Dental and Medical Problems最新文献

Background: Secondary caries is one of the main reasons for the clinical failure in dental restorations. Therefore, it is preferable for restorative materials to possess antibacterial properties, which support a longlasting restoration.

Objectives: The present in vitro study aimed to evaluate the effect of both the polyamidoamine (PAMAM) liquid and bioactive glass (BAG) powder added to glass ionomer cements (GICs) on their antibacterial properties.

Material and methods: Polyamidoamine was prepared and characterized. Four groups were distinguished, as follows: GI - samples of commercially available GIC (control); GII - samples of GIC mixed with PAMAM; GIII - samples of GIC mixed with BAG; and GIV - samples of GIC mixed with PAMAM and BAG.The biofilm assessment test was conducted using a colony forming unit (CFU) count, and the ion release test was used to quantify the amount of released silica (Si), calcium (Ca), phosphorus (Ph), and sodium (Na) ions in mg/L. Thirty-six samples were prepared for each test. Furthermore, the pH of the soaking solution was measured for each sample in the ion release test. The parametric data was examined using one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test.

Results: The biofilm assessment test revealed a significant reduction in the recovered Streptococcus mutans counts in all modified groups compared to the control group (p < 0.05). Also, the ion release test demonstrated a significant increase in the release of Si and Na ions for all modified groups compared to the control group (p < 0.05).

Conclusions: The modification of GICs with PAMAM and BAG enhances their antibacterial properties.

Background: The examination of pro-health behaviors is important in the assessment of factors that influence the health of the population. Despite a constant increase in pro-health awareness observed within Polish society, the epidemiological picture of adult oral health remains unsatisfactory.

Objectives: The aim of the study was to assess the level of knowledge of the study population regarding the prevention of caries, the role of fluoride compounds, and hygiene habits.

Material and methods: A quantitative cross-sectional methodology was employed in the study. A specially designed anonymous survey was used to ensure the confidentiality of participants and to encourage truthful responses. The data was collected over a 5-month period using computer-assisted web interviewing (CAWI) with a Google Forms survey. The link to the survey was shared in public groups and on social media platforms, ensuring the collection of a diverse sample. Submitted surveys were cataloged and de-identified prior to analysis.

Results: The final sample size of the study was 643 participants. In the present study, only 95 respondents (14.77%) demonstrated sufficient knowledge about oral hygiene and declared behaviors that align with recommended practices. Factors such as place of residence, education and income did not have a statistically significant effect on the level of health awareness in relation to the preferred health attitude of the "ideal patient". The study revealed a lack of knowledge regarding the role of fluoride in caries prevention, with some individuals considering it harmful and refraining from using fluoride toothpaste. Approximately 20% of the surveyed population lacked awareness of the presence of fluoride in their toothpaste. These observations were comparable across both rural and urban areas.

Conclusions: The present study indicates insufficient knowledge regarding oral health among the study population. It is necessary to introduce more comprehensive oral health education programs targeted at the adult population of Poland.

Background: Chitosan prepared with acetic acid is commonly used as an endodontic irrigant. However, the chitosan solution prepared with distilled water has not been evaluated for endodontic usage.

Objectives: The present study aimed to compare the effects of ethylenediaminetetraacetic acid (EDTA), fumaric acid, and the chitosan solutions prepared with distilled water (C-DW) and acetic acid (C-AA) on dentin microhardness and dentinal tubule penetration.

Material and methods: Eighty maxillary central incisors were endodontically instrumented and randomly divided into 2 main groups (n = 40) for the evaluation of dentin microhardness and tubular penetration, with 4 subgroups in each main group (n = 10) according to the final irrigation solutions used (EDTA, fumaric acid, C-DW, and C-AA). The C-AA solution was prepared by diluting medium-molecularweight chitosan in acetic acid. The C-DW solution was prepared with distilled water and chitosan ammonium salts, which were synthesized using trichloroacetic acid and low-molecular-weight chitosan. After irrigation, the roots were sectioned horizontally 2 mm (the apical third) and 5 mm (the middle third) from the apex. The microhardness measurements were taken at depths of 500 μm and 1,000 μm from the canal lumen. The sections were examined for tubular penetration using confocal laser scanning microscopy. The data was analyzed using the analysis of variance (ANOVA), with a significance level set at p < 0.05.

Results: The microhardness values were statistically similar at either depth for each third (p > 0.05), except for the 1,000-μm depth in the apical third, where the use of the C-AA solution resulted in lower microhardness as compared to fumaric acid (p < 0.05). No significant differences were observed in tubular penetration with regard to each third (p > 0.05).

Conclusions: All solutions showed a similar penetration ability in each third. At the 1,000-μm depth in the apical third, the fumaric acid solution provided a higher microhardness value than the C-AA solution.

Background: The effectiveness of guided tissue regeneration (GTR) has been thoroughly documented. Since most post-GTR complications are related to the exposure of the membrane and its subsequent bacterial contamination, clinicians treat the incorporation of systemic antibiotics as an integral component of the standard surgical procedure. However, this approach remains controversial.

Objectives: The aim of the study was to assess the effect of postsurgical administration of antibiotics on early healing and patient morbidity after treatment of periodontal intrabony defects with deproteinized bovine bone mineral (DBBM) and a collagen membrane (GTR).

Material and methods: The study encompassed 41 patients with 41 intrabony defects. The subjects were randomly assigned to either the test group (DBBM/GTR+AB (postsurgical antibiotic)) or the control group (DBBM/GTR). In the test group, 1 g of amoxicillin was administered twice daily for 7 days. The early healing index (EHI) was assessed 1 and 2 weeks after the procedure. Patient morbidity was recorded. The clinical attachment level (CAL), probing depth (PD) and gingival recession (GR) were measured at baseline and 6 months after surgery.

Results: Early healing was uneventful in both groups. No adverse events were recorded in either group. In the second week, EHI-defined primary flap closure was evident in 95% of the test group sites and 80% of the control group sites. The CAL changed significantly in both groups: from 8.7 ±1.4 mm to 4.6 ±1.7 mm in the DBBM/GTR+AB group (p < 0.0001); and from 8.6 ±1.9 mm to 5.7 ±1.2 mm in the DBBM/GTR group (p < 0.0001). The significant outcome was in favor of the test group (p = 0.010). Probing depth significantly decreased in both groups, without any observed intergroup differences.

Conclusions: The administration of systemic amoxicillin after regenerative periodontal surgery did not have any effect on early wound healing; however, it yielded a statistically significant CAL gain after 6 months compared to the group treated without antibiotics.

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.