Contemporary Clinical Dentistry最新文献

Escape rooms in medical education are relatively a novel approach to facilitate critical thinking and decision-making in simulated realistic clinical scenarios among the medical students. The success of escape rooms in the attainment of specified competencies depends on several factors that must be given due consideration for optimizing the overall outcome. Further, there might be multiple ethical concerns that must be given due attention before, during, and after the conduct of such sessions. There is an immense need to integrate ethical considerations while designing and implementing escape rooms in medical schools, as it will aid in the creation of a respectful and encouraging learning atmosphere for the students. In conclusion, escape rooms provide a great learning opportunity for medical students to critically think, engage in teamwork, and learn the art of adaptation depending on the given clinical scenario. However, the successful conduct of such sessions is determined by a wide range of factors, including ethical considerations, and all of them need to be systematically analyzed and measures should be taken to reduce their impact on students.

Background: The condylar and glenoid fossa morphology can alter in patients with temporomandibular disorders (TMD), which can lead to changes in the temporomandibular joint (TMJ) space volume. Volumetric evaluation of TMJ can represent the entire three-dimensional (3D)-joint space between the condyle and glenoid fossa.

Aims: To perform 3D assessment of TMJ volume, condylar, and glenoid-fossa morphology using cone-beam computed tomography and evaluate the correlation between these parameters.

Settings and design: Thirty-four patients (age: 13.50 years) who had no previous history of TMD were included.

Materials and methods: The volume of TMJ space was measured and divided into anterior, posterior, medial, and lateral TMJ volume. The antero-posterior (AP) and medio-lateral (ML) condylar width, AP and ML glenoid-fossa width, and glenoid-fossa depth were evaluated.

Statistical analysis used: Statistical analyses were performed with R software at a 0.05 significance level. Each parameter was compared between the left and right sides using a paired-t test. The correlations between the parameters were obtained by the Pearson correlation coefficient.

Results: There was no significant difference between lateral and medial TMJ volume; however, posterior TMJ volume was significantly greater than anterior TMJ volume. A significant correlation was observed between AP glenoid-fossa width and TMJ volume, glenoid-fossa depth and TMJ volume, AP position of the condyle and anterior TMJ volume, ML position of the condyle and medial TMJ volume, glenoid-fossa width and condyle width in AP and ML dimension, glenoid-fossa depth and AP glenoid-fossa width.

Conclusions: In addition to the evaluation of condylar and glenoid-fossa morphology, assessment of TMJ space volume is important for comprehensive evaluation of the joint.

Background: Early childhood caries (ECC) is a common public health problem in developing countries. Children with severe decay can also have altered eating habits and preferences. Therefore, ECC can influence nutritional health.

Aim: The aim is to find the prevalence of ECC and nutritional status and to evaluate its association among preschool children in Northeast India.

Study design and data collection methods: This descriptive cross-sectional study was conducted among 384 preschool children aged 2-6 years. The sampling unit comprised the children attending the pediatric dentistry department of one dental college. Information regarding sociodemographic factors, child feeding habits, and child oral hygiene practices was obtained from the parents using a pretested questionnaire. Weight and height were evaluated to assess the nutritional status. The decay, missing, filled teeth index for primary teeth was used to determine the dental caries status.

Results: The mean value of carious teeth for 384 children aged 2-6 years was 5.6 ± 2.43. Most kids who had caries (74.7%) belonged to the moderate category (dmft >7), followed by the low sort, which was 16.7%, and then by those in the higher class (8.6%). The body mass index (BMI) for age revealed that 5.2% were overweight, 15.1% were thin, and 8.3% were obese. Most of those with high caries (i.e., dmft >7) were underweight or in the normal weight category. Pearson correlation showed no significant correlation between ECC with BMI-for-age (r = 0.04, P > 0.05).

Conclusion: The prevalence of dental caries among children below the age of 5 years in Imphal was high. The risk factors for ECC included age, low maternal education, improper feeding, and oral hygiene habits. However, the results revealed no significant relationship between ECC and BMI.

Keratocyst is a developmental odontogenic cyst arising from remnants/rests of the dental lamina with biologic behavior similar to benign neoplasm. The presence of multiple odontogenic keratocysts is rare and seen in Gorlin-Goltz syndrome (GGS). GGS syndrome presents with multisystem involvement and the classical triad of multiple basocellular epitheliomas, keratocysts in the jaws, and bifid ribs; that characterize the diagnosis of this syndrome. Multiple odontogenic keratocyst are the most consistent features of the syndrome in 65%-100% of affected individuals and are generally diagnosed at a very early age. Early diagnosis and proper counseling of the parent and patient might help to reduce the morbidity, encourage follow-up for timely treatment, and help in avoiding ionizing radiation that would lead to the development of malignancies.

Aim: To evaluate the efficacy of enamel matrix derivative (EMD) on periodontal regeneration defects.

Materials and methods: Four databases were searched until October 2021. Experimental animal studies evaluating the efficacy of EMD were used. The primary outcomes were bone formation (BF) and cementum formation (CF). The secondary outcomes were junctional epithelium (JE), gingival recession (GR), and clinical attachment level (CAL). Measures of effect were mean difference (MD) with 95% confidence intervals (CIs). Random-effects model were used for all meta-analyses. The Systematic Review Centre for Laboratory animal Experimentation tool was used to assess the risk of bias.

Results: Seven experimental animal studies (n = 40) used with a maximum follow-up period of 3 months. Compared to control, EMD did not significantly reduce BF (MD 0.02 mm; 95% CI - 1.91-1.96; I² = 89%). However, it increased CF (MD 1.38 mm; 95% CI 0.01-2.74; I² = 55%). For secondary outcomes it was found that compared to control, EMD only significantly reduced JE (MD - 0.54 mm; 95% CI - 1.06 to - 0.02; I² = 55%). However, the other secondary outcomes were not significant as in the case of GR (MD - 3. 88 mm; 95% CI - 68.29-60.53; I² = 82%), and in CAL (MD 0.02 mm; 95% CI - 0.29-0.39; I² = 38%). Finally, according to the risk of bias assessment, all included studies had a high risk of bias.

Conclusion: EMD had no effect on BF values while it did not reduce CF. Otherwise, in the secondary outcomes, EMD only significantly reduced JE values and had no effect on GR and CAL.

Objective: The objective of this research is to determine whether the thermoplastic polyurethane (TPU) coated with carboxymethylcellulose chitosan has better mechanical and antibacterial action (anti-Streptococcus mutans) when utilized in intraoral simulations with synthetic saliva.

Materials and methods: The TPU sheets (n = 45) were divided into three groups. Control (n = 15) consists of as-received TPU sheets. Test 1 consists of TPU sheets coated with carboxymethyl cellulose (CMC) chitosan (CHI) (n = 15). Test 2 consists of thermoformed nano-coated TPU (n = 15). For the polyurethane sheets, CHI-CMC sheets, and thermoformed CHI-CMC sheets, scanning electron microscopy (SEM) and three-point flexural tests were conducted and assessed. The materials testing software was used to calculate the elastic modulus and tensile strength. To study the bacterial accumulation, the cut circles of the TPU aligner were placed in centrifuge tubes with 2.5 mL of bacterial suspension at a concentration of 104 or 105 CFU/mL. SEM was done to assess the presence of cell growth in all three groups.

Results: According to SEM analyses of bacterial buildup, the coated TPU had minimal biofilms compared to the bare TPUs numerous biofilms. The effect of aging on coating thickness reveals that the thickness of thermoformed coated TPU films dramatically decreased over time, while the thickness of coated TPU films was maintained. When TPU is coated with CMC/CHI, the elastic modulus and tensile strength were observed to improve.

Conclusion: The development of a super-hydrophilic coating by the CHI CMC coating on TPU sheets improved the coating's biocompatibility while also changing the shape of the multilayer film to prevent bacterial adhesion. The effect on the improvement in the mechanical properties diminished after the material underwent a thermoforming process. It is therefore suggested that the nanofilm be used in therapeutic applications following the thermoforming process.

Aims: The aim was the study was to evaluate and compare the mechanical properties of ACTIVA Bioactive Base/Liner (ABBL) enhanced with phytosynthesized titanium dioxide nanoparticles (nTiO₂) and nano-curcumin (nCur).

Methodology: Thirty samples each of ABBL (Group 1), ABBL + nTiO₂ (Group 2), and ABBL + nCur (Group 3) were prepared for testing the compressive strength (CS) and flexural strength (FS). Forty-five cylinders (15 per group) (6 mm × 4 mm) were fabricated for CS and 45 for three-point bending FS measurements (22 mm × 2 mm × 2 mm). They were tested in a universal testing machine at a crosshead speed of 0.5 mm/min for CS and 0.5 mm/min with 20 mm space between the two supports for FS measurements.

Statistical analysis: Intergroup comparison of CS and FS was assessed using one-way ANOVA. The level of significance was set at 0.05.

Results: Intergroup comparison showed an overall significant difference (P = 0.016 for CS) and (P = 0.001 for FS), where Group 1 had the highest and Gr 3 the least strength. No significant difference was observed between Group 1 and Group 2, while Group 3 showed significantly low strength when compared to Group 1.

Conclusions: ABBL + 3% nTiO₂ showed nonsignificant decrease while ABBL + 7% nCur showed significant decrease in mechanical properties.

Cleft lip and palate are the most common orofacial anomalies affecting the quality of life of an individual. Bilateral cleft lip and palate are the most difficult to treat due to missing premaxilla, and removable prosthesis is the only treatment in such situations to satisfy esthetics, function, and phonetics. In this case report, we have discussed a novel technique of rehabilitating a bilateral cleft palate patient with a fixed hollow prosthesis that would replace the missing hard and soft tissue, yet is light weighed. This unique prosthetic solution could set a new standard of treatment in a seemingly compromised situation.

Background: Assessment of dental anxiety in children is difficult because of their immature cognitive and emotional development. Drawings are well well-established emotion assessment tool. These can be used as nonverbal methods of communication for expressing the children's anxiety and emotions. Art therapy utilizes creative therapy interventions to deal with children suffering from emotional problems.

Aims and objectives: The aim of the study is (1) To assess the drawings of children for the presence of dental anxiety. (2) To study the effectiveness of art therapy on dental anxiety in children.

Materials and methods: One hundred and twenty children within the age group of 6-12 years were part of this study. The pretest assessment of dental anxiety was done using Frankl and Five facial anxiety scales. All the participants received local anesthesia during their first treatment session. At the end of the treatment session, all the participants were asked to draw a picture of their experience. The drawn figures were assessed by a psychologist. The children were allotted randomly into the study group (n = 60) and control group (n = 60). Art therapy was given to 60 children in the study group for three consecutive appointments. The posttest assessment of dental anxiety was done using Frankl and Five facial anxiety scales after completion of the entire dental treatment.

Results: The pretest scores revealed very high level of dental anxiety in 33 (55%) children in study group and 34 (56.67%) children in control group. The posttest scores of study group, who received the art therapy, revealed that 24 (40%) children had little anxiety and 32 (53.33%) children had some anxiety. Whereas in the control group, the posttest scores showed 20 (33.33%) children had high anxiety and 39 (65%) children had very high anxiety scores. There was a significant correlation between the objective score of dental anxiety and the subjective scores of CD: H.

Conclusion: Drawings can be used as an assessment tool for the detection of dental anxiety and art therapy effectively reduces the anxiety in pediatric patients undergoing dental treatment.

Background: Calcium phosphate-based systems have been introduced as promising bio-mimetic materials due to their close resemblance to the enamel. Chitosan and its derivatives have been an emerging biomaterial due to their additional antibacterial effect and promising re-mineralizing ability.

Aim: The aim of this study is to evaluate the effect of chitosan nanoparticles on the remineralization of the demineralized enamel surface after being added to nano-hydroxyapatite and nano-calcium phosphate materials.

Setting and design: This was in vitro study.

Materials and methods: Twenty specimens of extracted permanent molars were collected, and then immersed in demineralizing solution, then distributed into four groups according to the remineralizing material. Group 1: Treated with Nano-beta-tricalcium phosphate (Nβ-TCP) gel, Group 2: Treated with Nβ-TCP with chitosan gel, Group 3: Treated with Nanohydroxyapatite (NHA) gel, and Group 4: Treated with NHA with chitosan gel. The surface hardness of the teeth was measured at baseline, after demineralization, and after remineralization. The structural changes in each group were analyzed using the scanning electron microscopy.

Statistical analysis: Shapiro-Wilk's test, one-way ANOVA followed by Tukey's post hoc test was used.

Results: In all groups, there was a significant difference in mean Vickers hardness number (VHN) at different intervals, with the highest value found after treatment (301.64-395.65) VHN, followed by the baseline (236.97-276.15) VHN, while the lowest value was detected after demineralization (121.23-124.39) VHN. It was also indicated that baseline treatment, the Hardness percentage change (%) of the nano NHA + Chitosan group showed the highest significant value (55.10%), while the Nβ-TCP group exhibited the lowest significant value (9.56%).

Conclusions: It can be concluded that NHA and NΒ-TCP modified by chitosan NPs as remineralizing agents of enamel surface hold promising results.