Dentistry Journal最新文献

Background: Caries experience in Argentine children is quite high and no national data are present.

Aim: This cross-sectional observational survey aimed to assess the oral health status of schoolchildren in Buenos Aires (CABA) using CTNI and to evaluate the ecological association between health inequalities and caries prevalence.

Design: Data were collected, via a clustered procedure, during the 2016-2018 school years. Children were examined at school to determine dental status according to the CTNI performed under standardized conditions, using light, dental mirrors, WHO probes and magnification (2.5×). Secondary sources were used to acquire socio-demographic and epidemiological data. A hierarchical cluster analysis was carried out with the municipalities of the CABA as the dependent variable and the socio-demographic factors.

Results: The study population consisted of 62,904 schoolchildren, 43,571 of whom were enrolled into the study. Total caries prevalence was 67.78% while severe caries prevalence was 28.29%, which was statistically associated with the year of the survey (p < 0.01). Four territorial conglomerates from a socio-epidemiological standpoint outline homogeneous areas of social risk; cluster 1 had the highest social risk. The prevalence of severe caries (CTNI 7-14) was highest in cluster 1 (44.7-53.2% of the population).

Conclusion: The social inequalities between municipalities of the CABA were statistically associated with high inequalities in oral health needs.

The purpose of this clinical epidemiological investigation was to examine the oral health conditions of homeless people in the city of Rome, Italy. A total of 157 homeless subjects were subjected to a first dental visit, during which anamnestic information was recorded in a digital medical record. A diagnosis of dental disorders was performed by assessing oral hygiene conditions, periodontal health, the presence of caries and/or root residues, and the presence of partial and/or total edentulousness. Caries and missing teeth were evaluated by the DMFT index. The first major criticality was represented by poor or absent oral hygiene. The examined sample showed a major percentage of high DMFT (63.0%); the most common clinical condition was the presence of numerous root residues. Regarding periodontal health, 73.2% of patients had gingivitis, 21.6% periodontitis, while 11 patients had periodontal pathologies with tooth mobility (7%). Finally, 8.9% of patients had one or two missing elements, 22.9% had partial edentulousness, and 8.9% of the sample had total edentulism. This analysis provides an important basis for strengthening health promotion and the importance of accessible and effective care for this population. It will therefore be necessary to continue to adopt a patient-centered approach geared towards addressing the demands that this population faces in maintaining their oral health.

Dietary Factors and Oral Health: Risky dietary behaviors, particularly excessive sugar consumption, significantly contribute to dental caries. Dental practitioners are tasked with detecting and managing these behaviors to effectively treat caries and prevent recurrences. Although dietary assessment tools exist to identify such behaviors, they have limits. Furthermore, traditional methods, focused on information dissemination and advice, often fall short in promoting sustainable changes in patient behavior toward oral health. From our perspective, there is a necessity to integrate educational approaches with therapeutic management for enhancing the ability current and future dental practitioners to effectively care for their patients' oral health needs. Discussion: Specific educational models have been developed for patients with chronic diseases, through Therapeutic Patient Education (TPE), defined as helping patients acquire or maintain the skills they need to best manage their lives with a chronic disease. Future Directions: By incorporating TPE into dental practice, oral health professionals can empower patients to take control of their eating habits and reduce their risk of caries disease. This holistic approach addresses both the carious lesions and underlying causes of tooth decay, leading to better oral health outcomes for patients.

Background: Dental caries remains a significant global health problem. One of the fundamental mechanisms underlying the development and progression of dental caries is the dynamic process of demineralisation/remineralisation. In vitro models have played a critical role in advancing our understanding of this process and identifying potential interventions to prevent or arrest dental caries. This literature review aims to provide a structured oversight of in vitro mineralisation models which have been used to study the tooth demineralisation/remineralisation process.

Methods: Publications from 2019 to 2023 were screened to identify articles reporting the use of in vitro models to study the demineralisation/remineralisation of tooth caries. The included studies were methodologically assessed for their information on (i) substrate, (ii) lesion formation, and (iii) mineralisation models.

Results: The most reported substrates used in the studies were human teeth along with bovine incisors. Acetic/lactic buffers were the most common solutions to induce caries lesions. pH cycling was the most frequently used mineralisation model for simulating the daily change within the oral environment. This review discussed the advantages and limitations of various approaches.

Conclusions: Standardisation of in vitro mineralisation models is crucial for enabling effective comparison between studies and advancing caries research.

(1) Background: In recent years, there has been a growing interest in tooth-derived materials as valuable alternatives to synthetic biomaterials for preventing alveolar ridge dimensional changes. This study aimed to evaluate the histological and clinical differences between alveolar ridge preservation procedures in the maxilla and mandible using demineralized dentin treated with Tooth Transformer^®. (2) Methods: A total of 178 patients in good general health were enrolled, with 187 post-extractive sockets lacking buccal and/or palatal bone walls. Alveolar socket preservation procedures and histological evaluations were performed. The sites were divided into two groups: Group A (99 mandibular samples) and Group B (108 maxillary samples). After 5 months (±1 month), single bone biopsies were performed for histologic and histomorphometric analysis. (3) Results: Clinical outcomes demonstrated a good healing of hard and soft tissues with an effective maintenance of bone architecture in both groups. Histomorphometric analysis revealed a total bone volume of 50.33% (±14.86) in Group A compared to 43.53% (±12.73) in Group B. The vital new bone volume was 40.59% (±19.90) in Group A versus 29.70% (±17.68) in Group B, with residual graft dentin material volume at 7.95% (±9.85) in Group A compared to 6.75% (±9.62) in Group B. (4) Conclusions: These results indicate that tooth-derived material supports hard tissue reconstruction by following the structure of the surrounding bone tissue. A 6.8% difference observed between the maxilla and mandible reflects the inherent disparities in natural bone structures in these regions. This suggests that the bone regeneration process after tooth extraction adheres to an anatomical functional pattern that reflects the specific bone characteristics of each area, thus contributing to the preservation of the morphology and functionality of the surrounding bone tissue.

Background: The aim of the present parallel clinical study is to evaluate the efficacy of 3D-printed biopolymers compounded with osteoconductive material (beta-tricalcium phosphate and hydroxyapatite) for soft tissue closure after tooth extraction.

Materials and methods: this study followed the CONSORT reporting guidelines; 39 patients were treated with socket preservation using 3D-printed biopolymers and randomly divided into 3 groups (Test 1, Test 2, and Control). All cases were treated without flap elevation, careful cleaning and debridement of the sites, and then randomly sealed as follows: In T1, with a 3D-printed disk of poli-D-lactic acid with 10% of hydroxyapatite; in T2, using a 3D-printed disk of poli-ε caprolactone with 20% of β-tricalcium phosphate; and in T3, the socket was left open to heal. At baseline (extraction time) and 6 weeks after extraction, the rate of exposure was evaluated and stratified according to the site (anterior, posterior).

Results: No dropouts were observed during the 6 weeks follow-up. All sites underwent uneventful healing with no complications. For posterior teeth, Test 1 and Test 2 showed full healing of the soft tissues with a reduction of the exposed area from 46.5 ± 8.25 mm² to 0.6 ± 0.84 mm² and from 47.1 ± 8.67 mm² to 0.6 ± 0.7 mm², respectively. The Control group exhibited a reduction from 45.6 ± 7.25 mm² to 1.2 ± 0.9 mm². Both Tests 1 and 2, when compared to the Control group, showed statistically significant better healing (p < 0.05). Anterior teeth showed a complete closure of the socket 4 weeks after the extraction with no noticeable differences between Test and Control.

Conclusions: Both materials used in this study showed evidence to achieve the purpose. Ethical Guidelines: written informed consent was obtained from the participants of the study, as requested by the Ethics Committee for Health Research Faculty of Dentistry, Universitas Trisakti, with the following number: 641/S3/KEPK/FKG/5/2023.

A gummy smile, defined as excessive gingival exposure while smiling, is an esthetic and functional condition affecting an individual's quality of life. Despite its prevalence and impact, the classification and treatment of the gummy smile remain challenging in clinical practice. The problem lies in (1) the fact that the etiology of this pathology is multifactorial, and these factors sometimes go unnoticed, (2) the lack of consensus on the classification criteria, which, together, create (3) challenges in designing an optimal treatment plan for each patient. This article reviews the etiologic factors of this condition as the main basis for understanding the existing classifications of the gummy smile. It highlights the importance of muscle dynamics in the genesis and treatment of this clinical condition. We present a new, treatment-oriented classification that integrates the muscle hyperactivity present within the classification criteria and explore the implication of this interaction in the design of effective treatments. The ultimate goal of this present work is to improve the clinical understanding of the gingival smile and offer more personalized treatment strategies, through a more complete classification.

Background: Anti-cariogenic properties of silver nanoparticles and fluorides have been probed mainly in vitro and with the objetive to evaluate the remineralizing effects of an applied silver nanoparticle compound plus fluoride varnish, a randomized split-mouth clinical trial was conducted in children aged 6 to 7 years. Methods: The project was approved by the ethics committee of the faculty. Primary molars were randomly distributed into two groups, as follows: Group A was treated with a compound based on silver nanoparticles plus fluoride varnish (SNP-FV), and Group B was treated with a silver diamine fluoride compound (SDF-KI), which is the current standard treatment. Laser fluorescence with a DIAGNOdent pen was used for the evaluation, with follow-up examinations at 15 days, 6 months, and 12 months. ANOVA test was used to compare the groups. The results showed a decrease in demineralization was observed after treatment with SNP-FV; similar results were observed after treatment with SDF-KI. Within each group, there were favorable changes. In the SDF-KI group, the differences in demineralization were 25.63 at 15 days, 29.37 at 6 months, and 30.6 at one year (p < 0.05). Meanwhile, in the SNP-FV group, the decreases were 22.7 at 15 days, 28.78 at 6 months, and 31.11 at one year (p < 0.05). Conclusions: The SNP-FV combined treatment represents an alternative remineralizing treatment for the management of carious lesions in the dentin of primary molars.

Objectives: The objective of the present study was to evaluate the cyclic fatigue strength of clockwise cutting rotary endodontic instruments when subjected to two different kinematics: continuous clockwise rotation and clockwise reciprocation movement under optimum torque reverse (OTR) motion. Methods: New ProTaper Next X1 (n = 20) and X2 (n = 20) instruments were randomly divided into two subgroups (n = 10) based on kinematics (continuous rotation or OTR). The specimens were tested using a custom-made device with a non-tapered stainless-steel artificial canal measuring 19 mm in length, featuring a 6 mm radius and an 86-degree curvature. All instruments were tested with a lubricant at room temperature until a fracture occurred. The time to fracture and the length of the separated fragment were recorded. Subsequently, the fractured instruments were inspected under a scanning electron microscope for signs of cyclic fatigue failure, plastic deformation, and/or crack propagation. The subgroup comparisons for time to fracture and instrument length were performed using the independent samples t-test, with the level of statistical significance set at 0.05. Results: When using OTR movement, the ProTaper Next X1 increased the time to fracture from 52.9 to 125.8 s (p < 0.001), while the ProTaper Next X2 increased from 45.4 to 66.0 s (p < 0.001). No subgroup exhibited plastic deformations, but both showed dimpling marks indicative of cyclic fatigue as the primary mode of failure. Additionally, OTR movement resulted in more metal alloy microcracks. Conclusions: The use of OTR motion extended the lifespan of the tested instruments and resulted in a higher number of metal microcracks. This suggests that OTR motion helped to distribute the mechanical stress more evenly across the instrument, thereby relieving localized tension. As a result, it delayed the formation of a single catastrophic crack, enhancing the overall performance of the instruments during the experimental procedures.

This article provides the foundation for employing nonparametric testing in dental clinical research. To make wise judgments in their research, investigators should learn more about the main nonparametric tests and their particular uses. Biostatistical analysis is essential in dental research; dental research frequently deviates from the assumptions that underpin traditional parametric statistics. Nonparametric statistics are useful for studies with small sample sizes, nominal- or ordinal-level data, and non-normally distributed variables. These statistical tests make no assumptions about the sampled population. Nonparametric tests are statistical methods based on signs and ranks. For dental research to be conducted effectively and accurately, statistical approaches must be applied correctly. Therefore, dental researchers must understand the many statistical methods at their disposal and know when to use them.