Dental and Medical Problems最新文献

Background: Gingival inflammation has been increasingly linked to metabolic and endocrine disorders, such as polycystic ovary syndrome (PCOS). This connection may involve immune system activation and cellular stress mechanisms, particularly the unfolded protein response (UPR), which regulates endoplasmic reticulum (ER) stress.

Objectives: The aim of the study was to investigate whether gingivitis modulates UPR activation in peripheral blood mononuclear cells (PBMCs) of women with PCOS.

Material and methods: In this case-control study, female subjects were divided into 2 groups: a control group (n = 48); and a PCOS group (n = 68), which included 24 individuals with gingivitis (PCOS+). Anthropometric, biochemical and periodontal parameters were determined, namely probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index. Markers of oxidative stress, including total superoxide and glutathione peroxidase 1 (GPx1), and UPR mediators, such as glucose-regulated protein 78 (GRP78), activating transcription factor 6 (ATF6), phosphorylated eukaryotic initiation factor 2 alpha subunit (p-eIF2α), and C/EBP homologous protein (CHOP), were evaluated in PBMCs.

Results: Polycystic ovary syndrome was associated with an increased plaque index and significantly higher BOP in PCOS+. Increased superoxide and reduced GPx1 levels were observed in women with PCOS, with no significant differences between subgroups. Gingivitis in PCOS was correlated with the activation of specific UPR pathways; higher levels of p-eIF2α and CHOP and lower GRP78 levels were detected in PCOS+, while ATF6 was increased in the overall PCOS group. Moreover, BOP demonstrated a direct correlation with p-eIF2α and the plaque index.

Conclusions: The association of leukocyte ER stress responses in PCOS with gingival inflammation underscores the impact of periodontal disease on modulating systemic cellular stress in the context of multifactorial metabolic disorders.

Background: Self-adhesive resin cements (SARCs) are widely used in the field of restorative dentistry due to their simplified application and adequate bonding properties. However, their long-term color and surface stability, particularly under the influence of pigment-rich dietary substances, remain a critical concern in aesthetic restorations.

Objectives: The aim of the study was to evaluate the color stability and surface roughness of 4 contemporary SARCs after immersion in various staining media using digital photography.

Material and methods: A total of 160 disc-shaped specimens (n = 40 per group) were fabricated from 4 SARCs: Maxcem Elite™ (MXC); G-CEM ONE™ (GCO); SpeedCEM® Plus (SPC); and RelyX™ Universal (RLX). The specimens were immersed in artificial saliva, coffee, red wine, or matcha tea at 37°C for 0 (T0), 7 (T1), 14 (T2), 21 (T3), and 28 (T4) days. Color changes (ΔE₀₀) were measured, and surface roughness parameters were evaluated using 3D laser scanning microscopy. The statistical analysis was performed using linear mixed models (LMMs) and Tukey's honestly significant difference (HSD) post hoc test (α = 0.05).

Results: All materials showed visually perceptible color changes (ΔE₀₀ > 1.1). The highest discoloration and roughness values were observed in MXC, especially after exposure to red wine. RelyX™ Universal exhibited the greatest resistance to staining and surface degradation. 2-Hydroxyethyl methacrylate (HEMA)-based SARCs (MXC, GCO) were more susceptible to pigment infiltration and roughness increase than urethane dimethacrylate (UDMA)-based cements (RLX, SPC).

Conclusions: The aesthetic stability of SARCs is influenced by both material composition and exposure to staining agents. Red wine caused the most severe discoloration and surface changes, followed by coffee, matcha tea and artificial saliva. Higher water sorption and surface roughness were associated with increased staining. Preserving surface integrity is essential for maintaining the long-term aesthetic performance of SARCs.

Background: The technique described in this study has been used by our group for approx. 20 years. It involves fabricating a provisional or definitive prosthesis over a metal structure made of several wing abutments that can be intraorally welded to connect the adjacent implants.

Objectives: The aim of this retrospective observational study was to evaluate the effectiveness of and the complications associated with the use of intraorally welded wing abutments in patients with edentulous maxilla undergoing sinus floor augmentation with frozen homologous bone.

Material and methods: Data from adult patients diagnosed with edentulism in the posterior maxilla were retrospectively analyzed. All patients underwent sinus augmentation with homologous bone and were rehabilitated for 5-6 months after surgery, using wing spindles. The primary outcome of the study was to evaluate the prosthetic success, while the secondary outcomes included the assessment of the implant success and the incidence of complications.

Results: Data analysis included 35 patients, corresponding to 220 implants. At the last follow-up, a 100% prosthetic success and a 96.36% implant survival rate were obtained. A total of 8 patients (22.86%, corresponding to 8.64% of total implants) experienced complications, such as radiographic radiolucency, peri-implantitis and implant mobility.

Conclusions: The results of this retrospective study suggest that patients with edentulous maxilla undergoing sinus floor augmentation with frozen homologous bone might benefit from the use of intraorally welded wing abutments.

Background: The number of patients with bone defects is increasing. The treatment of damaged bones or bone defects is essential. Bone graft materials are frequently used in bone repair procedures. Researchers are attempting to replace damaged or defective bones with artificial ones, while also striving to improve the mechanical and biological compatibility of the scaffolds.

Objectives: The study aimed to establish and validate novel demineralized freeze-dried bovine bone xenograft nanoparticles (DFDBBX-NPs) for enhancing bone repair.

Material and methods: Demineralized freeze-dried bovine bone xenograft nanoparticles were extracted from bovine femoral bone. The physicochemical and biochemical properties of both native and demineralized freeze-dried materials were evaluated using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM), and the BrunauerEmmett-Teller (BET) analysis. Enzyme-linked immunosorbent assay (ELISA) kits were utilized to determine the content of type 1 collagen (Col-1) and bone morphogenetic protein-2 (BMP-2), water content percentage (WCP), and enzymatic degradation.

Results: The physicochemical analysis revealed non-porous DFDBBX-NPs with near spherical shapes of various sizes. The dried sample presented the nanoparticles agglomerated together, with an average size of 10-50 nm. The nanoparticles exhibit a type IV isotherm with an H3 hysteresis loop. They have a BET-specific surface area of 3 m2/g and a pore diameter of approx. 5.9 nm. The bioactive content of BMP-2 was higher than that of Col-1 in the DFDBBX-NPs. The DFDBBX-NP scaffold exhibited a slow rate of enzymatic degradation (0.098-0.240% over 14 days) and high water absorption (WCP ~202-215%).

Conclusions: Demineralized freeze-dried bovine bone xenograft nanoparticles demonstrated remarkable potential for the development of new bone grafts.

Background: The bond strength between self-adhesive resin cements (SARCs) and computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics is crucial for restoration durability, yet data on the aging effects of different SARCs remains limited.

Objectives: The aim of the study was to evaluate the shear bond strength (SBS) and failure modes of various SARCs on 2 CAD/CAM silicate ceramics after thermal aging.

Material and methods: A total of 360 samples from 2 ceramics (CEREC Tessera™ HT (CTS group); IPS Empress CAD LT (IEC group)) were treated with hydrofluoric acid (HF) and bonded with 6 SARCs: G-CEM ONE™ (GCO); Maxcem Elite™ (MXC); Nexus™ Universal (NXU); SpeedCEM® Plus (SPC); RelyX™ Universal (RLX); and PANAVIA™ SA Cement Universal (PSA). The samples underwent water storage (24 h, 37°C) or thermal aging (30 days, 20,000 cycles, 5-55°C). The shear bond strength and failure modes were measured, with the bonding interfaces being assessed via scanning electron microscopy (SEM). A multifactorial analysis of variance (ANOVA) was applied for the statistical analysis.

Results: Significant differences were identified in aging (F = 117.64, p < 0.001), ceramic types (F = 28.91, p < 0.001) and among SARCs (F = 34.79, p < 0.001). The highest SBS post-aging was found with IEC+GCO (24.92 ±2.90 MPa) and CTS+MXC (21.68 ±3.16 MPa), while the lowest SBS was recorded with CTS+PSA (6.22 ±4.31 MPa). Failure modes shifted from cohesive to mixed after thermocycling.

Conclusions: All tested SARCs bond effectively to CAD/CAM ceramics, with GCO and PSA being recommended for IEC ceramics, and MXC for CTS ceramics to optimize bond strength.

Background: Gamma-ray sterilization is commonly used for dental implants, but may alter their physical, chemical and surface properties.

Objectives: The present study compared gamma-ray irradiation doses of 15 kGy and 25 kGy in terms of their effects on the physical (microhardness), chemical (titanium (Ti) ion release) and surface (morphology and hydrophilicity) properties of sand-blasted, large-grit, acid-etched (SLA) Ti Grade 4 (G4) implants.

Material and methods: A total of 48 cylindrical Ti G4 samples (4 mm in diameter, 8 mm in thickness) were irradiated using cobalt-60 (Co-60) gamma radiation at 0 kGy (non-irradiated), 15 kGy or 25 kGy doses. Post-irradiation analyses included testing Vickers hardness (HV), Ti ion release in simulated body fluid (SBF) after 2 weeks, the water contact angle (θ), and scanning electron microscopy (SEM) for morphology assessment. Statistical significance was set at α = 0.05.

Results: Gamma-ray irradiation significantly impacted all measured properties. The mean hardness decreased from 536.5 HV (non-irradiated) to 251.3 HV (15 kGy) and 203.8 HV (25 kGy) (p < 0.001); no significant difference was observed between 15 kGy and 25 kGy. Titanium ion release increased with a radiation dose: 44.68 μg/L (non-irradiated); 93.75 μg/L (15 kGy; p = 0.0292 vs. control); and 218.98 μg/L (25 kGy; p < 0.001 vs. control and 15 kGy). The water contact angles approached 0° postirradiation, indicating a shift to superhydrophilicity, significantly different from the moderately hydrophilic control (p = 0.0085), with no difference between the radiation doses (p = 0.1266). The SEM analysis revealed more pronounced micro-damage and roughness at 25 kGy.

Conclusions: Both 15 kGy and 25 kGy significantly altered surface properties, but 25 kGy induced greater Ti ion release and micro-damage. Within the study limitations, 15 kGy is recommended as the preferred sterilization dose, as it maintains sterility while minimizing mechanical degradation and excessive Ti ion release as compared to 25 kGy.

Nocturnal yawning may represent a subtle clinical marker of arousal instability in patients with sleep-disordered breathing (SDB), potentially unveiling latent comorbid insomnia and sleep apnea (COMISA) phenotypes, and expanding the interpretative scope of sleep-related behaviors.

This paper outlines the development of a distinctive, full-time, 3-year postgraduate Master of Science (MSc) program in Orofacial Pain and Dysfunction (OPD), which integrates advanced clinical training, interdisciplinary care and research publication.

Background: Anxiety resulting from dental treatment often leads to avoidance of dental appointments and consequently has a negative impact on oral health. Non-pharmacological approaches have been identified as suitable alternatives for the management of dental anxiety. In this context, lavender oil has traditionally been used in aromatherapy (AT) due to its sedative, carminative, antidepressive, antiinflammatory, and antimicrobial properties.

Objectives: The aim of the study was to perform a triple-blind randomized clinical trial to address the effectiveness of AT with lavender essential oil (ATL) on the dental anxiety of patients undergoing mandibular third molar surgery.

Material and methods: Participants scheduled to undergo mandibular third molar surgery were enrolled in the study and randomly assigned to either the ATL group or the control group. Dental anxiety was assessed using the preoperative Modified Dental Anxiety Scale (MDAS). Vital signs were evaluated before and after the intervention. Cortisol levels were measured by enzyme-linked immunosorbent assay (ELISA). Additionally, a visual analog scale (VAS) was used, and the requirements for anesthesia were determined.

Results: A comparison of the pre-operative MDAS scores between the ATL and control groups revealed no statistically significant differences (p = 0.268). The levels of respiratory rate (RR) (p = 0.011) and heart rate (HR) (p = 0.021) significantly decreased in the ATL group after the intervention. Also, the number of local anesthetic cartridges needed (p = 0.030) and cortisol levels (p < 0.0001) were significantly lower in the ATL group.

Conclusions: The evidence suggests that ATL could be helpful in the management of dental anxiety.

Background: The conventional method of removing caries lesions is an anxiety-inducing process that often necessitates the administration of local anesthesia and the extensive removal of tooth structure. Therefore, minimally invasive procedures are required to preserve tooth structure and minimize discomfort.

Objectives: The aim of the study was to compare 3 minimally invasive treatments for the management of dental caries, evaluating factors such as treatment time, the need for anesthesia, reported adverse events, and restorative material follow-up.

Material and methods: A clinical trial was conducted on 45 children aged 7-8 years with active caries in primary molars. The samples were divided into 3 groups based on the applied treatment: 38% silver diamine fluoride (e-SDF®) group; BRIX3000® group; and CeraBur® group. The duration of treatment was recorded using a stopwatch. Adverse events, including tooth pain irritations, lesions, spots, and discolorations, were reported by parents within 2 weeks. The durability of the restorative material, namely glass ionomer cement (GIC), was assessed after 3 months. The χ2 and Kruskal-Wallis tests were conducted to analyze the data. The values were considered statistically significant at p ≤ 0.05.

Results: A significant difference in the duration of caries removal procedure was noted between the 3 treatment methods based on the median values (e-SDF®: 471 s, CeraBur®: 171 s, BRIX3000®: 1,173 s) (p < 0.001). Post hoc pairwise comparisons indicated significant differences in duration of the procedure between the CeraBur® and BRIX3000® groups, as well as between the e-SDF® and BRIX3000® groups (p < 0.001). The need for local anesthesia varied significantly between the 3 methods (p = 0.021). A significant difference was observed in the incidence of postoperative complications among the 3 methods, with the rate of adverse events equaling 9 (60.0%) in the e-SDF® group and 2 (13.3%) in the remaining groups (p = 0.013). A 3-month follow-up revealed a borderline significant difference in GIC integrity among the 3 methods (p = 0.052).

Conclusions: Caries excavation using BRIX3000® required a longer duration compared with e-SDF® and CeraBur®. Silver diamine fluoride was found to be a simple, minimally invasive approach for caries management and was effective in reducing the need for local anesthesia during treatment. Further research is required to evaluate patient satisfaction and restoration outcomes over longer follow-up periods.