Dentistry Journal最新文献

Background: The coronavirus (COVID-19) pandemic created challenges for healthcare providers, especially dental professionals in practices and universities. This study investigated dental students' concerns about COVID-19 and whether institutional communication influenced pandemic-related stressors.

Methods: An online survey designed to elicit dental students' concerns about COVID-19 was distributed to all dental students enrolled at a private non-profit academic institution in the Western United States from 26 April 2021 to 25 August 2021. Descriptive statistics were used to characterize the respondents, and Chi-square test and z-test analyses were used to compare students' experiences.

Results: A total of 92 dental students answered the survey. The respondents' ages ranged from 22 to 47 years. Slightly more than half (50.5%) were male and 93.3% were non-Hispanic or non-Latino. Over one-fourth of the students (27.5%) reported that they either often or always felt anxious that they might become infected with the COVID-19 virus, with 16.3% of the students expressing concern about contracting COVID-19 while on campus. There were no statistically significant differences in anxiety levels about contracting COVID-19 from clinic patients or while on campus between the group of students who perceived the institution communicated effectively and those who did not. However, students who felt that the dental school clearly communicated COVID-19 protocols were more likely to believe that students took protocols seriously and expressed less concern about contracting COVID-19 by touching dental school items.

Conclusions: About one-quarter of dental students expressed high levels of anxiety about being infected with COVID-19. Clear communication about COVID-19 protocols reduced students' fear of contracting COVID-19 from dental school items and strengthened their belief that other students followed protocols.

Radiography facilities face challenges with the positioning of digital radiography detectors. This study evaluates the image quality, radiation dose, and patient comfort associated with wireless sensors in digital radiography. A systematic exploration was performed across PubMed/MEDLINE, EMBASE, SCOPUS, Web of Science, and SCIELO. Nine papers met the eligibility criteria, including three observational studies with 111 patients, four in vitro experiments with 258 extracted human teeth, and two ex vivo investigations with 16 cadaver mandibles. All studies consistently reported high-quality images produced by wireless sensors. Two studies demonstrated the superiority of wireless sensors, one found comparable accuracy with conventional radiography, and another indicated similar image quality among the sensors. Both wireless and wired sensors significantly reduced radiation doses compared to conventional X-rays. The Visual Analog Scale (VAS) did not reveal a clear superiority of wireless over wired sensors, though both were generally less comfortable than traditional film. The wireless sensors consistently produce high-quality images, comparable to or superior to other digital devices. Both wireless and wired sensors significantly reduce radiation doses compared to conventional X-rays, emphasizing their safety and efficacy. Patient comfort levels vary, with neither sensor type showing clear superiority over the other, and both being less comfortable than traditional film.

Medication-related osteonecrosis of the jaw (MRONJ) is a drug complication that can occur in patients taking antiresorptive or antiangiogenic drugs. Although it is a well-documented disease, there is no widely accepted treatment. However, several therapeutic approaches have been proposed. The surgical approach in many advanced cases appears inevitable; however, the results are not yet defined and predictable. This study aimed to propose a combined surgical approach with a piezoelectric device and laser (Er:YAG for bone ablation and Nd:YAG laser for photobiomodulation) in a young patient with breast cancer and bone metastasis under denosumab treatment, affected by spontaneous stage 3 MRONJ with maxillary sinus involvement. The patient under study reported no post-operative discomfort, with painkiller intake limited to the day after surgery. Total mucosal healing was observed without recurrences for more than 4 years after surgery. According to the results of our preliminary study, a combined surgical approach using a piezoelectric device and laser therapy is effective in managing patients affected by MRONJ, leveraging the clinical and biological advantages of these different techniques.

Objective: The primary goal of this investigation was to ascertain the efficacy of the CALM^® motion artifact reduction algorithm in diminishing motion-induced blurriness in Cone Beam Computed Tomography [CBCT] images. The assessment was conducted through Fractal Dimension [FD] analysis of the trabecular bone.

Methods and materials: A desiccated human mandible was subjected to Planmeca ProMax 3D^® scanning under eight distinct protocols, marked by variations in motion presence [at 5, 10, and 15 degrees] and the deployment of CALM^®. In every scan, five distinct regions of interest [ROIs] were designated for FD analysis, meticulously avoiding tooth roots or cortical bone. The FD was computed employing the box-counting method with Image-J 1.53 software.

Results: Our findings reveal that a 5-degree motion does not significantly disrupt FD analysis, while a 10-degree motion and beyond exhibit statistical differences and volatility among the sites and groups. A decreased FD value, signifying a less intricate or "rough" bone structure, correlated with amplified motion blurriness. The utilization of CALM^® software seemed to counteract this effect in some instances, reconciling FD values to those akin to the control groups. Nonetheless, CALM^®'s efficacy differed across sites and motion degrees. Interestingly, at one site, CALM^® application in the absence of motion resulted in FD values considerably higher than all other groups.

Conclusion: The study indicates that motion, particularly at 10 degrees or more, can considerably impact the FD analysis of trabecular bone in CBCT images. In some situations, the CALM^® motion artifact reduction algorithm can alleviate this impact, though its effectiveness fluctuates depending on the site and degree of motion. This underscores the necessity of factoring in motion and the employment of artifact reduction algorithms during the interpretation of FD analysis outcomes in CBCT imaging. More research is necessary to refine the application of such algorithms and to comprehend their influence on different sites under varying motion degrees.

Aim: The aim of this systematic review and meta-analysis was to assess possible histomorphometric differences in new bone formation and in remaining graft particles when hyaluronic acid (HA) was added and mixed with graft materials in bone regeneration.

Materials and methods: This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) of the National Institute of Health Research (registration number CRD42024530030). Electronic research was performed, and involved studies published up to 29 February 2024 using a specific word combination. The primary outcome was to assess possible histomorphometric differences in new bone formation and in remaining graft particles when HA was added and mixed with graft materials in bone regeneration. The search resulted in 138 potential studies. Meta-analyses were performed using the fixed and random effects model to identify significant changes in new bone formation and in the remaining graft particles.

Results: After screening procedures, only three randomized controlled trials fulfilled the inclusion criteria and were selected for qualitative and quantitative analysis. The effect size of HA in the new bone formation was not statistically significant at 95% CI (Z = 1.734, p-value = 0.083, 95 % CI -,399; 6516). The effect size of HA in the remaining graft particles was not statistically significant at 95% CI (Z = -1.042, p-value = 0.297, CI -,835; 255).

Conclusions: Within the limitations of the present systematic review and meta-analysis, the addition of HA to bone graft did not result in significant changes in bone regeneration procedures in terms of new bone formation and residues, even if the included studies showed encouraging and promising results.

(1) This study aimed to evaluate the influences of differences in denture teeth shade on harmony ratings and esthetic quality. Particular attention was paid to the question of how the overall variance of shade differences in the dental arch influences the perception of shade differences between adjacent teeth. (2) A total of 51 pictures of upper front teeth with standardized different colors of the left central incisor and different color variance of the dental arch were created. Eighty participants without dental knowledge and of different age, sex and educational level rated the pictures on a visual analogue scale from 0 (strongly disagree) to 100 (strongly agree) with regards to esthetic and color equality. (3) Results: The color differences between two teeth were judged in a negative linear correlation to the evaluation of color and esthetic quality. There was a sex- and education-specific difference in color and harmony ratings. In relation to the age of the participants, there was a significant difference in the color rating (p = 0.01) but not in the harmony rating (p = 0.27). Lower rating of color difference and harmony was found for a color difference in the dental arch up to ΔE = 3.1. In contrast, higher color differences resulted in higher ratings. (4) There is an influence of personal parameters on color perception. Color inhomogeneity in a dental arch leads to significant differences in color and harmony rating in a non-linear relation.

Introduction: Chronic oral mucosal diseases (COMDs) can significantly impair the quality of life (QoL) of affected individuals. Monitoring the overall disease's impact and the efficacy of treatments requires the use of the Chronic Oral Mucosal Diseases Questionnaire-15 (COMDQ-15) as a standardized instrument for measuring QoL in these patients.

Objective: This study aimed to assess QoL in patients with COMDs using an Indonesian version of the COMDQ-15.

Methods: Seventy patients diagnosed with recurrent aphthous stomatitis (RAS), oral lichen planus, autoimmune blistering diseases (ABD), and cheilitis were included. Levels of QoL among different groups of disease were compared. Various potential factors influencing QoL were evaluated. Bivariate analysis was performed to identify factors associated with overall and specific aspects of QoL.

Results: The mean total COMDQ-15 score was 20.83 ± 10.07. The highest scores were in the physical discomfort domain (8.76 ± 4.65), while the lowest was in the medication and treatment domain (2.13 ± 1.99). Physical discomfort was significantly associated with gender, major RAS, and cheilitis. Social and emotional aspects were significantly associated with age and ABD, while patient support was linked to employment status, RAS types, and cheilitis.

Conclusions: The Indonesian version of the COMDQ-15 is a valid and reliable tool for assessing QoL in patients with COMDs.

Background: Virtual simulators are increasingly being introduced in dental education. This study investigates whether virtual simulators offer comparable or superior educational efficacy when compared to traditional phantom simulators.

Materials and methods: Participants were randomly allocated into groups: Virtual Preparation (SIM; n = 30) and Traditional Preparation (FRA; n = 30). Students were tasked with preparing tooth 36 for a full-cast crown during free practice for four days. Faculty staff provided feedback to both groups. Examinations were administered and graded by three examiners (preclinical and clinical consultants and a dental surgery consultant). Additionally, a survey was conducted to assess each training concept.

Results: The FRA group achieved significantly better grades in the preparation exam evaluations by all three examiners, compared to the SIM group. Interrater reliability showed only moderate agreement, with the clinical examiner giving better grades than the other two. The questionnaire results indicate that while participants managed with the virtual system, they preferred the analog system for exams and patient preparation.

Conclusion: Virtual simulators do not seem to be as good when it comes to practicing for a preparation exam or clinical preparation, especially for unexperienced students. However, they still appear to be useful as an additional tool for introducing students to the topic of preparation.

The introduction of nickel-titanium rotary instruments revolutionized shaping procedures as they were able to produce a well-tapered preparation while reducing operator fatigue. The major drawback of rotary instruments was the high risk of fracture due to bending and torsional stress. Thus, the creation of a glide path has been advocated and recommended by most rotary instrument manufacturers. The aim of the present review is to summarize existing knowledge on glide path preparation and identify areas where further research is needed. The primary goal is to provide a comprehensive overview of the techniques and instruments used in glide path preparation, highlighting their advantages and limitations. The secondary goal is to explore the effect of glide path creation on the overall success of endodontic treatment, particularly in terms of reducing procedural errors and improving treatment outcomes. An online search on PubMed, ScienceDirect, UCLA, and Scopus databases was conducted, and 116 articles were identified. Eligible articles were divided into nine categories based on what they researched and compared. The categories included centering ability and/or root canal transportation, cyclic fatigue resistance, glide path and shaping time, tortional stress resistance, apical extrusion of debris and/or bacteria, defects in dentine walls, file separation, postoperative pain assessment, and scouting ability and performance. Establishing a glide path reduces root canal transportation, especially with rotary methods. Reciprocating and heat-treated files offer higher fatigue resistance and shorter preparation time. Instruments with shorter pitch lengths have greater torsional strength. Preparation and coronal preflaring reduce apical debris and bacteria. Glide paths do not affect dentine microcracks, file separation, or defects but reduce immediate postoperative pain and improve cutting ability. Randomized trials are needed to assess their impact on treatment outcomes.

Objective: This study examined the potential use of computed tomography panoramic mandibular indices on cone beam CT (CBCT) for assessing bone density in postmenopausal women with low bone mass.

Study design: The study enrolled 104 postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) using a DXA scanner and mental foramen region CBCT alongside the NewTom VGi EVO Cone Beam 3D system. We assessed the relationship between the following DXA parameters: lumbar, femoral neck, and total hip T score, bone mineral density (BMD), and lumbar trabecular bone score (TBS). The following panoramic mandibular indices were also considered: the computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)), and computed tomography mental index (CTMI).

Results: The study revealed moderate correlations between CBCT indices and BMD/TBS scores: CTMI showed the highest correlation with the femoral neck T-score (r = 0.551, p < 0.0001). TBS scores were also moderately correlated with CBCT indices: CTMI showed a moderate positive correlation with TBS (r = 0.431, p < 0.0001); CTI(S) had a similar moderate positive correlation with TBS (r = 0.421, p < 0.0001). AUC values ranged from 0.697 to 0.733 for osteoporosis versus the osteopenia/normal group and from 0.734 to 0.744 for low versus normal bone quality groups, p < 0.0001. The comparison of the values of the studied indices between low versus normal bone quality (quantified with TBS) groups showed high sensitivity but low specificity.

Conclusions: CBCT-measured indices CTI(S), CTI(I), and CTMI are useful in assessing patients with low bone mass to improve, by specific treatment, the prognosis of dental implants.