European Journal of Dentistry最新文献

Objective:  This article compares the effect of ultrasonic, sonic activation of intracanal heated 3% sodium hypochlorite and laser-activated 3% sodium hypochlorite (NaOCl) on root canal cleanliness using scanning electron microscope.

Materials and methods:  Eighty-eight permanent mandibular premolars were extracted and decoronated to obtain 14 mm of standardized root length. Working length was calculated and canals were prepared till size 25/0.04. Samples were randomly divided into four groups according to the method of irrigation employed (n = 22)-group A: passive ultrasonic irrigation (PUI) of 3% intracanal heated NaOCl, group B: sonic activation of 3% intracanal heated NaOCl, group C: activation of 3% NaOCl by diode laser, and group D: conventional needle irrigation (CNI). Samples were split into two halves and the presence of debris at these regions was graded under scanning electron microscope. The chi-square test was employed to assess significant differences in cleanliness scores and pairwise comparisons using the Dunn test were performed to identify specific group difference. A p-value of < 0.05 was kept as level of significance for all analysis.

Results:  Group A and group B showed maximum cleanliness in middle third as compared with apical third. Group C (laser) showed better cleanliness in apical third as compared with middle third. While group D (CNI) irrigation showed the lowest cleaning efficiency both in the middle third and apical third.

Conclusion:  It was concluded that PUI with intracanal heating of 3% NaOCl and diode laser activation of 3% NaOCl can be recommended as a potential irrigant activation strategy to effectively clean inaccessible areas of the root canal system.

With resurgence in immediate tooth replacement therapy (ITRT) as a method of preserving both hard and soft tissues for improved aesthetic outcomes, this multicenter, prospective study looked at two novel products and their effect on those outcomes. Thirty-one maxillary single-tooth implants were included, of these 54.8% were central incisors, 25.8% lateral incisors, and 19.4% canines. Three complications were reported; one case nondraining fistula, one case a nonseated provisional restoration, and one case a fractured zirconia abutment. The definitive restorations were delivered between 4 hours and 18 months postimplant placement and all restorations were screw-retained. ITRT is frequently utilized when a tooth to be extracted will be replaced by an implant aiding in preservation of the hard and soft tissue that may be lost due to resorption during healing of the extraction socket. The narrower neck region of the Inverta implant results in thicker crestal bone around the implant, where loading under function occurs. Grafting that area around the implant at placement with EthOss results in more predictable bone stability in the long term.

Objectives:  This study evaluated surface roughness, biaxial flexural strength, and phase transformation of 5Y-PSZ after grinding and polishing with different protocols.

Material and methods:  Two commercial 5Y-PSZ, Lava Esthetic (L) and Cercon xt (C), were used and divided into 3 groups: LC and CC represented unpolished control groups; LE and CE were polished with protocol I (EVE DIASYNT® PLUS HP following with EVE DIACERA RA); and LJ and CJ were polished with protocol II (Superfine diamond bur following with Jota ZIR Gloss polishing kit). Surface roughness was evaluated after polishing step-by-step with a contact-type profilometer. After high-gross polishing, the specimens were subjected to biaxial flexural strength test, crystallographic microstructure analysis using an X-ray diffractometer (XRD), and surface micro-topography using scanning electron microscopy (SEM).

Statistical analysis: Surface roughness differences after each step and biaxial flexural strength between groups were evaluated with one-way ANOVA, followed by Bonferroni post-hoc analysis. Changes in surface roughness across four different time points within groups were assessed using one-way repeated measures ANOVA, followed by Bonferroni post-hoc analysis.

Results:  After high-gross polishing, both polishing protocols showed significantly lower surface roughness than the grinding group (p < 0.05). The LE and CE groups exhibited the highest surface roughness values, which were significant differences from the LJ and CJ groups (p < 0.05). The LE group showed significantly lower biaxial flexural strength compared to the LC group (p < 0.05). However, there was no statistically significant difference in the CE and CJ groups compared to the control group (p > 0.05). Furthermore, all polishing protocols did not change the phase transformation of zirconia.

Conclusion:  Polishing protocol II provided a smoother surface than the protocol I after high-gross polishing, while the biaxial flexural strength of materials remained unaffected.

Objective:  The aim of this study was to compare the Morse taper (MT) + titanium base (Ti-Base) abutment with the external hexagon (EH) + Ti-Base abutment by using the strain gauge method in the mesial, distal, and apical-buccal areas around these types of implants.

Materials and methods:  This study investigated two groups, MT and EH, each comprising five polyurethane samples with a dental implant (3.75 × 11.5 mm) in the area of artificial tooth 15. The strain gauges were glued to the mesial, distal, and apical-buccal polyurethane areas of all samples in relation to the implant. Ti-Base nonangled abutments were installed on the implants in each group. Ten identical zirconia crowns were constructed by scanning and milling and were subsequently cemented onto the Ti-base abutments with calcium hydroxide cement. Then, an axial load of 100 N was applied to the occlusal region of the zirconia crowns, and strain gauge measurements were taken.

Statistical analysis:  Strain gauge data were assessed by a two-way analysis of variance (ANOVA) with "implant connection" and "strain gauge position" factors, followed by the Bonferroni test (p < 0.05).

Results:  The MT group showed significantly lower microstrain values in the mesial and apical strain gauges compared to the EH group.

Conclusion:  The MT group exhibited less microstrain in the mesial and apical areas of the polyurethane samples near the implant. Consequently, the MT connection was considered more biomechanically advantageous.

Diagnosing oral submucous fibrosis (OSMF) is invariably challenging. The disease can be detected after reaching its final stage and requires complex treatment. Changes in its salivary profile can be used as a reference to see this disorder and as a basis for diagnostic prediction. This study is aimed to analyze the salivary profile as a diagnosis marker in patients with OSMF. The study using Preferred Reporting Items for Systematic Reviews and Meta-analyses was conducted using PubMed, Science Direct, and Scopus databases. A thorough literature search between 1991 and 2023 was performed. Twenty-eight full-text articles were reviewed in detail. Twenty-eight articles were included; a total of 929 patients of OSMF and 826 controls were found. The scoping review showed that levels of salivary protein (including lactate hydrogenase, immunoglobulin G, immunoglobulin A, S1007A protein, 8-hydroxydeoxyguanosine, 8-isoprostane, malondialdehyde, matrix metalloproteinase-12, salivary C-reactive protein, fibrinogen producing factor, salivary miRNA-21, and salivary lipids [cholesterol, high-density lipoprotein, triglyceride) were higher in OSMF. Meanwhile, trace elements (vitamin C, vitamin E, iron, zinc, and magnesium) were lower; only copper was higher in OSMF patients. Alteration in salivary components such as protein, lipid, and trace elements detection can be a basis for providing a noninvasive supportive examination and thus be used as a diagnosis marker of OSMF.

Objectives:  Due to the lack of literature concerning the selection of crown materials for the restoration of anterior teeth, this study aimed to investigate the effects of six distinct computer-aided design and computer-aided manufacturing (CAD-CAM) crown materials on stress and strain distribution within implant-supported maxillary central incisor restorations, employing finite element analysis (FEA). Furthermore, a comparative analysis was conducted between models that incorporated adjacent natural teeth and those that did not, intending to guide the selection of the most suitable modeling approach.

Materials and methods:  Crown materials, including Lava Ultimate, Enamic, Emax CAD, Suprinity, Celtra Duo, and Cercon xt ML, were the subjects of the investigation. FEA models incorporating Coulomb friction were developed. These models were subjected to an oblique load, simulating the average maximum bite force experienced by anterior teeth. The potential for failure in titanium implant components and the prosthesis crown was evaluated through von Mises and principal stress, respectively. Furthermore, the failure of crestal bone was assessed through principal strain values.

Statistical analysis:  Stress values for each implant component and strain values of the bone were extracted from the models. To assess the impact of the six groups of crown materials, Kruskal-Wallis analysis of variance and post-hoc comparisons were conducted. Additionally, a statistical comparison between the two groups with Lava Ultimate and Cercon xt ML was performed using the Mann-Whitney U test to determine the difference in the two modeling approaches.

Results:  Higher crown material stiffness led to decreased stress in the abutment, fixture, and retaining screw, along with reduced strain in the surrounding bone. However, the decrease in stress and strain values became less significant with increasing crown stiffness. Additionally, the model with adjacent teeth showed significantly lower stress and strain concentrations compared to the model without adjacent teeth.

Conclusion:  Crowns with a high elastic modulus were the optimal choice for anterior teeth restoration. Constructing FEA models with adjacent teeth was highly recommended to gain a deeper understanding of the mechanical behavior of dental implant restorations.

Objectives:  This study aims to investigate Limosilactobacillus reuteri DSM 17938's antibiofilm effects on Prevotella intermedia and Fusobacterium nucleatum, common causes of alveolar osteitis. It seeks topical alternatives to prevent this condition posttooth extraction. The secondary objective is to assess these effects under different pH conditions (pH 4.5 and pH 7), mimicking oral cavity saliva pH dynamics.

Materials and methods:  Ethical approval was secured for the saliva collection process involving five healthy adult participants who had undergone wisdom tooth extraction. Saliva samples were diligently collected on the 7th day post-surgery. The unstimulated saliva underwent a series of treatments, including the addition of phenylmethylsulfonyl fluoride (PMSF), pH adjustments, centrifugation, and filtration. The pH levels were re-measured, and subsequent adjustments were made to achieve pH values of 4.5 or 7. Limosilactobacillus reuteri DSM 17938, with a concentration of 1×10⁸ colony-forming units (CFU) per 5 drops, was utilized in the study. Biofilm testing involved incubating saliva samples with varying pH (4.5 or 7) alongside bacterial suspensions (Prevotella intermedia, Fusobacterium nucleatum, or a mixed species). The Interlac suspension was introduced, and plates were anaerobically incubated for 24 hours. Biofilm results were obtained using a spectrometer. The test is conducted in triplicate.

Statistical analysis:  To scrutinize the impact of pH on biofilm development, the acquired data underwent a two-way ANOVA test in SPSS as part of the statistical analysis. A significance level of p<0.05 was used to determine statistical significance.

Results:  Limosilactobacillus reuteri DSM 17938 significantly reduced biofilm formation across bacterial strains (p = 0.000). Statistical analysis indicated a significant impact of pH on biofilm development (p = 0.000) compared to no saliva samples, with higher formation observed under acidic conditions (pH 4.5). However, the pH levels of 4.5 and 7 did not result in significantly different bacterial biofilm formation (p = 0.529).

Conclusion:  This research highlights Limosilactobacillus reuteri DSM 17938's potency in inhibiting biofilm formation of Prevotella intermedia and Fusobacterium nucleatum. Salivary pH variations significantly influence biofilm development, emphasizing the need to consider pH when assessing probiotic effectiveness. Despite limitations in saliva sample sterilization, this study provides valuable insights into alternative approaches for preventing alveolar osteitis. Further research should explore clinical applications and refine sterilization methods for more accurate results.

Objectives:  Combining a three-dimensional scaffold with growth factors before implantation is one method used to increase scaffold bioactivity in bone tissue engineering. The mesenchymal stem cell (MSC)-conditioned medium (CM), called secretome, contains many proteins and growth factors required for tissue repair and growth. This study evaluated the bioactivity of a bovine bone scaffold combined with the secretome of human umbilical cord MSCs (hUC-MSCs) by analyzing MC3T3-E1 cell adhesion and viability on the scaffold.

Materials and methods:  This in vitro laboratory study evaluated the effect of hUC-MSC secretome applied to bovine bone scaffolds processed using various techniques on MC3T3-E1 cell adhesion and viability. The three experimental groups included deproteinized bovine bone mineral-secretome (DBBM-CM), freeze-dried bovine bone-secretome (FDBB-CM), and decellularized FDBB-CM, whereas the control group was treated with DBBM alone. The cell adhesion test was performed using the centrifugation method after 6 and 24 hours, whereas the cell viability test was conducted using the trypan blue exclusion method after 24, 48, and 72 hours. Cell attachment was visualized after 4',6-diamidino-2-phenylindole staining and viewed under inverted fluorescence microscopy.

Stastical analysis:  Statistical analyses were performed using one-way analysis of variance, followed by a post hoc test in cases of significant differences.

Results:  Statistical analyses showed significantly greater adhesion of the preosteoblasts to the FDBB-CM scaffold at 6 hours (p = 0.002). The results of the adhesion test at 24 hours and the viability tests at all observation times showed no significant differences (p > 0.05). This study found that the average MC3T3-E1 cell adhesions and viabilities were highest for the FDBB-CM and DBBM-CM scaffolds. DBBM scaffolds with the secretome had better cell adhesion and viability than those without the secretome.

Conclusion:  The addition of MSC secretome increased bovine bone scaffold bioactivity especially in DBBM and FDBB scaffolds.

Oral squamous cell carcinoma (OSCC) is a type of cancer that has a low survival rate and high recurrence and metastasis rates. To date, there is still no effective treatment for OSCC. Various types of cancer, including OSCC, have reported quercetin to act as an anticancer agent, but there is no clear research data on how it may affect OSCC. To determine the anticancer potential of quercetin in OSCC, we conducted a scoping review, and to determine the interaction of quercetin with one of the proteins that plays a role in carcinogenesis, namely, BCL-2, we conducted molecular docking. The scoping review process was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The scoping review was searched by collecting articles related to the research topic in Google Scholar, PubMed, ScienceDirect, Cochrane, and EBSCOhost databases. All of the literature records found during the search were imported into the Mendeley software to remove duplication. Nine studies were generated after the titles and abstracts were reviewed according to the inclusion and exclusion criteria. After the full-text screening, no studies were excluded, leaving nine publications determined to be eligible for inclusion in the scoping review. Quercetin showed effects on inhibiting cancer invasion, migration, proliferation, and many protein expressions, as well as increasing cell apoptosis. Molecular docking was done for quercetin and BCl-2 protein. Doxorubicin was utilized as a comparison ligand. The in silico study was utilized using AutoDock Vina, AutoDock Tools 1.5.6, Biovia Discovery Studio 2021, and PyMol. Molecular docking indicated quercetin has a strong binding affinity with BCl-2 protein (ΔG -7.2 kcal/mol). Both scoping review and molecular docking revealed that quercetin is a promising candidate for anticancer agent.

Regenerative endodontics is a rapidly growing field within dentistry that aims to replace damaged tooth structures and cells of the pulp-dentin complex. This case report presents the successful management of an immature permanent second mandibular premolar with an acute apical abscess and extensive apical bone loss caused by a dens evaginatus. This tooth was unexpectedly treated with long-term calcium hydroxide (Ca(OH)₂) that was replenished several times over 6 months. During the treatment process, this tooth became reinflamed developing a chronic apical abscess after resolution of the initial acute apical abscess, which resulted in the replacement and prolonged use of Ca(OH)₂. The final regenerative procedures were completed using a bioceramic fast set putty placed directly over the blood clot and an occlusal composite restoration. At the 6-month follow-up, the patient was asymptomatic with a fully healed radiographic lesion, new periodontal ligament, and the apex closed with thickening of the mesial and distal aspects of the root. At the 15-month follow-up, the patient remained asymptomatic with continued evidence of radiographic development of the apical aspect of this tooth, displaying root end closure and thickening. This is a unique case report of the management of a complex infection process in an immature tooth with regenerative techniques with repeated and long-term use of Ca(OH)₂. This novel report provides dental practitioners with a new potential protocol for the management of these immature cases with advanced periapical infections that require extensive disinfection to have successful outcomes.