Dentistry Journal最新文献

Composite resins are the material of choice for direct restorations, and their success depends mainly on their color stability, since discoloration causes color mismatch, and consequent patient dissatisfaction. A single- and a multi-shade resin were compared in order to evaluate their pigmentation after immersion in staining substances and to investigate the effect of the polymerization time on their color stability. Two-hundred-and-forty composite specimens were created, half made of a single-shade (Group ONE, n = 120) and half of a multi-shade composite (Group OXP, n = 120). Each group was further divided into ONE30 (n = 60) and OXP30 (n = 60), polymerized for 30″, and ONE80 (n = 60) and OXP80 (n = 60), polymerized for 80″. Randomly, the specimens were immersed in turmeric solution, soy sauce, energy drink, or artificial saliva. By means of a spectrophotometer, ΔE₀₀ and WI_d were calculated at 24 h (T₀), at 7 (T₁), and 30 (T₂) days. Single-shade composites showed statistically significant differences in color change from the turmeric solution, energy drink, and soy sauce than the multi-shade composites (p < 0.005), showing a higher discoloration potential. The polymerization time did not have significative effects on color stability. Single-shade composites showed more color change than multi-shade systems after immersion in staining substances, and the curing time did not influence color variations.

Background: The choice of the correct color is of paramount importance in esthetic dentistry; however, there is still no consensus on the best technique to determine it. The aim of the present study is to compare the accuracy of a recently introduced colorimeter in shade matching with human vision. In addition, possible variables affecting color-matching by human eye have been analysed.

Methods: 18 disc-shaped composite samples with identical size and shape were produced from a composite flow system (Enamel plus HriHF, Micerium): Nine were considered control samples (UD 0-UD 6), and nine were test samples with identical flow composite shade to the control ones. Parallelly, 70 individuals (dental students and dental field professionals) were individually instructed to sit in a dark room illuminated with D55 light and to perform visual shade matching between control and test discs. An error matrix containing ΔE₉₄ between control and test discs was generated, containing four match-clusters depending on perceptibility and acceptability thresholds. The frequency and severity of errors were examined.

Results: The colorimeter achieved a 100% perfect matching, while individuals only achieved a 78%. A higher occurrence of mismatches was noted for intermediate composite shades without a statistically significant difference. No statistically significant differences were reported for age, sex, and experience. A statistically significant difference was present among the Optishade match and the visual determination.

Conclusions: The instrumental shade-matching evaluation proved to be significantly more reliable than the human visual system. Further research is needed to determine whether the same outcomes are achieved in a clinical setting directly on patients.

Root canal therapy (RCT) is usually performed in Romania by general dentists (GDPs) because they are more readily available and more reasonably priced than endodontists. Concerns have been raised about the quality of RCTs performed by GDPs, possibly due to insufficient equipment or knowledge; therefore, this study aims to investigate current endodontic practices in Romania. Materials and Methods: A cross-sectional study was conducted via a questionnaire distributed to 400 randomly selected Romanian dentists, with 285 fully validated completed responses (71.25% response rate). Respondents were grouped by speciality, and statistical analysis, including cross-tabulation and the χ² (chi-square) test, was used, with a significance level set at p ≤ 0.05 for all tests. Results: Significant differences were found in the use of magnification, rubber dam, sodium hypochlorite concentration, and bioceramics (p < 0.001). No significant differences were observed in preferences for measuring working length (p = 0.166) or rotary instrument motion (p = 0.289). Approximately 6% of the respondents used laser technology with no significant difference across specialities (p = 0.571). Additionally, 77.9% preferred using sodium hypochlorite, with no significant difference between groups (p = 0.006) regarding concentration. Conclusions: Most participants, including GDPs, use modern equipment and techniques during RCT, indicating their awareness and competence in current endodontic practices.

Adolescents and young adults' active lifestyles make dental trauma a significant medical concern.

Aim: This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence.

Results: Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241).

Conclusions: Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups.

Previously, we reported the serious game HistoRM as an innovative learning approach for an oral histology course. This study aimed to examine the impact of HistoRM on summative assessment and the enablers and barriers factors affecting HistoRM as an interactive learning strategy in an oral histology course. A crossover randomized controlled trial was performed. Study participants were first-year dental students at the Universitas Indonesia. The average final grades of students who participated in HistoRM serious game were significantly higher than those of students who did not participate in this trial (p < 0.001). Positive responses of HistoRM were observed in the learning content, games and learning experience domains. The enabler factors most recognized by the students were the game method, which helped students to understand the learning materials; the immediate feedback provided following each gameplay; as well as the fun and interesting gameplay. The barrier factors most recognized by the students were some challenges of the gameplay, which resulted in a longer time needed to study. While the HistoRM serious game can stimulate student motivation and engagement in learning oral histology, overcoming the barriers is essential for the implementation of serious games as a complementary learning approach in the dental curriculum.

This in vitro study assessed the efficacy of three cleaning methods on lithium disilicate ceramic after the application of different try-in pastes through SEM analysis. Ten rectangular specimens of IPS e.max CAD were prepared using a diamond disc, crystallized, etched with 5% hydrofluoric acid, and subjected to three try-in pastes-Calibra ©, Variolink (V), RelyX Veneer^®-and three cleaning techniques-air-water spray (RD), ultrasonic bath in distilled water for five minutes (ULT/W), and ultrasonic bath in distilled alcohol for five minutes (ULT/A). A control specimen was also included. After one-minute paste application and subsequent cleaning method application, SEM evaluation was conducted. The results indicate that RD was as effective as CTRL in removing remnants from R-RD, V-ULT/W and V-ULT/A samples, but ineffective for all Calibra paste-contaminated specimens. In conclusion, the optimal removal of try-in paste residues from lithium disilicate restorations is paste-dependent; however, ultrasonic baths with distilled water or alcohol proved effective for most pastes tested.

The aim of the present study was to assess the occurrence of intra-, peri-, and post-operative bleeding following tooth extractions in patients treated with direct oral anticoagulants (DOACs). Consecutive patients requiring at least one dental extraction were enrolled. The DOAC regimen was either maintained or suspended. Patients were classified in subgroups depending on the number of teeth extracted per procedure (≤3 or >3), the need for flap elevation, and the performance of osteotomy. Bleeding was recorded intra-operatively; peri-operatively at 20, 40, 60, and 80 min after the procedure; and daily in the first seven days following tooth extractions. Forty-nine patients treated with DOACs (17 with rivaroxaban, 16 with apixaban, 8 with edoxaban, and 8 with dabigatran) were enrolled. Of them, 33 refrained from DOAC administration pre-operatively. The performances of >3 teeth extractions, flap elevation, and osteotomy were significantly associated with higher bleeding rates (p < 0.05). In patients treated with rivaroxaban and apixaban, bleeding episodes were more frequent. Although DOAC treatment may increase the rates of intra-operative, peri-operative, and post-operative bleeding, the recorded episodes were mild and manageable. DOAC suspension may reduce peri-operative bleeding, while no effect could be observed for post-operative bleeding.

This study aimed to describe the changes produced on the occlusal plane (OP), the mandibular position and the dentoalveolar compensations of patients with distalization of the maxillary/mandibular arch assisted by mini-screws (MS). A descriptive case-series study was performed using the digital lateral cephalograms (DLC) of nine patients who underwent orthodontic treatment and required the use of MS for a complete distalization of the maxillary/mandibular arch. Records were collected at three different times (T1-T2-T3) and digitally analyzed (variables: Skeletal diagnosis; maxillary occlusal plane; position of the maxilla/mandible; and dentoalveolar changes of the distalization arch tracing the longitudinal axis of incisors/molars regarding the palatal/mandibular plane). Findings show that the OP varied from T1-T2-T3 in all cases, indicating its stepping or flattening. ODI, APDI, SNA, SNB, and ANB changed minimally in all cases, without variations in the mandibular position or in the skeletal diagnosis. Dentoalveolar measurements also showed differences between T1-T2-T3. In summary, conventional orthodontic treatment modified the OP during the first phase of treatment. Moreover, the distalization mechanics with MS changed the OP and produced dentoalveolar changes, mainly in the inclination of incisors and molars. Other measures considered in the study did not change substantially.

This retrospective study evaluated the effectiveness of different types of general anesthesia (GA) and sedation in pediatric dental procedures, focusing on treatment outcomes and follow-up compliance with an emphasis on gender differences. Clinical records of 1582 pediatric patients, aged 0-18 years, were analyzed to examine the distribution, duration and impact of anesthesia types on dental procedure complexity. The study population was divided into three age groups: 0-6, 7-12 and 13-18 years. We assessed follow-up attendance rates by gender and anesthesia type, calculated the decayed, missing and filled (DMF) index and evaluated the need for further treatment and reasons for retreatment. Our findings indicated that general anesthesia with inhalational agents and muscle relaxants was the most frequently used method (1260 instances), followed by nitrous oxide sedation (163 instances) and sevoflurane GA with a laryngeal mask airway (158 instances). Inhalational GA with muscle relaxants had the longest average duration (2.78 h) and the highest DMF index (7.43), reflecting its use in more severe dental conditions. Gender analysis revealed a slight male predominance in using inhalational GA with muscle relaxants (55.87% male vs. 44.13% female). Female patients demonstrated higher follow-up compliance across all periods. Overall, our results highlight the importance of tailored anesthesia and sedation plans, as well as follow-up protocols, in pediatric dentistry. This study provides valuable insights for practitioners in selecting appropriate anesthesia and sedation types and developing strategies to improve follow-up compliance and treatment success.

Implant abutments are essential components of implant prosthetic restorations. The golden standard for abutment material is titanium; however, due to its properties, the esthetic result can be compromised. The most popular esthetic material alternatives are one- and two-piece zirconia. The study aimed to answer the questions of whether zirconia abutments can be used interchangeably with titanium in both anterior and posterior regions and how aging of the abutment affects durability. For this study, an electronic search of MEDLINE (PubMed) and Scopus (Embase) was conducted. The PRISMA guidelines were followed, and a systematic review was registered with PROSPERO. The search revealed 4031 results, of which 17 studies were selected. The strongest material for abutments is titanium, closely followed by two-piece zirconia. One-piece zirconia abutments were the weakest. The cyclic loading above 1,000,000 cycles decreased the fracture resistance of the abutments. Differences in implant diameter, angulation, and restoration affected the fracture strength of all compared materials. The main mode of failure for titanium abutments was screw bending or screw fracture. One-piece zirconia most often presented catastrophic failure with internal hexagon fracture below the implant neck. Two-piece zirconia exhibits a combination of failure modes. Two-piece zirconia abutments may be suitable for use in the posterior region, given their comparable fracture resistance to titanium abutments. Despite the fact that one-piece zirconia is capable of withstanding forces that exceed those exerted during mastication, it is recommended that it be employed primarily in the anterior dentition due to its propensity for unfavorable failure modes.