Dental and Medical Problems最新文献

Background: Dentists are the first healthcare professionals to identify cases of domestic violence and abuse (DVA) with head and neck injuries.

Objectives: The aim of this study was to assess dentists' knowledge regarding behavioral and physical findings in female victims of DVA.

Material and methods: The study included 558 volunteer dentists who completed a two-part questionnaire designed to assess their knowledge and awareness of DVA against women. The first part of the questionnaire inquired about the participants' demographic data, including age, sex, specialty, and the duration of professional practice. The second part assessed 15 statements on a 5-point Likert scale, concerning both behavioral (5/15) and clinical aspects (10/15) of DVA. For each statement, if a minimum of 70% of respondents selected the same option, it was interpreted as being agreed upon by the participants. The level of statistical significance was set at p < 0.05.

Results: Most of the participants were between the ages of 31 and 40 (29.1%). The study sample was predominantly female (70.4%), with 57.2% of the participants being married. The statement "Abused women tend to avoid eye contact" had the highest agreement rate (70.6%) for the behavioral assessments. However, the participants were mostly "undecided" on the remaining 4 statements in this section. In contrast, the agreement rate for 5 statements related to the clinical assessment of head, neck and intraoral injuries exceeded 70%. One-fifth of the behavioral assessment statements and half of the clinical assessment statements were negatively correlated with the age of the participants (p < 0.05).

Conclusions: The findings of this study indicate that dentists can recognize and diagnose DVA symptoms to a certain extent. However, they may encounter difficulties in identifying the suspicious behavior that is indicative of DVA.

Background: Changes in the fatty infiltration and/or muscle volume of neck muscles can alter cervical spine alignment and cranial load distribution, which may cause pain in the orofacial region.

Objectives: The aim of the study was to examine the muscle volume and fatty infiltration of neck muscles in patients with temporomandibular disorders (TMD).

Material and methods: This case-control study included 18 patients with TMD and 18 ageand sex-matched controls. The muscle volume and fatty infiltration of the neck muscles of the participants were measured using magnetic resonance imaging (MRI) and ITK-SNAP software. The 3D models of the sternocleidomastoid (SCM), splenius capitis (SPLC), semispinalis cervicis (SC)-semispinalis capitis (SCP), and multifidus (M) muscles within the C3-C7 range were created using ITK-SNAP, a semi-automatic segmentation software. The models were used to determine the volumes and fatty infiltration levels. The Neck Disability Index (NDI) was used to assess neck pain-related disability. The severity of TMD was determined using the Fonseca Anamnestic Index (FAI), while jaw-related disability was measured with the Jaw Functional Limitation Scale-20 (JFLS-20). Pain levels were recorded at rest and during chewing using the numeric rating scale (NRS).

Results: There were no statistically significant differences in total muscle volume, fatty infiltration volume and fatty infiltration percentage of the SCM, SPLC, SCP, SC, and M muscles between the 2 groups (p > 0.05). The patient group had higher NDI scores compared to the controls (p < 0.001). The NDI scores correlated positively with the JFLS-20 (r = 0.831, p < 0.001), FAI (r = 0.815, p < 0.001) and NRS scores at rest (r = 0.753, p < 0.001) and during chewing (r = 0.686, p < 0.001).

Conclusions: The present study did not identify any significant differences in the neck muscle volume or fatty infiltration between the TMD patients and controls. However, the severity of neck disability was found to correlate with jaw function, pain and TMD levels.

Background: The trueness of intraoral scanners (IOSs) has been evaluated in many clinical situations. However, the tests of their performance when scanning post-space preparations are still lacking.

Objectives: The aim of the present study was to compare the trueness of the digital impressions of post spaces with different depths, captured by means of different IOSs.

Material and methods: Digital impressions of teeth (N = 16) with post spaces of depths of 8 mm and 10 mm were captured. Three IOSs were used, including Primescan AC, Medit i500 and CS 3600. The STL files were compared to the files obtained from the traditional impression scanning performed with an InEos X5 desktop scanner. Then, reverse engineering software measured the trueness values, which were analyzed using the two-way analysis of variance (ANOVA), followed by Tukey's post-hoc test. The significance level was set at p < 0.05.

Results: Significant differences were found between the scanners in terms of root mean square (RMS) values (p < 0.001). The highest RMS value was found for CS 3600 (0.30 ±0.11 mm), followed by Primescan AC (0.26 ±0.09 mm), while the lowest value was found for Medit i500 (0.18 ±0.05 mm). The 8-millimeter-deep post spaces had a significantly higher RMS value than the 10-millimeter-deep ones (0.28 ±0.10 mm and 0.21 ±0.09 mm, respectively) (p = 0.009).

Conclusions: The Medit i500 scanner showed the highest post-space digital impression trueness as compared to Primescan AC and CS 3600. In the digital impressions captured with CS 3600, the 10 mm postspace depth had higher trueness than the 8 mm depth. Moreover, CS 3600 was less able to capture the full length of both the 8 mm and 10 mm post-space depths than Primescan AC and Medit i500.

Background: The probability of a positive outcome of root canal therapy is substantially higher if the infection is eradicated successfully before the obturation of the root canal system. Irrigation is an essential aspect of root canal debridement, as it enables more thorough cleaning than is possible with root canal instrumentation alone. To overcome the side effects of chemical irrigants, there has been a search for herbal medicines as substitutes.

Objectives: The aim of the present study was to explore the antimicrobial efficacy of white tea-mediated silver nanoparticles (AgNPs) formulated as an intracanal irrigant against Enterococcus faecalis, and to compare it with the efficacy of chlorhexidine and sodium hypochlorite irrigants.

Material and methods: The experimental groups were as follows: group I - white tea-mediated AgNPs; group II - 2% chlorhexidine; and group III - 2.5% sodium hypochlorite. The characterization of AgNPs was performed using ultraviolet-visible (UV-Vis) spectroscopy and transmission electron microscopy (TEM) analysis. Enterococcus faecalis was inoculated onto Mueller-Hinton agar plates. The disks impregnated with irrigants were placed on the inoculated plates and incubated aerobically at 37°C for 24 h. Then, the growth inhibition zones were measured. Statistical analysis was performed using the one-way analysis of variance (ANOVA) and the post hoc tests.

Results: A concentration of 50 μL of white tea-mediated AgNPs exhibited the greatest zone of inhibition (32 ±2 mm), followed by 2% chlorhexidine (25 ±1 mm) and 2.5% sodium hypochlorite (23 ±3 mm).

Conclusions: White tea-mediated AgNPs showed promising results in the elimination of E. faecalis, being superior to chlorhexidine and sodium hypochlorite irrigants.

Currently, a new non-subtractive drilling technique, called osseodensification (OD), has been developed. It involves using specially designed drills with large negative cutting angles that rotate counterclockwise, causing expansion through plastic bone deformation, thus compacting the autologous bone to the osteotomy walls, which improves the primary stability of the implant.The present systematic review aimed to determine whether the OD technique can increase the primary stability of dental implants in the posterior maxilla region as compared to the conventional drilling (CD) technique.Five databases were searched up to June 30, 2022. The inclusion criteria embraced observational clinical studies, randomized and non-randomized controlled trials, human studies in vivo, comparing OD and CD, with the measurement of the primary stability of implants in the posterior maxilla region by means of the implant stability quotient (ISQ). The tools used to assess the risk of bias were RoB 2 and the NewcastleOttawa Scale (NOS).Seven articles met the inclusion criteria, with 4 classified as having a low risk of bias and 3 with a moderate risk of bias. The OD technique consistently demonstrated an average ISQ value of 73 KHz across all studies, whereas CD yielded an average value of 58.49 kHz (p < 0.001 for 5 articles).It can be concluded that in comparison with CD, OD improves primary stability at baseline in low-density bone, such as the maxilla.

Background: The clinical and radiographic efficacy of bone grafts and biomaterials, such as platelet-rich plasma and platelet-rich fibrin (PRF), for reconstructing lost periodontal structures has been well documented. However, there is limited data regarding the presence of demineralized freeze-dried bone allograft (DFDBA) in an environment with abundant growth factors provided by platelet concentrates.

Objectives: The aim of the study was to compare the clinical and radiographic effectiveness of DFDBA with PRF versus DFDBA alone in the treatment of intrabony defects.

Material and methods: Twenty-four intrabony defects in contralateral sites were randomly assigned to either the DFDBA group or the DFDBA combined with PRF group. Clinical parameters, including the plaque index (PI), the gingival index (GI), probing pocket depth (PPD), relative attachment level (RAL), and radiographic bone fill (RBF), were measured at baseline, and at 6 and 9 months. Paired and unpaired t-tests were used for intraand intergroup comparisons.

Results: Both the PI and the GI showed statistically significant improvements from baseline to 9 months. However, the intergroup comparisons did not reveal any significant differences (p < 0.05) between the groups with regard to clinical and radiographic measurements from baseline to 9 months.

Conclusions: Platelet-rich fibrin in combination with DFDBA did not show any additional benefit in terms of reconstructive output in the treatment of intrabony defects compared to the use of DFDBA alone.

Movement disorders of the stomatognathic system include oromandibular dystonia (OMD), oral dyskinesia, sleep/awake bruxism, functional (psychogenic) stomatognathic movement disorders (FSMDs), tremors, and hemimasticatory spasm (HMS). Most patients first consult dentists or oral surgeons. The differential diagnoses of these involuntary movements require both neurological and dental knowledge and experience, and some of these movement disorders are likely to be diagnosed as bruxism or temporomandibular disorders (TMDs) by dental professionals. However, excepting movement disorder specialists, neurologists may find it difficult to differentially diagnose these disorders. Patients may visit numerous medical and dental specialties for several years until a diagnosis is made. Therefore, movement disorders of the oral region may represent a blind spot between dentistry and medicine.The present narrative review aimed to describe the clinical characteristics and differential diagnoses of some movement disorders, as well as the problems bridging dentistry and medicine. Movement disorders have the following characteristic clinical features: OMD - task specificity, sensory tricks and the morning benefit; FSMDs - inconsistent and incongruous symptoms, spreading to multiple sites and the lack of sensory tricks; and HMS - the paroxysmal contraction of unilateral jaw-closing muscles, the persistence of symptoms during sleep and the loss of a silent period. A careful differential diagnosis is essential for the adequate and effective treatment of each involuntary movement. Refining the latest definition of bruxism may be necessary to prevent the misdiagnosis of involuntary movements as bruxism.Both dental and medical professionals should take an interest in the movement disorders of the stomatognathic system, and these disorders should be diagnosed and treated by a multidisciplinary team.

In this comment, we explored the link between sleep fragmentation and the cardiovascular risk, considering various sleep disorders and methodologies for assessing sleep fragmentation.

Background: Sleep is a physiological function essential for survival, recovery, tissue repair, memory consolidation, and brain function. Pain is also an indispensable aspect of human life. The coexistence of sleep disorders and pain is often described in the literature, yet it is critical to define sleep not only subjectively but also using objective instrumental methods, such as polysomnography, that provide data on sleep quality.

Objectives: The aim of the study was to determine the relationship between orofacial pain (OFP), headache (HA) and sleep quality using subjective and objective sleep quality assessment methods. Additionally, we aimed to explore whether poor sleep quality was related to OFP and HA alone or was influenced by the coexistence of psycho-emotional factors such as depression, anxiety and stress.

Material and methods: A single-night video-polysomnography was performed on patients from the Outpatient Clinic for Temporomandibular Disorders at Wroclaw Medical University, Poland, who had been diagnosed with OFP and HA. Additionally, questionnaires were employed to assess sleep quality, pain, HA, and the psycho-emotional state.

Results: There was no statistically significant relationship between the severity of OFP and HA and polysomnographic sleep quality parameters. On the other hand, the quality of sleep as determined by questionnaire studies correlated markedly with the severity of experienced pain. The severity of pain was found to be significantly correlated with depression, anxiety and perceived stress scores.

Conclusions: The psycho-emotional aspects are of critical importance in the perception of OFP and HA. They can be associated with worsened subjective sleep quality, insomnia or daytime sleepiness. Therefore, the treatment of such patients must be preceded by a comprehensive assessment of their psychoemotional state, as anxiety, stress and depression can significantly influence the course of the disease and the response to treatment procedures.

Background: Although the microplate system is commonly used for the treatment of maxillofacial fractures, its use in the fixation of mandibular fractures is not widely accepted.

Objectives: The study aimed to evaluate and compare the efficacy of microplates and miniplates in osteosynthesis for the internal fixation of undisplaced and minimally displaced anterior mandibular fractures.

Material and methods: A total of 40 patients diagnosed with undisplaced or minimally displaced symphyseal and parasymphyseal fractures were randomly assigned to 2 study groups (group A and group B). Patients in group A (microplate group) were treated with two 0.8-mm microplates, whereas patients in group B (miniplate group) received two 2.0-mm miniplates. Bite force values were recorded in 30 healthy individuals (control group) to establish baseline values. Postoperative bite force values were recorded at various intervals and compared between the study groups and the control group.

Results: Both groups demonstrated a progressive improvement in the bite force. However, the bite force values recorded at the 2nd, 4th and 6th postoperative weeks were comparatively lower in the microplate group. At the six-week follow-up, the bite force values were lower in both study groups in comparison to the control group. There were no differences in the incidence of postoperative complications between the study groups.

Conclusions: The use of microplates in the management of undisplaced or minimally displaced anterior mandibular fractures results in a reduction in the recovery of biting force in comparison to the conventional miniplate system.