Dental and Medical Problems最新文献

Background: The effect of the macrogeometry of dental implants with double trapezoidal threads on the probability of survival and the long-term success of oral rehabilitation is unclear.

Objectives: The purpose of this in vitro study was to evaluate the effect of dental implant macrogeometry on the probability of survival, failure mode and strain distribution of an implant-abutment set.

Material and methods: Dental implants were divided into 2 groups according to their macrogeometry (n = 21 per group): trapezoidal thread (control group); and double trapezoidal thread (test group). The macrogeometry analysis was performed with the use of computed microtomography (n = 1). The specimens were subjected to single load to failure (SLF) (n = 3), which permitted the step-stress profiles for design-based step-stress accelerated life testing (SSALT) (n = 18). The probability of survival and reliability for a mission of 50,000 cycles were calculated at 100 N and 150 N. The scanning electron microscope (SEM) was used to analyze the failure mode of the implant-abutment set. The digital image correlation (DIC) (n = 3) was performed using the implant-abutment set embedded in a polyurethane resin subjected to a static load of 250 N in axial and non-axial positions.

Results: No statistically significant differences were observed between the groups with respect to the probability of survival. All groups showed a reliability level higher than 95% at 100 N, while a decrease in reliability was observed at 150 N. The Weibull modulus and characteristic resistance exhibited no significant differences between the groups. The β mean values (control = 0.66, test = 0.33) indicated that failures were dictated by material strength. The SEM revealed an abutment and implant body fracture, characterized by fracture initiation on the lingual surface that subsequently propagated to the opposing buccal side. In the context of non-axial loading, the test group exhibited a higher concentration of tensile strain in the cervical region (152.05 μs), while the control group exhibited a predominance of compression strain (-800.00 μs).

Conclusions: The macrogeometry of dental implants did not influence the failure mode and probability of survival, but modified the strain distribution of the implant-abutment set.

Background: Host response to periodontal pathogens present in microbial plaque is characterized by the expression of various inflammatory and immune mediators known as biomarkers. There is a paucity of literature addressing the impact of non-surgical periodontal therapy (NSPT) on serum biomarkers, such as mannose-binding lectin (MBL), sirtuin 1 (SIRT-1) and C-reactive protein (CRP), in non-smokers and smokers with stage III periodontitis.

Objectives: The study aimed to evaluate and compare the effect of NSPT on serum levels of MBL, SIRT-1 and CRP in non-smokers and smokers with stage III periodontitis.

Material and methods: A total of 105 patients were equally divided into 3 groups, as follows: group I - periodontally healthy individuals; group II - non-smokers with stage III periodontitis; group III - smokers with stage III periodontitis. Probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were recorded, and serum MBL, SIRT-1 and CRP levels were analyzed using enzyme-linked immunosorbent assay (ELISA). The patients underwent NSPT, and all parameters were re-evaluated 6 weeks after the procedure.

Results: The mean change in MBL levels across the 3 groups from baseline to recall was significant. Conversely, SIRT-1 and CRP levels exhibited non-significant differences from baseline to recall, with p-values of 0.172 and 0.548, respectively. The mean differences in MBL and SIRT-1 levels between groups I and III at baseline (p < 0.0001 and p = 0.041 for MBL and SIRT-1, respectively) as well as in MBL between groups II and III at recall (p < 0.0001) were statistically significant.

Conclusions: A positive association of serum MBL levels and CRP levels as well as a negative association of SIRT-1 with the severity of periodontal disease may serve as a valuable, precise and feasible method of identifying individuals at risk of developing periodontal disease.

Background: Since impacted canines are a frequent eruptive anomaly, it is imperative to study their etiological aspects. A possible cause of impaction is the presence of odontogenic lesions close to the impacted canine.

Objectives: The aim of this study was to evaluate the frequency of odontogenic lesions in patients with impacted canines and their association with the characteristics of impaction.

Material and methods: This cross-sectional study was carried out with the scans of 93 impacted maxillary canines obtained from cone-beam computed tomography (CBCT) studies performed in 3 radiological centers. The selection criteria regarded male and female patients older than 12 years, and were based on the CBCT scans of impacted canines, showing unilateral or bilateral maxillary impaction, with or without odontogenic lesions. The position of the impacted canines, the sector of impaction, the presence or absence of a dentigerous cyst, an odontoma or follicular enlargement, as well as the total diameter of the lesion, were evaluated. The χ2 test and logistic regression analysis were performed, and the level of statistical significance was set at p < 0.05.

Results: The frequency of odontogenic lesions near the canine impaction area was generally low (7.5% for a dentigerous cyst, 6.5% for follicular enlargement and 3.2% for a mesiodens). However, there was a significant association between the presence of a dentigerous cyst and buccal or mid-alveolar impacted canines (p = 0.032). The alpha and beta angles influenced the possibility of the occurrence of dentigerous cysts, with the alpha angle increasing the risk (B = 1.22; p = 0.041) and the beta angle decreasing the chance of developing a dentigerous cyst (18%) (p = 0.024).

Conclusions: The presence of odontogenic lesions in impacted maxillary canine cases is low, and involves mainly dentigerous cysts and follicular enlargement in buccal or mid-alveolar impacted canines. The alpha and beta angles may influence the development of dentigerous cysts.

Background: Root resorption (RR) is usually a consequence of dental trauma, pulpal infection, primary occlusal pressure, or orthodontic tooth movement, leading to the loss of anatomical root formation. As a result of apical RR, the apical constriction is destroyed, and the determination of the working length (WL) may become difficult.

Objectives: The purpose of the present study was to evaluate the accuracy of 4 different electronic apex locators (EALs) - ProPex® II, Propex Pixi®, DentaPort ZX, and DTE DPEX V - in the determination of WL in teeth with natural apical RR in the presence of different irrigation solutions (ISs).

Material and methods: A total of 36 teeth with natural apical RR were included in the study. The actual length (AL) was determined under a stereomicroscope at ×15 magnification. Afterward, the electronic length (EL) was established by using 4 different EALs in the presence of different ISs. The ISs used in the measurements were freshly prepared, and 6 groups were organized based on the solution used. The control group was marked as group 1. For groups 2-6, 1% sodium hypochlorite (NaOCl), 2.5% NaOCl, saline, 2% chlorhexidine (CHX), and 17% ethylenediaminetetraacetic acid (EDTA) were used, respectively. After each measurement, the roots were washed with 5 mL of distilled water and dried with paper points before the same teeth were used in the subsequent group. The absolute length was subtracted from EL for each tooth to calculate the difference. The data was analyzed statistically.

Results: For each device, there were no significant differences in the success rates between the ISs used. In group 1, there were no significant differences among the 4 EALs. In group 2, DentaPort ZX was significantly more successful than DTE DPEX V (p = 0.037). There were no significant differences among EALs in groups 3-6.

Conclusions: The difference between DentaPort ZX and DTE DPEX V was statistically significant in group 2 (1% NaOCl).

Background: Temporomandibular disorders (TMDs) are challenging to manage due to their multifactorial nature. As with other joints, the function of temporomandibular joint (TMJ) is influenced by proprioception, making it an essential factor in TMD management. However, previous studies on the joint position error (JPE) in TMD patients lacked a proper diagnosis and reliability assessment.

Objectives: The aim of the present study was to develop a reliable JPE test in healthy adults as a foundation for future evaluation in TMD patients.

Material and methods: Two examiners conducted the JPE assessment, utilizing a methodology encompassing between-days intra-rater and within-day inter-rater reliability assessments. A total of 22 healthy participants (7 men and 15 women) with a mean unassisted mouth opening of 46 ±5 mm were recruited. The evaluation targeted specific distances (10 mm, 20 mm and 30 mm) within the participants' mouth opening range, with proprioceptive accuracy evaluated through the measurement of the absolute error (AE) and the constant error (CE).

Results: The CE was consistently lower than AE across all the targeted distances, although with higher standard deviations. Intra-rater reliability varied across the distances, with poor reliability observed for AE at 10 mm, moderate reliability for CE at 10 mm, good reliability for both AE and CE at 20 mm, and moderate reliability for both AE and CE at 30 mm. Inter-rater reliability was moderate at 10 mm and good at 20 mm for both AE and CE, with equally moderate reliability levels at 30 mm.

Conclusions: The 20 mm target distance demonstrated good intraand inter-rater reliability, warranting its evaluation in patients with TMDs in the subsequent investigation phase.

Background: Rapid maxillary expansion (RME) is a common treatment for maxillofacial skeletal abnormalities. Numerous studies have explored the impact of RME on skeletal, dental and nasal structures.

Objectives: The aim of the study was to evaluate the effects of RME on the three-dimensional (3D) Eustachian tube (ET) and auditory tube morphologies of adolescents using cone-beam computed tomography (CBCT).

Material and methods: A total of 97 patients (59 females and 38 males; age: 13.27 ±2.10 years) with maxillary transversal deficiencies who had undergone orthodontic RME were enrolled in the study. The treatment concluded when a cusp-to-cusp relationship was achieved between the palatal cusp of the maxillary first molar and the buccal cusp of the mandibular first molar. Cone-beam computed tomography was performed before maxillary expansion (T0) and after expansion (T1). The measurement of 2 linear and 4 angular, 3D, right and left ET parameters, as well as the ET and auditory tube angles, was conducted. The paired t-test was used to compare the data.

Results: There was no significant difference between T0 and T1 in any angular or linear ET parameters or the left auditory tube angle (p > 0.05). The T0 right auditory tube angle was significantly greater than the T1 angle (p < 0.05). Rapid maxillary expansion did not modify the 3D ET parameters; only the right auditory tube angulation improved after expansion.

Conclusions: Compared to conventional radiography, CBCT provides better morphological, angular and linear data regarding the ET and auditory structures. No significant differences were observed in linear or angular ET parameters based on the status of maxillary expansion treatment. The right auditory tube angle differed significantly between T0 and T1.

Background: Periodontal diseases are chronic inflammatory diseases related to many hereditary, environmental, physical, and psychological factors.

Objectives: The aim of the present study was to determine the demographic data, periodontal status and systemic conditions of patients who reported to the Department of Oral and Maxillofacial Radiology, and to evaluate the relationship between the periodontal status and the associated risk factors.

Material and methods: The study included a total of 2,000 patients (974 males and 1,026 females). The anamnesis data on the patients' systemic diseases/conditions and periodontal diagnoses were analyzed statistically.

Results: Upon evaluating the clinical and radiological examination data, the findings were as follows: 9.20% of patients had clinically healthy gingiva; 15.20% had gingivitis on an intact periodontium; 22.75% had gingivitis on a reduced periodontium (in total, 37.95% had gingivitis); 47.20% had mild to moderate periodontitis (stages I and II, grades A and B); and 3.45% had severe periodontitis (stages III and IV, grades B and C) (in total, 50.65% had periodontitis). Additionally, 2.20% of patients were diagnosed with necrotizing periodontal diseases (NPD). Gingival health was significantly poorer in patients with hypertension, diabetes, gastrointestinal system diseases (GID), cardiovascular system diseases (CVD), gynecological disorders, psychiatric disorders, hypothyroidism, rheumatological diseases, osteoporosis, chronic respiratory diseases/asthma, anemia, a history of cancer, and dermatological problems (p < 0.001).

Conclusions: Periodontitis is a significant public health concern among the Turkish population, with high incidence rates of mild to moderate periodontitis attributed to risk factors such as age, smoking and various systemic diseases.

Background: Obstructive sleep apnea (OSA) is associated with an increased likelihood of health issues, such as hypertension, cardiovascular disease and stroke. Screening is typically performed through selfreport questionnaires related to OSA symptoms.

Objectives: The present study aimed to evaluate sex differences in the commonly used questionnaires for the evaluation of OSA symptoms in order to determine whether different OSA screening tools should be considered in males and females.

Material and methods: The data was collected from the general population (N = 622, 66% female) through an online cross-sectional survey. The survey incorporated the STOP-Bang Questionnaire, the Epworth Sleepiness Scale (ESS), the Patient Health Questionnaire-4 (PHQ-4), the Fatigue Assessment Scale (FAS), and sleep bruxism (SB) questionnaires.

Results: Female subjects exhibited elevated levels of anxiety and fatigue (p < 0.001 for both) and the potential presence of SB (p < 0.005). The logistic regression analysis revealed that the odds of moderate to severe OSA increased by 5-8% for age and sleepiness, were higher for subjects exhibiting SB (an increase of 82%), and were particularly high for males (male sex increased the odds of moderate to severe OSA by over 5 times). Despite higher fatigue scores among females, the effect of fatigue on the probability of moderate to severe OSA in females was non-significant. While male subjects demonstrated lower fatigue scores, these levels were significantly associated with the risk of moderate to severe OSA. Daytime sleepiness did not influence the OSA risk for either sex.

Conclusions: The impact of reported fatigue on the prevalence of OSA is substantial among males but non-significant among females. The efficacy of daytime sleepiness scales in evaluating OSA is poor. The fatigue scale may be more effective in the screening of OSA, at least in males. Limitations of the study include potential response bias due to participant anonymity and the use of the STOP-Bang Questionnaire instead of polysomnography, the gold standard for OSA diagnosis.

Background: Periodontitis and peri-implantitis are chronic inflammatory diseases that lead to progressive connective tissue degradation and alveolar bone resorption. The presence of characteristic periodontitisassociated fibroblasts (PAFs) that display a remarkably high capacity for extracellular matrix (ECM) degradation was previously reported in periodontitis lesions.

Objectives: The aim of the study was to analyze collagen gel degradation in an experimental cell culture model using fibroblasts isolated from peri-implantitis lesions.

Material and methods: A patient-derived experimental cell culture model of periodontitis was developed. Gingival tissues were obtained during peri-implant, periodontal, and tooth extraction surgeries. Fibroblasts isolated from tissues affected by peri-implantitis, mixed in a three-dimensional (3D) collagen gel, were co-cultured with gingival epithelial cells. The degree of collagen gel degradation was analyzed using gel contraction, and a histologic examination was performed.

Results: In 5 examined cases, gel contraction was observed in the 3D co-culture model to considerably different degrees, which may demonstrate the presence of peri-implantitis-associated fibroblasts (PIAFs) that display a high capacity for collagen degradation. Histologically, the collagen gels with PIAFs showed numerous vacuoles adjacent to the cells when compared to gels with normal fibroblasts. The PIAFs from one case showed a rapid and significantly elevated level of collagen gel degradation in comparison to the PIAFs from the other cases.

Conclusions: The study revealed the presence of PIAFs among the fibroblasts isolated from peri-implantitis lesions, displaying a capacity for collagen degradation. Further detailed studies are required to clarify the characteristics of PIAFs as well as their role in the occurrence and progression of peri-implantitis.

Background: Children with Down syndrome (DS) frequently experience nutritional issues. Some of them are attributed to gastrointestinal tract abnormalities, while others are due to feeding behaviors. Previous studies have reported inconclusive results regarding the prevalence of dental caries among individuals with DS.

Objectives: The study aimed to assess the nutritional status, prevalence of dental caries and oral hygiene level among children and adolescents with DS aged 8-15 years in comparison to healthy peers.

Material and methods: A case-control observational study was carried out in Damascus, Syria, and its surrounding countryside. The study included 135 participants between the ages of 8 and 15 years who were divided into 2 groups based on the presence of DS. The data was processed using the IBM SPSS Statistics for Windows software, v. 26. The Kruskal-Wallis H test, Mann-Whitney U test and χ2 test, as well as Spearman's correlation were implemented.

Results: Almost half of the participants in the DS group were classified as overweight or obese (33.9% and 19.1%, respectively), while the percentages of overweight and obese children in the control group were 14.9% and 10.4%, respectively. No statistically significant results were noted between oral hygiene levels and the prevalence of dental caries among the study groups (p > 0.05). Only 50% of parents thought that their children needed help during daily oral hygiene practices; however, only 39.4% of parents actually provided such assistance.

Conclusions: Children and adolescents with DS exhibited a tendency toward shorter stature in comparison to their peers. In the DS group, the economic status and paternal education level exhibited an inverse correlation with body mass index (BMI)-for-age. Oral hygiene practices and dietary habits are the most influential factors in the development of dental caries. The DS group followed an unhealthy dietary pattern, characterized by elevated levels of sugar consumption. There is an urgent need for effective promotion programs within the educational plans of schools and centers of special needs. These programs must educate parents and caregivers about effective oral hygiene practices and make them aware of their children's need for help during the oral hygiene process.