Clinical Oral Investigations最新文献

Introduction: There is currently no recommendation for retaining corrected bimaxillary proclination cases. This study aimed to compare retention protocols for maintaining stability of such cases.

Materials and methods: In this single-center, single-blinded parallel control trial, 27 participants were assigned to three groups using block randomization with a 1:1:1 allocation ratio; fixed bonded retention (FBR), vacuum-formed retention (VFR), and dual retention (DR) comprising both types. Data were collected every 3-months from debond (T0) for 12 months (T4). The primary outcomes measured changes in soft and dental tissue parameters on traced lateral cephalograms. Secondary outcomes included intra-arch changes and the oral health impact profile (OHIP-14[M]). This trial was registered with Clinicaltrial.gov (NCT04578704).

Results: At T4, the upper lip, lower lip, and upper incisors moved anteriorly (mean difference (MD) of 1.63 mm (SD 3.7), 0.48 mm (SD 1.1), and 0.54 mm (SD 0.97), respectively). The upper and lower incisors were proclined by 0.96 degrees (SD 2.1) and 1.11 degrees (SD 2.63), respectively. The interincisal angle was reduced by 0.56 degrees (SD 1.23). Only the upper incisor inclination (UII) change showed significant differences between groups (η² = 0.296; p = 0.015). Post-hoc comparisons revealed that the FBR and VFR groups exhibited greater proclination than the DR group (UII, MD = 3.33 degrees and 3.22 degrees, respectively). No differences were observed in OHIP-14[M] scores between the groups.

Conclusion: All three retention protocols showed statistically small but clinically insignificant changes.

Clinical relevance: Dual retention offers better control in preventing upper incisor proclination in bimaxillary proclination cases.

Trial registration: This trial was registered with Clinicaltrial.gov (NCT04578704).

Aims: To investigate systemic risk factors contributing to the formation of sialolithiasis.

Methods: A retrospective big-data cohort study was conducted using data from Clalit HMO in Israel. Sialolithiasis patients were identified based on ICD-10 codes and matched with controls. Univariate and multivariable logistic regression analyses were performed to assess the relationship between systemic conditions and sialolithiasis. P-value < 0.05 was considered significant.

Results: 5100 sialolithiasis cases were collected. The statistical analysis revealed that hypertension (OR = 1.14, 1.08-1.24, p < 0.001), dyslipidemia (OR = 1.33, 1.27-1.41, p < 0.001), nephrolithiasis (OR = 1.55, 1.42-1.63, p < 0.001) and cholelithiasis (OR = 1.22, 1.16-1.27, p < 0.001) were significantly correlated with sialolithiasis.

Conclusions: Systemic diseases, particularly dyslipidemia, play a role in the development of sialolithiasis. Further research is needed to explore the underlying mechanisms linking these conditions and to develop targeted strategies for the prevention of sialolithiasis.

Clinical relevance: This study highlights the potential interplay between systemic conditions and sialolithiasis. Recognizing these associations can inform clinical practice in understanding the pathogenesis of the disease, risk assessment, early diagnosis, and preventive measures.

Objective: The aim of this clinical trial was to evaluate the effectiveness of Piano level laser therapy using Nd-YAG laser and intramuscular EGF injection in pain alleviation, function, and quality of life improvement in patients suffering from myogenic TMD.

Materials and methods: A randomized clinical trial was performed on 29 patients suffering from chronic painful myogenic TMD based on diagnostic criteria for temporomandibular disorders. Group I (n = 13patients) was treated using 1064 nm Nd-YAG Laser (4 sessions once/week). Group II (n = 14 patients) was treated by intramuscular injection of EGF. Pain using numerical rating score, pain free opening and unassisted maximum opening were measured at baseline, 7,14,21 days, 1 and 3 months. Quality of life using OHIP-14 was assessed at baseline, 1 and 3 months.

Results: Results showed that there was a significant pain reduction (P < 0.000) and increase in pain free opening (P < 0.0001) in both test groups. However, only group I showed a significant increase in maximum opening (P = 0.007). Quality of life significantly improved in both groups (P = 0.0001). There was no significant difference between the two treatments in pain scores, pain free opening, maximum opening nor quality of life.

Conclusion: Both treatment modalities offered effective and cost-effective non- to minimally invasive treatment options for myogenic TMD with no side effects.

Clinical relevance: Myogenic TMD forms a public health issue and is a common musculoskeletal problem causing pain and disability. The proposal of effective, non-invasive, and affordable treatment options can help solve this issue.

Objectives: To compare the long-term remineralization of initial caries lesion (ICL) treated with different remineralizing agents during orthodontic retention using optical coherence tomography (OCT).

Materials and methods: This randomised clinical trial recruited 30 patients on fixed appliances with at least one ICL labially on any maxillary incisor. At debond (baseline), they were allocated to three groups, where twice daily fluoride toothpaste was given: (1) as control; (2) supplemented with daily casein phosphopeptide amorphous calcium phosphate with fluoride (CPP-ACPF); or (3) supplemented with three-monthly professional applied fluoride varnish (FV). Primary outcome was the OCT backscatter reflectance changes of the ICL, measured as integrated reflectivity (IR). Follow-ups were at three-month intervals up to 12 months. The trial was registered with Clinicaltrials.gov (NCT04788550).

Results: Analyses included 26 participants (nine control; nine CPP-ACPF; eight FV). There were significant reduction in integrated reflectivity over time. Post hoc comparisons showed reductions were significant up to 150-micron depth at 6-months, and up to 250-micron depth at both 9- and 12-months follow-up compared to baseline. At 12-months, FV had the lowest IR values, followed by CPP-ACPF and control, but the differences between groups were not significant.

Conclusions: After 12-months observation, use of fluoridated toothpaste alone or supplemented with either fluoride varnish or CPP-ACPF promotes enamel remineralization up to 250-micron depth.

Clinical relevance: Daily fluoridated toothpaste with regular 3-monthly recall visits from the start of orthodontic retention is recommended for effective control of initial caries lesions. FV and CPP-ACPF supplementation can be considered but their long-term benefits remain inconclusive.

Objectives: Herbst appliance treatment results in posterior airway space (PAS) increase. The published data, however, is based on rather small samples and shows large inter-individual variation. Therefore, the current aim was to investigate PAS changes during and after Herbst plus subsequent multibracket appliance (MBA) treatment in a retrospective cohort study and to search for possible pre-treatment influencing factors.

Materials and methods: 503 former Class II:1 patients (overjet = 7.8 ± 2.4 mm, ANB angle = 5.0 ± 2.1°) who had undergone treatment at 13.8 ± 3.4 years (Department for Orthodontics, University of Giessen, Germany). Cephalograms from before (T0), after 24.9 ± 9.2 months of treatment (T1) and 26.1 ± 8.0 months after treatment (T2) were analysed for PAS changes (area-size and linear distances p, t, pC2, pC3, pC4. In addition, possible influencing pre-treatment characteristics were evaluated: overjet, ANB angle, Wits appraisal, ML/NSL angle, ArGoGn angle, age and skeletal maturity.

Results: On average, the PAS area increased by 23% during Herbst-MBA treatment (T1-T0) and remained constant (± 0%) thereafter (T2-T1). All linear distances also increased (6-19%) during T1-T0 and showed further increase (1-7%) during T2-T1. For all variables a large inter-individual variation existed. With regard to possible influencing factors on PAS changes, significant associations were observed for pre-treatment age and Wits appraisal of the patients.

Conclusions: PAS increases during Herbst-MBA treatment. For none of the assessed variables, relapse occurred afterwards. Young age and a large Wits appraisal were determined to be beneficial for PAS enlargement.

Clinical relevance: Herbst-MBA treatment seems to have a positive effect in the majority of Class II patients with reduced PAS.

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 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.

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.