Clinical Oral Investigations最新文献

Objectives: This cross-sectional study aimed to assess the natural bone healing process in mandibular cystic cavities after enucleation surgery using three-dimensional (3D) analysis. By assessing key indicators, including bone cavity healing percentage, mean reduction in bone cavity radius, and mean bone volume increase, we sought to provide a detailed quantification of postoperative bone regeneration.

Methods: 223 CT records from 84 patients with initial bone cavity volumes exceeding 1000 mm³ were included. 3D mandibular models were generated from the CT scans, and digital software was employed to measure cavity volume, surface area, and anatomical distances. The influence of cyst size, gender, and age on healing outcomes was evaluated at various intervals.

Results: Mandibular bone cavities healed most rapidly during the first three months, shrinking by approximately 1.14 mm/month (IQR: 0.66-1.53 mm/month) while bone volume increased by 0.61 mm/month (IQR: 0.39-1.12 mm/month). By three months, approximately 58.32% (IQR: 37.54-65.87%) of the cavity volume had healed. By 12 months post-operation, cavities were nearly healed with a healing rate of 90.23% (IQR: 80.69-94.45%). Bone accumulation was influenced by gender (P < 0.001), age (P = 0.014), cavity size (P = 0.004), and position (P = 0.029), with cavity shrinkage more significantly affected by the initial cavity size (P = 0.015) and gender (P = 0.004). Newly formed bone contributed to 63.28%(IQR:45.78-83.68%) of the total healing.

Conclusions: This study offers a comprehensive 3D evaluation of mandibular bone healing after cyst enucleation. Both bone formation and cavity shrinkage were key components of healing.

Clinical relevance: The study provides valuable insights for monitoring postoperative recovery and predicting bone healing.

Objective: Conduct a cross-sectional study to investigate the periodontal conditions and oral health behaviours among adult subjects with type one diabetes mellitus and compare them with those of a group of age- and gender-matched without diabetes. Furthermore, we also intend to evaluate the potential indicators of the risk for the development of periodontal disease.

Methods: The evaluation was undertaken with patients with diabetes (n = 70) from a patients' cohort of the the Hospitalar Center of Tâmega e Sousa and subjects without diabetes (n = 69).

Results: The prevalence of periodontal disease showed significant differences between groups. Gingivitis reached a prevalence of 37.1% in patients with type one diabetes mellitus and periodontitis 55.7%. These systemically compromised patients exhibited a higher prevalence of Plaque Index, Bleeding on Probing and Periodontal Probing Depth and a reduced number of teeth when compared to the control group. The stage II was the most prevalent in the diabetes population, followed by the stage IV and most of diabetes subjects presented grade C progression.

Conclusions: There is a higher prevalence of periodontal disease in type one diabetes mellitus individuals when compared to the controls. Age, Bleeding on Probing and number of cigarettes per day are associated with higher risk of periodontal disease in type one diabetes mellitus patients.

Clinical relevance: Our study provides evidence about the prevalence of periodontal disease among type 1 diabetes mellitus and creates awareness regarding the factors that potentially contribute to worsening periodontal tissues. Furthermore, informing diabetic patients about the importance of early diagnosis and prevention of periodontal disease and the importance of reducing/quitting smoking.

Objectives: Only a little is known about the tooth brushing behaviors and oral health care of people with early childhood autism (P-EA). To remedy this, a survey was carried out with P-EA of all ages.

Materials and methods: In summer 2021, an online survey questionnaire with 124 questions, addressed only at caregivers of P-EA, was sent to all members of the Bundesverband Autismus Deutschland e.V. Our present study evaluated the 20 survey questions related to dental self-care.

Results: In total, 130 questionnaires were evaluated. The mean age of the P-EA was 22.7 years (min: 3y; max: 60y; SD ± 14.1y). Only 17.7% (n =23) of the P-EA were female, while 82.3%(n =107) were male. Overall, 54.6% (n = 71) of P-EA are always actively assisted in tooth brushing. Although 57.7% (n = 75) of P-EA brushed teeth twice daily, 39.2% brushed for one to two minutes (n = 51). P-EA younger than 18 years old selected toothpaste primarily for taste reasons (32.7%;n = 18). Only 9.3% (n = 7) of adult P-EA selected toothpaste because of the fluoride content. Manual toothbrushes were preferred by 40.8% (n = 53) of the P-EA, and electric toothbrushes by 34.6% (n = 45). Almost three quarters (71.5%;n = 93) did not use additional dental care implements. The same number (75.4%;n = 98) of P-EA had not practiced supervised brushing in a dental office.

Conclusions/clinical relevance: Active support in dental self-care is crucial for a majority of the P-EA in Germany, regardless of their age. Professional support needs to be fundamentally improved. Clinical concepts for practical instruction in dental hygiene should be developed for P-EA.

Objectives: This study aimed to establish a method to detect and quantify mucosal malperfusion intraorally using state-of-the-art Endoscopic Hyperspectral Imaging (EHSI). For this purpose, mucosal ischemia was selectively induced by intraligamentary anesthesia (ILA) with and without + epinephrine using a standardized protocol.

Materials and methods: EHSI was performed using a novel endoscopic hyperspectral imaging system. Parameters assessed were Tissue Oxygen Saturation (StO₂ [%]), Tissue Hemoglobin Index (THI), Near Infrared Perfusion Index (NPI) and Tissue Water Index (TWI). Fifty-seven healthy subjects received ILA using Articaine 4% with (ILA+) and without (ILA-) epinephrine at a dosage of 1:200,000 administered mesially and distally to the target tooth 42 (Universal No. 26). Mucosal perfusion was assessed using EHSI for 45 min post-injection.

Results: After ILA+, a distinct ischemia of the mucosa was already clinically apparent after 30 s with significant reduction of THI and StO₂ by an average of 57% (p < 0.001) and 7% (p < 0.040) compared to baseline values. Persistent hypoperfusion of the oral mucosa was observed throughout the monitoring period, exhibiting a gradual resolution at the 30-minute mark, and nearing baseline perfusion approximately 45 min post-injection. There was no papillary necrosis after ILA + injection.

Conclusion: EHSI is suitable to adequately detect and visualize actual perfusion of the intraoral mucosa. The study revealed that LA with epinephrine (1:200,000) induce temporary hypoxia in the dental papilla but without causing severe ischemia.

Clinical relevance: EHSI will enable promising applications in the future, i.a. success monitoring of periodontal therapies, intraoral free flap monitoring and the assessment of cancer margins.

Purpose: This study aimed to analyze changes in the pharyngeal airway structure and function in patients with skeletal Class III malocclusion one year after orthognathic surgery.

Materials/methods: In this research, cone-beam computed tomography (CBCT) images of 30 patients (14 men and 16 women; mean age 20-30 years) with skeletal Class III malocclusion who underwent Lefort I osteotomy and bilateral sagittal split osteotomy were obtained before and one year after the surgery. Changes in pharyngeal airway structure were achieved by comparing CBCT data, and changes in function were achieved by comparing fluid dynamics models. The pharyngeal airway was analyzed by Element 3D (E3D) and the nasal airway 3D model was reconstructed. The meshing was implemented in ICEM-CFD (ANSYS, Canonsburg, PA, USA), and improved the mesh quality. The meshes were imported into Fluent (ANSYS, Canonsburg, PA, USA) to stimulate a fluid analysis.

Results: The minimal anteroposterior diameter, minimal cross-sectional area and volume of pharyngeal airway were significantly reduced after surgery. There was no significant difference in the nasopharyngeal cross-sectional area. Pharyngeal airway resistance increased significantly after surgery, wall shear stress changed little before and after surgery. The anatomic structure of pharyngeal airway changed after surgery, but the morphological change of pharyngeal airway was not significant.

Conclusions: One year after surgery, the anatomical structure and function changed compared with those before surgery, and the changes of minimal cross-sectional area of pharyngeal airway should be considered when designing the treatment plan for the patients.

Objectives: To carry out physicomechanical characterization of the HA/DCPA/TiO₂ and to evaluate the tissue repair in rat calvaria.

Methods: Two bone defects were made in the calvaria of 36 Wistar rats, divided into groups: HA/DCPA, HA/DCPA/TiO₂ and sham (blood clot). The animals were euthanized at 30, 60 and 90 days and calvaria slides were processed with hematoxylin/eosin. The newly formed bone, connective tissue, biomaterial remnant, and total tissue repair percentages were calculated in relation to the total defect area. The HA/DCPA/TiO₂ was characterized structurally by scanning electron microscopy (SEM), and chemically by energy-dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD). It was submitted to apparent density (AD), apparent porosity (AP), water absorption (WA) and compressive strength (CS) physical tests. The ANOVA test was applied, followed by Turkey's test and Student's t-test (p ≤ 0,05).

Results: The SEM showed biomaterials inside the bone defects and newly formed bone. EDS identified oxygen, calcium, phosphorus, and titanium in the sample. The HA/DCPA/TiO₂ and HA/DCPA groups presented a total tissue repair area that was larger than the sham group (p < 0.001).

Conclusions: The physical-mechanical assays showed that HA/DCPA/TiO₂ has AD and CS properties within the limits of trabecular bone and with values higher than HA/DCPA.HA/DCPA/TiO₂ presented higher densification and compressive strength rates than HA/DCPA.

Clinical relevance: Potential as a scaffold for bone.

Objectives: To evaluate the efficacy and safety of cryogun cryotherapy in treating benign oral vascular anomalies (BOVAs).

Materials and methods: We conducted a retrospective longitudinal study on patients with BOVA who underwent cryogun cryotherapy. The clinical outcomes assessed included lesion regression, recurrence, complications, and clinical predictors of prognosis.

Results: Cryogun cryotherapy demonstrated high efficacy in treating BOVA in a study of 33 patients, with 97% of lesions achieving complete regression after an average of 1.64 ± 0.93 sessions (range: 1-4). Treatment outcomes were influenced by factors such as lesion morphology and anatomical location. Lesions in the buccal mucosa required more sessions compared to other anatomical sites, and exophytic lesions necessitated more sessions than flat lesions.

Conclusions: Cryogun cryotherapy is a safe and effective treatment option for BOVA, regardless of lesion size or location. Residual lesions can be treated successfully with additional sessions.

Clinical relevance: Cryogun cryotherapy offers a reliable prognosis for BOVA patients and provides a cost-effective, non-invasive alternative to other treatment methods.

Introduction: Clinicians have access to a variety of suture materials for effective wound repair. Recent studies have suggested utilizing coatings on sutures to enhance their properties. Literature indicates that such coatings may improve the tensile strength of sutures and augment their antimicrobial capabilities. Various materials, including zinc oxide (ZnO) nanoparticles, silver nanoparticles, and antimicrobial agents, have been investigated. This study aims to elucidate the materials utilized for coating sutures, identify the types of sutures employed, and detail the properties imparted by each coating.

Method: A systematic search was conducted in the Scopus, Web of Science, and PubMed databases using the keywords "coat*," "sutures," and "oral surgery."

Results: 20 articles met the inclusion criteria and were incorporated into this review. The literature is sparse regarding comparative studies on sutures with specific coatings. Triclosan-coated sutures have not shown a significant reduction in microbial load in oral surgery. However, silver nanoparticle coatings have been effective in reducing wound contamination. Antiseptic-coated silk sutures demonstrated significantly lower microbial colonization compared to controls. Notably, sutures with lycopene coatings did not exhibit superior antimicrobial or mechanical properties to uncoated sutures. ZnO nanoparticle-coated silk fibers displayed higher tensile strength than their uncoated counterparts. Other coatings, such as silicone or wax, have been developed to reduce suture friction.

Conclusion: In oral surgery, the effectiveness of coatings remains limited, potentially due to the high microbial load present in the anatomical region. Many coated materials are available for use in oral surgical sutures, but further research is necessary. Timely removal of sutures is recommended to minimize the risk of surgical wound infections, along with maintaining good oral hygiene.

Objectives: This study aimed to investigate the effectiveness of a national population-based dental sealant in South Korea.

Materials and methods: This nationwide, population-based cohort study involved all children in South Korea aged 6-7 years who received sealants from 2010 to 2011 and were followed up for 10 years using the Korea National Health Insurance Service (NHIS) database. After 1:2 propensity score matching, 857,723 children were selected for analysis. During the 10-year follow-up, the permanent first molars of the participants were assessed for caries-related treatments (pulpotomy and pulp capping, root canal treatment, and tooth extraction) using multilevel Cox proportional hazards models. The risk of caries-related treatment was lower in the sealant treatment group than in the control group.

Results: The hazard ratios (HRs) for caries-related treatments among participants were 0.59 (95% confidence interval [CI] 0.57-0.61) for pulpotomy and pulp capping, 0.57 (95% CI 0.55-0.58) for root canal treatment, and 0.29 (95% CI 0.27-0.32) for tooth extraction. This large-scale nationwide cohort study indicated that the sealant treatment in children aged 6-7 years significantly reduced the risk of caries-related treatments (pulpotomy and pulp capping, endodontic treatment, and tooth extraction) by at least 40% during the 10-year follow-up period.

Conclusion: Sealant treatment in children reduced the caries risk during the 10-year follow-up.

Clinical relevance: The results demonstrate the effectiveness of the insurance policy for dental sealants.

Objectives: This RCT aimed to evaluate the effect of topical Rebamipide (regular and nanoparticulated) in comparison to topical Clobetasol propionate in the management of methotrexate-induced oral ulcers in rheumatoid arthritis patients.

Materials and methods: Patients were divided randomly into three parallel arms: 1% Rebamipide; 1% nanoparticulated Rebamipide, Clobetasol propionate. The outcome measures included WHO oral mucositis grading, pain (NRS), ulcer size, and healing time. The data was analyzed for any statistical significance.

Results: Intragroup comparisons of mucositis grade improvement and pain reduction revealed significant differences in all the groups. All intergroup comparisons demonstrated non-significant difference, yet nanoparticulated Rebamipide was leading, and all group participants achieved complete healing earlier than the other groups.

Conclusion: Rebamipide, regular and nanoparticulated forms, showed comparable results to potent Corticosteroid, Clobetasol propionate in management of the oral ulcers.

Clinical relevance: Rebamipide is an efficient promising alternative modality for management of methotrexate-induced oral ulcers in rheumatoid arthritis patients.