Clinical Oral Investigations最新文献

Objectives: This study evaluates the effect of different irrigation solutions for postoperative pain in the regenerative endodontic treatments (RET) of necrotic teeth with open apex.

Materials and methods: This study included necrotic, deeply carious lower molars of 42 patients. Access cavities of the teeth were opened and working lengths were measured at the first visit. In Group 1, the root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and 17% Ethylenediaminetetraacetic-acid (EDTA), in Group 2, with 1.5% NaOCl and 10% citric acid, and in the Group 3, with 1.5% NaOCl and 9% Etidronic acid (HEDP) mixture solution. Final irrigation was performed with distilled water. The canals were dried, filled with calcium hydroxide paste, and sealed with Cavit. Postoperative pain was assessed using a numerical rating scale, and Paracetamol was prescribed. At the second visit, calcium hydroxide was removed with 1.5% NaOCl, irrigated with chelators, and sealed with Sure-Seal PT 3 mm below the cementoenamel junction before composite resin filling.

Results: Postoperative pain was higher in Group 3 (p < 0.05), but analgesic consumption did not show a significant difference (p > 0.05).

Conclusions: HEDP caused significantly more postoperative pain than EDTA and citric acid (p < 0.05). While the study provided information regarding the effects of irrigation solutions on postoperative pain, further research is needed as it did not include detailed assessments of long-term periapical healing and apex closure.

Clinical relevance: When HEDP is used as a chelation agent in RETs, it shows a higher degree of postoperative pain than EDTA and citric acid solutions.

Clinical trial registration: The study protocol was registered at www.

Clinicaltrials: gov (ID: NCT06386991).

Objectives: To conduct a comprehensive bibliometric analysis of the literature on artificial intelligence (AI) applications in orthodontics to provide a detailed overview of the current research trends, influential works, and future directions.

Materials and methods: A research strategy in The Web of Science Core Collection has been conducted to identify original articles regarding the use of AI in orthodontics. Articles were screened and selected by two independent reviewers and the following data were imported and processed for analysis: rankings, centrality metrics, publication trends, co-occurrence and clustering of keywords, journals, articles, authors, nations, and organizations. Data were analyzed using CiteSpace 6.3.R2 and VOSviewer.

Results: Almost 83% of the 381 chosen articles were released in the last three and a half years. Studies were published either in highly impacted orthodontic journals and also in journals related to informatics engineering, computer science, and medical imaging. Two-thirds of the available literature originated from China, the USA, and South Korea. AI-driven cephalometric landmarking and automatic segmentation were the main areas of research.

Conclusions: This report offers a thorough overview of the AI current trend in orthodontics and it highlights prominent research areas focused on increasing the speed and efficiency of orthodontic care. Furthermore, it offers insight into potential directions for future research.

Clinical relevance: Collaborative research efforts will be necessary to strengthen the maturity and robustness of AI models and to make AI-based clinical research sufficiently reliable for routine orthodontic clinical practice.

Objectives: This study aimed to evaluate the effectiveness of home-use desensitizing agents over an 8-week period by comparing them using different measurement methods.

Methods: A randomized, controlled clinical trial was conducted with 180 individuals aged between 18 and 70 who clinically diagnosed dentin hypersensitivity (DH) in two or more non-adjacent teeth. Subjects who met the inclusion criteria (n = 164) were randomly allocated into five test groups-using Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), Arginine, Novamin, Propolis, and Potassium nitrate-and a control group using standard fluoride toothpaste. The status of DH was assessed at week 4 and week 8 by the same independent examiner. Changes from baseline in Dentine Hypersensitivity Experience Questionnaire-15 (DHEQ-15), Schiff Sensitivity Scale (SSS) and Visual Analog Scale (VAS) were analysed using ANOVA and Kruskall-Wallis tests.

Results: All test groups showed statistically significant improvements in DH at weeks 4 and 8 compared to baseline in the DHEQ-15, VAS, and SSS assessments (p < 0.005). In the control group, significant improvements were observed only in the VAS and SSS measurements from baseline to weeks 8 (p < 0.005). The CPP-ACP group demonstrated the greatest reduction in scores by the end of week 8 compared to baseline, with DHEQ-15 (56.68 ± 17.87), VAS (6.52 ± 1.48), and SSS (2.32 ± 0.56).

Conclusions: Among the tested agents, the CPP-ACP group demonstrated the most notable reduction in DH symptoms by week 8, highlighting its potential as an effective method for alleviating DH symptoms in a home-use agents.

Clinical relevance: Home-use desensitizing agents are effective in the treatment of DH, improving the daily activities of patients who cannot access clinical care and ensuring the relief of DH before clinical invasive procedures.

Trial registration: ClinicalTrials.gov Identifier: NCT06216262.

Objectives: The presented study aimed to evaluate the effect of mandibular protrusion with a temporarily applied mandibular advancement device (MAD) on the posterior airway space and to determine a reliable metric constant based on a three-dimensional computed tomography (CT) evaluation.

Materials and methods: The study population consisted of patients with oral squamous cell carcinoma who were treated at least six months prior to the follow-up CT in supine position. Each patient received an individually adjusted MAD that was temporarily applied with three different protrusion distances (P₀ = 0 mm, P₄ = 4 mm, and P₈ = 8 mm) during follow-up CT. The open-source software Slicer was used to calculate three parameters: minimum cross-sectional area (minCSA), mean cross-sectional area (meanCSA), and volume.

Results: The results showed a significant increase for all three parameters. The minCSA increased as follows: P₀ = 236.4 mm² ± 192.2; P₄ = 309.2 mm² ± 235.4; and P₈ = 430.6 mm² ± 265.3. The meanCSA increased significantly (p < 0.001) in all protrusion steps and all parts of the pharynx. The volume changed as follows: P₀ = 24.0 cm³ ± 5.0; P₄ = 29.6 cm³ ± 18.1; and P₈ = 33.6 cm³ ± 19.0. The minCSA increased by 24.9 mm² ± 13.0 per millimeter mandibular protrusion. CONCLUSION AND CLINICAL RELEVANCE: The results are interesting for both conservative and surgical therapy and could find future application in dental, orthodontic, and combined oral surgical therapy. With the results of this study, surgeons and dentists may better predict the change of PAS parameter in order to better prepare for orthognathic surgery. They also could ensure the right protrusion distance for mandibular advancement devices in the case of obstructive sleep apnea.

Objective: Aim of this study was to critically appraise clinical evidence on the potential benefits of adjunctive use of superfoods green tea and turmeric as mouthrinse or local delivery agents in the treatment of periodontal disease.

Materials and methods: Electronic searches were performed in four databases for randomized trials from inception to February 2024 assessing the supplemental use of superfoods green tea and turmeric for gingivitis/periodontitis treatment. After duplicate study selection, data extraction, and risk-of-bias assessment with the RoB 2 tool, random-effects meta-analyses of Mean Differences (MD) or Standardized Mean Differences (SMD) with their 95% confidence intervals (CI) were performed.

Results: Nineteen studies (814 patients) were included, with 11 on gingivitis and 8 on periodontitis patients. No benefits were seen from the use of mouthwashes containing green tea extract or turmeric for gingivitis treatment, while green tea was associated with smaller Gingival Index (GI) reductions than chlorhexidine (5 studies; MD = 0.08; 95% CI = 0.01 to 0.14; P = 0.01). As far as periodontitis treatment is concerned, local supplementation with turmeric showed no benefits, whereas local supplementation with green tea extract was associated with improved treatment outcomes in terms of probing depth (4 studies; MD=-0.79; 95% CI=-1.29 to -0.29 mm; P = 0.002) and GI (3 studies; MD=-0.53; 95% CI=-1.01 to -0.05; P = 0.02) than the control group. However, the strength of evidence was moderate to very low due to bias, imprecision, and inconsistency.

Conclusion: Limited evidence indicates that supplemental use of green tea extract is associated with improved periodontal treatment outcomes. However, the strength of evidence is weak and further research is needed.

Clinical relevance: Green tea extract could be a natural adjunct to enhance periodontal treatment, without the potential side-effects of other adjuncts like chlorhexidine.

Objective: Titanium surface modifications improve osseointegration in dental and orthopedic implants. However, soft tissue cells can also reach the implant surface in immediate loading protocols. While previous research focused on osteogenic cells, the early response of soft tissue cells still needs to be better understood.

Material and methods: We have established a bioassay to this aim where human gingival fibroblasts, HSC2 oral squamous carcinoma cells, and murine bone marrow cells were cultured onto titanium discs or exposed to the respective supernatants for overnight. Modifications were double acid-etching (SLA), and coating with simulated body fluid (SBF) with or without odanacatib (ODN), a selective cathepsin K inhibitor reducing bone resorption.

Results: Our findings indicate that direct contact with titanium discs, with all surface modifications, slightly reduces cell viability. Growing gingival fibroblasts on discs consistently showed a trend toward increased IL8 expression. In HSC2 cells, this setting significantly increased IL1 and IL8 expression, confirmed by the immunoassay. Murine bone marrow macrophages also showed an increase in IL1 and IL6 expressions. Supernatants of the respective discs failed to cause these changes. Although ODN coating inhibited cathepsin K, osteoclastogenesis remained unchanged.

Conclusions: These findings suggest that titanium discs do not provide a favorable in vitro surface for oral soft tissue cells as they lose viability and respond with a moderately increased expression of inflammatory cytokines.

Clinical relevance: The soft tissue surrounding a dental implant can impact rehabilitation success. Understanding how soft tissue cells respond to titanium surface is potentially relevant to understand clinical outcomes.

Aim: To perform a systematic review to investigate if the use of audio distraction reduces signs of stress and anxiety in paediatric patients undergoing dental treatment.

Materials and methods: Search was made in electronic databases (MEDLINE, Scopus, Embase, Web of Science, Scielo, BVS, Springer Link, Science Direct, Cochrane Library, and grey literature) until March 11th, 2024. The eligibility criteria were: paediatric patients under dental treatment; use of audio as a distraction method; comparison between groups with and without use of audio distraction; Clinical trials. The outcomes measured were alterations in the anxiety, fear and/or stress levels. Evaluation of the risk of bias and assessment of the certainty of the evidence (GRADE) were performed. Meta-analysis was conducted for four outcomes, considering 95% confidence interval (CI), random effects and heterogeneity from Tau².

Results: From 5,495 results, 25 studies composed the narrative sample and 12 composed the meta-analysis. High risk of bias was generally observed. Three results from the meta-analysis showed high heterogeneity and some outcomes presented a statistical association: systolic blood pressure reduction (p = 0.52; CI= -6.05 [-7.50 to -4.60]), pulse rate (p < 0.00001; CI= -4.95 [-9.95 to -3.52]), Venham's test scores (p < 0.00001; CI= -1.24 [-1.79 to -0.68]), and oxygen saturation (p < 0.00001; CI = 0.14 [-0.04 to 0.33]). The outcomes presented "very low" and "low" certainty of evidence.

Conclusion: Although a low certainty of evidence was observed, our study suggests that audio may be an effective alternative for reducing stress and anxiety and pain perception during non-invasive treatments. Future well-designed studies are necessary.

Clinical relevance: Audio distraction presents a potential role as an efficient method to reduce stress in children undergoing dental treatment. More RCTs are necessary to improve the evidence level, considering the main variables related to audio distraction.

Objectives: To investigate the performance of a deep learning (DL) model for segmenting cone-beam computed tomography (CBCT) scans taken before and after mandibular horizontal guided bone regeneration (GBR) to evaluate hard tissue changes.

Materials and methods: The proposed SegResNet-based DL model was trained on 70 CBCT scans. It was tested on 10 pairs of pre- and post-operative CBCT scans of patients who underwent mandibular horizontal GBR. DL segmentations were compared to semi-automated (SA) segmentations of the same scans. Augmented hard tissue segmentation performance was evaluated by spatially aligning pre- and post-operative CBCT scans and subtracting preoperative segmentations obtained by DL and SA segmentations from the respective postoperative segmentations. The performance of DL compared to SA segmentation was evaluated based on the Dice similarity coefficient (DSC), intersection over the union (IoU), Hausdorff distance (HD95), and volume comparison.

Results: The mean DSC and IoU between DL and SA segmentations were 0.96 ± 0.01 and 0.92 ± 0.02 in both pre- and post-operative CBCT scans. While HD95 values between DL and SA segmentations were 0.62 mm ± 0.16 mm and 0.77 mm ± 0.31 mm for pre- and post-operative CBCTs respectively. The DSC, IoU and HD95 averaged 0.85 ± 0.08; 0.78 ± 0.07 and 0.91 ± 0.92 mm for augmented hard tissue models respectively. Volumes mandible- and augmented hard tissue segmentations did not differ significantly between the DL and SA methods.

Conclusions: The SegResNet-based DL model accurately segmented CBCT scans acquired before and after mandibular horizontal GBR. However, the training database must be further increased to increase the model's robustness.

Clinical relevance: Automated DL segmentation could aid treatment planning for GBR and subsequent implant placement procedures and in evaluating hard tissue changes.

Objective: To investigate if changes in body mass index (BMI) result in changes of the mandibular trabecular bone structure.

Materials and methods: Females (18-35 years at baseline, mean BMI 42,3) were followed from before (n = 117) until two years (n = 66) after obesity treatment (medical or surgical). The mandibular bone trabeculation was classified as sparse, dense, or mixed on intraoral radiographs (Lindh's index). A digitized method (Jaw-X) assessed the size and intensities of intertrabecular spaces. The main predictor variable was BMI reduction over the period.

Results: Before treatment, the group with a high BMI (≥ 45) had a significantly denser bone than those with a lower BMI (p = 0.035). Two years after treatment, fewer were classified with sparse bone (Lindh's index p = 0.001, Jaw-X p = 0.009). The physical activity increased with fewer having a sedentary lifestyle (40% before, 17% after treatment). The association between BMI reduction and the difference in Jaw-X was significant in regression models and not influenced by obesity treatment method but by baseline factors as age, trabecular bone pattern and level of ionized calcium.

Conclusions: Before obesity treatment, high BMI was associated with dense bone trabeculation in the jaw. The group with sparse bone had decreased at follow-up. The association between BMI reduction and bone trabeculation was influenced by individual and medical factors.

Clinical relevance: Bone trabeculation in the mandible was maintained during the first years after obesity treatment but new health habits should be encouraged, and patients need to be monitored and followed up further.