Dentistry Journal最新文献

Background/Objectives: The design of removable partial dentures (RPDs) influences long-term clinical success and patient satisfaction. Maxillary Kennedy Class I partial edentulism can be treated with clasp-retained (C-RPD), attachment-retained (A-RPD), or implant-retained (I-RPD) removable partial dentures. Evidence on their long-term effects on esthetics, oral health-related quality of life (OHRQoL), and masticatory function is limited. This study compared patient-reported outcomes of these three RPD types over five years. Methods: Eighty-eight patients received C-RPD, semi-precision attachment A-RPD, or mini-implant I-RPD. Outcomes: Esthetic satisfaction (OES), OHRQoL (OHIP-14), and chewing function (CFQ) were assessed pre-treatment, post-treatment, and at 1- and 5-year follow-ups. Treatment effect sizes were analyzed using ANCOVA adjusting for baseline scores, age, gender, and education, while long-term trends were assessed by repeated-measures ANCOVA. Results: Treatment group significantly influenced outcomes. C-RPD users reported lower esthetic satisfaction, OHRQoL, and chewing function than A-RPD or I-RPD users (p < 0.001). Baseline scores predicted post-treatment outcomes (lower pre-treatment = lower post-treatment scores). Over five years, OES worsened in all groups (p = 0.004) with C-RPDs, consistently showing the worst scores. OHIP-14 scores increased most in C-RPD wearers (17.6 → 28.4; p < 0.001) indicting worst OHRQoL, while A-RPD and I-RPD scores remained significantly lower (10.8 → 17.4 and 10.9 → 13.1, respectively). CFQ scores followed similar trend: C-RPD: 20.43; A-RPD: 13.59; I-RPD: 12.40 (p < 0.001). Age, gender, and education had minimal or no significant impact. Conclusions: C-RPDs are associated with lower esthetic satisfaction, poorer OHRQoL and reduced chewing function, with a marked decline over five years. In contrast A-RPDs and I-RPDs showed higher treatment effect sizes and more stable patient-reported outcomes over 5 years. Due to study limitations, results should be interpreted cautiously, as they may reflect treatment self-selection rather than prosthesis design alone.

Background: Chlorhexidine (CHX) is an effective antiseptic rinse for managing gingival inflammation; however, side effects such as staining and altered taste limit its long-term use. StellaLife^® (SL), an herbal-based mouth rinse and a gel, has shown promising in vitro effects, including enhanced biocompatibility and wound healing. This study aimed to compare the clinical efficacy of SL and 0.12% CHX in an experimental gingivitis model. Methods: In this randomized, controlled, cross-over clinical trial, 34 dental students received both treatment regimens in alternating two-week phases following prophylaxis. Group 1 used SL (mouth rinse and the gel) and then crossed over to CHX with placebo gel. Group 2 followed the reverse sequence. Participants refrained from oral hygiene during treatment phases. Clinical parameters and gingival crevicular fluid (GCF) were assessed at baseline and post-treatment. Paired t-tests and Bonferroni corrections were applied (p < 0.05). Bacterial count was determined by an external laboratory using a PCR test. Mean values for bacteria after SL and CHX use measured in genome copies/mL for Aggregatibacter actinomycetemcomitans, P. gingivalis, T. denticola, T. forsythia and F. nucleatum. Results: No statistically significant differences were observed between the SL and CHX groups for PI (p = 0.057), GI (p = 0.960), PD (p = 0.112), BOP (p = 0.895), GR (p = 0.768), CAL (p = 0.112), or GCF (p = 0.951). Both regimens improved periodontal parameters similarly. No significant differences were found between CHX and SL use in respect to periodontal pathogenic bacteria in the oral cavity. Conclusions: SL demonstrated clinical efficacy comparable to CHX in managing experimental gingivitis. Given its favorable safety profile, SL may serve as a promising alternative to CHX, though larger and longer-term studies are warranted.

Background: Chronic inflammation is a hallmark of many oral and systemic diseases and has long been recognised as a risk factor for cancer development. Central to inflammatory responses are inflammasomes-multiprotein complexes that, upon activation, trigger caspase-1-mediated release of the pro-inflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18). Their emerging contribution to chronic oral inflammatory conditions has generated interest in understanding whether persistent inflammasome activity may also influence pathways involved in oral carcinogenesis. This review summarises current evidence on the role of inflammasomes in oral inflammatory diseases and explores their potential involvement in the transition from chronic inflammation to malignant transformation. Methods: A narrative review of the literature was conducted by searching major scientific databases for studies investigating inflammasome activation in oral tissues, inflammatory oral diseases, and mechanisms linking chronic inflammation to oral cancer. Eligible articles included experimental studies, animal models, observational clinical research, and review papers that provided mechanistic or associative insights. Due to heterogeneity in study designs, a qualitative synthesis was performed. Results: Available evidence indicates that inflammasomes, particularly NLRP3 and AIM2, contribute to the pathophysiology of pulpitis, periodontitis, and several systemic conditions that affect oral health. Preclinical and observational findings also suggest potential involvement of inflammasome-related pathways in early tumorigenic processes, although these associations require further clarification. Preliminary biomarker-based studies demonstrate that inflammasome components measurable in saliva, pulpal blood, or gingival crevicular fluid may offer minimally invasive indicators of inflammatory burden and oral health status. Conclusions: Inflammasomes appear to play a meaningful role in oral inflammatory diseases, and growing evidence links their persistent activation to mechanisms relevant to oral carcinogenesis. However, current findings are largely associative and derived primarily from experimental and early clinical research. Additional work is needed to define precisely how inflammasomes contribute to the progression from chronic oral inflammation toward malignant change and to evaluate whether targeting inflammasome pathways offers viable therapeutic or diagnostic potential.

Background/Objectives: The effect of metformin combined with bone grafting materials and its effect on the hydrophilicity of different implant surfaces has not been investigated. Investigation of the use of metformin as a therapeutic for implant surface treatment may be useful in improving overall implant longevity and success. Methods: Herein, a 1.5% metformin solution was created with crystalline metformin and distilled water. Titanium alloy (machined surface), titanium with sandblasted, large-grit acid-etched surface (Ti-SLA), and zirconia (SDS) surfaces were treated with five different solutions: 0.9% sodium chloride (Group A), bovine cancellous bone graft (Bio-Oss^®)/0.9% sodium chloride solution (Group B), Bio-Oss^® bone graft with metformin/0.9% sodium chloride solution (Group C), algae-based bone graft (AlgOss^®)/0.9% sodium chloride solution (Group D), and AlgOss^® bone graft with metformin/0.9% sodium chloride solution (Group E). Hydrophilicity tests utilizing droplet angle measurements (n = 20 droplets/disk) of each of the solutions were carried out (total N = 600 contact angle measurements). Statistical comparison between treatment groups for each implant surface using ANOVA and Bonferroni correction at p < 0.05 was performed. Results: Analyses revealed a statistically significant improvement in hydrophilicity for group C compared to group B (p < 0.05) in Ti-alloy, but a significant decrease in hydrophilicity for group E compared to group D in Ti-SLA. Zirconia surfaces displayed a decrease in hydrophilicity for all groups compared to group A. Conclusions: Thus, there were varying effects of combined metformin and bone graft on implants.

Periodontal disease (PD) is an inflammatory condition caused by multiple periodontal pathogens, particularly those belonging to the Red Complex. Various risk factors influence the development of PD, including age, sex, socioeconomic status, ethnicity, and underlying health issues. Numerous molecular and cellular processes govern the inflammatory response, which affects the gums and tooth-supporting structures and ultimately leads to alveolar bone loss. Accumulating evidence suggests that Human Immunodeficiency Virus-1 (HIV-1) infection significantly impacts the initiation and progression of PD. While HIV-1 is treated with antiretroviral therapy, this treatment can also affect the course of periodontal disease and systemic health status. AI/ML and precision medicine integrates genomic and computational data to enable individualized disease prevention and treatment strategies. When applied responsibly, these technologies can assist clinicians in the timely detection of both PD and HIV-1. This review aims to discuss the factors that exacerbate PD and the available therapeutic options for persons living with (PLWH) and without HIV-1. Additionally, we emphasize the need for developing biomarkers for early diagnosis and intervention to manage PD effectively, ultimately improving the quality of life for those living with HIV.

Background/Objectives: Complete denture rehabilitation in edentulous patients presents functional and biomechanical challenges. Mini-implant-supported overdentures improve retention, stability, function, and comfort, particularly in complex class II or class III mandibulo-maxillary relationships. However, mechanical complications such as ball abutment wear may compromise long-term success. This case report aims to describe the clinical context, methods employed to manage ball abutment wear, and related complications in a patient with a mandibular mini-implant overdenture. Methods: This retrospective case report presents two approaches to managing abutment wear and enhancing overdenture retention: silicone matrices (Retention.Sil, Bredent Medical GmbH & Co.KG, Senden, Germany) and abutment reconstruction using prefabricated cemented spheres (Concave Reconstructive Sphere, Rhein83, Bologna, Italy). Results: A significant mechanical complication associated with mini-implant overdentures is the wear of ball abutments, which may develop over time as a result of continuous interaction between the O-ring system and the abutment surfaces. Both techniques effectively preserved mini-implants while enhancing denture retention, function, and comfort. Conclusions: Mechanical complications, such as ball abutment wear, may compromise the retention and functional performance of mandibular overdentures. Alternatives like silicone matrices and reconstructive spheres address abutment wear in mandibular overdentures, ensuring long-term retention and sustainable, patient-centered care for the elderly.

Background/Objectives: Pathological tooth loss resulting from poor oral hygiene or systemic diseases can lead to partial edentulism, affecting patients both psychologically and physically. These consequences include facial height reduction, temporomandibular dysfunction, and impaired phonetics and mastication. Immediate complete dentures are often an effective provisional solution during the transition to full edentulism; however, establishing the occlusal plane can be challenging when remaining teeth prevent a conventional wax try-in. This clinical case aims to present a qualitative clinical case study of a single patient, illustrating the use of the Broadrick Occlusal Plane Analyzer (BOPA) for the establishment of an occlusal plane in harmony with the anterior and condylar guidance. Methods: A 51-year-old male patient presented to the Department of Prosthodontics at the School of Dentistry, Autonomous University of Guadalajara, with partial edentulism, periodontal disease, and generalized Grade III tooth mobility. Immediate maxillary and mandibular complete dentures were selected as the treatment of choice. Due to the presence of remaining teeth that hindered clinical determination of the occlusal plane, the BOPA was used during the denture design process. Results: Anatomical landmarks were combined with BOPA tracing to establish an occlusal plane harmonious with anterior and condylar guidance. The center of the curve was modified to accommodate anatomic variability in anteroposterior reference points. Conclusions: The use of the Broadrick Occlusal Plane Analyzer facilitated the accurate determination of the occlusal plane for the fabrication of immediate complete dentures in a patient where clinical assessment was limited. This modification allowed the establishment of a bilateral balanced occlusal scheme, contributing to functional and acceptable provisional oral rehabilitation during postoperative alveolar healing.

Background: Platelet-rich fibrin (PRF) is an autologous biomaterial utilized as an adjunct in dental implant surgeries owing to its significant biocompatibility, supra-physiological concentration of growth factors, and ability to speed either soft or hard tissue regeneration. Methods: Today, PRF is available in both solid and liquid forms with an average resorption period of roughly 2 weeks. While various research endeavors have attempted to utilize Solid-PRF as a barrier membrane in guided bone regeneration (GBR) and various other applications, its two-week resorption period has limited its use as a solo "barrier" membrane owing to its faster-than-ideal resorption properties. Results: Recent studies have demonstrated that by heating and denaturing Liquid-PRF/albumin, the resorption properties of the heated albumin gel could be extended from 2 weeks to 4-6 months by utilizing the Bio-Heat technology. This emerging technology was given the working name 'extended-PRF' or e-PRF, with many clinical indications being proposed for further study. Numerous clinicians have now utilized extended-PRF (e-PRF) membranes as a substitute for collagen barrier membranes in various clinical applications, such as guided tissue/bone regeneration, recession coverage, and lateral window sinus lifts. Conclusions: This two-part case series paper aims to first illustrate the evolution of techniques developed taking advantage of this new technology in clinical practice for alveolar ridge preservation. This includes four different methods of fabrication of e-PRF along with its application in clinical practice. This article discusses the clinical outcomes, including the advantages/disadvantages of utilizing each of the four separate techniques to prepare and utilize e-PRF membranes for ridge preservation.

Background/Objectives: The long-term clinical success of dental luting cements largely depends on their mechanical performance. This study systematically compared six commonly used definitive dental cements by assessing key mechanical characteristics such as compressive strength and fatigue resistance. Methods: The tested materials included Adhesor Zinc Phosphate (AphC), Harvard Zinc Phosphate (HphC), polycarboxylate cement (CaC), glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), and resin cement (ReC). Both static and dynamic compressive load tests were performed using an Instron ElectroPuls E3000 dynamic testing instrument. During static testing, 77 samples were subjected to an increasing load up to 1500 N. Dynamic tests on 78 samples involved cyclic loading over seven phases from 50 N to 1600 N, with 1500 cycles per phase at 10 Hz. Results: Static load results indicated that GIC, CaC, and phosphate cements exhibited similar performance and were significantly weaker compared to RMGIC and ReC. In the dynamic fatigue tests, most ReC and RMGIC samples maintained integrity throughout the entire protocol, demonstrating markedly superior mechanical reliability. Finite element analysis (FEA) further confirmed the experimental observations, revealing more homogenous stress distribution and lower peak stresses in ReC and RMGIC compared with the conventional cements. Conclusions: Overall, the resin-based and resin-modified glass ionomer cements showed the highest compressive strength and fatigue resistance, indicating superior long-term mechanical stability compared to the conventional cements. These findings support the clinical use of resin-based cements as reliable luting agents for definitive fixation in high-load prosthodontic applications.