Dental and Medical Problems最新文献

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.

Background: A variety of firing protocols are available for the IPS e.max lithium disilicate (LD) and can be used for new, 'advanced' LD (ALD). However, the impact of firing protocols on the optical properties of ALD is still unknown.

Objectives: The aim of the present study was to evaluate the color difference (ΔE00), the translucency parameter (TP00) and the whiteness index for dentistry (WID) for both LD glass ceramics after the processes of firing/glazing.

Material and methods: Fifty disk-shaped specimens, with a diameter of 10 mm and a thickness of 1.2 mm, were fabricated from IPS e.max CAD (LD; Ivoclar) and another 50 from CEREC Tessera™ (ALD; Dentsply Sirona). The specimens from each group were further divided into 5 subgroups (n = 10) according to the firing/glazing protocol applied: crystallization (c); one-step crystallization and glazing (cg); crystallization and refiring (c-r); two-step crystallization and glazing (c-g); or long-firing crystallization (lfc). The ΔE00, TP00 and WID were assessed. The statistical analysis of ΔE00 was performed using the one-way analysis of variance (ANOVA) and Tukey's post hoc test, while TP00 and WID were analyzed with the two-way ANOVA and Tukey's post hoc test at a statistical significance level of 0.05. The cg groups were designated as the reference.

Results: The ANOVA showed that the firing procedures had no effect on ΔE00, TP00 and WID in the case of LD. In addition, LD exhibited greater translucency and brightness as compared to ALD. For ALD, all color changes observed in relation to the reference firing protocol were clinically unacceptable. The ALD specimens which underwent 1 standard firing cycle showed higher TP00 and WID values than other ALD groups.

Conclusions: The choice of the firing protocol has no impact on the color, TP00 or WID of LD. Additionally, LD presents higher WID values than ALD, irrespective of the firing protocol used. Alternative firing protocols result in clinically unacceptable color variations when compared to the manufacturer-recommended protocol for ALD. Advanced LD is more sensitive to different firing protocols with regard to its optical properties, which makes the workflow less predictable in comparison with LD.

Background: Odontomas are odontogenic tumors located in the jawbone, referred to by the World Health Organization (WHO) as hamartomatous (Greek hamartion - a bodily defect) developmental malformations. The term was first used by Brock in 1866 to refer to every odontogenic tumor. Today an odontoma is believed to be a congenital malformation of dental hard tissues. Odontomas can contribute to the development of dental abnormalities and bite disorders.

Objectives: The study aimed to present tooth eruption disorders caused by the occurrence of odontomas in 20 patients treated at the Dental Surgery Clinic for Children.

Material and methods: The study group comprised 20 patients (13 in good general health, 6 with systemic diseases and 1 with a congenital malformation), aged 2-17 years (mean age: 8.96 years), with jawbone odontomas diagnosed through clinical and radiological examination. These odontomas were the cause of disorders in the eruption of deciduous and permanent teeth. The treatment method applied in all patients involved the enucleation of the tumor with its capsule and sending the material for histopathological examination.

Results: Odontomas were discovered accidentally or were accompanied by such clinical symptoms as retained deciduous teeth, impacted deciduous and permanent teeth, missing teeth in the oral cavity, gaps, displaced teeth, and the distension of the alveolar process of the maxilla/alveolar part of the mandible. The odontomas occurred in both the maxilla and the mandible, more often in boys. The compound odontoma (OCp) was the most common type.

Conclusions: Odontomas are benign odontogenic tumors that do not undergo neoplastic transformation. The treatment of choice is a surgical procedure involving the complete removal of the tumor with its capsule, which results in full recovery.

Background: Nasal obstruction in pediatric patients can lead to serious issues, such as facial growth alterations, otitis media with effusion, and sleep disorders. Diagnosing nasal obstruction is challenging because subjective evaluations are often inaccurate, and objective measures like rhinomanometry are difficult to perform in children. This study proposes using an oral screen test as a rapid and cost-effective diagnostic method.

Objectives: The aim of the study is to validate the oral screen test as a method for diagnosing nasal obstruction in children. This objective is based on the observation that children with nasal obstruction do not tolerate the oral screen test well.

Material and methods: The validation of the diagnostic test was assessed based on the results of 104 children aged 4-15 years undergoing rhinomanometry. A silicone oral screen (Forwardontics®) and the Spanish version of the Sinus and Nasal Quality of Life Survey (SN-5) were used.

Results: The oral screen test yielded a positive result in 78 participants (75%). The children with a positive test result exhibited higher nasal resistance (561.3 ±140.5%) than those with a negative test result (102.0 ±3.4%), with an odds ratio (OR) of 18.5 (95% confidence interval (CI): 5.5-64.1).

Conclusions: The oral screen test is a highly sensitive and moderately specific method for diagnosing nasal obstruction in children, making it a useful screening tool in clinical practice.

Gingival recessions are a common disease and one of the most frequently used method for managing them is the tunnel technique (TUN). Although more and more articles are addressing the problem, few are adequately structured, usually without following the standard protocols. Many checklists have been developed for this purpose. Among them, the Template for Intervention Description and Replication (TIDieR) checklist is commonly used. Therefore, the present review analyzed trials based on it. The completeness of registration of the trial protocol data was assessed using the TIDieR checklist with regard to the coronally advanced tunnel technique (CAT) with subepithelial connective tissue graft (sCTG) (CAT + sCTG) and CAT alone. The review also investigated the consistency of the research description in the published articles.A total of 37 records were gained from ClinicalTrials.gov and the corresponding publications, including 32 studies employing CAT + sCTG and 5 studies using only CAT. The description of intervention in ClinicalTrials.gov was inadequate for all analyzed trials, and there were also differences between the registered and published studies. The present analysis showed that the description of the registered trials is often incomplete and that detailed data is not pro-vided. It is essential that clinical research is well documented and properly described, so that the findings can be easily implemented in daily clinical practice without confusion.