Contemporary Clinical Dentistry最新文献

Introduction: Restorative composite resin material compositions are frequently improvised to clinically achieve success. Dental composite material to be the choice of restorative material should be compatible with different oral conditions, providing good marginal seal and mechanical integrity. Innovations and modifications done in compositions of these materials for long-lasting restorations in the oral environment require constant testing to evaluate their clinical performance. Different testing systems help researchers to evaluate the properties of materials. This research objective is to compare new modified materials and the effectiveness of the testing method technologies.

Aim: The aim of this study was to compare and evaluate different testing methods used to evaluate surface topography and hardness of newer restorative composites.

Materials and methods: Five single shade composites, Bulk fill and nano hybrid (BK and NH), nano fill (NF), nanohybrid (NH), and Glass fiber reinforced (BF) composites resin materials were selected for this study. The composites selected were bulk-fill (BF) and packable composites. The specimens prepared were subjected to surface characteristics analysis with stylus profilometer and atomic force microscopy (AFM), and hardness was evaluated with the Vickers hardness test and nanohardness test.

Results: Results obtained were subjected to statistical analysis using two-way analysis of variance and Tukey's post hoc test at significance P < 0.05. There was a significant difference with surface roughness analysis with Profilometer and AFM methods among all groups except with NH composites. The hardness test did show significant difference among groups. The Vickers hardness tester showed higher values except with BF composites.

Conclusion: Significant difference in test methods and the materials tested were due to different resin matrix, filler sizes, and percentage of volume of fillers, 3-dimensional surface evaluation techniques, and type, size, and forces of indenter needles.

Odontogenic maxillary sinusitis (OMS) is an inflammation of the epithelial lining of the maxillary sinus mucosa caused by an odontogenic infection. This study reports a case of OMS associated with an endodontic infection in an upper first molar. The patient reported severe headache and was referred by an otorhinolaryngologist. Clinical examination revealed a periapical fistula associated with tooth 26 and cone-beam computed tomography (CBCT) revealed mucositis in the left maxillary sinus and close proximity of the palatal root of tooth 26 to this sinus. The diagnosis was odontogenic sinusitis associated with tooth 26 with necrotic pulp and a chronic periapical abscess. The tooth was submitted to root canal treatment. After 6 months, follow-up showed no symptoms and regression of the periapical lesions and mucositis. Root canal treatment is an effective procedure for the management of OMS caused by the lesions of endodontic origin.

The uprighting of mesial or distal inclination of mandibular molar teeth is very challenging in orthodontic therapy. The mesially inclined molars usually result from early tooth loss, caries, or periodontal disease. The conventional techniques are effective; however, they lead to unwanted side effects such as molar extrusion, prolonged treatment time, and discomfort due to the complexities of the appliances. The sleeve push technique (SPT) involves the use of a rubber-tubing as "sleeve" on the nickel-titanium archwire to create space, applying light continuous force in a controlled manner for molar uprighting. This case report showcases the use of SPT in an 18-year-old female with a mesially inclined mandibular second molar on the right side that was successfully treated. The uprighting was achieved with distal crown movement with negligible adverse effects, avoiding the need for auxiliaries like temporary anchorage devices or open coil springs, thus reducing the cost. This technique reduced the treatment time and discomfort, offering a minimally invasive alternative for molar uprighting. While promising, further studies are needed to confirm its broader applicability in complex orthodontic cases.

Background: Orbital floor fractures are among the most common craniofacial injuries, often resulting from high-impact trauma such as motor vehicle accidents. Orbital floor fractures comprise 4%-16% of facial fractures and are of particular interest due to their unique anatomy and proximity to the eye. Treatment typically involves reconstruction with various materials as described in the literature.

Aim: The aim of the study was to evaluate the effectiveness of polycaprolactone (PCL) mesh in comparison to titanium mesh in the management of orbital floor fractures.

Methods: Twenty patients with clinically and radiographically confirmed orbital floor fractures were assigned to two groups: Group A (PCL mesh) and Group B (titanium mesh). Pre- and postoperative assessments included ocular motility, diplopia, dystopia, enophthalmos, infection, and implant stability. Follow-up evaluations were conducted on postoperative day 1, at 1 week, 1 month, and 3 months.

Results: PCL mesh demonstrated superior intraoperative handling, whereas adaptability and stability were similar between groups. Postoperatively, diplopia occurred in one patient (5%), dystopia in three patients (15%), and enophthalmos in five patients (25%), with no cases of infection, inflammatory response, implant migration, or hardware failure. All fractures achieved successful defect closure.

Conclusion: Both PCL and titanium meshes are effective for moderately sized orbital floor reconstructions. PCL mesh offers easier handling and is a viable alternative to titanium, though larger studies with longer follow-up are needed to confirm these findings.

Context: Dentinal microcracks during root canal preparation with endomotor-driven files suggest adverse consequences, while research results remain inconsistent. Diabetic individuals have modified dentin properties due to advanced glycation end-products (AGEs), altering collagen-rich tissue mechanics. Age-related changes and diabetes reduce mechanical strength and cause progressive dentinal tubule occlusion.

Aims: This pilot in vivo study assessed microcrack formation following rotational and reciprocating instrumentation in diabetic versus nondiabetic elderly adults using micro-computed tomography (CT).

Settings and design: Pilot in vivo comparative study design.

Subjects and methods: Twenty-two vital mandibular anterior teeth from patients aged 50-70 years requiring extraction were included. Teeth were categorized into diabetic (n = 9) and nondiabetic (n = 8) groups, instrumented with ProTaper Gold or Reciproc Blue systems. An over-instrumented control group (n = 5) was prepared 3 mm beyond the apex. Following atraumatic extraction, specimens were scanned using micro-CT (7.9 μm resolution) and analyzed for microcracks in coronal, middle, and apical thirds using ImageJ software.

Statistical analysis used: Frequency and percentages were calculated for microcrack occurrence.

Results: Irrespective of the type of instrumentation, no microcracks were observed in diabetic or nondiabetic groups. In the over-instrumented group, 60% of samples (3/5) developed incomplete apical microcracks extending from the canal into root dentin.

Conclusions: Root canal instrumentation to apical constriction did not produce microcracks in diabetic or nondiabetic older patients. However, over-instrumentation significantly increased microcrack formation, suggesting adherence to root canal anatomy improves endodontic treatment efficacy.

Loss of the maxillary anterior teeth in childhood following an odontoma can set the stage for a complex malocclusion with enduring effects on facial esthetics, function, and psychosocial health. We report the management of a 15-year-old boy who presented 8 years after odontoma excision with an anterior maxillary defect, rightward dental midline deviation, crowding, and a crossbite. Treatment combined passive self-ligating brackets with customised torque, nickel-titanium open-coil springs for controlled space regaining, and an infrazygomatic crest temporary anchorage device to drive asymmetric midline correction. At debond, a Lucitone-based removable partial denture restored anterior form and function. After 12 months of active therapy, occlusion was stable, facial symmetry improved, and the patient reported greater confidence. This case illustrates how coordinated orthodontic-prosthodontic planning that leverages contemporary biomechanics and age-appropriate prosthetics can deliver durable functional stability, esthetic enhancement, and meaningful psychosocial gains.

This case report highlights the use of the Osseodensification technique with Densah burs to perform a crestal sinus lift with simultaneous implant placement. A particulate bone graft (Osseograft) was used along with sinus membrane elevation to enhance bone regeneration. The procedure achieved excellent implant primary stability with a minimally invasive approach and favourable healing outcomes.

Conventional orthognathic surgery has traditionally followed an orthodontics-first approach (OFA), whereas the surgery-first approach (SFA) has gained attention for its potential to shorten overall treatment time and provide earlier esthetic improvement; however, uncertainties remain regarding skeletal stability, condylar adaptation, temporomandibular joint (TMJ) outcomes, and patient-reported measures. This systematic review compared the clinical outcomes of SFA and OFA in orthognathic surgery, focusing on treatment duration, skeletal stability, condylar changes, TMJ symptoms, patient-reported quality of life, and cost-effectiveness. A systematic search of the Web of Science Core Collection (2009-2025) identified comparative human studies that directly contrasted SFA and OFA, and nine studies met the inclusion criteria for qualitative synthesis. Data were extracted on study design, surgical procedures, outcomes, and follow-up, and risk of bias was assessed using the Newcastle-Ottawa scale. Across studies, SFA consistently shortened overall treatment duration compared with OFA. Skeletal stability at approximately 1 year was broadly comparable between approaches, although counterclockwise mandibular rotation and vertical dimension control were highlighted as critical factors in SFA. Condylar displacement and remodeling patterns were similar, with larger immediate postoperative shifts in SFA that tended to regress toward baseline. TMJ symptoms generally improved after surgery in both groups without meaningful between-group differences. Patient-reported outcomes improved in both cohorts, with SFA offering earlier esthetic benefit by avoiding the preoperative decompensation phase. Cost-effectiveness analyses indicated similar overall costs but a shorter time-to-benefit with SFA. Within the limitations of predominantly observational designs, SFA appears to offer shorter overall treatment time with broadly comparable skeletal, condylar, TMJ, and quality-of-life outcomes to OFA, underscoring the importance of careful case selection, strict protocol adherence, and prospective standardized research to confirm long-term stability and optimize clinical protocols.

The pathologies that arise from the odontogenic apparatus may be categorized into infections, cystic lesions, neoplasms, and even developmental/hamartomatous lesions. The nature of a hamartoma is characterized by slow growth potential, microscopic appearance of unencapsulated mature cells, and it is associated with chromosomal aberrations. Whereas the neoplasm signifies an abnormal and uncontrolled proliferation of cells that originate from a single cells or a clone. Many odontogenic lesions are still under controversy of being classified as hamartomatous lesions because of their biological behavior and limited growth potential. This report presents the case of an 18-year-old female with an asymptomatic intraoral swelling over the left maxillary anterior region; radiographs reveal a unilocular radiolucency associated with the roots of the left maxillary lateral incisor and canine. Histologically, the lesion was consistent with the diagnosis of adenomatoid odontogenic tumor (AOT; extrafollicular type). AOT is a rare benign odontogenic tumor; it shows characteristics of both hamartoma and true neoplasm. This case report emphasizes its clinical presentation as well as its categorization among hamartomatous and true neoplastic odontogenic lesions.