Contemporary Clinical Dentistry最新文献

Background: In the background of reported high distress among medical students and health professionals, character building at the level of health institutions may be helpful for augmenting academic performance and nurturing well-being during the training period of budding health professionals.

Aim: This study aims to assess non-cognitive positive traits, particularly Values in Action-character strengths related to the virtue of courage among trainees and doctors. It may reveal the association of challenging situations being faced in health profession with inculcation of the virtue of courage.

Materials and methods: Data regarding character strengths profile with reference to the psychological virtue of courage among students and residents of dental institution (n = 54) were collected and analyzed.

Results: Participants of all the three groups were found to display at least a minimum of each of the character strengths included in the virtue of courage. Perseverance was significantly higher in postgraduate students than undergraduate students and senior residents. Recurrent physician burnout has been reported to be associated with distress symptoms during their medical education at least once.

Conclusion: Positive institutions may play an important role to reduce the intensity and incidence of distress sequelae among medical students by taking initiatives for character building, with reference to augmenting character strengths of virtue of courage.

Background: Traumatic ulcer is a wound on the oral mucosa that often causes pain and impaired eating function. Healing of these wounds takes a long time and can interfere with an individual's daily activities. One therapeutic approach that is being developed is the use of topical application of chum salmon skin-derived collagen extract. Collagen is the main component of the extracellular matrix and plays a major role in wound healing. The skin of chum salmon (Oncorhynchus keta) contains collagen that is effective for the treatment of wounds.

Aim: The aim of this study was to evaluate the effectiveness of topical applications of chum salmon (O. keta) skin-derived collagen extracts in improving the healing of traumatic ulcers through analysis of neutrophil and macrophage numbers and collagen density.

Materials and methods: Twenty-four male Wistar rats were randomly divided into four groups consisting of six rats each. The labial mucosa of the lower lips of the rats was injured with heated amalgam stoppers to create oral traumatic ulcers. Group 1 was a control group; in Groups 2, 3, and 4, 25%, 50%, and 75% of collagen extracts from chum salmon (O. keta) skin were applied topically once a day for 7 days, respectively. The neutrophil and macrophage numbers were observed by hematoxylin and eosin staining. Masson's Trichrome staining was used to analyze the collagen density. Data were analyzed using one-way analysis of variance and continued with post hoc least significant difference tests. Significance is considered if P < 0.05.

Results: The oral traumatic ulcers gradually healed until day 7. The number of neutrophils and macrophages was significantly decreased in the treatment groups, and collagen density was increased, compared to the control group (P < 0.05). The decrease of neutrophil and macrophage numbers occurred significantly with the increased collagen extract concentrations (P < 0.05). Collagen density also increased significantly with the increased collagen extract concentrations (P < 0.05).

Conclusion: Topical applications of chum salmon (O. keta) skin-derived collagen extracts accelerate the healing process of oral traumatic ulcers by decreasing neutrophil and macrophage numbers and increasing collagen density.

Introduction: The technique of endodontic surgery had evolved tremendously in the recent years with introduction of new instruments and materials.

Aim: This study aims to compare the clinical outcome of endodontic microsurgery using three different techniques with three different root-end filling materials for 16 months.

Materials and methods: A total of 45 maxillary incisors indicated for root-end surgery were selected for the study. They were enrolled into three groups, i.e. Group A (traditional [TRS]/heat burnished gutta-percha), Group B (concave [CON]/Retroplast), and Group C (cavity/DiaRoot BioAggregate), of 15 teeth each. The clinical and radiographic outcome was recorded at 1, 6, 12, and 16 months using various criteria.

Statistical analysis: The data were analyzed by one-way analysis of variance and Tukey's post hoc test using SPSS V. 21 software (IBM Corp., Somers, NY, USA).

Results: All patients had uneventful healing at the final follow-up. Radiological intratime analysis concluded a highly high significant (P < 0.0001) decrease in the size of radiolucency between the three groups at the third recall visit. Intertime analysis recorded no significant decrease in radiolucency between Groups A and B, a significant decrease in B and C, and a highly significant decrease between Groups A and C at 12 months.

Conclusions: There was no significant difference in the clinical outcome after endodontic surgery when comparing TRS/heat burnished gutta-percha, CON/Retroplast, and cavity/DiaRoot BioAggregate techniques at 16 months. However, cavity/DiaRoot BioAggregate resulted in significantly rapid and predictable healing at 12 months.

Aim: Urine as a biofluid has been rarely used as a diagnostic fluid in oral diseases. The article aims to systematically review the utility of human urinary carcinogen metabolites as an approach for obtaining important information about tobacco and cancer.

Materials and methods: The following article reviews the use of urine and its metabolites as biomarkers in various lesions of the oral cavity including oral squamous cell carcinoma and as a screening method in evaluating tobacco and its components. A bibliographic comprehensive search was carried out in the main databases: PUBMED, SciELO, Google Scholar, VHL, and LILACS for articles that were published from 1985 to 2020. The inclusion criteria were "urinary metabolites," "oral cancer/HNSCC," "body fluids," "tobacco," and "metabolomics." A total of 55 articles were collected which included laboratory studies, systematic reviews, and literature of urinary metabolites in tobacco users.

Results: Most of the studies carried out show accurate results with high sensitivity of urinary metabolite biomarkers in individuals with tobacco-based habits and lesions caused by them.

Conclusion: The review indicates that urinary metabolite analysis demonstrates its applicability for the diagnosis and prognosis of disease. Urine is a remarkable and useful biofluid for routine testing and provides an excellent resource for the discovery of novel biomarkers, with an advantage over tissue biopsy samples due to the ease and less invasive nature of collection.

This case report describes a case of intention replantation in a 15-year-old patient with a mandibular permanent right second molar that had undergone root canal treatment previously. The tooth was tender on percussion. Radiographic evaluation showed the presence of a separated instrument and periapical radiolucency. The surgical procedure was performed under local anesthesia, and the tooth was extracted. After cleaning and disinfecting the root canal system, the tooth was reimplanted, and the socket was filled with a mixture of bone graft material and a growth factor. A stainless steel crown was then placed to protect the tooth. A follow-up examination was performed after 12 months. The clinical and radiographic examinations revealed a well-healing periapical lesion with no signs of infection. The patient was asymptomatic, and the tooth was functional. The results of this case indicate that intentional replantation can lead to a favorable outcome.

The buccal fat pad (BFP) is a specialized encapsulated adipose tissue, located intimately between the buccinator muscle and oral mucous membrane. A small perforation of buccinator muscle can lead to herniation of BFP into the oral cavity, which can be readily mistaken with a pathological entity. In general, the size of herniated BFP is larger than the perforation. The treatment options for BFP are excision or repositioning in its anatomical position if noticed early. This article reports two such cases presenting with herniation of the BFP, following trauma to buccal mucosa and its surgical management.

Background: Four different designs of mini-implant-assisted rapid palatal expansion (MARPE) and protraction in nasomaxillary complex and mid-palatal sutures in late adolescent skeletal Class III malocclusion were compared using a three-dimensional finite element analysis.

Methods: A finite element model of skull and related sutures was constructed using the computed tomography scan of a 16-year-old female patient with skeletal Class III and ANB of -2°. Four appliance designs: Type I: MARPE with palatal force, Type II: MARPE with buccal force, Type III: Hybrid hyrax with palatal force, and Type IV: Hybrid hyrax with buccal force. Protraction vectors were and analyzed using Ansys software (ANSYS 2021 R2). The displacement pattern of the nasomaxillary structures and the stress distribution in the sutures were examined in all four appliance designs.

Results: All the appliance designs resulted in a forward movement of the maxilla, while Type I and III, which used palatal protraction force, caused the greatest forward displacement. In Type I, II, and III, along with forward movement, a clockwise rotation of maxilla was observed, while in Type IV, an anticlockwise rotation of maxilla was observed. Type I, II, and III resulted in higher stress distribution around the superior structures, while Type IV resulted in less stress distribution around the superior structures of maxilla.

Conclusion: The forward displacement was enhanced when palatal plates were used to protract the maxilla. The effective appliance design for skeletal class III with open bite case was Type I, II, and III and Type IV for deep bite cases.

Objectives: This study aimed to assess the effect of a nano-hydroxyapatite (nano-HA) toothpaste on erosive enamel lesions of third molars induced by exposure to orange juice.

Materials and methods: In this in vitro, experimental study, the microhardness of 24 sound-extracted third molars was measured by a Vickers tester. The teeth were then randomly assigned to three groups (n = 8) of nano-HA toothpaste (Pharmed), 1.23% sodium fluoride gel, and artificial saliva. The teeth were exposed to orange juice for 5 min daily for 7 days and were then exposed to nano-HA toothpaste, fluoride gel, or artificial saliva (depending on their group allocation) for 10 min a day. The microhardness of the teeth was measured again after 7 days. Data were analyzed using paired t-test, analysis of variance, and Bonferroni test (alpha = 0.05).

Results: Within-group comparisons showed a significant reduction in microhardness of the teeth after the intervention in artificial saliva (P = 0.000), and fluoride gel (P = 0.002) groups. However, no significant reduction occurred in the microhardness of the nano-HA group, compared with the baseline (P = 0.132). Between-group comparisons revealed no significant difference in the microhardness of the three groups at baseline (P > 0.05). However, after the intervention, the microhardness of the nano-HA group was significantly higher than that of other groups (P < 0.05). However, the difference in secondary microhardness between fluoride gel and artificial saliva groups was not significant (P = 1.00).

Conclusion: Pharmed toothpaste containing nano-HA has optimal efficacy for remineralization of enamel erosive lesions induced by exposure to orange juice.

Background: Early childhood caries is one of the most serious and high-priced oral health conditions among young children. With advancing dental sciences, the focus of dental caries treatment is shifted from restorative procedures to preventive measures, and a modality grabbing attention is probiotics. Probiotics exert their effects in many ways as chemical inhibition of pathogenic bacteria and stimulation of the immune response through the production of immunoglobulin A and many more.

Objective: This systematic review aims to explore the efficacy and safety of probiotics in dental caries in preschool children.

Methodology: The study was registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42020159058). The search was done for randomized control trials in electronic databases such as Cochrane, PubMed, ClinicalTrials.gov, Medline, and Embase. It has further included manual searches of journals, conference abstracts, and books. Three reviewers done the selection of the study as per the criteria and also did the risk of bias assessment independently and wherever required, a fourth reviewer resolved the discrepancy in case of disagreement.

Results: The nine randomized control trials were included in the study, and the pooled analysis revealed probiotics as an effective intervention in preschool children with dental caries.

Conclusion: The results about the efficacy of probiotics in the prevention of dental caries are very encouraging, though the level of evidence is still inadequate.

Background: Computer-aided design/computer-aided manufacturing (CAD/CAM) resin ceramics allow easier milling than glass ceramics but are suspected to be more stainable. Although Photoshop^® is widely used for picture analysis, its potential for shade selection has not been properly assessed.

Aim: Purpose primary: To evaluate the color stability of three CAD/CAM resin ceramics and Lithium Disilicate. Secondary: to compare the color evaluation between a spectrophotometer (Vita Easyshade compact) and Photoshop software.

Materials and methods: Three CAD/CAM resin ceramic materials (n = 10) and a fourth group of lithium disilicate were used. Half of each group were thermocycled (5°C and 55°C; 3000 cycles). All samples were immersed in colored beverages (coffee, tea and red wine) for 30 days. Values were obtained by spectrophotometry and photographs analyzed using Photoshop software. The parameters measured were CIEL*a*b, and the color difference (ΔE) was analyzed. A mixed model test was used to compare the results through time and materials (α = 0.05). The comparison between the spectrophotometer and Photoshop results was performed using the bivariate Pearson's correlation test.

Results: Lithium disilicate glass ceramic exhibited less color change (ΔE = 14) than resin ceramics (15.7 < ΔE < 18.7). The least change was noted with GC Cerasmart (ΔE = 15.7) followed by Vita Enamic (ΔE = 17*) and Brilliant Crios (ΔE = 18.7*). Spectrophotometer and Photoshop values showed low correlations.

Conclusions: Resin ceramics may suffer from color change in clinical use. Photoshop is technique sensitive; pictures are easily affected by the light conditions and camera settings.