Clinical Oral Investigations最新文献

Aim: The purpose of this study was to assess the accuracy of two web-based automated cephalometric landmark identification and analysis programs. Manual landmark identification using Dolphin Imaging software was used as reference.

Materials and methods: 105 cephalograms were selected and divided into three groups of 35 subjects each, Class I, II and III. Radiographs were traced using Dolphin imaging software. WebCeph™ (South Korea) and Cephio™ (Poland) were used for the automated cephalometric analysis. Bland-Altman limits of agreement and the concordance correlation coefficient (CCC) were calculated. Kruskal Wallis test was used to compare the accuracy of WebCeph™ and Cephio™ measurements between the three groups. Mann-Whitney U test was used to compare the absolute difference between cephalometric measurements obtained using WebCeph™ and Cephio™.

Results: The mean difference (MD) between AI and manually-derived measurements was less than 1 mm/degree and ranged from 0.01 to 0.8 except for upper lip protrusion (MD 1.35°), nasolabial angle (MD 5.01°), SN-GoGn (MD 1.41°), Ramus height (MD 1.46°), and IMPA (MD 1.94°). The mean CCC was 0.91 (range 0.60 to 0.96). No statistically significant differences were found between the three malocclusion groups for most of the measurements (P > 0.05).

Conclusions: For most of the measurements, automated cephalometric measurements were clinically acceptable. Few differences were found between Webceph™ and Cephio™ for most measurements. Measurements including SNA, SN-PP, IMPA as well as soft tissue measurements require extra consideration and manual adjustment of respective landmarks for higher precision and improved efficiency.

Objective: This study aimed to investigate the features of bone mineral density (BMD) and cortical bone thickness in grafted fibula.

Materials and methods: Eighty-six patients who underwent mandibular reconstruction using vascularized fibula flaps were enrolled, all of whom were followed up at 3, 6, and 12 months after surgery. The patients were grouped according to whether the condyle was preserved. BMD and cortical bone thickness were also measured.

Results: Condyle-preserved group consisted of 65 patients and condyle-unpreserved group consisted of 21 patients. There was a significant correlation between thickness and BMD, which was significantly correlated with follow-up time. One year after surgery, the BMD of the condyle-preserved group decreased from 1029.61 ± 156.01 mg/cm³ to 978.6 ± 141.90 mg/cm³, and thickness decreased from 3.29 ± 0.65 mm to 2.72 ± 0.72 mm. BMD of the condyle-unpreserved group decreased from 1062.21 ± 126.01 mg/cm³ to 851.26 ± 144.38 mg/cm³, and thickness decreased from 3.46 ± 0.89 mm to 2.56 ± 0.73 mm. In the condyle-preserved and unpreserved groups, the absorption rates of BMD were 3.29 ± 11.97% and 17.09 ± 12.42% at 12 months, respectively, and the rate of thickness was 20.7 ± 11.45% and 26.39 ± 12.23% at 12 months, respectively.

Conclusion: BMD and thickness showed a decreasing trend over time. Preserving the condyle can slow bone resorption of the fibula. Regarding implant restoration, we recommend doctors to perform the treatment within 6-12 months after surgery in order to effectively manage bone resorption.

Clinical relevance: Our study found that condylar preservation can decrease the absorption rate of BMD and cortical bone thickness, helping doctors make better clinical decisions.

Trial registration number: ChiCTR2300069661 (March 22, 2023).

Objectives: We aimed to determine the predictors of maximum bite force (MBF), as measured with the Innobyte system, and to assess the reliability and reference values for MBF in young adults with natural dentitions.

Methods: This cross-sectional test-retest study included 101 dental students with natural dentitions. Participants had their dental occlusion examined and completed three questionnaires: the Temporomandibular disorders Pain Screener, Oral Behavior Checklist, and Jaw Functional Limitation Scale. Body mass index and muscle mass percentage were determined, and handgrip strength was measured with a dynamometer. The MBF was measured with Innobyte, with reliability assessed by the intraclass correlation coefficient, expressing reference values as MBF percentiles. Bivariate tests and multiple linear regression models were used for statistical analysis.

Results: The intraclass correlation coefficient for the MBF was 0.90, with 10th to 90th percentiles of 487-876 N for females and 529-1003 N for males. A positive relationship existed between the MBF and male sex, muscle mass percentage, overbite, handgrip strength, and possible sleep/awake bruxism. Stepwise regression showed that overbite, handgrip strength, and possible sleep/awake bruxism had the greatest effect on the MBF, explaining 27% of the variation.

Conclusions: This study provides reference values for MBF when using the Innobyte system and shows excellent reliability. Overbite, general strength, and self-reported bruxism appear to be important predictors of MBF.

Clinical relevance: Innobyte is a reliable device that can be used to measure MBF bilaterally. Self-reported bruxism is associated with an 8%-10% increase in MBF.

Objective: The aim of this study is to evaluate the effect of Chloramine T in reducing gingivitis in hospitalized patients, in addition to providing an alternative to the use of Chlorhexidine.

Materials and methods: A randomized, triple-blind, placebo controlled clinical trial was performed with 45 volunteers presenting with gingivitis, using the Löe Gingival Index (LGI). Patients were randomly allocated into one of three groups: (G1): Chloramine T 0.2%; (G2): Chlorhexidine 0.12% and (G3): distilled water.

Results: After five days, the control group (G3) remained without relevant differences in relation to the first pre-treatment assessment, while the groups tested with chlorhexidine and chloramine T showed improvement in the LGI (p < 0.05). After ten days, G3 maintained the results of the previous assessments, G1 repeated the five-day assessment and G2 obtained a statistically significant difference, with a better result in relation to the previous assessment (p < 0.05). After fifteen days, G3 showed no differences in relation to the other assessments, G1 had a statistically significant difference, showing better performance in relation to the previous assessment and G2 continued the gradual improvement it had been showing in the LGI (p < 0.05).

Conclusions: Chloramine T and Chlorhexidine present similar results in the treatment of gingivitis, when evaluated by probing by the LGI, and Chloramine T can be used effectively, without causing the adverse effects inherent to prolonged use of chlorhexidine.

Clinical relevance: Importance of oral hygiene for patients admitted to hospitals with the use of adjuvant substances that do not present adverse effects such as chlorhexidine, which is considered the gold standard, seeking to provide better clinical protocols.

Objectives: To highlight the critical role of integrating oral health assessments into routine stroke care for better patient outcomes.

Materials and methods: The Eto et al. study utilizes the modified oral assessment grade (mOAG) to evaluate the oral health of acute ischemic stroke patients upon admission and its predictive value for functional outcomes and hospital-acquired pneumonia (HAP).

Results: Evidence from Eto et al. study shows that mOAG scores at admission significantly predict 3-month functional outcomes and the incidence of HAP, emphasizing the need for comprehensive oral evaluations.

Conclusions: Integrating oral health assessments into stroke care protocols can improve recovery outcomes, reduce HAP incidence, and lower healthcare costs through preventive oral care.

Clinical relevance: Routine oral health evaluations for stroke patients are crucial for better recovery and overall health outcomes, advocating for policy changes and multidisciplinary approaches to patient care.

Introduction: This study analyzed complication rates of guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes for alveolar ridge augmentation.

Material and methods: 84 patients treated with GBR using titanium-reinforced PTFE membranes (91 sites) were retrospectively analyzed. Complications such as membrane exposure and early removal were analyzed concerning patient age, defect site position, size, simultaneous vs. two-stage implant placement, smoking, and the use of bone grafts (BG) and substitutes (BS).

Results: Early removal due to membrane exposure was necessary in 14/91 sites (15.4%). No correlation was found between early removal and patient age (p = 0.917). Analyzing early removal between the upper and lower jaw and between both jaws' anterior and posterior tooth regions revealed no correlations (p = 0.381 and 0.477, respectively). Defect sites sizes of 5-6 mm exhibited the highest rate of membrane exposure, requiring early removal, accounting for 57.1% of these sites (8/14). No correlation was observed between the defect sites size and early removal (p = 0.660). Comparison of simultaneous (74 sites) vs. two-stage implant placement (16 sites) showed no correlation with early removal (p = 0.706). Membrane exposure incidence was 42.9% among smokers (27 patients, 32.1%) and 57.1% among non-smokers (57 patients, 67.9%), without correlation. No correlation was found between the type of BG and BS and early removal (p = 0.500).

Conclusion: GBR using titanium-reinforced PTFE membranes is effective for alveolar ridge augmentation and has favorable long-term outcomes.

Clinical relevance: Careful surgical technique and postoperative care can minimize the notable risk of PTFE membrane exposure.

Objectives: To date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF.

Materials and methods: This prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group's sockets were treated with solid PRF clots, whereas the control group's sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0-7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses.

Results: Swelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05).

Conclusions: PRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical.

Clinical relevance: PRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption.

Trial registration: clinicaltrials.gov (NCT05089812).

Background: Periodontics and gingivitis are two of the most widely prevalent illnesses that affect people nowadays. The sixth most common disease in the world is periodontitis, and detecting periodontal bone loss is essential in the earlier condition and is crucial for the development of the proper diagnosis. Early bone loss detection can be assisted by using computer-assisted radiography examination. Understanding disease progression helps to select the most effective treatment action.

Objectives: An effective deep model is suggested to detect periodontal bone loss at an earlier stage for preventing the progression of Periodontics bone loss.

Methods: This work is intimated by collecting images from online resources. Further, the images gathered from the dataset are preceded by the tooth segmentation which is done using DenseUNet +  + . Further, the segmented images are given to the Adaptive DenseNet with Gated Recurrent Unit (AD-GRU) for detecting periodontal bone loss and this diagnosis is used for the periodontitis stage, where the ADGRU performance is augmented by optimizing the attributes using the Refined Red Kite Optimization Algorithm (RRKOA).

Results: The offered approach attained an accuracy of 94.45% which is higher than the88.63%, 90.58%, 89.54%, and 92.96% attained by the LSTM, DenseNet, GRU, DenseNet-GRU.

Data conclusion: The findings of the simulation proved the designed framework outperformed the traditional model with high accuracy.

Clinical relevance: The developed effectual deep model-based periodontal bone loss and stage periodontitis diagnosis structure is used in healthcare applications.

Objectives: This 2-part randomized parallel triple-blind clinical trial adopts a unique model assessing clinically-set hydraulic calcium silicate-based sealers (HCSBS) after different root canal dryness protocols and obturation techniques.

Methods: For the first phase of the study, 24 teeth scheduled for orthodontic extractions were allocated into four groups according to the canal dryness protocol and the obturation technique. G1 (CLC-AHP): cold lateral compaction (CLC) with AH Plus sealer, G2 (CLC-ES-SD): CLC with Endosequence (ES) after standard canal(s) dryness (SD); G3 (SC-ES-SD): matching single-cone (SC) with ES after SD; G4 (SC-ES-PD): as G3 but after partial canal(s) dryness (PD). Teeth were extracted after one month of clinical service and examined for intracanal voids by micro-CT (2D & 3D). For the 2nd phase, another 24 teeth were allocated into four groups according to the root canal dryness protocol and the HCSBS used (ES or CeraSeal (CeS)). Teeth were extracted after one month and sectioned vertically for energy dispersive X-ray (EDX)/scanning electron microscope (SEM) examination. One-way ANOVA with Games-Howell post-hoc test and Chi-square test with multiple z-tests were used for statistical analysis.

Results: SC-PD showed the highest percentage of voids (p < 0.05). MicroCT scans as well as EDX/SEM examination showed that PD resulted in significantly larger interfacial gaps (p < 0.001) with more hydration products at the sealer/dentin interface than SD.

Conclusions: Both tested dryness protocols allowed the hydration of HCSBS and the formation of hydration products, thus standard dryness is recommended to reduce the incidence of intracanal voids.

Clinical relevance: When using the single-cone obturation technique, intentional root canal moisture negatively affects the performance of HCSBS.

Protocol registration: http://www.

Clinicaltrials: gov, ID: NCT05808062.