Dentistry Journal最新文献

Background/Objectives: Down Syndrome (DS) is frequently associated with oral-motor dysmorphologies, like oral hypotonia, tongue protrusion, short palate, and malocclusion, compromising the oral functions of sucking, chewing, swallowing, and speech production. Therapeutic interventions with stimulating palatal plates (SPP) have been proposed to prevent and improve oral-motor dysmorphologies in DS. This study proposes a new digital workflow for the manufacturing and use of a modified SPP. Methods: We report the application of the new workflow to five clinical cases, all infants with DS showing oral-motor disorders, aged between 5 and 11 months. The workflow is described step-by-step, from the mouth scanning protocol and model printing to SPP manufacturing and delivering, and assessment of oral-morphological features and language abilities via video captures and parental questionnaires. Key novel features include an SPP with an acrylic extension with a pacifier terminal and, importantly, the use of an infant-friendly intraoral scanner. Results: The new workflow had good acceptability by infants and parents, offering a safe, easy-to-implement, and feasible solution for SPP design, as it avoided the high risks associated with impression materials. It also supported the use of the SPP to promote tongue stimulation, retraction, and overall oral-muscle function in oral-motor disorders in children with DS, especially in infants. Conclusions: Within the limitations of the current study, it was shown that the proposed digital workflow constitutes a viable and infant-friendly approach to the production and use of a modified SPP, and thus promises to contribute to improving oral morphology and auditory-motor language abilities.

Obstructive sleep apnea (OSA) is a prevalent disorder characterized by repeated upper airway collapse during sleep, significantly impacting quality of life. Orthodontists are increasingly recognized for their role in screening and managing anatomical factors contributing to airway obstruction. One such intervention is rapid maxillary expansion (RME), originally developed to address transverse maxillary deficiencies but now also studied for its influence on nasal and oropharyngeal airway dimensions. This literature review evaluates the effects of maxillary palatal expansion on airway volume and respiratory function. Evidence consistently shows increases in nasal cavity volume and reductions in nasal airway resistance, particularly in patients treated before the peak of skeletal growth. Some studies reported improvements in sleep outcomes and enhanced oxygen saturation following MARPE in adults with OSA. Results regarding changes in oropharyngeal volume were more variable, with several studies showing significant expansion. Factors influencing outcomes include patient age, skeletal maturity, appliance type, and aging modality. Hybrid and bone-borne expanders generally demonstrated greater skeletal effects compared to tooth-borne devices, though statistical significance was not always reached. While MARPE has shown promising results in non-obese adults with OSA, long-term stability of airway improvements and translation into consistent functional respiratory benefits remain uncertain. Overall, maxillary expansion demonstrates measurable skeletal and airway changes, with the greatest respiratory improvements in growing patients and selected adult populations. Incorporating patient-reported outcomes and standardized polysomnographic measures in future trials will be critical to determine whether these structural gains consistently translate into durable improvements in sleep-disordered breathing and quality of life.

Background/Objectives: Formation of tight contacts between oral soft tissue and dental implants is a significant challenge in contemporary implantology. An essential role in this process is played by oral epithelial cells. In the present study, we investigated how titanium and zirconia surfaces with different roughness influence various parameters of oral epithelial cells in vitro. Methods: We used the human oral squamous carcinoma Ca9-22 cell line and cultured them on the following surfaces: machined smooth titanium (TiM) and zirconia (ZrM) surfaces, as well as sandblasted and acid-etched titanium moderately rough (SLA) and zirconia (ZLA) surfaces. Cell proliferation/viability was measured by CCK-8 assay, and cell morphology was analyzed by fluorescent microscopy. The gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, E-cadherin, integrin (ITG)-α6, and ITG-β4 was measured by qPCR, and the content of IL-8 in conditioned media by ELISA. Results: At the initial culture phase, cell proliferation was promoted by rougher surfaces. Differences in cell attachment were observed between machined and moderately rough surfaces. Machined surfaces were associated with slightly higher IL-8 levels (p < 0.05). Furthermore, both ZLA and SLA surfaces promoted the expression of (ITG)-α, ITG-β4, and ICAM-1 in Ca9-22 cells (p < 0.05). Surface material had no impact on the investigated parameters. Conclusions: Under the limitations of this in vitro study, some properties of oral epithelial cells, particularly the immunological and barrier function, are moderately modified by roughness but not by material. Hence, the roughness of the implant surface might play a role in the quality of the peri-implant epithelium.

Background/Objectives: The novel wave electric toothbrush is considered potentially helpful in removing subgingival plaque to prevent the occurrence of periodontal diseases. This study aimed to assess the cleaning efficacy of a novel wave electric toothbrush on subgingival plaque and its safety profile for oral soft tissues. Methods: In vitro cleaning efficacy evaluations were conducted using oral dental models. The wave electric toothbrushes were divided into low-, medium-, and high-swing parameter groups, with manual brushing (Bass technique) as the control. Simulated plaque was applied to the buccal and gingival sulcus sites of the four first molars, and the plaque removal area and sulcus cleaning depth were measured. For safety evaluation, Sprague Dawley (SD) rats were brushed on their molars daily for 30 days, with bleeding incidents recorded. Oral soft tissues were analyzed through H&E staining and immunohistochemical analysis. Statistical analysis included ANOVA and Kruskal-Wallis (p < 0.05). Results: Medium- and high-swing groups demonstrated superior gingival sulcus cleaning efficacy, showing significant differences compared with the low-swing and control groups (p < 0.05). All swing parameters achieved complete plaque removal on buccal surfaces. No significant differences were observed between the low-swing and manual groups, or between the medium- and high-swing groups, regarding sulcus cleaning efficacy and maximum sulcus depth. During the 30-day in vivo experiment, medium- and high-swing groups showed low bleeding frequencies, primarily at the palatal gingiva and vestibule. Histological analyses indicated that higher swing parameters increased the likelihood of soft tissue injury. Conclusions: Wave electric toothbrushes enhance subgingival plaque removal, with higher swing parameters improving gingival sulcus cleaning. However, stronger parameters may increase the risk of soft tissue damage. Further clinical studies are required to establish optimal guidelines.

Objectives: This study compared the cyclic fatigue resistance and the mechanical, thermal, and metallurgical characteristics of SlimShaper^® and SlimShaper PRO^® instruments. Both sequences include three instruments (ZS1-ZS3) with identical geometries, although SlimShaper PRO features an apically modified thermal treatment. Methods: Cyclic fatigue tests were performed using a standardized metallic guide with a 45° curvature, on six instruments of each sequence type. Fractured segments were measured, and fracture surfaces were analyzed using optical microscopy and Scanning Electron Microscopy (SEM). Elemental composition was assessed by Energy-dispersive Spectroscopy (EDS), while Differential Scanning Calorimetry (DSC) was used to determine transformation temperatures and enthalpy. Results: ZS1 and ZS1 PRO exhibited comparable cyclic fatigue resistance, whereas ZS2 and ZS3 showed significantly higher resistance than their PRO counterparts. SlimShaper PRO^® instruments fractured with segments approximately 0.5-1 mm longer. EDS confirmed that both instruments were made of NiTi, with minor differences in surface composition, while DSC demonstrated similar enthalpy values but distinct transformation ranges. At room temperature (27 °C), SlimShaper^® ZS2 remained predominantly martensitic, whereas ZS2 PRO could be partially austenitic, explaining its observed reduced fatigue resistance. The results of the DSC allowed to deduce the microstructure and thus the fatigue behavior at the temperature of the oral cavity. Conclusions: SlimShaper ZS2 and ZS3 showed significantly greater cyclic fatigue resistance than their PRO counterparts, while DSC analysis revealed distinct differences in phase transformation behavior that explain their mechanical performance.

Background: Dens invaginatus is a rare developmental tooth anomaly that can occur in permanent, primary, and supernumerary teeth, with a tendency to affect the maxillary second incisors. It develops during odontogenesis due to the invagination of the enamel organ into the dental papilla. Methods: This study describes the endodontic management of a 24-year-old patient with a type IIIb invaginated tooth in the mandibular second molar. Clinical examination revealed no response to thermal and electrical stimuli, no response to vertical and horizontal percussion, and no pathological mobility. The depth of the gingival pocket was 8 mm. Root canal therapy was performed over three sessions. The patient remained asymptomatic during the treatment and follow-up visits. Results: Radiographs at 4-, 6-, and 9-month post-treatment showed healing of the periapical lesion. Conclusions: Due to the complex canal anatomy of invaginated teeth, confirming the diagnosis with cone-beam computed tomography (CBCT) is essential. Treating invaginated teeth presents significant challenges for clinicians, requiring a thorough understanding of the dental anatomical variability, advanced manual skills, and the use of specialized equipment.

Background/Objectives: Accurate drug dosage calculation in pediatric dentistry represents an essential component of everyday clinical practice. However, manual calculation methods, reliance on memory, and inconsistent pharmacological education often lead to uncertainty among practitioners. Methods: To support clinicians in this process, a mobile application-Dent.IN CALC-was developed as a rapid, evidence-based, and user-friendly tool. The app allows the input of age and weight to instantly generate recommended and maximum safe dosages of commonly prescribed antibiotics, analgesics, and local anesthetics. Additionally, it includes a list of corresponding pharmaceutical preparations available on the local market. A preliminary evaluation among sixty dentists revealed significant variability in dosage knowledge and confirmed the need for digital tools that facilitate accurate and efficient prescribing. Results: Most users rated the app as intuitive, time-saving, and highly beneficial for daily practice (mean satisfaction score 4.7 ± 0.4; 95% would recommend the app). Conclusions: The Dent.IN CALC app shows strong user acceptance and demonstrates how digital solutions can streamline workflow and support clinicians in routine pediatric pharmacological decision-making.

Background/Objectives: Mini-Screw-Assisted Rapid Skeletal Expansion (MARPE) appliances have been widely used for maxillary skeletal expansion in non-growing subjects and adolescents with a fused midpalatal suture. The current case report describes the immediate 3D cephalometric changes in the skeletal and soft tissue parameters, along with upper airway volume, shape, and dimensions, in a patient with Skeletal Class I anterior underbite. Methods: The pre- and post-expansion full-face Cone-Beam Computed Tomograms (CBCTs) of a 19-year-old patient who underwent 3D-guided midpalatal piezocorticotomy-assisted MARPE were compared and analyzed using 3D cephalometric software. Both CBCT volumes were re-oriented relative to the Frankfurt horizontal plane (FHP) to accommodate postural changes. Results: The total upper airway volume and minimum upper airway cross-section increased after expansion. The nasal base plane (ANS-PNS) rotated in all three spatial planes, including the sagittal plane (anterior downward and posterior upward rotation, with the center of rotation around the maxillary center of rotation) and the vertical plane (upward rotation on the left side). The maxillary canine and molar cant planes rotated around the center of rotation in the midface, with left upward and right downward rotation. The orientation of the ANS-PNS plane changed due to the leftward rotation of the ANS, with the center of rotation approaching the PNS. Cervical curvature improved from kyphotic to lordotic immediately following expansion. Conclusions: Three-dimensionally guided midpalatal piezocorticotomy-assisted MARPE has been shown to produce midfacial changes in all three spatial planes when evaluated via 3D cephalometric analysis. Comprehensive observational studies are necessary to analyze these changes and their effects for different skeletal classifications.

Background/Objectives: Orthodontic retention is a critical phase of treatment aimed at maintaining teeth in corrected positions and preventing relapse, which may occur in up to 70% of cases. Successful retention depends on both orthodontists' application of effective strategies and patient compliance in retainer use and maintenance. While previous studies have focused on orthodontists' retention protocols, less is known about patients' knowledge and expectations. This study assessed knowledge and expectations of orthodontic retention among individuals seeking orthodontic treatment in Saudi Arabia. Methods: A cross-sectional survey was conducted at the orthodontic clinics of King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia. Patients on the waiting list who had not yet begun treatment were invited to participate; guardians completed surveys for minors. Data were collected using a validated, culturally adapted questionnaire and analyzed with descriptive statistics and multivariable logistic regression. Results: Of 243 patients contacted, 161 responded (66.3%). While 62.1% were aware of retention appliances, only 31.1% believed they were always required. Overall, 57.1% expected retention to last 1-3 years and were divided between bonded and removable retainers. Orthodontists were the most trusted information source, while social media was least trusted. Family history and higher education were associated with greater awareness and support for lifelong retention, though most associations were not significant after multiple-testing correction. Conclusions: Despite awareness of retention appliances, misconceptions persist. Family history, education, and age influenced perceptions, underscoring the need for tailored education and guidance toward reliable orthodontic information sources.

Background: Several minimally invasive techniques have been introduced to augment horizontal ridge volume for prosthetically driven implant placement, utilizing different biomaterials to enhance regenerative outcomes. This article presents two clinical cases illustrating a tunneling approach for horizontal alveolar ridge augmentation using a combination of xenogeneic bone graft, hyaluronic acid, and an acellular dermal matrix. Methods: A single vertical incision was made mesial to the bone defect and a dermal matrix was suitably shaped and positioned into the subperiosteal tunnel. Subsequently, the bone graft was inserted between the dermal matrix and the buccal bone plate. Primary wound closure was achieved. After six months, implants were placed. For each patient, an optical scan was performed at baseline (T₀), at six months post-operative ridge augmentation surgery (T₁) and at two months post-implant insertion (T₂). A digital measurement of the horizontal ridge thickness was performed at each inserted implant site. Clinical parameters and patient postoperative morbidity were recorded. Results: The procedure was well tolerated by the patients. No postoperative clinical complications were observed. The mean tissue thickness achieved at T1 was recorded to be 13.3 mm. The same value was recorded at T2. Conclusions: This technique allowed the placement of prosthetically guided implants, with minimal morbidity and no observed complications. Further studies analyzing the histology of newly formed bone and performing three-dimensional radiological examinations to confirm the effectiveness of the surgical technique are warranted to validate these preliminary findings. Clinical Trial Number (NIH): NCT06424223.