Clinical Oral Investigations最新文献

Objective: Assessment of periodontal and peri-implant inflammation, evidenced by bleeding on probing (BOP), among partially dentate patients receiving supportive periodontal care (SPC).

Material & methods: Patient charts from the Center for Dentistry and Oral Medicine of Goethe-University Frankfurt with at least one dental implant were reviewed. Measurements included probing pocket depth (PPD), BOP, and full-mouth bleeding and plaque scores for all teeth and implants.

Results: 100 patients (median; lower/upper quartile: age 68.9; 62.6/76.5 years; 51 females, 6 smokers, 16 with anticoagulative medication, 6 localized stage III, 57 generalized stage III, 37 stage IV, 70 grade B, 30 Grade C, 22; 20/25 teeth left, 2; 1/4 implants) were examined. Peri-implant BOP (24; 11.5/41.5%) was significantly higher than BOP at teeth (14; 8/21.5%) (p < 0.001). A median of 0 (0/1) implants exhibited no BOP and 0 (0/1) only one site with BOP. Shallow pockets (PPD 1-3 mm) were significantly more frequent in teeth (93; 87/97%) than in implants (72.5; 58/94.5%; p < 0.001). Moderately deep pockets (PPD 4 and 5 mm) were less frequent in teeth compared to implants (6; 2/11%; 22; 5.5/33%; p < 0.001).

Conclusions: Peri-implant sites exhibit a higher prevalence of BOP compared to periodontal sites in SPC patients.

Clinical relevance: Practitioners providing supportive periodontal care to patients with dental implants should anticipate a greater prevalence of BOP around implants compared to teeth.

Objectives: The aim of this study was to evaluate the changes of upper airway ventilation function after molar distalization with aligners in adult patients by computational fluid dynamic simulation.

Materials and methods: A total of 15 subjects were included (3 males and 12 females, with an average age of 20.00 ± 0.50 years) who required en masse distal movement of the whole dentition using Invisalign aligners. The software Mimics 19.0 was used to reconstruct the upper airway based on their CBCT images and measure the minimum cross-sectional area and volume before and after treatment. Then the upper airway flow during inspirations was simulated and evaluated using Ansys software. At last, the morphologic and hydrodynamic parameters before and after treatment were compared using paired T-test.

Results: For morphological evaluation, the volume changes of velopharynx, glossopharynx and hypopharynx volume revealed no statistically significance after treatment compared to the data before treatment, the minimum cross section of upper airway decreased significantly. For hydrodynamics parameters, the minimum pressure, maximum shear force, velopharynx and glossopharynx pressure drop increased 50.2 Pa, 0.66 Pa, 5.78 Pa and 5.32 Pa respectively. At last, the correlation analysis between CFD data and MCA is of no statistical significance.

Conclusion: Non-extraction molar distalization using invisible aligners and mini-screws may lead to adverse changes in upper airway fluid dynamics, potentially increasing the risk of pharyngeal collapse.

Clinical relevance: The combination of invisible appliances with anchorage implants for the distalization of maxillary and/or mandibular teeth has emerged as a prevalent orthodontic technique. Clinicians should consider the potential impact on respiratory function when contemplating such treatment for patients with pre-existing respiratory conditions or those at a higher risk of ventilation issues.

Objectives: To investigate the influence of combining levels of metal artifact reduction (MAR) tool with different filters and slice-thickness in the detection of mandibular canals perforated by implants on CBCT scans and to objectively assess the impact of the aforementioned combinations.

Materials and methods: Implants were placed above (8 implants) and inside (10 implants) mandibular canals of dried-mandibles. CBCT scans were obtained with the Eagle 3D unit (85 kVp, 8 mA, 5 × 5 cm FOV, 130 μm voxel size, and off/medium/high MAR levels). Examiners evaluated the scans under each MAR level and across different conditions: no filter, Sharpen 1×, Sharpen 2×; 0 mm, 1 mm, and 2 mm slice-thickness. The gray values on axial reconstructions were assessed. Area under the receiver operating characteristic curve (AUC), sensitivity, specificity, mean and standard deviation (SD) for gray values were calculated and compared by multi-way Analysis of Variance.

Results: Overall, the AUC and sensitivity decreased with high-level MAR (p < 0.0001), regardless other variables tested. Enabling MAR tool decreased mean gray values (p < 0.01) and increasing MAR levels reduced the SD values on scans with Sharpen 2× (p < 0.012).

Conclusions: High-level MAR impairs the visualization of mandibular canals perforated by implants. Moreover, enabling MAR tool decreases the mean gray values.

Clinical relevance: MAR tool, filters, and slice thickness influence the image quality of CBCT scans. Therefore, it is important to evaluate the impact of these parameters on the diagnosis of mandibular canals perforated by implants.

Objectives: To investigate the effects of denture cleansers on the various properties of CAD/CAM and heat-polymerized polymethyl methacrylate (PMMA).

Materials and methods: Two different brands of heat-polymerized and two of milled PMMA were fabricated (n = 50), in total 200. Each group was randomly divided into five subgroups (n = 10): control groups (D1) kept in distilled water, cleaning tablets (D2, D3), neutral (D4) and acidic electrolyzed acid water (EAW) (D5). Surface roughness, hardness and flexural strength values were evaluated. Data were statistically analyzed with two-way ANOVA and Tukey post hoc test for comparison (p<0.05).

Results: The milled group showed significantly lower surface roughness, greater surface hardness, and higher flexural strength values than heat polymerized denture bases (p<0.05). The denture cleansers had no significant effect on the surface roughness values of the milled specimens (p>0.05), whereas the specimens in the heat-polymerized groups and treated with D5 showed greater surface roughness values compared with the other cleaning agents (p > 0.05). The denture cleansers had no significant effect on surface hardness and flexural strength of heat polymerize groups (p > 0.05). However, D2, D3 and D5 cleaning agent decreased the hardness values of the milled group (p<0.05) and D5 cleaning agent decreased the flexural strength of the milled group (p<0.05).

Conclusions: It was observed that the applied denture cleansers affected the surface roughness, surface hardness, and flexural strength values of both denture bases but within a clinically acceptable value.

Clinical relevance: CAD/CAM denture bases showed significantly higher physical and mechanical properties than to heat-polymerized base materials. Although the applied neutral EAW cleaners give desired results for denture bases, clinical studies are needed for biological compatibility.

Objectives: To highlight the critical need for integrated healthcare approaches for individuals with severe mental disorders and poor oral health.

Materials and methods: Review and discussion of factors contributing to elevated DMFT (decayed, missing, and filled primary teeth) indices in individuals with severe mental disorders.

Results: Higher DMFT indices are reported in individuals with schizophrenia and bipolar disorder due to medication side effects, cognitive impairments, and socio-economic challenges.

Conclusions: Emphasis on the necessity of combining mental and dental health services through regular dental check-ups, specialized education programs, and professional collaboration.

Clinical relevance: Integrated healthcare strategies are essential to improve overall patient care and well-being for those with severe mental disorders.

Background: The pathological evaluation of cancellous bone at resection margins of mandibular osteoradionecrosis (ORN) has not been well elucidated. Here, we developed a unique classification system for evaluating the degree of bone marrow fibrosis, one of most common pathological features, in patients with mandibular ORN, based on which we investigated its relationship with treatment outcome.

Methods: This study included 15 patients who underwent mandibulectomy and free fibula osteocutaneous flap reconstruction. The extent of mandibulectomy was determined, with safety margins of approximately 10 mm from the apparent osteolytic areas on preoperative computed tomography image. Special staining was performed on thin sections from center of the osteolytic areas (medial area) and bilateral resection margins, and the degree of bone marrow fibrosis was evaluated and investigated its relationship with presence of bone union as a treatment outcome.

Results: The degree of bone marrow fibrosis of medial area was significantly higher than those of resection margins. Although most resection margins had collagen fibers which indicate severe fibrosis, all transferred fibula flaps achieved bone union.

Conclusion: When mandibulectomy is performed with safety margins of approximately 10 mm from the apparent osteolytic areas, all transferred fibula flaps achieved bone union regardless of the degree of bone marrow fibrosis at resection margin. In other words, the association between severe bone marrow fibrosis at resection margins and treatment outcome was not seen.

Clinical relevance: Setting safety margins of approximately 10 mm may achieve bone union, but further study is needed.

Objectives: The study investigated the influence of retention grooves and material thickness of the retainer wing on the retentive strength of resin-bonded attachments (RBAs).

Materials and methods: Sixty-four extracted human molars were used. Each tooth received a preparation limited to the enamel for the retainer wings of the RBAs. The specimens were divided into eight groups, each containing eight specimens. The groups varied based on the number of conical retention grooves (0, 1, 2, or 4) and the thickness of the CoCr retainer wings (0.4 mm and 0.8 mm). Before testing the retentive strength of the RBAs, the specimens underwent 37,500 thermal cycles followed by dynamic loading of 1,200,000 cycles on the RBAs' patrices using a chewing simulator. The debonding test was conducted using a universal testing machine at a crosshead speed of 2 mm/min.

Results: The mean retentive strength ranged from 326 ± 96 N to 440 ± 77 N. Only a small portion of specimens (10.9%) exhibited adhesive failure, while the remainder demonstrated cohesive failure within the tooth structure. Neither the number of retention grooves, the thickness of the retainer wings, nor the size of the bonding surface significantly affected retentive strength.

Conclusions: The findings suggest that reducing the number of retention grooves and the material thickness does not influence the retentive strength of RBAs.

Clinical relevance: The retention of RBAs appears promising, supporting the clinical application of this treatment modality.

Objectives: The primary objective of this study was to compare implant survival rates (ISR) in patients undergoing maxillary sinus floor augmentation (MSFA) with lateral approach with and without membrane perforation. Secondary objectives were to establish the percentage of perforations in these procedures and to evaluate the influence of perforation size on ISR.

Materials and methods: This retrospective study included patients requiring MSFA with lateral approach. Cases were assigned to two groups according to the occurrence or not of perforation. The exact size of each perforation was registered. Descriptive statistics and associations between the groups were calculated.

Results: This study analyzed data from 90 MSFA in 72 patients. Membrane perforation occurred in 24.44%. A total of 170 implants were placed; 72.35% were placed under intact membranes and 27.65% on repaired membranes. The overall ISR in MSFA procedures with intact membranes was 98.37%, and 93.62% in perforated membranes. No statistically significant relationship between groups was observed although the odds of implant failure increased by 4.125 times when perforation occurred. In turn, no statistically significant relationship was observed between perforation size and ISR.

Conclusions: Implants inserted below repaired membranes had a lower ISR compared with implants inserted below intact membranes although the difference was not statistically significant. Moreover, no significant statistical correlation was observed between perforation size and ISR.

Clinical relevance: Membrane perforation does not have a significant influence on subsequent implant survival rates. Knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

Objective: Aimed to compare the volumetric calculations (VC) of intra-and-extraoral scanners on carious teeth before/after caries removal.

Materials and methods: 120 extracted human molars with ICDAS scores of 3, 4, and 5 were included. The teeth were scanned using an extraoral scanner (Ineos-X5, Dentsply Sirona) and three intraoral scanners (IOS) (iTero Element-5D, Align Technology; Primescan, Dentsply Sirona; Trios 4, 3Shape) before-and-after caries removal (CR). Eight Standard Tessellation Language (STL) data of each tooth sample were overlapped in Meshmixer (Autodesk) software for VC. Shapiro-Wilk, Paired Two-Sample T-test, repeated analysis of variance test statistics, and intraclass correlation coefficient (ICC) were used (p < 0.05).

Results: In initial VC, a significant difference observed between Ineos-X5 and iTero Element-5D (p < 0.001) and Ineos-X5 and Primescan (p < 0.001), regardless of the ICDAS score. No significant difference observed after CR between Ineos-X5 and iTero Element-5D (p = 0.917), Ineos-X5 and Primescan (p = 0.936), and Ineos-X5 and Trios 4 (p = 0.727) respectively. There was also no difference between the three IOS after CR (p ≥ 0.05), whereas the iTero Element-5D scanner significantly calculated less volume than Primescan and Trios-4 initially (p = 0.003). Maximum ICC was observed between the Ineos-X5 and Primescan in the ICDAS 5 score, before CR (ICC = 1, p < 0.001) and triple comparisons of iTero Element-5D, Primescan, and Trios-4 (ICC = 1, p < 0.001).

Conclusion: Carious and irregular surfaces might affect the data collection of IOS.

Clinical relevance: Intra-and-extraoral data may present negligible differences in the volumetric calculation, depending on the caries status and anatomical properties. These differences and factors may be important for future artificial intelligence networks that simulate the aftermath of caries removal. The IOSs tested in the current study can successfully collect data from irregular, deep and shallow cavities after caries removal.

Objectives: We investigated the association of female reproductive factors with periodontitis.

Materials and methods: This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey 2009-2014 on 2321 women aged 45-80 years who had full-mouth periodontal examination and reproductive questionnaire. The 2018 World Workshop Classification of Periodontal and Peri-implant Diseases was used to classify periodontitis stages.

Results: After adjustment, > 3 pregnancies or live births were associated with increased stage III/IV periodontitis but age at first birth (AFB) > 23 years and female hormone use were associated with decreased stage III/IV periodontitis, while there were no associations of oral contraceptive use or menopause status with stage III/IV periodontitis. Stage III/IV periodontitis was more common in women with > 3 pregnancies or live births and AFB ≤ 23 years or never using female hormones but less common in women with ≥ 3 pregnancies or > 3 live births and AFB > 23 years or using female hormones. >3 pregnancies or live births were related with increased stage III/IV periodontitis and increased AFB was related with lowered stage III/IV periodontitis in overweight and smoking subgroups but using female hormone was related with reduced stage III/IV periodontitis in nonsmoking, non-overweight and black subgroups.

Conclusions: >3 pregnancies/live births were related with severe periodontitis but AFB > 23 years and female hormone use were related with ameliorating periodontitis.

Clinical relevance: Women with > 3 pregnancies/live births should receive intensive periodontal interventions. Female hormone therapy or AFB > 23 years may be beneficial for periodontal health of > 3 pregnancies/live births women.