Dental and Medical Problems最新文献

Background: The treatment of temporomandibular disorders (TMD) often includes the management of sleep bruxism (SB) and awake bruxism (AB). However, few studies have investigated how SB and AB change after the initiation of the interventions aimed at reducing the activity of masticatory muscles in TMD patients.

Objectives: The aim of the present study was to investigate changes in self-reported SB and/or AB with regard to baseline at 6 weeks after receiving TMD treatment, i.e., counseling alone or counseling combined with any other treatment, and to investigate the association between the type of TMD treatment and changes in self-reported SB and/or AB.

Material and methods: A total of 68 TMD patients were included in this prospective study, and they all received counseling. Thirty-three of the 68 patients received additional treatment, e.g., physical therapy, psychological therapy and/or an oral appliance, beside counseling. The self-reported SB and AB frequency values were obtained from the Oral Behavior Checklist (OBC) questionnaire at baseline (t0) and at week 6 after receiving treatment (t1). The frequency of SB and AB was assessed as SB, AB-grinding, AB-clenching, AB-bracing, and AB-combined (i.e., the maximum frequency of all AB types combined). The Wilcoxon signed-rank test was used to compare the SB and AB frequency at t0 and t1 in patients who received counseling alone and those who received counseling combined with other treatment. The χ2 test was used to investigate the association between the type of TMD treatment and changes in SB and/or AB.

Results: The frequency of self-reported SB and all types of AB did not change in patients who received counseling only. In contrast, there was a significant increase in the frequency of AB-bracing and AB-combined between t0 and t1 in patients who received counseling combined with other treatment.

Conclusions: No changes in the frequency of self-reported SB and all types of AB were found in patients who received counseling only. However, patients who received counseling combined with other treatment showed a significant increase in the frequency of AB-bracing and AB-combined as compared to baseline.

The complex interplay between the gut microbiota, cancer treatments and patient characteristics has emerged as a significant area of research. This study sought to examine these relationships in the context of colorectal cancer (CRC).A comprehensive search of relevant studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The studies included a variety of treatment modalities and microbiological parameters. A data extraction form, designed specifically for this review, was used to assess a range of variables across all studies.The analysis revealed a multifaceted interaction between the gut microbiota, genetic factors and treatment outcomes. Elderly patients with CRC frequently received single-agent chemotherapy, with outcomes that were comparable to those of younger patients. The presence of tumorigenic bacteria, including Escherichia coli and Bacteroides fragilis, was associated with early colon neoplasia. Additionally, an abundance of Fusobacterium spp. was observed in colonic adenomas, contributing to a pro-inflammatory environment. Although the FcγRIIIa-158 V/V genotype was associated with higher cetuximab-mediated antibodydependent cellular cytotoxicity (ADCC), no direct influence of FcγR polymorphisms on treatment response was noted. Furthermore, the combination of programmed cell death protein-1 (PD-1), BRAF and MEK inhibition showed favorable response rates. The gut microbiome, especially the presence of Fusobacterium spp., had a notable influence on the therapeutic response in CRC.These findings underscore the role of the gut microbiota and genetic factors in cancer treatment outcomes, emphasizing the potential of a holistic approach to cancer management. Future research should exploit these findings in order to develop microbiota-modulating strategies and personalized medicine approaches for the purpose of improving the efficacy of cancer treatment.

Background: The durability of indirect restorations is significantly influenced by marginal adaptation and internal fit. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) with digital impressions has reduced dental prosthesis fabrication errors, improving the long-term survivability of the restorations.

Objectives: The present study assessed the impact of intraoral and extraoral scanning methods on the marginal adaptation and internal fit of 2 different types of monolithic crowns manufactured using CAD/CAM.

Material and methods: A total of 40 three-dimensional (3D) resin-printed dies were randomly assigned to 2 groups based on the type of crown material (n = 20 per group). Each group was divided into 2 subgroups (n = 10 per group) according to the die-scanning technique: subgroup A, scanned using the intraoral scanner (IOS) Primescan; and subgroup B, scanned using the extraoral scanner (EOS) inEos X5. The digitized photos were converted into a 3D virtual crown design using CAD software. The internal discrepancy values, and the marginal gap between the 3D resin-printed die and the crown were assessed using a ×50 digital microscope. The data was checked for normality with the Kolmogorov-Smirnov test, and the Mann-Whitney U test was used to compare the tested groups. The collected data was analyzed at a significance level set at p < 0.05.

Results: The different scanning techniques used had a statistically significant effect on the vertical marginal gap and the internal fit [μm] (p < 0.05). As far as the crown materials are concerned, BRILLIANT Crios showed a significantly higher marginal gap as compared to Tetric CAD when scanned with inEos X5 (p = 0.004), whereas the differences were insignificant with regard to the internal fit (p > 0.05).The crown parameters tested with both scanning systems were within the clinically acceptable ranges.

Conclusions: Scanning methods and crown materials had an impact on the internal fit and vertical marginal gap of monolithic crowns.

Background: Coronavirus disease 2019 (COVID-19) quickly reached the pandemic status, with 765.22 million confirmed cases of COVID-19 and 6.92 million COVID-19 deaths reported worldwide by May 2023. Due to its sudden and global nature, the COVID-19 pandemic has had a significant impact on the emotional and mental health of many people. A group of COVID-19 patients who frequently require intensive care are geriatric patients. The cognitive performance of these patients and their independence in instrumental activities of daily living (IADL) may be crucial to their prognosis and risk of in-hospital death.

Objectives: The present study aimed to assess the level of independence in activities of daily living (ADL), mental fitness, the level of fear of COVID-19, and cognitive functions to determine their impact on in-hospital mortality in geriatric COVID-19 patients.

Material and methods: A total of 300 intensive care unit (ICU) patients with COVID-19 were included in the cross-sectional study, using the following questionnaires: the Lawton IADL scale, the Katz ADL index of independence, the fear of COVID-19 scale (FCV-19S), the abbreviated mental test score (AMTS), and the 15-item geriatric depression scale (GDS15).

Results: Patients aged 64 or below reported significantly greater independence on the IADL scale and the basic ADL scale, and showed a significantly higher level of mental fitness (Mann-Whitney U test; p = 0.001). Patient survival and in-hospital mortality were influenced by independence in basic and complex ADL.

Conclusions: The level of independence is an important prognostic indicator for in-hospital mortality in geriatric COVID-19 patients. The higher the level of mental fitness, the higher the level of independence in basic and instrumental activities of daily living. Patients aged ≥65 years are less independent in basic and instrumental activities of daily living. Moreover, they show a significantly lower level of cognitive functions.

Background: Preand probiotics may help restore a dysbiotic oral ecosystem. The first years of life provide a window of opportunity to modulate the composition of the oral microbiota and prevent disease.

Objectives: The aim of the present study was to investigate the effect of a tablet containing inactivated Ligilactobacillus salivarius CECT 5317 and the cranberry extract on the development of caries in cariesactive preschool children.

Material and methods: The study employed a randomized, placebo-controlled, double-blind design. Preschool children (N = 73) with at least one active carious lesion were enrolled and randomly assigned to the test group or the placebo group. The intervention period was 3 months. Caries was assessed according to the International Caries Detection and Assessment System (ICDAS) II criteria at baseline and after 9 months, and oral hygiene was evaluated with the simplified oral hygiene index (OHI-S). The salivary counts of Streptococcus mutans and Lactobacillus spp. were determined at baseline, and then after 3 and 9 months through the conventional cultivation on TYCSB and MRS agar, respectively.

Results: Sixty children completed the trial (a dropout rate of 19%). The baseline caries prevalence was high in both groups (~71%) and there were no major differences between the groups with regard to background variables. The 9-month incidence of initial carious lesions (ICDAS 1+2) was significantly lower in the test group as compared to the placebo group (p < 0.05). The plaque levels, and the salivary counts of S. mutans and Lactobacillus spp. remained unchanged in both groups throughout the study.

Conclusions: A daily intake of a tablet containing a paraprobiotic and the cranberry extract reduced the 9-month incidence of initial non-cavitated carious lesions in caries-active preschool children. The present study is one of the first to show the impact of synbiotics on the development of caries in children.

The International Agency for Research on Cancer (IARC) "Handbook of Oral Cancer Prevention", vol. 19, provides a thorough and comprehensive evidence-based evaluation of primary and secondary prevention interventions for oral cancer.

The aim of this proposal is to (1) review the current literature, (2) shed light on the importance of creating universally accepted guidelines, (3) provide help and guidance in the decision-making process with regard to the removal of mandibular third molars (M3Ms), and (4) reduce the risk of exposing the patient to unnecessary harm and complications due to the inappropriate removal or retention of M3Ms.It is obvious that the indications for the extraction of M3Ms will continue to be an area of controversy and strong debate. The evidence for or against prophylactic extraction is ambivalent; there is evidence to accept or reject the stance against prophylactic extraction in some specific cases, and there are published articles to support both opposing views. The available guidelines on the extraction of third molars are limited in number, and are mostly tailored to fit specific settings or countries. There are no available guidelines that might be widely used to help in the decision-making process for the international community. We hope this proposal will constitute an important first step toward creating universally accepted guidance.

Background: Pit and fissure sealants are the most commonly used preventive measure against caries in permanent molars. Advancements in dental materials have led to the development of hydrophilic sealants. However, their clinical efficacy must be evaluated and compared with that of conventional hydrophobic sealants.

Objectives: This study aimed to clinically evaluate and compare the retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants over a 12-month follow-up period.

Material and methods: The study was a split-mouth, double-blind, randomized controlled trial. A sample size calculation was performed, and 120 first permanent molars (60 in each group) were selected for inclusion in the study. According to the split-mouth design, the sample was randomly divided into 2 groups. Group A was treated with a hydrophilic sealant (UltraSeal® XT Hydro), while Group B was treated with a hydrophobic sealant (Conseal F). The sealants in both groups were applied in accordance with the manufacturer's instructions by a single operator. The sealants were evaluated clinically using visual and tactile methods by 2 independent examiners who were blinded to the procedure in accordance with the modified United States Public Health Service (USPHS) clinical rating system at placement and at 1, 3, 6, and 12 months.

Results: After 12 months of follow-up, the Conseal F sealant showed significantly better retention (p = 0.001), marginal adaptation (p = 0.023) and reduced marginal discoloration (p = 0.004) in comparison to the UltraSeal XT Hydro sealant.

Conclusions: The Conseal F (hydrophobic) sealant demonstrated superior retention, marginal adaptation and marginal discoloration compared to the UltraSeal XT Hydro (hydrophilic) sealant.

Background: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment.

Objectives: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery.

Material and methods: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure.

Results: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain.

Conclusions: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.

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.