ at 1-year was not different to that of its predecessor SBU in Class I and Class II restorations of adult patients using the self-etch strategy.

Clinical relevance: The two dental adhesives used in this clinical trial showed excellent results in posterior restorations at 1 year without using a separate phosphoric etching step.

Objectives: The aim of this study was evaluate the effect of Platelet-Rich Fibrin (PRF) in patients after mandibular third molar extraction through an analysis of the most current literature on systematic reviews and meta-analyses.

Data, sources and study selection: By using computer-assisted search technology, we comprehensively searched several reliable databases, such as China National Knowledge Infrastructure (CNKI), WanFang Data, the Chinese biomedical literature database, PubMed, Web of Science, EMBase, and the Cochrane Library, and performed a systematic retrospective meta-analysis on all of the collected studies on the therapeutic effects of PRF on patients after mandibular third molar extraction. A total of nine meta-analyses were performed in this study, and all nine studies were rated as high quality on the basis of the AMSTAR 2 criteria. Seven outcome indicators were extracted from the nine meta-analyses.

Conclusion: According to the included studies, which all demonstrated high scientific quality, PRF application after mandibular third molar extraction significantly reduces postoperative pain and inflammation, accelerates soft tissue healing, and effectively lowers the incidence of complications such as dry socket and alveolar osteitis. However, PRF did not significantly affect trismus or bone density. The conclusion has reliable support and clinical significance.

Objective: To evaluate the 36-month clinical performance of Single Bond Universal Adhesive (SBU; 3M ESPE, Germany) in non-carious cervical lesions (NCCLs) using different modes of adhesion according to the FDI criteria. The primary outcome was the retention loss of the restorations, while the secondary outcomes included marginal staining, marginal adaptation, post-operative sensitivity and tooth vitality, recurrence of caries erosion and abfraction, and tooth integrity, all evaluated according to the FDI criteria.

Materials and methods: In this study, the SBU Adhesive was applied to 246 NCCLs of 25 patients using different modes of adhesion: Self-etch (SE), selective-enamel-etching (SLE), and etch-and-rinse (ER). All lesions were restored with the same nanohybrid resin composite. The restorations were evaluated at the 1st, the 6th, 12th, 18th, and 36th month using the FDI criteria. The differences between SE, SLE, and ER groups were tested using the Kruskal-Wallis and Mann-Whitney U tests where a value of p < 0.05 was accepted as a criterion for statistical significance.

Results: After 36-month the recall rate was 96%. The retention loss rates were 29.33% for SE, 16.66% for SLE, and 3.89% for ER modes. Interactions between time periods and adhesive modes were found to be statistically significant (p < 0.05) for all FDI criteria. ER mode performed significantly better than SE mode for marginal staining, marginal adaptation and recurrence of caries, erosion and abfraction criteria after the 36th month (p < 0.05). There was no statistically significant difference between SE and SLE mode (p > 0.05), nor between SLE and ER mode (p > 0.05).

Conclusions: After the 36-month evaluation of all adhesive modes used in the study, restorations performed with the ER adhesion mode were clinically good (2), while those performed with the SE adhesion mode and SLE adhesion mode were clinically satisfactory (3) according to the FDI criteria. The primary outcome, retention loss, was significantly lower in the ER mode compared to SE and SLE modes. For secondary outcomes, the ER mode showed better performance in marginal staining, marginal adaptation, and the recurrence of caries, erosion, and abfraction highlighting its clinical advantages for mid-term success in non-carious cervical lesions.

Clinical relevance: Restorations performed with the SE adhesion mode of universal adhesives exhibit clinically acceptable behavior after 36 months of evaluation, although with less success than those performed with the ER adhesion mode.

Clinical trial registration: Clinical trials number- NCT06227715, Clinical trials link: https://clinicaltrials.gov/study/NCT06227715.

Objectives: This study aimed to investigate cracked teeth and vertical root fracture observable on micro-CT images of extracted roots of mandibular incisors, after fiber post removal.

Materials and methods: Thirty mandibular incisors were selected with any degree of slight incisal wear inspected with the aid of a stereomicroscope under 12x magnification, in order to have a group of young adult specimens according to the criteria of Hugoson et al. A sample of twelve mandibular incisors were selected, aged between 20 and 30 years old, with similar dentine volume and thickness. The specimens were scanned in a micro-computed tomography (micro-CT) device and submitted to root canal shaping, root canal filling, post space preparation, post placement and post removal.

Results: From a total of six experimental endodontic timepoints until post removal of 12 mandibular incisors, 64,800 cross-sectional images were analyzed and no vertical root fracture (VRF) or cracked tooth were detected.

Conclusions: Micro-CT assessment after ex vivo fiber post removal did not detect vertical root fracture or cracked tooth formation in the root canal walls of mandibular incisors.

Clinical relevance: This study highlighted that fiber post removal per se was not able to propagate VRF or cracked tooth formation or promoted any interruption of the integrity of human root dentin.

Objectives: To compare the variations in the upper airway of children with skeletal Class II mandibular retrognathism treated with van Beek Headgear-Activator (vBHGA) and Twin-Block (TB) appliances.

Materials and methods: 40 children were involved in this retrospective study and divided into two intervention groups: the vBHGA group and the TB group, each comprising 20 individuals with an average age of 11.13 years. Employing Cone Beam Computed Tomography and Geometric Morphometric analysis, a comprehensive assessment of the upper airway's volume, minimum cross-sectional area (m-CSA), and 3D shape characteristics was conducted pre-and post-treatment.

Results: The total volume, oropharynx volume, oropharynx m-CSA, and hypopharynx m-CSA significantly increased in both the vBHGA and TB groups (p < 0.05). The sole discrepancy between the two groups was observed in comparing the nasopharynx m-CSA (p < 0.05). A morphological difference was observed in the vBHGA group before and after treatment (p < 0.05), characterized by a wider and shorter airway, positioning of the posterior nasal spine closer to the anterior inferior area, and a more posterior nasopharyngeal wall. However, there were no significant shape differences between the two groups or before and after treatment within the TB group.

Conclusion: It appears that both vBHGA and TB interventions contribute positively to alleviating upper airway constriction. Nonetheless, the vBHGA group exhibits more alterations in the configuration of the nasopharynx.

Clinical relevance: Both orthodontic appliances have a positive impact on the upper airway but still have differences, emphasizing the need for individualized consideration when selecting orthodontic interventions.

Clinical trial registration: This study was also registered with the Chinese Clinical Trial Registry with registration number ChiCTR2400086867.

Objectives: Daily-use fluoride products are first-line protection against enamel wear from dietary-acid exposure (DAE). This study aimed to understand effects of fluoride concentration, fluoride salt, product form and ingredients in daily-use products on remineralisation and demineralisation, via network meta-analysis (NMA) of 14 studies using one well-established in-situ model. Remineralisation (surface-microhardness recovery, SHMR) after treatment, and protection against subsequent demineralisation (acid-resistance ratio, ARR) were measured.

Materials and methods: Healthy participants, wearing intra-oral palatal appliances holding enamel specimens eroded with standardised DAE, used test products once. Enamel hardness was assessed (Knoop microhardness probe) pre-DAE; post-DAE; after 4 h intra-oral remineralisation; and after post-remineralisation DAE. NMA was performed using a mixed-models approach on subject-level data to estimate and compare means.

Results: There was a dose-response for fluoride ion in toothpastes (0-1426ppm F; p < 0.001 for SMHR and ARR). One toothpaste (silica-based, 1150ppm F as NaF) showed a benefit for SMHR versus placebo [mean(standard error)]: 8.8%(0.6%) (33.0% vs. 24.2%; p < 0.001); for ARR: 0.27(0.03) (0.43 vs. 0.15; p < 0.001; 9 mutual studies). Use of fluoride mouthwash after fluoride toothpaste increased SMHR [2.4%(1.1%); p = 0.043; 3 studies]; the effect on ARR [0.08(0.05)] was not significant (p = 0.164). Negative effects of polyvalent metal ions and polyphosphates on SMHR (p < 0.05) were observed.

Conclusions: NMA proved effective in discriminating between fluoride-based treatments in this in-situ study, highlighting the importance of fluoride ion to enamel protection and showing formulation ingredients can affect its performance.

Clinical relevance: Daily-use fluoride products can protect enamel against dietary acids, but careful formulation is required for optimal performance.

Objectives: This study aims to comparatively assess the preventive and protective effects of the self-assembling peptide P₁₁-4 on enamel erosion and evaluate the potential for enamel surface recovery when professional products are combined with home-use dental-care products during the erosive process.

Materials and methods: Ninety-nine bovine incisors were divided into nine groups: a control group, four groups with the application of professional-products [P₁₁-4 peptide (Curodont-Repair), stannous/Sn²⁺ containing solution (8% Sn²⁺), casein-phosphopeptide-amorphous-calcium-phosphate fluoride/CPP-ACPF (MI Varnish), sodium fluoride/NaF (Profluorid)] and four groups with the combination of professional products and home-use daily dental care products [P₁₁-4 peptide (Curodont Repair + Curodont Protect), stannous ions containing agents (8% Sn²⁺+Emofluor Gel Intensive-Care), CPP-ACPF (MI Varnish + MI Paste Plus), NaF (Profluorid + ReminPro)]. Professional products were applied once before a five-day erosive cycle, involving six 2-minute citric-acid exposures per day. In combined-groups, a home-use dental-care product was applied daily at the end of each cycle day. After the cycle, lesion depth and fluorescence were analyzed using confocal-laser-scanning-microscopy, and results were statistically evaluated using paired t-tests, ANOVA, and Tukey's post-hoc tests.

Results: The P₁₁-4 group was significantly more effective among the professional-only groups in both parameters (p<0.001). All combined-groups were determined to be statistically more successful than their respective professional-groups in both parameters (p<0.05). Based on lesion depth data, it was observed that the P₁₁-4 and stannous-containing combined-groups showed statistically similar results (p>0.05). In terms of lesion fluorescence data, the P₁₁-4 combined-group was found to be statistically more successful than all other study groups (p<0.05).

Conclusion: The self-assembling peptide P₁₁-4 was determined to exhibit the best preventive and protective anti-erosive effect in both professional and combined applications.

Clinical relevance: A positive relationship was observed between the support of professional applications with home-use daily-dental-care products and protection against erosive lesions.

Introduction: This study aims to determine if intraoral 850 nm LED irradiation could reduce the duration of lower anterior crowding alignment.

Methods: In a parallel-designed, randomized controlled clinical trial 60 patients with 2 to 6 mm of lower incisor crowding who need non-extraction treatment, were randomly assigned to the intervention and control groups by block randomization (36 females, 24 males, mean age: 19.93 ± 3.05). MBT brackets (0.022 × 0.28-inch) were bonded for both groups and the NiTi wires in sequences were put in place until correction of crowding. The intra-oral LED device with a wavelength of 850 nm and power density of 70 mW/cm² was used for 5 min per day in the intervention group. The control group did not receive any light. The primary outcome was the duration of crowding correction. The patient's pain according the modified McGill pain questionnaire was the secondary outcome. The Cox regression model was used to compare groups. Mann-Whitney test was used for pain analysis.

Results: The crowding at baseline was the same between the two groups (P > 0.05). Duration of treatment in the intervention group was 104.7 days (95% CI: 95.6 -113.8) and significantly shorter than 161.9 days (95% CI: 151.5 -171.2) in the control group. The control group experienced a significantly higher pain score of 6.8 (95% CI: 6.1-7.5) immediately after archwire placement than the intervention group 5.4 (95% CI: 4.6-6.3).

Conclusions: Intra-oral LED 850 nm significantly decreased the relieving time of lower incisor crowding by up to 36% and reduced pain experience.

Objectives: To analyze the trends in the context of implant therapy in a 3-year patient population and compare it with data obtained over the last 20 years.

Materials and methods: All adult subjects who received treatment in the context of implant therapy between 2020 and 2022 were included in this retrospective study. Data regarding patient demographics, indications and location of implant therapy, implant characteristics, surgical techniques, complications, and early implant failures were recorded and compared to data obtained in the years 2002-2004, 2008-2010, and 2014-2016.

Results: Between 2020 and 2022, n = 1555 implants were placed in n = 1021 patients. The mean age at implant placement was 59.9 + 15.1 years, demonstrating an increase over time in the age group 61-80 years of 23.1% and > 80 years of 3.2% (p < 0.0001). Single tooth gaps (48.9%) remained the main indication. The use of narrow diameters ≤ 3.5 mm increased (9.4% vs. 26.6%, p < 0.0001), while implant lengths > 10 mm decreased (45.7% vs. 23.5%, p < 0.0001). A reduction in more invasive techniques and an increase in computer-assisted implant surgeries (CAIS) of 19.5% was found.

Conclusions: The mean age of patients receiving dental implant therapy, with the use of narrow-diameter and shorter implants has progressively increased in the last 20 years. The observed trends suggest a transition from conventional to CAIS, accompanied by the introduction of minimally invasive surgical techniques.

Clinical relevance: The adoption of narrower and shorter implants, along with minimally invasive techniques and CAIS, enables clinicians to tailor treatment plans that accommodate the unique needs of aging patients and optimize clinical outcomes.

Objectives: This study aims to develop an automated radiomics-based model to grade the pathological differentiation of head and neck squamous cell carcinoma (HNSCC) and to assess the influence of various magnetic resonance imaging (MRI) sequences on the model's performance.

Materials and methods: We retrospectively analyzed MRI data from 256 patients across two medical centers, including both contrast-enhanced T1-weighted images (CET1WI) and T2-weighted images (T2WI). Regions of interest were delineated for radiomics feature extraction, followed by dimensionality reduction. An XGBoost classifier was then employed to build the predictive model, with its classification efficiency assessed using receiver operating characteristic curves and the area under the curve (AUC).

Results: In validation cohort, the AUC (macro/micro) values for models utilizing CET1WI, T2WI, and the combination of CET1WI and T2WI were 0.801/0.814, 0.741/0.798, and 0.885/0.895, respectively. The AUC for the three differentiations, ranging from well-differentiated to poorly differentiated, were 0.867, 0.909, and 0.837, respectively. The macro/micro precision, recall, and F1 scores of 0.688/0.736, 0.744/0.828, and 0.685/0.779 for the CET1WI + T2WI model.

Conclusion: This study demonstrates that constructing a radiomics model based on CET1WI and T2WI sequences can be used to predict the pathological differentiation grading of HNSCC patients.

Clinical relevance: This study suggests that a radiomics model integrating CET1WI and T2WI MRI sequences can effectively predict the pathological differentiation of HNSCC, providing an alternative diagnostic approach through non-invasive preoperative methods.