Dental and Medical Problems最新文献

Background: The dentinal debris produced during root canal preparation can be extruded through the apical foramen, which may cause undesired consequences, such as the postoperative inflammation of periapical tissues.

Objectives: The aim of the present in vitro study was to evaluate the effect of glide path preparation on apical debris extrusion for the Reciproc®, WaveOne Gold® and One Curve file systems.

Material and methods: A total of 72 mandibular incisors were divided into 6 groups according to the nickel-titanium (NiTi) system used and glide path preparation: group Rp - Reciproc; group Rp-O - Reciproc after glide path preparation; group WG - WaveOne Gold; group WG-O - WaveOne Gold after glide path preparation; group OC - One Curve; and group OC-O - One Curve after glide path preparation. The preand post-instrumentation weight of Eppendorf tubes was measured. The pre-weight was subtracted from the post-weight to calculate the amount of apically extruded debris. The data was analyzed using the one-way analysis of variance (ANOVA) with the statistical program PASW Statistics for Windows, v.18.0.

Results: No statistically significant differences were found between the single-NiTi file systems with different kinematics in terms of apical debris extrusion, with or without glide path preparation (p > 0.05).

Conclusions: The amount of apically extruded debris was not affected by the kinematics of different single-NiTi file systems. Moreover, creating a glide path had no effect on the apically extruded debris in straight root canals.

Background: The application of natural products in dentistry has been widely explored. Anchovy (Stolephorus in Latin) has been examined for its bioactive content (calcium, phosphorus and fluoride) as an agent for bone stimulation and tooth development, topical fluoridation and pulp capping. Ball milling has been used to prepare calcium oxide nanoparticles from snakehead fish bone.

Objectives: The aim of the study was to reduce the particle size of Stolephorus sp. powder to the nanoscale using high-energy ball milling for 8, 12 and 24 h, and to analyze the optimal milling time by comparing the powder characteristics.

Material and methods: The Stolephorus sp. were oven-dried at 50°C for 6 h, after which the entire fish were crushed into powder. The fish powder was produced by blending the material for 5 min and passing it through a 200-mesh sieve. The remaining dried fish was blended again for 5 min until it passed through the sieve. The top-down approach to the particle size reduction was performed using high-energy milling at 3 distinct time points (8, 12 and 24 h). The characteristics of the powder were evaluated using a particle size analyzer, a Fourier-transform infrared spectrometer (FTIR) and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS).

Results: The Stolephorus sp. powder contained 64.50% protein, 7,420 mg/kg sodium, 28,912 mg/kg calcium, and 1,924 mg/kg magnesium. The high-energy milling process resulted in a reduction of the particle size from the microscale to the nanoscale. The analysis of the average particle size and polydispersity index indicated that 24 h of milling showed the most optimal results. Furthermore, the functional groups exhibited no significant alteration at 3 milling times (p ≥ 0.05, FTIR analysis).

Conclusions: The high-energy milling method has the potential to reduce the particle size of Stolephorus sp. powder to the nanoscale at the 8- and 24-h milling periods. The powder resulting from the 24-h milling process had a size of 789.3 ±170.7 nm, smooth size distribution, good size uniformity, a polydispersity index of 0.763, no significant change in organic and inorganic compound content, and a calcium/phosphorus ratio that was the closest to that of hydroxyapatite (HAp).

Background: Dental implants are increasingly favored as a therapeutic replacement option for edentulism. Titanium (Ti), due to its excellent biocompatibility and unique osseointegration properties, is commonly used in dental implants. Various surface modifications have been explored to improve osseointegration outcomes. Graphene oxide (GO) is a promising material with various applications. Chitosan, found in the exoskeleton of crustaceans and in marine algae, has several biomedical applications. Silver (Ag) is another promising antibacterial agent that increases permeability and damages the bacterial cell membrane upon binding.

Objectives: The present study applied a novel implant surface coating of Ag-decorated GO and chitosan on Ti implants to promote bone formation. We further analyzed the physiochemical and antibacterial properties of this surface coating.

Material and methods: A solution was prepared by mixing 3 mL of 1% chitosan solution with 10 mg of Ag-GO nanoparticles (NPs). Titanium metal was heated to 70-80°C on a hotplate and the solution was applied onto Ti to obtain an adhesive surface coating. The coated implant was further analyzed for surface properties, using scanning electron microscopy (SEM), the energy dispersive X-ray (EDX) analysis, the attenuated total reflectance-Fourier transform infrared (ATR-FTIR) technique, and the biocompatibility and corrosion analyses.

Results: The SEM analysis revealed a homogenously spread, rough, fibrillar and porous layer of coating on the metal surface. The EDX and ATR-FTIR analyses confirmed the successful coating of the implant surface with Ag-decorated GO and chitosan layers. The cell culture assay demonstrated excellent biocompatibility of the surface coating. The corrosion analysis showed improved corrosion resistance of the developed implant surface coating.

Conclusions: The various analyses of the coating showed ideal properties for improved cell attachment, differentiation and proliferation while maintaining an antimicrobial environment on the implant surface.

Background: Toothbrushing twice daily is essential for maintaining oral hygiene, which is a cornerstone of overall health. This is particularly important during childhood and adolescence, when lifelong habits are established. Nevertheless, many children and adolescents worldwide face challenges in maintaining good oral health due to limited access to resources and education.

Objectives: This study used nationally representative samples from the Global School-based Student Health Survey (GSHS) (2010-2019) to determine the frequency of toothbrushing among school-going students (N = 266,113) in 72 countries.

Material and methods: The country-specific sample size ranged from 130 in Tokelau to 25,408 in Malaysia. The outcome variable was the frequency of brushing or cleaning teeth once daily within the past 30 days prior to the survey. Bivariate analysis was conducted following a descriptive study to determine the frequency of toothbrushing or cleaning across different age groups (≤12, 13, 14, 15, ≥16 years), sexes, World Health Organization (WHO) regions, and gross domestic product (GDP) per capita quintiles.

Results: The overall proportion of males to females in the sample was 50.9:49.1. In 45 countries or territories (62.5%), the proportion of participants who reported brushing their teeth at least once a day was above 90%. Participants from 10 countries or territories (13.9%) reported never or rarely brushing their teeth. In 69 countries or territories (95.8%), male students were more likely than female students to never or rarely brush their teeth. The highest rate of individuals who never or rarely brush their teeth (32.1%) was reported in the Eastern Mediterranean Region. In comparison, the Region of the Americas had the highest frequency of brushing twice or more daily (82.9%).

Conclusions: Educational interventions focused on dental health implemented in schools and aimed at early adolescents have the potential to promote the formation of healthy habits, which may lead to improved well-being over both short and long terms.

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: Dentofacial infection resulting from untreated dental caries or periodontal disease is a serious disease that can spread to deeper tissues of the face and neck.

Objectives: The present study aimed to analyze the salivary cytokine profile and oxidative stress parameters as potential biomarkers of acute odontogenic infections in children.

Material and methods: The prospective study group (DI) consisted of 28 children aged 3-17 years with acute dentofacial infections, and the control group (CG) comprised 52 children aged 4-17 years with uncomplicated dental caries. The cytokine profile was analyzed using the Bio-Plex Pro™ Human Cytokine 27-plex kit. In addition, oxidative stress parameters, such as catalase (CAT), glutathione reductase (GR), superoxide dismutase (SOD), manganese SOD (Mn-SOD), copper-zinc SOD (CuZn-SOD), total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA), in the saliva of children in both groups were compared.

Results: The levels of interleukin 6 (IL-6), macrophage inflammatory protein 1 alpha (MIP-1α) and tumor necrosis factor alpha (TNF-α) were significantly increased in children with dentofacial infections as compared to CG. In contrast, the levels of other pro-inflammatory cytokines, such as IL-1β, IL-1 receptor agonist (IL-Ra), IL-8, monocyte chemoattractant protein 1 (MCP-1), and MIP-1β, did not show statistically significant differences between the 2 groups. Among the measured oxidative stress and antioxidative parameters, only CAT and GR were elevated in children with dentofacial infections as compared to controls.

Conclusions: IL-6, MIP-1α, TNF-α, CAT, and GR can serve as selective biomarkers of oral cavity inflammation in children. These biomarkers can be useful in identifying and monitoring the progress and treatment of bacterial infections resulting in dentofacial inflammation.

Alveolar reconstructive surgery employs a variety of surgical techniques and biomaterials, with a particular focus on bone blocks as a crucial methodology for restoring and augmenting deficient bone structures. Bone blocks are often employed to support periodontal health or as a foundation for future prosthetic rehabilitation with dental implants. This systematic review investigated recent advances in bone blocks for alveolar bone reconstruction, comparing autologous, allogeneic and xenogeneic types. A search of PubMed identified 56 records, of which 21 were included in the qualitative analysis. The studies involved 685 patients in total. Bone blocks are pivotal for three-dimensional bone regeneration, providing a stable scaffold for achieving the desired bone volume during healing. Autologous bone, harvested from the patient, boasts high biocompatibility, excellent osteogenic properties and minimal immunologic risks. However, its drawbacks include the need for an additional surgical site and extended procedural times. Allogeneic bone blocks involve transferring bone between individuals, offering increased graft availability and customization options without requiring a second surgical site. However, they exhibit moderate resorption rates and carry a heightened risk of immunologic reactions and disease transmission. Innovative techniques, such as tunneling, laser osteotomy, graft customization, and platelet-rich fibrin (PRF) application on wound during surgical treatment show promise in enhancing alveolar bone reconstruction efficacy. In conclusion, despite the traditional preference for autologous bone, the review suggests that alternative materials, particularly individualized allogeneic bone blocks, coupled with modern techniques, could emerge as a standard procedure for regenerating alveolar bone defects due to their satisfactory results and potential advantages.

Focal microdontia is a dental anomaly characterized by the presence of a single abnormally small anterior or posterior tooth. The objective of this article is to provide an updated review of the literature on the advanced restorative management of focal microdontia, and to document a clinical case where the reviewed advanced restorative approaches were applied to treat a young adult presenting with a non-syndromic asymmetrical focal microdontia.We conducted a preliminary examination of the existing literature on the advanced restorative management of focal microdontia. Additionally, we presented a minimally invasive approach to the treatment of an 18-year-old female patient with non-syndromic asymmetrical focal microdontia. The primary advantage of adhesive dentistry is that it can better preserve the structure of smaller teeth. A review of literature reveals a paucity of reports on localized microdontia in the maxillary anterior region of the mouth. However, novel minimally invasive restorative procedures satisfy patients' aesthetic and functional preferences. Well-executed additive diagnostic wax-ups and intraoral mock-ups can serve as a permanent restoration blueprint, providing predictable results for focal dental anomalies in the aesthetic zone. In conclusion, the use of minimally invasive dental approaches in young patients with focal microdontia can result in long-term satisfactory aesthetic outcomes.

Background: Stroke is among the leading causes of morbidity and mortality. Chronic inflammatory conditions may lead to atherosclerosis and a subsequent stroke.

Objectives: This systematic review and meta-analysis aimed to review the association of periodontitis and gingivitis with stroke.

Methods: An electronic search of PubMed, Ovid EMBASE, Ovid MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Science Citation Index, Database of Abstracts and Reviews of Effects (DARE), and various clinical trial registries was conducted to include studies published up to February 2022. Data was retrieved by 2 independent reviewers. The Stata software, v. 13, was used to conduct a meta-analysis.

Results: Thirteen studies stated an association between periodontitis, determined based on clinical attachment loss (CAL), and stroke. Meanwhile, 6 studies described an association between gingivitis, determined based on the gingival index (GI), and stroke. Out of the 6 studies on gingivitis, 5 also investigated CAL, which means the meta-analysis included 14 studies in total. The total number of participants from the included studies was 35,937, and they were all above 17 years of age. There was a significant association between periodontitis and gingivitis and stroke and its all types. There was a significant association between periodontitis and stroke and its all types in 13 studies (ES (effect size): 1.32; 95% CI (confidence interval): 1.04-1.60), and between gingivitis and all stroke types in 6 studies (ES: 1.17; 95% CI: 0.42-1.92).

Conclusions: This systematic review indicated a significant association between stroke and periodontal disease in case-control, cohort and cross-sectional studies. The findings need to be further substantiated in prospective cohort studies with an optimal sample size.

Background: Salvadora persica (miswak) is known to exert antibacterial, antifungal, antioxidant, and anticariogenic effects by elevating the pH of plaque after the consumption of sucrose.

Objectives: The study aimed to compare the effectiveness of S. persica and probiotic yogurt in the remineralization of tooth enamel on artificially produced enamel lesions.

Material and methods: A total of 40 intact human premolars were collected and each tooth was sectioned longitudinally into 2 identical halves in a buccolingual direction. The buccal halves were selected for inclusion in this study, and standardized windows (5 mm × 3 mm) were isolated on the buccal surface of the enamel. The samples were incubated in a demineralizing solution at 37°C for 96 h. Subsequently, they were randomly selected for treatment with one of the experimental remineralizing solutions (S. persica or probiotic yogurt). After treatment, the samples were examined using scanning electron microscopy (SEM), energy dispersive X-ray (EDX) and polarized light microscopy at baseline, after demineralization and after remineralization.

Results: The remineralizing effect of S. persica was found to be greater than that of probiotic yogurt. With regard to mineral content, S. persica exhibited the highest calcium and phosphorus levels among all groups. No significant differences were observed between the samples treated with S. persica and normal enamel.

Conclusions: Salvadora persica extract has been demonstrated to effectively reduce the demineralization of enamel in experimental conditions. Furthermore, it has the potential to restore the mineral content to its original level.