Clinical Oral Investigations最新文献

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.

Objectives: The aim of this systematic review was to assess the effect of DM (Type 1 and Type 2 Diabetes) and hyperglycaemia on the physical and mechanical properties of dentine which is critical for successful endodontic treatment.

Method: An electronic search of the following databases: PubMed, MEDLINE, Web of Science and the grey literature was performed up until July 2024. In vitro and in vivo studies on the effect of DM or hyperglycaemia on the mechanical and physical properties of dentine were included. Non-English language literature was excluded.

Results: Of the 234 articles identified, 15 met the inclusion criteria. Four studies evaluated how artificially induced glycation or natural glycation of dentine due to aging affects the mechanical properties of dentine. Five studies investigated the influence of Type 2 Diabetes (T2D) on dentine's mechanical properties, while two studies focused on the effects of Type 1 Diabetes (T1D). A further, four studies compared the effects of both T1D and T2D on the dentine. The studies were heterogeneous and a range of mechanical and physical properties were evaluated.

Conclusion: DM and AGEs negatively influence the physical and mechanical properties of dentine however, there remains a paucity of evidence and further studies are needed.

Clinical significance: Diabetes Mellitus (DM) is a chronic metabolic disease characterised by hyperglycaemia, an altered immune response and complications associated with collagen connective tissues. DM can influence bone metabolism and alter its physical and mechanical properties via glycation processes within collagen and changes to osteoblast activities. While bone and dentine share similarities, dentine is unique as it is intimately associated with the dental pulp. Inflammation within the pulp can induce calcification and tertiary dentine deposition and so exploring the influence of DM on the mechanical properties of dentine is warranted to understand the clinical significance.

Objectives: This cross-sectional study aimed to evaluate the occurrence of Streptococcus spp., Streptococcus mutans, its serotypes (c, e, f, and k), collagen-binding genes (cnm/cbm), and Candida albicans in medium deep (D2) and deep (D3) dentin carious lesions of permanent teeth.

Materials and methods: Carious dentin was collected from D2 (n = 23) and D3 (n = 24) lesions in posterior teeth from 31 individuals. DNA was extracted and analyzed using polymerase chain reaction (PCR).

Results: Streptococcus spp. exhibited a high prevalence in both D2 and D3 lesions, with a 100% occurrence rate in D3. Although S. mutans was prevalent in both lesion types, serotype distribution highlighted differences in complexity. Serotype e was the most frequently detected in D2 samples. Serotype c was absent in D2 but present in 19.0% of D3; serotype k was exclusively found in multi-serotype D3 alongside f, c, and e. The cbm gene and undetermined serotypes were detected only in D3. Candida albicans was not found in any samples, regardless of lesion depth.

Conclusion: Dentinal lesions exhibited a complex array of S. mutans serotypes, with a notable prevalence of the genus Streptococcus and an overall S. mutans prevalence of approximately 35%. Candida albicans was absent. In addition, a high diversity of serotypes was observed, including multiple and indeterminate serotypes, along with the presence of the collagen-binding cbm gene.

Clinical relevance: The identification of diverse Streptococcus mutans serotypes and the cbm gene in carious dentin from permanent teeth offers insights into microbial factors potentially linked to dentinal caries lesions. Additionally, the absence of Candida albicans suggests a limited role in this context.

Objectives: To compare the plaque reducing efficacy of oil pulling with sesame oil compared to distilled water in a randomized, controlled, examiner-blinded parallel group study.

Materials and methods: Forty probands without advanced periodontal disease of the University Hospital for Restorative Dentistry and Periodontology, Medical University of Innsbruck (Austria) were randomized allocated to test- (sesame oil) or control group (distilled water) and asked to pull daily in the morning for eight weeks with their allotted fluid for 15 min. Rustogi Modified Navy Plaque Index (RMNPI) and gingival bleeding index were assessed at baseline and after four and eight weeks. Plaque samples underwent microbiological analysis.

Results: Pulling with sesame oil was significantly more effective in reducing full mouth RMNPI compared to distilled water after eight weeks (median reduction 18.98% versus 10.49%; p = 0.023), and was most pronounced in anterior, buccal, and lingual subscales. On approximal surfaces, significantly higher plaque reduction was found in the test group after four (24.07% versus 14.29%) and eight weeks (16.00% versus 5.36%) of intervention (p < 0.05). No significant changes in gingival index and mirobiological analysis could be detected.

Conclusion: Plaque reduction was statistically significantly higher with oil pulling than with distilled water, however, a study bias cannot be ruled out. Further high-quality trials are needed to understand the mechanisms and effectiveness of oil pulling, to finally clarify the evidence.

Clinical relevance: Oil pulling may be recommended as an adjuvant to mechanical dental cleaning. Individuals with keratosis may experience adverse effects.

Trial registration: ClinicalTrials.gov NCT06327841.

Objectives: For this research two different ways for integrating intra-oral scans into three-dimensional (3D) stereophotogrammetric images are analyzed and compared to the gold standard method.

Materials and methods: A cross-sectional study was performed. For each patient a complete dataset was collected, which was used to generate 3D fusion models by three different methods: method A using cheek retractors, method B using a tracer and method C using full-skull CBCT. The experimental methods A and B were compared to the gold standard method C.

Results: A group of eighteen patients were included in this study. The translation (X, Y,Z), the euclidean distance and the rotation (roll, pitch, yaw) were calculated for both experimental methods A and B in comparison with the gold standard method C. Twelve out of fourteen measurements were clinically acceptable (below 2 mm or 2 degrees). Method A shows the highest deviation in the pitch-orientation for rotation (2.51 degrees, 95% CI [1.756 … 3.272]), while method B shows a higher deviation along the y-axis (1.85 mm, 95% CI [1.224 … 2.467]).

Conclusions: This study shows promising results of non-ionizing methods to integrate intra-oral scans into 3D stereophotogrammetric images. With improved accuracy in pitch in method A and translation along the Y-axis in method B, all measurements will be within the clinically acceptable threshold. However, since these two measurements exceed the clinically acceptable thresholds, the complete model positioning is less accurate. Therefore the main goal in further research should be to improve the accuracy of the pitch in method A and the translation along the Y-axis in method B. Additionally, for clinical use the biggest improvement could be gained by optimizing the clinical workflow and data processing.

Clinical relevance: By using a non-ionizing 3D fusion model instead of a conventional cephalogram for treatment planning, the ionizing dose during orthodontic treatment can be significantly reduced.

Objectives: To compare the impact of intaglio surface treatments - airborne particle abrasion and hydrofluoric acid (HF) etching - of feldspar ceramic (FEL) crowns on the fracture load (FL) and to investigate the effects of abutment materials and artificial aging. The aim was to assess whether etching could be replaced by an alternative surface roughening method.

Materials and methods: FEL crowns had their intaglio surfaces either abraded (25 µm Al₂O₃, 0.1 MPa), etched (HF, 60 s), or untreated and then bonded to CoCrMo- and polymer-abutments. FL was measured for non-aged and aged (1.2 million mastication cycles) specimens. Data were analyzed using, Weibull modulus, two-/one-way ANOVA with Tukey HSD-post-hoc-test, t-tests, and TOST equivalence (p < 0.05).

Results: For crowns bonded to CoCrMo abutments, aging affected the FL and Weibull modulus, but pretreatment methods did not. For initial specimens, airborne abraded and etched crowns were equivalent within a 400N bound, however, for aged specimens, equivalence was inconclusive. For crowns bonded to polymer-abutments, pretreatment and aging influenced the FL. Etching decreased the initial FL by over 420N compared to airborne abraded and untreated specimens. After aging, untreated crowns' FL decreased by 528N, while airborne abraded and etched specimens showed no aging effect.

Conclusions: Airborne particle abrasion of FEL crowns' intaglio surfaces did not negatively impact FL and was comparable to etched crowns. Conclusions regarding pretreatment methods and aging differed between CoCrMo- and polymer-abutments.

Clinical relevance: Airborne particle abrasion may be an alternative procedure for the intaglio surface treatment of FEL crowns prior bonding.

Objectives: This study investigates the clinical and patient-reported outcomes of full-endoscopic parotidectomy compared to the conventional approach.

Methods: Between July 2021 and December 2023, patients who underwent parotidectomy were prospectively enrolled and assigned to either the full-endoscopic parotidectomy group (Group I) or the conventional surgery group (Group II). Clinical outcomes were evaluated, and patient-reported outcomes were assessed using a Visual Analogue Scale and five FACE-Q scales.

Results: A total of 293 patients were prospectively included, with 146 in the full-endoscopic group and 147 in the conventional group. Blood loss was significantly lower in the full-endoscopic group (regression coefficient, 0.61; 95% CI, 0.15 to 1.07), as was the rate of immediate facial paralysis (0.76; 95% CI, 0.25 to 1.27). The full-endoscopic group also showed superior outcomes on the Visual Analogue Scale (- 0.14; 95% CI, - 0.23 to - 0.05) and FACE-Q scales for Appearance-Related Psychosocial Distress (1.15; 95% CI, 0.59 to 1.71), Social Function (- 0.37; 95% CI, - 0.59 to - 0.15), Satisfaction with Facial Appearance (- 0.44; 95% CI, - 0.64 to - 0.23), Psychological Function (- 0.39; 95% CI, - 0.58 to - 0.20), and Satisfaction With Outcome (- 0.42; 95% CI, - 0.66 to - 0.19).

Conclusions: Full-endoscopic parotidectomy yields less blood loss and a reduced incidence of immediate facial paralysis compared to conventional surgery. Patients undergoing full-endoscopic parotidectomy reported better aesthetic and psychological outcomes.

Clinical relevance: The combined analysis of clinical and patient-reported outcomes is valuable in guiding surgical planning. These findings provide valuable insights for patients considering full-endoscopic parotidectomy and underscore the importance of addressing functional, aesthetic, and psychological aspects for both patients and healthcare providers.

Objectives: To summarize and analyze existing evidence regarding the clinical performance of high-viscosity glass-ionomer-based materials (HVGIs) and bulk-fill resin-based composites (BFs) in patients with occlusal or proximal cavities in permanent teeth.

Materials and methods: A literature search was conducted using PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Scopus, and Web of Science (WOS) (last update: April 19th, 2024). Randomized control trials (RCTs), retrospective and prospective comparative cohorts were included. Manual searching was performed for twelve relevant dental journals. The primary outcome was the retention of the restoration. The evaluation of included studies, data extraction, and study selection were completed by two independent reviewers. The Cochrane risk-of-bias tool (RoB 2) and the Newcastle-Ottawa scale were used to assess the quality of included studies. A quantitative meta-analysis was conducted, and the overall quality of the evidence was evaluated.

Results: Five RCTs and one retrospective study were included, of which one had a high risk of bias and the others had an unclear risk of bias. In meta-analyses, HVGIs were associated with a less favorable outcome on retention both at one (p = 0.013) and two-year follow-ups (p < 0.0001) compared with BFs. The quality of the evidence was very low.

Conclusions: Very low certainty evidence suggested that BFs presented favorable clinical performance on retention and marginal adaptation in Class I and II restorations in permanent teeth comparing HVGIs. Nevertheless, HVGIs with a resin-based coating showed acceptable clinical behavior.

Clinical relevance: For patients with a high caries risk, HVGIs serve as a direct restorative alternative for the posterior permanent teeth; however, they should be carefully considered as bulk-fill composite resin alternatives for long-term restoration.

Registration: PROSPERO (CRD42024535999).

Introduction: Regenerative endodontic procedures (REPs) aim to replace damaged dental structures and regenerate the dentin-pulp complex. Initially focused on teeth with incomplete root formation, recent research shows promise for necrotic teeth with complete root formation.

Methodology: This review, following PRISMA guidelines and registered in PROSPERO, included clinical studies on regenerative endodontic therapy in necrotic human teeth with complete root formation. Searches in PubMed, Web of Science, Embase, and Cochrane Library identified 10 studies meeting the criteria.

Results: The studies showed variable regenerative endodontic protocols and materials, with success rates ranging from 60 to 100%. Most studies reported favorable outcomes, such as symptom resolution and bone healing.

Discussion: Regenerative endodontic therapy for necrotic teeth with complete root formation shows high success rates, but the variability in protocols calls for standardized guidelines and further high-quality trials.

Conclusion: Regenerative endodontic therapy is a promising alternative to conventional treatments for necrotic teeth with complete root formation, with demonstrated potential for restoring pulp vitality.Future research should optimize protocols and materials for consistent success.