Dental and Medical Problems最新文献

Background: Erbium family lasers have been used as an alternative method for the treatment of dental caries in deciduous teeth, in comparison to traditional methods.

Objectives: The study aimed to determine the most optimal erbium-doped yttrium-aluminum-garnet (Er:YAG) laser settings for carious lesions in deciduous teeth on different surfaces with the evaluation of treatment time and pain level on a visual analog scale (VAS).

Material and methods: The randomized clinical trial involved 66 teeth with deep caries in 33 children aged 3-8 years, divided into 2 study groups: Er:YAG laser (test group); and conventional treatment with a dental turbine (control group). The time required for caries removal and cavity preparation using both methods was recorded. The inclusion criteria encompassed generally healthy pediatric patients, pain-free subjects, first-time dental appointment, and unicuspid primary teeth with caries. Dental caries treatment was performed without the administration of local anesthesia.

Results: The cavity preparation time was on average 2.5 times longer when the Er:YAG laser was used compared to the conventional method. The study demonstrated the effectiveness of the Er:YAG laser in hard tissue preparation of deciduous teeth with a pulse energy of 230 mJ for enamel preparation, mainly on occlusal and proximal surfaces, and with a pulse energy of 120 mJ and 150 mJ for dentin preparation. Optimum operating frequencies were 10 Hz and 20 Hz with corresponding water consumption. The level of discomfort among the laser-treated patients indicated 0 based on VAS, meaning no pain. Among patients treated with the traditional method, the pain level averaged 5.27.

Conclusions: The use of the Er:YAG laser offers substantial advancements in comparison to traditional treatment with dental turbines by enhancing the overall comfort during caries therapy in children. It fosters better patient cooperation and reduces the need for intraoperative anesthetics due to its minimally invasive nature and the fact that it is a relatively quiet operation. This approach minimizes anxiety and discomfort often associated with dental procedures, making them more amenable to children.

Gingivitis is defined as the inflammation of the gums. The condition may spread to other parts of the periodontium, including the periodontal ligament and alveolar bone, and lead to bony defects. Melatonin has a positive impact on the bone healing process, a phenomenon attributable to its antioxidant properties, as well as its capacity to regulate bone cells and promote angiogenesis. The present meta-analysis aimed to evaluate the effect of melatonin as an adjunct to non-surgical periodontal therapy (NSPT) in the treatment of periodontitis. A thorough electronic search of the PubMed®/MEDLINE and Google Scholar databases was conducted, in addition to a manual search of the reference lists of archived articles published until May 2023. Among the 8 reviewed articles, 3 studies that evaluated probing depth (PD) and had a 6-month follow-up period were considered for the meta-analysis. After extracting the relevant information, the risk of bias was estimated. A summary of the estimates for standardized mean differences (SMDs) from fixed-effects and random-effects models was obtained based on the mean treatment differences reported in the selected studies. The results demonstrated the overall estimated effect from the fixed-effects model (SMD = 0.862, 95% confidence interval (95% CI): 0.517-1.207, p < 0.001) and the random-effects model (SMD = 0.869, 95% CI: 0.499-1.238, p < 0.001), with minimal inconsistency as indicated by the Q statistic and I2, respectively. Thus, it can be concluded that melatonin may be used as an adjunctive medication with NSPT for the management of periodontitis.

Background: Artificial intelligence (AI) systems have the potential to revolutionize the fields of medicine and dentistry by identifying solutions for managing multiple clinical problems. This greatly facilitates the tasks of physicians. Bibliometric studies not only provide insight into the history of a particular topic, but also help to determine how the work evolves over time, and to identify interesting new research.

Objectives: The aim of the present study was to identify and analyze bibliographically recent research articles on the use of AI in endodontics.

Material and methods: The search was conducted in March 2024 in the Web of Science Core Collection (WoS-CC), using the Clarivate™ search engine. The search strategy in all fields included in the database was as follows: "endodontics" was the main keyword, and the other keywords were "artificial intelligence", "deep learning", "machine learning", "artificial neural network", and "convolutional neural network". The title, authors, institution, country, impact factor, total number of citations, year of publication, journal name, number of authors, keywords, abstracts, and other topics of interest were recorded. Bibliometric networks were generated and analyzed using the Visualization of Similarities Viewer (VOSviewer).

Results: Of the 54 articles published by the journals indexed in the WoS-CC between 2012 and 2024 that contained the search terms, 40 were included in this study. The article citations ranged from 0 to168, with an average of 18.97. The number of countries contributing to the research was 29. The country with the highest contribution rate in the field was the USA ranked first (27.5 %), followed by Germany (17.5 %), China (15.0%), and India (15.0%).

Conclusions: Based on this review, it can be concluded that a more significant research interest in AI and endodontics was observed in the USA. The most cited research articles dealt with dental image diagnosis with the use of convolutional neural networks (CNN), the radiologic diagnosis of apical lesions using AI, and the computer-aided diagnosis of periapical lesions using AI in computed tomography (CT) analyses.

The article presents recommendations from the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) for the management of temporomandibular disorders (TMD), following the article "Temporomandibular disorders: INfORM/IADR key points for good clinical practice based on standard of care" by Manfredini et al. The document was translated by Aleksandra Nitecka-Buchta, Karolina Walczyńska-Dragon and Justyna Sędkiewicz, and reviewed by Aleksandra Nitecka-Buchta, Stefan Baron, Małgorzata Pihut, Jolanta Kostrzewa-Janicka, Edward Kijak, Mieszko Więckiewicz, Magdalena Osiewicz, Małgorzata Gałczyńska-Rusin, Aneta Wieczorek, and Daniele Manfredini.

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: The post-coronavirus disease (post-COVID) syndrome (PCS), which occurs after severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection, can manifest a variety of symptoms in the oral cavity. Changes to the tongue tend to persist longer than other symptoms in this area.

Objectives: The aim of the study was to present the changes and lesions that occur on the tongue after SARS-CoV-2 infection, as well as their healing as a consequence of the therapy used or lack thereof.

Material and methods: The study sample included 426 individuals who had contracted SARS-CoV-2 and presented with changes on the tongue. Periodic checkups enabled to determine their variability and duration in response to treatment or lack thereof.

Results: The presence of various oral manifestations was reported, including strawberry tongue (women (F): 143; men (M): 65), depapillation (F: 86, M: 156), geographic tongue (F: 65, M: 124), vascular changes (F: 102, M: 46), aphthous changes (F: 106, M: 58), candidiasis (F: 89, M: 57), edema (F: 42, M: 52), herpetic lesions (F: 38, M: 49), ulcers (F: 38, M: 46), erosions (F: 32, M: 28), nodular lesions (F: 6, M: 19), and necrotic changes (F: 9, M: 7). Fungiform papillae were found to be enlarged in 189 women and 213 men. On average, from 3 to 5 changes were identified concurrently. In the majority of cases, the changes disappeared on their own and persisted from 4 weeks to 36 months. In 20% of cases, they recurred. Local therapy resulted in a 50% reduction in the duration of PCS.

Conclusions: Changes that manifest on the tongue require observation and basic or specialized treatment. In the absence of pain, monitoring is recommended for a period of 4 weeks, after which a spontaneous disappearance should be expected. In the event that various changes occur in the oral cavity, the patient should be referred for specialized treatment.

Background: The preparation of model teeth for prosthetic crowns plays a crucial role in preclinical dental education. Its primary objective is to ensure optimal conditions for training students to function in clinical settings.

Objectives: The aim of the study was to assess the quality of dental students' education regarding the preparation of model teeth for cast metal-ceramic crowns. An additional objective was to compare the agreement between measurements made by examiners on the model teeth prepared by the students.

Material and methods: A total of 180 model premolar teeth (KaVo) were used for the tests. The teeth were prepared by the third-year dental students, who created a shoulder finish line on the buccal surface and a chamfer finish line on the palatal surface. Two examiners assessed the convergence angles of walls, the margin width of surfaces, the reduction in the height of functional and non-functional cusps, the extent of the preparation, the smoothness of the preparation, and the continuity of the finish line using simple measuring tools.

Results: The students' most proficient parameters were margin width, the extent of the preparation, and the finish line continuity. The least accurate results were observed in the wall convergence angles and the reduction in the height of functional and non-functional cusps. The interexaminer reliability was considerable for convergence angles, the margin width and the reduction in the height of cusps (intraclass correlation coefficient (ICC) >0.75). The examiners demonstrated moderate agreement (kappa: 0.60-0.79) for parameters such as the extent of the preparation, wall smoothness and finish line continuity.

Conclusions: The exercises provided a solid foundation for the students. However, practice and more targeted feedback are necessary to improve performance in the more challenging aspects of tooth preparation. The traditional analytical approach that uses simple measuring tools to assess the tooth preparation procedure is a reproducible method that examiners can use to effectively evaluate students' work.

Background: Probiotics, known for their anti-inflammatory properties and ability to balance the oral microbiome, show promise in enhancing wound healing, particularly through topical application, in oral healthcare.

Objectives: The main objective of the present study was to investigate the topical application of probiotics to accelerate oral wound healing, focusing on key indicators, like collagen density, angiogenesis, the reepithelization rate, the wound area, and the wound length.

Material and methods: Palatal wounds were induced in 60 male Sprague-Dawley® rats, which were divided into 4 groups. Probiotics, including Streptococcus salivarius K12 (BLIS K12®) and Lactobacillus reuteri (Interlac® Pro-D and Interlac®), were topically administered. The rates were sacrificed on days 3, 7 and 14 to evaluate the early, middle and late proliferation phases. Histopathological examinations assessed collagen density, angiogenesis, the re-epithelialization rate, the wound area, and the wound length.

Results: Probiotics showed beneficial effects on the oral wound healing indicators examined in this study. This study demonstrates the significant benefits of applying probiotics in enhancing wound healing throughout various proliferation stages. Our findings consistently highlight their positive impact across key indicators. With 3 different probiotic types, we observed improvement in all aspects of wound healing, from early to late stages.

Conclusions: The study underscores the potential of probiotics as effective agents in promoting wound repair and regeneration, offering promising avenues for enhanced clinical outcomes.

The temporary use of contingent electrical stimulation with the GrindCare® device may offer a practical, non-invasive solution to reduce bruxism and protect restorations during vulnerable phases of phased dental rehabilitation.

Background: In the oral cavity, restorations and teeth are subject to occlusal stresses, as well as physiological and chemical wear processes. The consumption of alcoholic and non-alcoholic beverages is popular among adolescents, and this habit often persists into adulthood, contributing to tooth erosion. The erosive potential of these beverages is influenced by various factors, including the pH, acid type, buffer capacity, adhesion, chelating effect, and phosphate or calcium or fluoride content of the drink. Several studies have confirmed that the excessive consumption of alcoholic and non-alcoholic beverages reduces the microhardness and flexural strength of composites.

Objectives: The purpose of this study is to compare the compressive strength (CS) of 3 core build-up resin composite materials in the presence of different alcoholic and non-alcoholic beverages.

Material and methods: A total of 135 specimens (blocks measuring 5 mm × 4 mm) made from different composites (NexCore™, spee-dee™ build-up, and Ecosite Bulk Fill) were divided into 3 experimental groups (n = 45). The experimental liquids used in each group were artificial saliva, Kingfisher® beer (an alcoholic beverage) and Thums Up® (a non-alcoholic beverage), which were maintained for 24 h at 37°C. The compressive strength of the samples was measured with the use of a universal testing machine.

Results: Nexcore™ and Ecosite Bulk Fill exhibited the highest fracture resistance among the tested liquid mediums. The mean CS for NexCore™ was significantly higher after immersion in alcohol compared to saliva and non-alcoholic medium (p < 0.0001).

Conclusions: The immersion medium affects the CS of bulk-fill composites. Moreover, NexCore™ and Ecosite Bulk Fill composites exhibited substantial CS, while spee-dee™ build-up demonstrated the lowest CS among the tested media.