Dental and Medical Problems最新文献

Symmetry is present in various aspects of everyday life. A symmetrical face is considered attractive, whereas a lack of facial symmetry is regarded as a source of functional and aesthetic problems. Most of the people exhibit slight asymmetries, but some of them reveal severe asymmetries. Among patients presenting with severe facial asymmetries, there may be those with congenital defects. Congenital defects may manifest at the time of birth or be a result of birth trauma.One of the most prevalent asymmetrical birth defects is cleft lip and/or cleft palate. Other congenital defects include craniofacial syndromes, such as Treacher Collins syndrome (TCS) and Goldenhar syndrome. Among the rare syndromes with facial asymmetries, Klippel-Feil syndrome (KFS), PHACE (posterior fossa brain malformation, hemangiomas, arterial anomalies, cardiac anomalies, and eye abnormalities) syndrome, plagiocephaly, and Parry-Romberg syndrome are worth noticing. The majority of craniofacial asymmetries require surgery to improve the patient's facial appearance. The treatment is multidisciplinary and long, and the most common procedures involve reparative and regenerative surgeries. The aim of this review was to present the most common congenital defects with facial asymmetry.

Background: Self-assessment is key to improving the quality of work performed by dental professionals. The ability to accurately self-assess has been found to correlate with better clinical performance, making it an important skill for students to master during their dental education. Furthermore, studies conducted in dental schools across the world have shown that lower-performing students tend to overestimate their abilities compared to their peers.

Objectives: This study aimed to evaluate the self-assessment skills of dental students in pre-clinical operative dentistry and to investigate the impact of gender on these skills.

Material and methods: Third-year undergraduate dental students (N = 335) took 2 pre-clinical practical exams: class II composite preparation and restoration. Students self-assessed each assignment using a standardized rubric, and 6 calibrated faculty members graded all procedures blindly and independently. The difference between students' self-assessment scores (S) and mean faculty grades (F) reflected the students' self-assessment skills and was referred to as the Student-Faculty (S-F) gap. A positive S-F gap indicates that students overestimate their work, while a negative S-F gap indicates that students underestimate their work. Data was stratified by gender and by faculty-determined student performance, and then statistically analyzed.

Results: The study demonstrated a statistically significant difference between faculty grades and students' self-assessment scores. Positive S-F gaps were observed across all procedures, indicating overestimation, with a mean S-F gap of 11.4 ±9.9%. A negative correlation was found between faculty grades and S-F gaps. Higher-performing students showed smaller S-F gaps (4.8 ±5.3%) compared to lower-performing students (21.2 ±9.68%). Furthermore, male students showed significantly higher S-F gaps (14.0 ±10.3%) compared to females (9.7 ±9.4%).

Conclusions: Overestimation was more prevalent among lower-performing and male students compared to higher-performing and female students. Future investigations should consider exploring effective interventions and educational strategies aimed at improving students' self-awareness and their ability to accurately assess their performance.

Background: A variety of firing protocols are available for the IPS e.max lithium disilicate (LD) and can be used for new, 'advanced' LD (ALD). However, the impact of firing protocols on the optical properties of ALD is still unknown.

Objectives: The aim of the present study was to evaluate the color difference (ΔE00), the translucency parameter (TP00) and the whiteness index for dentistry (WID) for both LD glass ceramics after the processes of firing/glazing.

Material and methods: Fifty disk-shaped specimens, with a diameter of 10 mm and a thickness of 1.2 mm, were fabricated from IPS e.max CAD (LD; Ivoclar) and another 50 from CEREC Tessera™ (ALD; Dentsply Sirona). The specimens from each group were further divided into 5 subgroups (n = 10) according to the firing/glazing protocol applied: crystallization (c); one-step crystallization and glazing (cg); crystallization and refiring (c-r); two-step crystallization and glazing (c-g); or long-firing crystallization (lfc). The ΔE00, TP00 and WID were assessed. The statistical analysis of ΔE00 was performed using the one-way analysis of variance (ANOVA) and Tukey's post hoc test, while TP00 and WID were analyzed with the two-way ANOVA and Tukey's post hoc test at a statistical significance level of 0.05. The cg groups were designated as the reference.

Results: The ANOVA showed that the firing procedures had no effect on ΔE00, TP00 and WID in the case of LD. In addition, LD exhibited greater translucency and brightness as compared to ALD. For ALD, all color changes observed in relation to the reference firing protocol were clinically unacceptable. The ALD specimens which underwent 1 standard firing cycle showed higher TP00 and WID values than other ALD groups.

Conclusions: The choice of the firing protocol has no impact on the color, TP00 or WID of LD. Additionally, LD presents higher WID values than ALD, irrespective of the firing protocol used. Alternative firing protocols result in clinically unacceptable color variations when compared to the manufacturer-recommended protocol for ALD. Advanced LD is more sensitive to different firing protocols with regard to its optical properties, which makes the workflow less predictable in comparison with LD.

The presence of toxic metals in the human environment can have detrimental effects on people's wellbeing. This literature review examines the ways in which various environmental and non-environmental factors can contribute to the accumulation of heavy metals in hard dental tissues. It is of the utmost importance to ensure the safety of the environment by restricting the presence of toxic metals originating from both industrial and non-industrial sources. The aim of this study is to analyze current research and identify the primary sources of heavy metal exposure and the mechanisms by which these metals are deposited in dental tissues. Moreover, the objective of this review is to synthesize data from various studies to determine the main environmental and non-environmental sources of toxic metal exposure that contribute to their presence in dental tissues, as well as the biological and chemical processes that are responsible for the deposition of heavy metals in hard dental tissues. Additionally, the review aims to assess the impact of heavy metal accumulation on dental health and its potential systemic effects on overall well-being. The accumulation of heavy metals in the teeth is influenced by a number of factors, such as age, systemic conditions, the nutritional status, and dental caries. The presence of supernumerary teeth results in altered levels of microelements, including an increase in cadmium (Cd) and copper (Cu). Additionally, smoking exacerbates toxic metal accumulation, especially Cd and lead (Pb), and disrupts the balance of essential minerals within the teeth. These findings underscore the impact of environmental pollution on dental health and highlight the potential of teeth as biomarkers of environmental exposure, emphasizing the need for continued research to address the health risks associated with environmental toxins.

Tooth wear is an increasingly common problem that affects the quality of life. Although previous research suggested that oral health is adversely affected in individuals with Parkinson's disease (PD) compared to healthy controls, tooth wear has not been extensively studied in this context. Particularly, there is a paucity of data on the prevalence and risk factors associated with tooth wear in PD patients. The aim of this study is to review the current literature on the prevalence and risk factors of tooth wear in PD patients and to propose hypotheses for future research on this topic. A literature search was conducted in PubMed. A total of 4 publications were identified: 1 case report and 3 questionnaire-based studies. These articles suggest that tooth wear is a more significant issue in PD patients than in healthy controls. In addition, potential associations between oral health-related quality of life (OHRQoL), bruxism and temporomandibular disorder (TMD) pain on the one hand, and tooth wear on the other hand, were identified in PD patients. Due to the limited number of articles published on this topic, it is not possible to definitively conclude whether tooth wear is a common problem in PD patients. However, the following hypotheses could be formulated: 1) tooth wear is more prevalent in PD patients than in healthy controls; 2) risk factors for tooth wear observed in healthy individuals are more prevalent among PD patients; and 3) multiple risk factors for tooth wear likely coexist in people with PD, potentially influencing the prevalence and progression of tooth wear in this population.

Background: Given the notable prevalence of temporomandibular disorders (TMD) in the Polish population, there is a clear need for the use of simple, reliable questionnaires as screening tools to facilitate the referral of patients to TMD specialists.

Objectives: The aim of the study was to translate and adapt the Fonseca Anamnestic Index (FAI) into Polish and assess its reliability and validity in identifying TMD symptoms.

Material and methods: The Polish adaptation of the FAI (FAI-PL) was developed in accordance with the international guidelines, including the translation and evaluation of the psychometric properties of the questionnaire. Every patient received a standardized assessment, which involved history taking and clinical examination, including the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the FAI questionnaire. The psychometric analyses included an evaluation of the questionnaire's reliability and validity, as well as an exploratory factor analysis (EFA).

Results: Of the 122 individuals enrolled in the study, 63.9% were female. The mean age of the participants was 28.1 years (standard deviation (SD): 6.3). According to the RDC/TMD standards, 40.9% of patients had no TMD, while the FAI assessment indicated that 27% of patients had no TMD. The Cronbach's alpha coefficient for the FAI-PL was 0.75. The exploratory factor analysis revealed 3 factors, accounting for 55.2% of the total variation. The diagnostic sensitivity of the FAI-PL was 98.6%, while the diagnostic specificity reached a level of 65.3%.

Conclusions: The Polish version of the FAI is a reliable and valid tool for the screening of TMD symptoms in the Polish-speaking population.

Background: Calcium hydroxide is used as a reparative dentin inducer. The combination of cocoa pod husk and calcium hydroxide has also been studied as a reparative dentin inducer, whereas anchovy was identified as a good calcium source.

Objectives: The aim of the study was to investigate the optimal ratio of a nano-combination of calcium hydroxide, cocoa pod husk extract and anchovy powder as a reparative dentin inducer by analyzing their material, antioxidant and cytotoxic properties.

Material and methods: The ratios of the 3 elements were established and their performance was compared in terms of viscosity, setting time, pH, and solubility rate. The optimal ratio was then examined for its antioxidant capacity using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Additionally, its cytotoxicity against human dental pulp stem cells (hDPSCs) was evaluated through the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.

Results: A ratio of 1:1:1 of calcium hydroxide, cocoa pod husk extract and anchovy powder was identified as the optimal ratio. It exhibited the greatest flowability, the shortest final setting time, had a pH range of 8.5-10.5, and the second highest solubility rate in comparison with other ratios. Moreover, it demonstrated active radical scavenging activity and stimulated the proliferation of hDPSCs.

Conclusions: Based on the material, antioxidant and cytotoxic properties, a ratio of 1:1:1 of nano-calcium hydroxide, cocoa pod husk extract and anchovy powder was determined to be optimal for use as a reparative dentin inducer.

Background: Polyamide-based materials are suitable for three-dimensional (3D) printing.

Objectives: The aim of the study is to examine the impact of aging on the mechanical, surface and optical properties of polyamide 12.

Material and methods: A total of 116 specimens were examined, comprising 58 conventionally processed polyamide 12 (PA12_C) specimens and 58 3D-printed polyamide 12 (PA12_3D) specimens. The modulus of elasticity was determined before and after mechanical and thermal aging with 1,000, 3,000, 9,000, and 1,000, 3,000 and 7,000 cycles, respectively. The surface roughness (Ra), Ra change (ΔRa) and color change (ΔE) were examined before and after chemical aging (1, 12 and 36 days, with artificial saliva, coffee and red wine) using surface profilometry and color spectroscopy. The Kruskal-Wallis test, Mann-Whitney U test and Bonferroni-Holm correction were employed, with a significance level of p < 0.05.

Results: Before and after mechanical aging, the modulus of elasticity for PA12_3D showed significantly higher values (761 MPa and 747 MPa, respectively) in comparison to PA12_C (515 MPa and 455 MPa, respectively; adjusted p < 0.001). Additionally, before and after thermal aging, the modulus of elasticity for PA12_3D exhibited significantly higher values (833 MPa and 705 MPa, respectively) compared to PA12_C (516 MPa and 458 MPa, respectively; adjusted p < 0.001). The Ra of PA12_3D was higher than that of PA12_C at the baseline (0.41 μm compared to 0.31 μm, respectively), and remained higher during the aging process. The ΔRa values were small for both groups. The ΔE was significantly higher for PA12_3D compared to PA12_C after 12 days (6.2 (PA12_3D) compared to 4.8 (PA12_C), adjusted p = 0.003) and 36 days of storage in red wine (8.2 (PA12_3D) compared to 6.8 (PA12_C), adjusted p = 0.003). After 36 days of coffee storage, the observed changes were found to be statistically significant (8.6 (PA12_3D) compared to 6.7 (PA12_C), adjusted p < 0.001).

Conclusions: The 3D-printed polyamide 12 demonstrated higher rigidity, Ra and discoloration compared to the conventionally processed polyamide 12. However, not all of the observed parameter differences were significant or clinically relevant. These differences may impact clasp retention, biofilm formation and aesthetic appearance. Nevertheless, the clinical efficacy of 3D printing may be significant.

Background: Dental anxiety is characterized by distress in anticipation of dental visits, which may result in a child's refusal to undergo treatment and, ultimately, lead to parents' reluctance towards dental care.

Objectives: The aim of this study was to evaluate and compare the effectiveness of the tell-show-do technique, modeling technique and yogic relaxation technique in the reduction of dental anxiety among children aged 6-12 years.

Material and methods: The study was an interventional, parallel-group, single-center, double-blind, randomized controlled trial conducted on 120 children who required restorative treatment without the use of local anesthesia. The participants were selected based on specific inclusion and exclusion criteria and were randomly divided into 3 groups: group 1 - tell-show-do technique; group 2 - modeling technique; group 3 - yogic relaxation technique. The dental anxiety levels were evaluated 4 times using both physiological (oxygen saturation and pulse rate) and behavioral parameters (facial image scale (FIS) and the Face, Legs, Activity, Cry, and Consolability scale (FLACC)). The data was assessed by 2 blinded and calibrated specialists.

Results: Statistically significant differences were observed in all 4 parameters among the 3 groups. During both the intraoperative and postoperative periods, the oxygen saturation levels were significantly higher in the yogic relaxation technique group. Moreover, the yogic relaxation technique group exhibited lower pulse rates, FIS and FLACC scores compared to the tell-show-do and modeling technique groups.

Conclusions: The practice of yoga has a positive influence on the general health of the individual. Consequently, it can be considered one of the alternative behavioral modification techniques for the reduction of dental anxiety in children.

Background: The correlation between Behçet's disease (BD) and apical periodontitis (AP) has not been investigated.

Objectives: The aim of the study was to evaluate the association between BD and AP using different variables.

Material and methods: A total of 98 individuals (49 with BD and 49 controls) were recruited for the study. The presence of AP was confirmed through radiographic and clinical examination in all patients. The following data was evaluated in both the BD group and the control group: the presence of teeth with AP; the presence of root canal-treated (RCT) teeth; the presence of RCT teeth with AP; the severity of the disease; the types of medication taken; and the duration of the disease. The χ2 test and the logistic regression analysis were performed to ascertain the association between BD and AP.

Results: A total of 32 patients in the BD group and 12 patients in the control group presented with AP. The prevalence of teeth with AP was significantly higher in the BD group than in the control group (odds ratio = 5.804, p < 0.05). The χ2 analysis demonstrated a statistically significant association between AP and both gender and BD activity (p < 0.05). Furthermore, the logistic regression analysis indicated that the severity of the disease was a predictor of BD (p < 0.05).

Conclusions: A significantly higher prevalence of AP was observed in patients with BD. However, the success rate of endodontic treatment in patients with BD was comparable to that observed in healthy individuals.