Contemporary Clinical Dentistry最新文献

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: 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.

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.

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.

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.