Dentistry Journal最新文献

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey's post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath.

Background: Periodontitis, a chronic inflammatory disease, has been associated with an elevated risk of cardiovascular disease (CVD). Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has emerged as a potential biomarker linking periodontitis, endothelial dysfunction, and CVD. This systematic review aimed to synthesize the existing evidence on the relationship between ADMA, periodontitis, and CVD, and to evaluate ADMA's potential as a biomarker for periodontal disease progression and its correlation with endothelial dysfunction. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science databases from their inception to March 2023. Observational and interventional studies assessing ADMA levels in patients with periodontitis and/or CVD were included. The methodological quality of the included studies was evaluated using the NIH Quality Assessment Tools. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Results: Cross-sectional studies consistently demonstrated significantly elevated ADMA levels in patients with periodontitis and CVD compared to healthy controls. The prospective cohort study indicated that successful periodontal treatment was associated with a significant reduction in ADMA levels and concomitant improvement in endothelial function. The pilot cohort study reported a significant decrease in ADMA levels following periodontal therapy in patients with chronic kidney disease. However, the randomized controlled trials did not demonstrate significant alterations in ADMA levels or endothelial function subsequent to periodontal treatment in patients with periodontitis alone. Conclusions: Periodontal treatment may effectively reduce ADMA levels and improve endothelial function, particularly in patients with comorbidities. These findings suggest that ADMA is a promising biomarker linking periodontitis, endothelial dysfunction, and CVD. However, the limitations of this study include the small number of studies, heterogeneity in the study designs, and a lack of long-term follow-up data. Further high-quality, longitudinal studies are required to confirm its clinical utility and elucidate the underlying mechanisms of these relationships. The integration of periodontal care into CVD prevention and management strategies warrants consideration, as it may contribute to mitigating the cardiovascular risk associated with periodontitis.

(1) Background: The long-term survival of an endodontically treated tooth depends on a successful root canal treatment as well as an adequate definitive coronal restoration. This study aimed to evaluate the strength of endodontically treated premolars with mesial-occlusal-distal (MOD) cavity preparation restored with different direct coronal restoration materials but from the same manufacturer against fracture. (2) Methods: sixty intact premolars were selected and placed into five groups (n = 12): G1-intact teeth, G2-endodontic treatment and unrestored MOD cavities, G3-endodontic treatment and MOD cavities restored with Tetric PowerFlow and Tetric EvoCeram, G4-endodontic treatment and MOD cavities restored with Multicore Flow and Tetric EvoCeram, and G5-endodontic treatment and MOD cavities restored with Multicore Flow. The specimens were subjected to an axial compression load at a speed of 1.6 mm/min and optically inspected before and after with a stereomicroscope. For each premolars group, the following data were recorded: the compression resistance, the compressive strength, and the maximum force supported. The microstructure of the samples after the compression test was analyzed using scanning electron microscopy (SEM). (3) Results: statistical analysis (ANOVA and Tukey test) showed that there was a statistically significant difference between G1 and the other groups. Even though there was no statistically significant difference between the restored groups, a better mechanical behavior was registered within the G3. (4) Conclusions: this in vitro study indicated that none of the materials used can lead to a higher or at least similar fracture resistance as the intact teeth. The coronal restoration only with nano-hybrid composites may lead to a higher therapeutic benefit for the fracture-susceptible premolars.

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included "central giant cell granuloma", "recurrence", "treatment modalities", and "surgical excision". Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon-alpha therapy, and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (>3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options.

Dental implant education is required to prepare students for independent general practice. This investigation aimed to assess students' perceptions of their educational experience and training in a preclinical dental implant introduction course, using reflective logs anonymously extracted from course portfolios.

Methods: This study employed qualitative research methodology to analyze second-year dental students' reflections on their educational and development of psychomotor skills in a preclinical course focusing on dental implants at the University of Nevada, Las Vegas. These reflections served as the primary data source for qualitative analysis. The analysis was facilitated using NVivo software version 12 plus, which assisted in data coding and the organization of these codes into meaningful units, patterns, and themes.

Results: Four themes emerged, which interrelated to each other and to the research question. Students reported positive course outcomes in dental implant learning, improvements in applying theoretical implant knowledge while developing practical skills, digitally scanning implant cases for the final restoration, and enhancement of their insight in evidence-based restoratively driven implant planning. They generally found the hands-on experience to have improved their understanding of the dental implant as an option for restoration. Although there were challenges, students viewed these as learning opportunities. For us, as educators, it provided invaluable feedback to understand students' perceptions of difficulties in knowledge acquisition and psychomotor skill development in placing and restoring dental implants.

Conclusions: Within the limitation of this study, students expressed a positive perception of their learning experience in the introductory course on dental implants.

Objective: This randomized controlled split-mouth trial compared the performance of 5.5 mm length implants (test group; TG) splinted within the same fixed prosthesis as longer implants (≥6.5 mm; control group; CG) in posterior regions. Methods: The primary hypothesis was that implant length does not affect marginal bone loss (MBL) one year post-implantation, while the secondary hypotheses included implant survival, peri-implant clinical variables, and prosthetic complications. Fifteen patients (eight males, seven females) with a mean age of 67 ± 9 years were included. Results: No significant difference in the implant position between groups (p = 0.808) was observed. Implant diameters ranged from 3.00 to 4.25 mm, and the most common bone type was type I (67%). Bone density (p = 0.574) and implant insertion torque (p = 0.888) were similar between groups. Mesial MBL (mean: -0.1; range: -1.19 to 0.24 for TG, and -0.03; -1.75 to 0.45 for CG; p = 0.955) and distal MBL (mean: -0.05; range: -1.41 to 0.27 for TG, and 0.08; -1.45 to 0.72 for CG; p = 0.118) did not show statistical differences. There were no implant failures or technical complications. Conclusions: These findings suggest that 5.5 mm length implants could be a viable option for use in posterior regions, providing similar clinical outcomes to longer implants one year post-implantation.

This study investigated the efficacy of Isomalt-containing toothpaste in preventing development of dental caries.

Methods: Human dental enamel slabs were allocated to six groups (30/group) at random: De-ionized distilled water (DDW), and toothpaste containing 10% Isomalt, 1100 ppm fluoride, 0.05% cetylpyridinium chloride [CPC] (ICT); 10% Isomalt, 1100 ppm fluoride (IT); 10% Isomalt, 1100 ppm fluoride, 1.5% Sodium lauryl sulfate [SLS] (IST); 1100 ppm fluoride only (FT); 1100 ppm fluoride with SLS (FST). The enamel slabs were exposed to caries development via plaque growth in a Microbial Caries Model for 7 days. Toothpastes were applied as slurries (one toothpaste-three DDW) for 2 min twice daily. Demineralization was measured as the change in surface microhardness (ΔSMH) and amount of mineral lost (∆Z), and these metrics were assessed using Transverse Microradiography. Intra-group (SMH) and intergroup (%∆SMH and ∆Z) comparisons were paired t-test and Tukey's test (α = 0.05), respectively.

Results: With SMH, demineralization was found to be significant (p < 0.001) in all groups compared to sound enamel baseline, except ICT group. With %ΔSMH, all other groups had significantly (p < 0.001) less demineralization compared to DDW. Significantly (p < 0.001) greater demineralization was observed in IT, FT and FST compared to ICT, and no significant difference was observed between IST and ICT or FT. With ∆Z, relative to the DDW group, the inhibition of demineralization was significant (p < 0.0001) in all groups at varying percentages.

Conclusions: Toothpaste containing 10% Isomalt, 1100 ppm fluoride, and 0.05% CPC demonstrated greater efficacy in inhibiting caries development amid dental plaque compared to toothpaste containing only 1100 ppm fluoride.

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors.

Materials and methods: A search of the literature was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, on papers published between 1980 and 2024. The titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity.

Results: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival.

Conclusions: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided into three groups. In G1 (control group), each tooth was half-immersed in chlorinated pool water; in G2 (fluoride-treated group), after being totally immersed in chlorinated water, each tooth had half of its surface treated with a highly concentrated fluoride product once a week; in G3 (remineralization product-treated group), each tooth was totally immersed in chlorinated water and half of its surface was treated with a remineralizing product after each immersion. The study was conducted over a 4-week period, immersing the teeth for 4 h per day. In G1, statistically significant differences were observed in submerged versus non-submerged tooth surfaces at week 3 (T3) (p = 0.019) and week 4 (T4) (p = 0.0007), with four and eight surfaces showing erosive tooth wear (ETW), respectively. In G2, a difference was observed between fluoride-treated and non-fluoride-treated surfaces at T4 (p = 0.039), with three surfaces with ETW among the non-treated ones. In G3, the difference was observed between portions treated with F-APC and those not treated at T4 (p = 0.019), with four surfaces with ETW among the untreated ones. Chlorinated pool water is a potential erosive agent for teeth if water pH values reach a critical value. Treating the teeth surface with highly concentrated fluoride products, once a week for 5 min, and F-APC are effective in protecting teeth against tooth erosion.

The science of dental tissue grafting is evolving, with an increased understanding of factors influencing graft behavior. Despite the widespread clinical use of soft tissue grafts, the histological characteristics of different gingival harvesting sites are still underexplored. This study aimed to fill this gap by analyzing 50 tissue samples harvested from 25 patients across three sites: the hard palate, maxillary tuberosity, and palatal rugae. Each sample underwent thorough histological and histomorphometric analysis. Conventional statistical analysis was performed using SPSS, while predictive modeling was conducted with RapidMiner Studio. The study identified significant histological differences among the graft sites, with notable variations in total graft height, epithelial height, and interdigitation perimeter. These findings underscore the importance of donor site selection in influencing graft success. Pair plots and principal component analysis (PCA) further highlighted the distinct histological features of each tissue type. The random forest classifier identified total graft height, epithelial height, and perimeter as the most influential factors in predicting graft site behavior. This study offers valuable insights into the histological characteristics of soft tissue grafts, potentially leading to more predictable clinical outcomes.