Contemporary Clinical Dentistry最新文献

Background: Canine retraction has been successful with various force systems and retraction techniques. The appointment interval for force reactivation in canine retraction along the archwire is 4-8 weeks.

Aims: The aim was to evaluate the effect of different reactivation intervals on the rate of space closure.

Settings and design: This split-mouth randomized clinical trial recruited 38 patients indicated for the first premolar extraction.

Methods: Monthly digital models were acquired for 6 months. The first premolars were extracted, and temporary anchorage devices were placed for maximum anchorage control. The canines were retracted using elastomeric chains which were replaced every 2, 4, 6, or 8 weeks. The monthly rate of canine retraction was measured. The time to space closure was calculated. The secondary outcome was the mesial drift of the first molars.

Statistical analysis: The Kaplan-Meier survival analysis and the Friedman test evaluated and compared the groups.

Results: There was no significant difference between the monthly canine retraction rate or the first molar mesial drift between the groups. The mean time to space closure was 5.74 months in the 2-week reactivation group, which was statistically less than the other groups.

Conclusions: The 2-week reactivation interval may reduce time to space closure. Direct anchorage control with miniscrews limited anchorage loss significantly.

Ulcerated lesions have been observed in SARS-CoV-2 patients and their treatment is a challenge. We aim to report the treatment of oral lesions with low-level laser therapy (LLLT) in a patient with SARS-CoV-2. The patient diagnosed with COVID-19 was admitted to the intensive care unit, on mechanical ventilation, and on a nasogastric tube diet that persisted due to oral lesions. Painful ulcerated lesions, clinically diagnosed as viral ulcer, were found on the tongue, palate, labial commissure, and oropharynx during the oral evaluation. An antimicrobial photodynamic therapy with methylene blue and red laser (high energy) was performed, followed by treatment with LLLT with red laser. Significant clinical improvement of the lesions was observed after seven sessions of LLLT, with the oral diet being reestablished. Oral mucosal lesions in patients with COVID-19 are usually symptomatic and with onset after systemic symptoms. LLLT has been used in the management of these lesions, with promising results.

Background: For the elderly population, efforts are made to simplify the restorative procedure while maintaining good clinical performance. Glass ionomer (GI) cements are showing signs to fulfill many of these qualities. With their new properties and ease of use, they can be developed further to become a useful group of materials to overcome the problems of elderly patients.

Aim: The aim of the study was to evaluate the clinical performance of zirconia-reinforced versus conventional viscous GI restorations in Class I cavities of geriatric patients.

Setting and design: The study design was in vivo randomized clinical trial, parallel-arms, allocation ratio: 1:1.

Subjects and methods: A total of 28 Class I carious lesions in 21 geriatric patients were restored randomly either by zirconomer-improved or Ketac Molar Quick Aplicap (n = 14) each. Restorations were evaluated for 1 year by modified USPHS criteria.

Statistical analysis: Data were analyzed with the Chi-square test and Cochran's Q-test. Survival rate was analyzed using the Kaplan-Meier and log-rank test.

Results: Twenty-four restorations were evaluated in 19 patients with a recall rate of 85.7% at 12 months. Significant differences were found in marginal integrity and marginal discoloration within both restorative materials between different time intervals (P < 0.05). However, none of the materials were superior to another regarding all assessed criteria.

Conclusions: Both zirconia-reinforced GI and conventional highly viscous GI have acceptable clinical performance.

Bone deficiency in the posterior maxillary bone can be associated with a large sinus cavity and this dilemma can limit implant placement for dental rehabilitation in this area. The maxillary sinus lifting technique can be the solution for many clinical situations with minimal bone height, allowing the placement of longer implants. Autogenous bone graft is a safe and reliable material for reconstructive surgery. In this article, a case of an elderly male patient with inadequate maxillary bone height is presented. Simultaneous maxillary sinus elevation and implant placement with autogenous parietal bone graft were performed.

Aim: The aim of the study was to evaluate and compare the periodontal treatment outcomes in patients with periodontitis treated using conventional and microsurgical access flap procedure.

Materials and methods: Fifty chronic periodontitis patients were randomly assigned to conventional (Group I) and microsurgical (Group II) open flap debridement procedure. The parameters measured were probing pocket depth, clinical attachment loss (CAL), gingival recession (GR), bleeding on probing (BOP), wound healing, and postoperative pain. PD, CAL, GR, and BOP were assessed at pretreatment (baseline) and 3 months postoperatively. Wound healing was assessed using Landrey et al. healing index at 7th day and 3 months postoperatively and postoperative pain was assessed using number of analgesics taken for 7 days following surgery.

Results: Healing Index score of 4 (very good healing) was found in 40% of sites of Group I and 95% of sites of Group II. Comparison of number of analgesics taken between groups on day 7 showed a statistically significant difference (P < 0.01), indicating that pain was significantly reduced in Group II compared to Group I. At 3 months postoperatively, there was no significant reduction in PD, CAL, GR, and BOP between the groups.

Conclusions: In open flap debridement procedure, a microsurgical approach can substantially improve the early healing and induce less postoperative pain when compared to a conventional macroscopic approach.

Background: A surgical removal of the lower third molars can lead to a number of complications, and bone restoration typically takes a large amount of time. The aim of the study was to investigate the effect of the combination of beta-tricalcium phosphate (β-TCP), plasmogel, and platelet-rich plasma on postsurgery bone tissue restoration by means of X-ray.

Subjects and methods: A total of 200 patients who underwent a complicated removal of the lower third molars were nonrandomly assigned to the experimental (EXP, n = 100) or control (CTR, n = 100) group. In the EXP group patients, sockets were filled with a combination of β-TCP, plasmogel, and platelet-rich plasma. In the CTR group, sockets were not treated. X-ray examinations were performed 3, 6, and 9 months (T1, T2, and T3) postsurgery to define bone quality on the Misch scale. The Mann-Whitney U-test was used for between-group comparison.

Results: Aside from the overconsumption of sugars (more frequently in CTR) and marginally significant sex ratio difference (more females in CTR), the groups were equivalent. Although both groups improved on bone density with time, the EXP group demonstrated greater restoration at T1 (U = 3431, P < 0.001), T2 (U = 3190, P < 0.001), and T3 (U = 3505, P < 0.001) related to a greater percentage of D2 (dense thick porous cortical bone on the ridge and a coarse underlying trabecular bone).

Conclusion: A combination of β-TCP, plasmogel, and platelet-rich plasma, compared to no treatment, facilitates bone tissue restoration after complicated surgical removal of the lower third molars.

Background: The ultimate goal of advanced procedures in prosthetic dentistry is to construct a prosthesis based on the accurate reproduction of condylar guidance.

Aim: To compare the sagittal condylar inclination obtained using the cone-beam computed tomography (CBCT), panoramic image, and two articulator systems.

Settings and design: A cross-sectional study was carried out in 20 dentate patients in the age group of 20-40 years.

Materials and methods: Sagittal condylar guidance angles (SCGAs) were measured on two semi-adjustable articulators (Hanau Wide Vue and Denar Mark 320) using protrusive interocclusal record. SCGAs were also measured on the CBCT scans (CBCT reconstructed panoramic image and CBCT sagittal cross section) and the panoramic images obtained from the patients. The angles were determined on the radiographs by joining two lines: Frankfort's horizontal plane and the other plane were drawn by connecting the superior-most point on the glenoid fossa and the inferior-most point on the articular eminence. All the measurements were done twice by two operators independently.

Statistical analysis used: The data were analyzed using the paired t-test and Pearson's correlation coefficient with a P ≤ 0.05.

Results: There was no significant difference between the right and the left side in any of the groups (P ≥ 0.05). In addition, there was no significant difference between the clinical methods (P ≥ 0.05). However, there was a significant difference between the clinical and the radiographic methods (P ≤ 0.05). Furthermore, there was a strong correlation between the clinical and radiographic methods with Pearson's Correlation coefficient above 0.67.

Conclusion: There is a strong correlation between the clinical and radiographic methods. Thus, CBCT and OPG can be used an adjunct to clinical methods to record sagittal condylar guidance.

Background: Periodontal ligament-associated protein-1 (PLAP-1)/asporin is an extracellular matrix protein that plays a protective role in the pathogenesis of periodontitis. There is a paucity of information about the association between PLAP-1/asporin and periodontitis in human PDL. Thus, in this study, PLAP-1/asporin levels between participants with healthy periodontium and chronic periodontitis were compared and correlated with periodontal parameters.

Materials and methods: Fifty participants were recruited and divided into 25 in each group: Group 1 (control) and Group 2 (test). Probing pocket depth (PPD) and clinical attachment level (CAL) were recorded. Periodontal ligament (PDL) samples were collected from extracted teeth for estimating PLAP-1/asporin levels using the Human Asporin Enzyme-Linked Immunoassay Kit.

Results: A statistically significant difference (P = 0.001) in the PLAP-1/asporin levels was observed between Group 1 and Group 2. A weak negative correlation was observed between PLAP-1/asporin levels and periodontal parameters (PPD and CAL) in both groups.

Conclusion: In this study, higher PLAP-1/asporin levels in participants with healthy periodontium highlight the protective role of PLAP-1/asporin in maintaining periodontal homeostasis.

Background and aim: Oxidative stress markers have been firmly established as elevated in oral squamous cell carcinomas (OSCCs). These markers play a crucial role in the pathogenic mechanism underlying the accumulation of advanced glycation end products (AGEs) and their respective receptors. The primary objective of this study is to discern and compare the levels of receptors of AGEs (RAGEs) within tissue samples from patients diagnosed with oral submucous fibrosis (OSMF) at varying stages, oral leukoplakia at various stages, and OSCC.

Materials and methods: A cross-sectional investigation was conducted, enrolling a total of 49 patients, distributed across three distinct groups. Tissue samples were meticulously collected from the aforementioned patient groups. Subsequently, these samples underwent a process of homogenization and centrifugation. The supernatant obtained was subjected to enzyme-linked immunosorbent assay analysis to precisely determine the concentration of RAGE.

Results: The concentration of RAGEs was found to be significantly higher at various stages of OSMF when compared to the reference group of OSCC (P < 0.05). This difference was statistically significant, indicating a substantial association. In contrast, the levels of RAGE in patients with hyperkeratosis accompanied by epithelial dysplasia at various stages were observed to be lower than those in the OSCC group, with the difference in concentration being statistically insignificant (P > 0.05).

Conclusion: This comprehensive study has provided compelling evidence demonstrating the heightened levels of RAGE in OSMF when compared to OSCC. These findings collectively suggest the potential utility of anti-RAGE interventions as a promising avenue for novel therapeutic strategies in potentially malignant disorders such as OSMF.

Background: The COVID-19 pandemic has affected the delivery of dental care globally. Air contamination during aerosol and splatter-generating procedures is of great concern to dental healthcare provider during these times. Extra oral suction (EOS) apparatus has been shown to be effective in preventing infection by control of aerosol. But very limited data is available regarding the efficacy of the apparatus in preventing splatter contamination.

Objectives of the study: To assess the efficacy of EOS apparatus in reducing frequency and mean intensity of splatter contamination at clinician, assistant, patient sites during lower third molar surgical procedures.

Materials and methods: Patients who required surgical removal of an impacted lower third molar were divided into two groups (EOS and non-EOS) with 20 patients each. Universal indicating paper (UIP) was placed in specific locations on the surgeon, patient, and assistant. Colour changes after the settling of splatter on the UIP were analyzed to calculate the percentage intensity of splatter contamination.

Results: The use of an EOS device has shown an overall reduction in the total number of contaminated sites, with a difference of 6.36%. Surgeon, patient, and assistant sites showed reductions of 6.25, 10%, and 1.66%, respectively. The apparatus has showed statistically significant reduction of splatter frequency and intensity at the patient's chest and left shoulder regions respectively, during surgical removal of the impacted 48.

Conclusion: The magnitude of splatter contamination during minor dentoalveolar surgical procedures is inevitable. Therefore, to achieve a better working environment, usage of an EOS apparatus is advocated.