Contemporary Clinical Dentistry最新文献

Background: Periodontitis causes the destruction of soft and hard tissues. Stem cells have immense potential in regenerative cellular therapy. This clinical trial aimed to evaluate clinically and radiographically the effectiveness of the local application of Edelweiss stem cells as a nonsurgical treatment for stage III periodontitis.

Materials and methods: The trial included 40 periodontal pockets in participants who have stage III periodontitis with probing pocket depth (PPD) ≥5 mm and clinical attachment loss (CAL) ≥5 mm. Pockets were randomly divided into two groups Group 1: was given oral hygiene instruction, scaling, root planing, and subgingival application of plant stem cells on gel foam carrier after that a periodontal dressing was applied. The procedures were repeated after 2 weeks. Group 2: was treated only by scaling and root planing. Gingival index, CAL, and PPD were measured at baseline and 3 months' posttherapy. The radiographical evaluation was done by digital long-cone parallel periapical radiographs at baseline and 6 months posttherapy.

Results: Clinical parameters for both groups showed a statistically significant improvement. Regarding radiographic evaluation, there was a significant increase in bone density in favor of the study group.

Conclusions: Locally applied Edelweiss stem cells can be considered a promising nonsurgical treatment modality for periodontal regeneration.

Digital dentistry is disruptive to conventional methods for performing prosthetic rehabilitation. Fabrication of prosthesis for all-on-four implants involves multiple steps when done conventionally and is prone to error. The use of digital technologies such as intraoral scanners (IOS) and extraoral scanners can marginalize these errors and also reduce the chairside time. This clinical report outlined a method which used a conjunction of extraoral and IOS to collect data for implant position, soft tissue profile, and vertical and centric relations. These data were then combined and used to fabricate a hybrid denture for the patient. The hybrid denture was milled from graphene-reinforced poly methyl methacrylate puck which provided the advantages of monobloc prosthesis and the material advantages of graphene. The entire prosthetic rehabilitation was completed within three appointments.

Background: It has been speculated that a change in cervical spine posture occurs due to forward repositioning of the mandible. Therefore, this study aimed to evaluate and compare the cervical spine posture in Class II division one patient treated with three different treatment modalities.

Materials and methods: A retrospective cohort study was conducted using pre and post-treatment lateral cephalograms of Class II Division one patients who have undergone orthodontic therapy using twin block appliance, Forsus, and bilateral sagittal split osteotomy (BSSO). This study included a total of 57 subjects comprising 19 subjects in each group. Seven cervical, three sagittal, and one vertical parameters were compared within and between each group. The data were tested using the Dependent t-test, One-way analysis of variance, and Tukey's post hoc test.

Results: A significant difference existed between the pre- and post-treatment angular measurements within the three groups showing a change in the cervical spine posture with forward positioning of the mandible. A comparison of mean changes in angular measurements between the three groups showed a significant difference in SNA, SNB, ANB, and odontoid process tangent-cervical vertebral tangent (OPT-CVT), indicating a change in the cervical posture.

Conclusion: OPT-CVT angle predicts a change in cervical spine posture after treatment with a significant difference in the Twin Block group (P = 0.029) compared to Forsus and BSSO groups. Thus, the twin block group results in a more upright craniocervical posture than the other two treatment groups.

Background: The early tooth loss has an adverse effect on the overall well-being of an individual. The aim of the current study was to highlight the orthodontic complications of long-term tooth loss in the city of Najran.

Materials and methods: This was a cohort study of patients presenting for orthodontic rehabilitation. A total of 326 patients that presented for orthodontic rehabilitation were examined clinically and data such as age, gender, number of missing teeth, missing teeth, duration of missing teeth, tipping, and overerupted and rotated teeth were recorded. Patients that can be treated with orthodontic space closure were excluded from the study. Patients' data were analyzed using IBM SPSS Statistics and results were presented as simple frequencies and descriptive statistics.

Results: Out of 326 patients that presented for orthodontic rehabilitation, 259 patients had missing teeth with its sequelae that will demand prosthodontic rehabilitation with a prevalence rate of 79.4%. There are 97 (37.5%) males and 162 (62.5%) females with M:F ratio of 1:1.7. The age ranged from 15 to 52 years with mean ± standard deviation (28.5 ± 8.5). The age group 21-30 years constitutes the group with the highest number of missing teeth. A total number of 595 (60.2%) teeth were missing, 173 (17.5%) teeth were tipped, and 124 (12.5%) teeth were overerupted, whereas only 97 (9.8%) teeth were rotated (n = 989). Fixed orthodontic appliances (FOAs) were used for all cases with rotation and FOAs + Mini Screws were used for all cases with tipping, overeruption, and/or combinations. The dental loss was managed by prosthesis depending on patients' choice and financial capability ranging from removable/fixed prosthesis and dental implants.

Conclusion: Orthodontic consequences of early tooth loss include tipping and rotation of adjacent teeth and overeruption of opposing teeth. Early acknowledgment of tooth replacement after tooth loss is essential in preventing long-term orthodontic adverse effects.

Background: Postendodontic restoration with composite resins has gained popularity due to the development of more reliable adhesives with simplified bonding procedures and less technique sensitivity. Pulpal floor dentin is a complex biological structure and a more challenging bonding substrate. Hence, appropriate selection of the bonding agent for these regions of the tooth is important.

Aims: To compare the shear bond strength of a new generation of dental adhesives referred to as multimode adhesives, two-step self-etch adhesive, and a total-etch system to pulpal floor dentin.

Materials and methods: Sixty human mandibular molars were sectioned with a slow speed diamond disc to expose the pulp chamber and divided into four groups of 15 teeth each, based on the bonding agent used. Group A: Single bond universal (self-etch); Group B: Single Bond Universal (etch-and-rinse), Group C: Clearfil SE Bond, Group D: Adper Single Bond 2. Using a split Teflon mold, composite cylinders were built on the prepared dentinal surfaces. The shear bond strength was then evaluated with the universal testing machine.

Results: Two step self-etch adhesives recorded higher shear bond strength than total-etch and multimode/universal adhesives applied in both self-etch and etch-and-rinse techniques.

Conclusion: The self-etching/priming system bonded more strongly to the pulpal floor dentin than multimode adhesive and total-etch system.

Phantom bone disease, also known as Gorham's disease, is a rare disorder characterized by the progressive destruction of one or more skeletal bones. Commonly involved bones are the upper and lower extremities. Very few cases have been reported in the maxillofacial region with unilateral mandible being commonly involved. This case, to our knowledge, is the third case of Gorham's disease involving the whole length of the mandible in a 55-year-old female with a brief discussion on its clinical, radiographic, and histopathological presentation and treatment options.

Periodontitis results in loss of periodontal attachment. This case report focuses on diagnosing a special case of periodontitis that required extreme care and maintenance. The peculiarities of this case are that based on 1999 American Academy of Periodontology classification this is a case of generalized aggressive periodontitis, but as per the recent 2017 classification, this is a case of periodontitis - generalized, Stage IV, Grade B, progressive and with no risk factors. Although this case is ideal for surgical management using regenerative techniques, it has been limited to mechanical therapy and laser due to patient-related economical factors. Within the limitations, this case has been successfully managed by dental laser and strategic implants. Despite all the limitations, 1-year follow-up shows periodontal stability and bone regeneration as evidenced through series of panoramic radiographs (OPG).

Background: The aim of this study was to evaluate the effect of a simple irrigating device, which produced from the apical negative pressure concept, as a final irrigating method after calcium hydroxide (CH) medication on the bond strength of epoxy resin-based sealer in the oval-shaped root canal.

Methods: Forty-eight single-rooted premolars with oval-shaped canals were included in the study. The crown was decoronized and canal instrumented with Mtwo (VDW GmbH, Munich, Germany) up to size 40/04. The specimens were assigned to four groups according to the irrigation protocol after 1 week of CH medication: control group (no medication) and three experimental groups conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and simple apical negative pressure kit (sANP). The teeth were obturated with a warm vertical technique using epoxy resin-based sealers. After 1 week, the roots were transversally sectioned at coronal, middle, and apical thirds. A push-out test was performed by a universal testing machine, and statistical analysis was performed using One-Way ANOVA with Duncan's post hoc test.

Results: The bond strength in the control group was significantly higher than the CNI group in all root canal thirds (P < 0.05). At coronal third, sANP showed lower bond strength than PUI group (P < 0.05). However, the bond strength of sANP group was comparable to the control group (P > 0.05) which was significantly higher than the PUI group at apical third (P < 0.05).

Conclusion: A sANP enhanced the bond strength of epoxy resin-based sealer in the apical third of CH-medicated root canal in the oval-shaped canal.

Introduction: In root canal treatment, chemical debridement of the root canal with the help of irrigants is important due to the complex internal anatomy of the teeth. Biomechanical root canal preparation produces a smear layer. It covers the dentinal tubules, which may interfere with the penetration of various irrigants and intracanal medicaments, so the smear layer has to be removed. The potential side effects and certain limitations of chemical irrigants for smear layer removal have led to a shift toward herbal alternatives.

Objective: The aim of the present study was to evaluate and compare the smear layer removal efficacy of Neem leaf extract, Propolis, and Orange oil as endodontic irrigants using the scanning electron microscope.

Materials and methods: Ninety samples were taken and then randomly (simple random sampling method) divided into three experimental groups (n = 30) depending upon different endodontic irrigants used: Group 1-Neem leaf extract, Group 2-Orange oil and Group 3-Propolis and smear layer removal evaluation was done under the scanning electron microscope Scanning Electron Microscope (SEM) at all the levels, i.e., coronal, middle, and apical.

Results: The collected data were analyzed using the Chi-square test. Group 1 (Neem leaf extract) showed the highest smear layer removal efficacy, which was followed by Group 2 (Orange oil) and the least efficacy of smear layer removal was shown by Group 3 (Propolis) at coronal, middle, and apical levels.

Conclusion: Group 1 (Neem leaf extract) performed significantly better in removing the smear layer at coronal, middle, and apical levels as compared to the other two groups.