Dental and Medical Problems最新文献

Background: Titanium (Ti) biomaterials are widely used in the surgical management of maxillofacial trauma, in oncology and orthognathic surgery. Although Ti is considered highly biocompatible, adverse reactions at the implant site have been reported in numerous clinical studies. However, the influence of Ti mandibular implants on glutathione metabolism, nitrosative stress and systemic inflammation has not been investigated to date.

Objectives: The study aimed to evaluate the acute (short-term) effects of Ti mandibular implants on the circulating biomarkers of the antioxidant defense system, on oxidative and nitrosative stress, as well as the inflammatory response of the blood plasma/erythrocytes, in maxillofacial surgery patients compared to the control group.

Material and methods: The experimental group consisted of 40 patients with bilateral mandibular fractures, who received osteosynthesis treatment with the use of Ti-6Al-4V alloy miniplates and screws. The control group comprised 40 ageand gender-matched patients who were qualified for the surgical treatment of craniofacial defects through bimaxillary osteotomy.

Results: An increase in the activity of pro-oxidant enzymes (↑ nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX), ↑ xanthine oxidase (XO)), impaired glutathione metabolism (↓ total glutathione, ↑ oxidized glutathione (GSSG), ↓ reduced glutathione (GSH), ↓ redox status), higher levels of oxidative stress (↓ total thiols, ↑ malondialdehyde (MDA), ↑ lipid hydroperoxides (LOOHs)), ↓ total antioxidant status (TAS)), carbonyl stress (↑ dityrosine, ↑ N-formylkynurenine) and nitrosative stress (↑ nitric oxide (NO), ↑ S-nitrosothiols, ↑ peroxynitrite, ↑ nitrotyrosine), as well as an intensified systemic inflammatory response (↑ interleukin (IL)-1β, ↑ IL-6), were observed in maxillofacial surgery patients.

Conclusions: Despite the fact that the study examined only the circulating biomarkers of redox balance and inflammation, the results suggest that a systemic inflammatory response can be triggered by local immune reactions. Systemic inflammation and oxidative stress may stem from an early adaptive immune response to foreign objects in the body. Although further research is required, the removal of the existing Ti mandibular implants should be considered.

Background: Oral health behaviors are the primary determinants of dental health. They undergo modification and stabilization during adolescence, and can persist into adulthood.

Objectives: The aim of the study was to assess the oral health behaviors of individuals aged 12 and 15-18 years, and to examine the impact of these behaviors on the occurrence and severity of dental caries in different age groups.

Material and methods: A cross-sectional oral health national survey was conducted between 2016 and 2020, encompassing a total of 5,099 participants, including 2,496 individuals aged 12 and 2,603 participants aged 15-18 years. The presence of non-cavitated decay (D1-2), cavitation (D≥3), and missing (M) or filled (F) status at the tooth (T) or surface (S) levels was evaluated. The prevalence of caries (D≥3MFT > 0), as well as the mean values of the D1-2, D≥3MFT and D≥3MFS indexes were assessed. The questionnaire contained information on sociodemographic factors, oral health behaviors and the participants' diet.

Results: The prevalence of dental caries was 75% among 12-year-old and 90% among 15-18-year-old individuals. Indicators associated with a reduced likelihood and lower severity of dental caries in both groups included prophylactic dental visits (adjusted odds ratio (AOR) (12-year-olds): 0.83; AOR (15-18-yearolds): 0.64) and brushing teeth at least twice a day (AOR (12-year-olds): 0.72; AOR (15-18-year-olds): 0.59). Frequent consumption of sweet products and chips by 12-year-olds increased the likelihood of developing and exacerbating tooth decay. In the older group, the risk of developing caries was associated with the consumption of sweets and sugar-sweetened carbonated beverages.

Conclusions: Poor oral hygiene and inadequate diet are conducive to the development of caries, with the condition being exacerbated by these factors regardless of age. However, the influence of diet appears to be more pronounced in less mature dentition. The benefits of dental visits, oral hygiene practices and a preference for mineral water in quenching thirst have also been demonstrated. The health behaviors exhibited by older and younger adolescents are comparable, suggesting that these habits may persist into adulthood.

Background: Periodontal disease is the most prevalent chronic inflammatory condition that can cause the destruction of supporting periodontal tissues. It has been hypothesized that while the synthesis of proinflammatory cytokines causes tissue destruction and disease progression, anti-inflammatory cytokine production can result in protective immunity. The balance of inflammatory cytokines is central to the immunoregulation of the disease.

Objectives: The aim of the study was to assess and compare the salivary levels of interleukin (IL)-18 and IL‑35 in subjects diagnosed with gingivitis, periodontitis, and healthy individuals. Additionally, the study sought to evaluate the difference in the concentration of IL‑18 and IL‑35 after non-surgical periodontal therapy (NSPT) in subjects diagnosed with periodontal disease.

Material and methods: A total of 69 individuals were divided into 3 groups: healthy (group 1; n = 23); gingivitis (group 2; n = 23); and stage II periodontitis (group 3A; n = 23). Saliva samples were obtained from each participant at baseline and, in the periodontitis group, at baseline and 12 weeks after NSPT (group 3B; n = 23). Probing pocket depth (PD), bleeding on probing (BoP), gingival index (GI), and clinical attachment level (CAL) were recorded and IL‑18 and IL‑35 levels were analyzed using an enzyme-linked immunosorbent assay (ELISA).

Results: The mean salivary level of IL‑18 was significantly higher in the gingivitis group compared to the other groups (p < 0.05), whereas the mean IL‑35 level was significantly higher in the healthy group compared to the other groups (p < 0.05). Twelve weeks after NSPT, the periodontitis group demonstrated a statistically significant difference in cytokine levels, characterized by a decline in the IL‑18 concentration (229.63 ±49.35 pg/mL) and an increase in the concentration of IL‑35 (29.47 ±17.88 pg/mL).

Conclusions: In the present study, a significant difference in the salivary levels of IL‑18 and IL‑35 before and after NSPT was observed. Therefore, these cytokines could serve as potential inflammatory biomarkers.

This perspective presents a new comprehensive proposal for sleep bruxism management.

Background: The inferior alveolar canal (IAC) is a fundamental mandibular structure. It is important to conduct a precise pre-surgical evaluation of the IAC to prevent complications. Recently, the use of artificial intelligence (AI) has demonstrated potential as a valuable tool for dentists, particularly in the field of oral and maxillofacial radiology.

Objectives: The aim of the study was to compare the segmentation time and accuracy of AI-based IAC segmentation with semi-automatic segmentation performed by a specialist.

Material and methods: Thirty individual IACs from 15 anonymized cone-beam computed tomography (CBCT) scans of patients with at least 1 lower third molar were collected from the database of Poznan University of Medical Sciences, Poland. The IACs were segmented by a trainee in the field of oral and maxillofacial radiology using a semi-automatic method and automatically by an AI-based platform (Diagnocat). The resulting segmentations were overlapped with the use of Geomagic Studio, reverse engineering software, and then subjected to a statistical analysis.

Results: The AI-based segmentation closely matched the semi-automatic method, with an average deviation of 0.275 ±0.475 mm between the overlapped segmentations. The mean segmentation time for the AI-based method (175.00 s) was similar to that of the semi-automatic method (175.67 s).

Conclusions: The results of the study indicate that AI-based tools may offer a reliable approach for the segmentation of the IAC in the context of dental pre-surgical planning. However, further comprehensive studies are required to compare the methods and consider their limitations more comprehensively.

The important thing is not to stop questioning. Curiosity has its own reason for existence. One cannot help but be in awe when he contemplates the mysteries of eternity, of life, of the marvelous structure of reality. It is enough if one tries merely to comprehend a little of this mystery each day.Albert Einstein.

Background: Recent developments in computer-aided design/computer-aided manufacturing (CAD/CAM) and 3D printing have enabled the fabrication of digital indirect bonding (IDB) transfer trays. These modern products require thorough investigation.

Objectives: The aim of the study was to determine the accuracy of one-piece and three-piece IDB transfer trays in vitro.

Material and methods: An initial dental scan (IDS) of a randomly selected patient with digitally positioned brackets served as the master scan (MS) for designing 16 IDB transfer trays of each type. They were 3D printed and used for bonding 448 brackets to the models. Subsequently, the models were scanned with a TRIOS® 3 Intraoral Scanner (3Shape A/S, Copenhagen, Denmark), producing actual scans (ASs). The accuracy of bracket positioning was measured digitally on both MSs and ASs. The measurements were compared to the Objective Grading System for dental casts provided by the American Board of Orthodontics (ABO).

Results: The 2 types of IDB transfer trays showed comparable accuracy. All linear errors were within the clinically acceptable range, whereas the angular measurements demonstrated significant variability, resulting in clinically unacceptable transfer errors that ranged from 3.3% to 90.3%.

Conclusions: The study results cannot be unconditionally extrapolated to other types of IDB transfer trays due to the diversity of their properties and features. The study evaluated the in vitro accuracy of IDB transfer trays. The revealed number of errors may be even higher in vivo due to limitations in visibility, salivary flow, interference from the tongue, and difficulties in achieving a proper fit of the IDB transfer tray to the teeth.

Background: Although the macroscopic assessment of dental caries and the assessment of bone elemental composition are quite different, efforts can be made to identify commonalities in the assessment of health and nutritional quality. Both indicators are correlated with dietary habits and are dependent on taphonomic processes occurring in the postmortem substrate. However, teeth exhibit structural resilience of their hard tissues to adverse environmental factors.

Objectives: The aim of the study was to establish a correlation between the elemental composition of bones and the presence of carious lesions.

Material and methods: The study material consisted of the following skeletal parts: 161 permanent teeth from 36 individuals and bridge fragments of 36 ribs. The presence of caries was assessed visually using a modified International Caries Detection & Assessment System (ICDAS II) scale. The rib samples were subjected to elemental analysis (zinc (Zn), iron (Fe), magnesium (Mg), calcium (Ca), phosphorus (P), strontium (Sr), barium (Ba)) using spectroscopic methods.

Results: The odontological and chemical analyses did not reveal any statistically significant relationships between the Ca/P diagenesis index and dental features. Postmortem tooth loss showed a weak correlation with the diagenesis index.

Conclusions: Discoloration, cracks and flaking of the dental crown surfaces may be associated with the intensity of Ca/P diagenesis. However, no significant correlation was found between these phenomena. Among other elements, only Zn levels exhibited a correlation with the caries index.

Background: Intracanal medicaments are vital in treating the infections of the deciduous dentition due to the large percentage of accessory canals that hasten the microbial spread to the periradicular region. Though countless medicaments have been produced to reduce the microbial load and aid symptomatic relief, they still do not fulfill every function of an ideal medicament.

Objectives: The aim of the present study was to evaluate and compare the antimicrobial efficacy of Stevia rebaudiana (S. rebaudiana) and triple antibiotic paste (TAP) against Enterococcus faecalis (E. faecalis).

Material and methods: The present in vitro, parallel, double-blinded study had an equal allocation ratio. The specimens were prepared, randomly divided into 4 groups and inoculated with E. faecalis (ATCC35550). Following incubation, the first 3 groups were treated with S. rebaudiana, triple antibiotic therapy or carbopol gel, respectively, with the 4th negative control group left untreated. The microbial samples were collected before and after treatment, and the counts of colony-forming units (CFUs) were compared. The results were analyzed using the Kruskal-Wallis, Dunn's post-hoc and Wilcoxon's signed rank tests.

Results: The first 2 groups displayed a significant decrease in CFUs after drug application, while the carbopol and control groups showed an exponential increase. There was no statistically significant difference between the stevia and TAP groups (p = 0.630).

Conclusions: Stevia gel was comparable to TAP in terms of antimicrobial efficacy, and can therefore be considered a new alternative in intracanal treatment.

The important thing is not to stop questioning. Curiosity has its own reason for existence. One cannot help but be in awe when he contemplates the mysteries of eternity, of life, of the marvelous structure of reality. It is enough if one tries merely to comprehend a little of this mystery each day.Albert Einstein.