European Journal of Dentistry最新文献

To validate the use of panoramic radiographs and morphometric parameters in forensic odontology for accurate and efficient gender determination in the specific socio-cultural context of the Pakistani population.A retrospective study was conducted using orthopantomograms from 130 individuals aged between 16 and 30 years, sourced from a radiology department. The study included comprehensive measurements of mandibular indices such as condylar height, coronoid height, and antegonial depth. Measurements were made using Image J software. The indices were analyzed through univariate, multivariate, and best models to assess their effectiveness in gender prediction. Statistical analysis included independent samples t-test, binary logistic regression, and receiver operator characteristic (ROC) analysis to evaluate threshold values, sensitivity, specificity, and area under the curve (AUC) for each index.Independent samples t-test was used to compare the means of indices with gender. Binary logistic regression was used to estimate the likelihood of male gender, and ROC analysis was used to calculate threshold values, sensitivity, specificity, and AUC.Univariate analysis revealed that most indices, except for the gonial angle, showed significant differences between genders. The multivariate model stated the condylar height and coronoid height as a significant predictor. The best model confirmed condylar height, coronoid height, antegonial depth, and the inferior border of the mental foramen as reliable indices for male gender determination. The ROC demonstrated that the distance from the mean inferior border to the lower border of the mandible had the highest AUC of 82%, indicating strong predictive power.The study confirmed the effectiveness of specific mandibular measurements in gender determination within the Pakistani population. Condylar height, coronoid height, antegonial depth, and the inferior border of the metal foramen are consistently significant predictors across various models. Further research with a larger population sample is recommended.

To compare the effect of submucosal cryotherapy with steroids and nonsteroidal injections on postendodontic pain in maxillary premolars with symptomatic irreversible pulpitis.A total of 52 patients with maxillary premolars diagnosed with symptomatic irreversible pulpitis were randomly allocated into four equal groups (n = 13). Cold saline was injected submucosally in the experimental groups, while the two active comparator groups received dexamethasone sodium phosphate and diclofenac sodium submucosally. The control group did not receive any injections. Preoperative pain level was recorded using a numerical pain scale and subtracted from the postoperative pain level at 6, 24, 48, and 72 hours, to calculate the pain reduction, after single-visit root canal treatment. Data were statistically analyzed at a significance level of p < 0.05.Pain score reduction did not differ significantly between all the groups at all intervals. All groups showed a significant increase in pain reduction with time. The control and cryotherapy groups showed significantly lower incidence of flare-ups than the diclofenac group.Submucosal cryotherapy can be used as a safe and conservative alternative to steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) in the management of postoperative pain in cases with symptomatic irreversible pulpitis.Submucosal cryotherapy reduces postoperative endodontic pain and can be used as a safe and conservative alternative to steroid and NSAID injections for postoperative endodontic pain control in cases with symptomatic irreversible pulpitis.

This article examines the etiology of dental anxiety, a common yet often overlooked condition in dental practice. Ranging from mild discomfort to severe dental phobia, dental anxiety significantly affects a patient's ability to receive necessary care. Despite its prevalence, it remains underexplored in scientific research, leading to inadequate treatment and insufficient attention. Understanding the factors behind dental anxiety is crucial for prevention and for providing effective psychotherapeutic and pharmacological interventions.The review was based on a comprehensive search of several scientific databases, including PubMed, Cochrane Database, and Dentistry & Oral Sciences Source. Predefined keywords, such as "Dental Anxiety," "Dental Phobia," and "Etiology," were used to ensure broad coverage of relevant studies. The factors contributing to dental anxiety are multifactorial and involve both internal and external influences. Internal factors, such as genetic predispositions and central nervous system dysfunctions, interact with external influences, including personal experiences, negative past dental encounters, and environmental stimuli. Demographic factors, such as age, gender, and socioeconomic status, along with personal characteristics like temperament and coping mechanisms, further contribute to the development of anxiety.Previous negative dental experiences and self-reported poor oral health exacerbate anxiety, increasing the likelihood of developing dental phobia, which often results in care avoidance. This avoidance worsens oral health, resulting in conditions such as caries and periodontal disease, and significantly diminishes the quality of life. Addressing dental anxiety is critical for improving patient cooperation and ensuring better long-term oral health outcomes. A more comprehensive understanding of dental anxiety will help identify at-risk patients early, prevent severe forms of dental phobia, and ensure dental care is accessible to all individuals.In conclusion, dental anxiety is a multifactorial issue that impacts access to dental care and overall oral health. The most significant factor contributing to dental anxiety is trauma associated with previous dental procedures. Expanding the understanding of its causes enables dental professionals to identify at-risk patients and develop tailored interventions. By addressing anxiety early and adopting evidence-based strategies, dental professionals can reduce the prevalence of dental anxiety and improve patient care.

Over the past decade, the occurrence of bone defects has seen a notable rise. In both developed and developing nations, their prevalence tends to increase in parallel with population density and levels of physical activity. Various therapeutic approaches have been implemented to address bone fractures, focusing on preventing infections, promoting faster healing, and restoring normal bone function. Among these, bone grafting-a surgical technique involving the use of biomaterials-remains a widely utilized method for bone replacement. This review aims to identify biomaterials that have biocompatibility with bone, osteoinductive, and osteoconductive properties so that they can trigger good osteogenesis. This review is based on a compilation of publications from various databases related to factors affecting the process of bone ossification. This study also evaluates the characteristics of hydroxyapatite biomaterials that play a role in inducing osteogenesis. The phosphate/calcium ratio close to 1.67, porosity in the range of 40 to 60%, pore diameter of 200 to 900 nm, and crystallinity of 40 to 60% will help the osteogenesis to perform well. The results of this study highlight the advantages of hydroxyapatite in terms of its osteoconductive, osteoinductive, and osteointegrative properties, which can trigger osteogenesis.

This study aimed to evaluate the impact of different surface pretreatments and bonding protocols on the shear bond strength (SBS) of two monolithic zirconia materials to composite resin.A total of 200 zirconia specimens, 3Y-TZP (n = 100) and 5YSZ (n = 100), were allocated into five groups: Control with no treatment, air-particle abrasion (APA), Nd:YAG (neodymium-doped yttrium aluminum garnet) laser treatment (L), a combination of APA and L, and laser treatment followed by cold plasma (CAP). Half of the specimens received a primer application before bonding with resin cement. Surface morphology was assessed using scanning electron microscopy, and SBS testing was conducted with a universal testing machine.The SBS analysis was done using multiway analysis of variance (p ≤ 0.05).Different surface pretreatments and 10-methacryloyloxydecyl dihydrogen phosphate primer application significantly increased SBS values (p ≤ 0.001). APA was associated with the highest SBS values, followed by APA + laser and laser + CAP. However, the combination of APA with L slightly reduce the bond strength. While the application of laser alone possesses the lowest SBS among the surface pretreatment methods, the control group was the worst by far. Different zirconia materials showed no impact on SBS values.APA surface pretreatment might still be the gold standard for zirconia adhesion. Laser surface pretreatment is a viable, less destructive option. Combining APA with laser slightly reduces SBS, while combining two inert surface pretreatment methods, such as laser and CAP, leads to enhancement of SBS compared with laser alone. Zirconia primer is highly recommended for bonding protocol. No special considerations should be taken for different yttria contents, as both materials reported comparable bond strength within the same coupled variables.

The objective of this study was to evaluate the bonding performance and the interfacial ultramorphology of an innovative self-curing restorative system compared with a conventional light-curing resin composite applied on dentin in etch-and-rinse (ER) or self-etch (SE) mode.Twenty cavities (class I) were prepared in sound dentin and restored using two materials: (1) CERAM (n = 10; CERAM.X ONE, Dentsply Sirona) in combination with a universal adhesive system (PBU [Prime & Bond Universal]), or (2) STELA (n = 10; Stela Automix, SDI) in combination with its adhesive primer. Half of the specimens from each group were bonded in ER or SE mode. Specimens underwent microtensile bond strength testing after 24 hours of storage in artificial saliva. Failure mode was determined using a stereomicroscope, and fractographic analysis was performed using scanning electron microscopy. The interfacial ultramorphology/nanoleakage of the resin-dentin slabs was analyzed through dye-assisted confocal microscopy.For quantitative analysis, bond strength values (in MPa) were assessed for normality and variance using Kolmogorov-Smirnov and Levene's tests, followed by ANOVA based on restorative material and adhesive bonding protocol, with Fisher's least significant difference post hoc test (α = 5%).SE groups exhibited significantly lower bond strength (17.4 MPa for CERAM; 26.2 MPa for STELA) compared with ER groups (35.8 MPa for CERAM; 33.6 MPa for STELA) (p < 0.05). CERAM applied in SE mode showed significantly lower bond strength compared with STELA applied in SE mode. Furthermore, CERAM applied in SE mode was the only group presenting a pre-test failure rate (27%). The failure mode was predominantly mixed in ER groups and adhesive in SE groups. Nanoleakage was observed clearly in the CERAM groups applied in both ER and SE modes but was less evident in the STELA groups.The new self-curing material (STELA) used in SE or ER may represent a promising clinical option to provide adequate interfacial adaptation and strong bonding to dentin when restoring deep class I cavities. The use of conventional adhesives in deep class I cavities may generate resin-dentin interfaces characterized by gaps and leakages.

For cementation of ceramic restorations, a layer of adhesive followed by resin cement is applied to the treated enamel surface. The light activation of adhesive may occur before or simultaneously with the resin cement. The aim of this study was to evaluate the influence of ceramic thickness and previous light activation of adhesive on shear strength of resin cement to enamel.Vestibular bovine enamel was bonded to lithium disilicate ceramic cylinders with resin cement. The samples were divided into two groups, according to the ceramic thickness (1 or 2 mm). The cylinders had one surface treated for cementation and the enamel surface was treated with acid etching and adhesive system. Only half of samples received light activation of the adhesive prior to cementation. The samples were stored for 30 days in water at 37°C, and then subjected to the shear bond strength test.Two-way analysis of variance was applied to evaluate the influence of previous light activation and ceramic thickness on the bond strength to enamel (α = 0.05).The results of this study indicated that there is no significant difference in the shear adhesive strength between ceramics and dental enamel in relation to the factors evaluated.It is concluded that bond strength is not affected by neither the previous adhesive light activation nor ceramic thickness (1 or 2 mm).

This study aims to compare the elemental composition and surface characteristics of root cementum in teeth affected by severe periodontitis with those of healthy teeth.Forty-seven teeth, including 25 teeth affected by stage III, grade C periodontitis and 22 healthy teeth, were extracted from patients aged 17 to 34 years. The cementum surfaces were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) to evaluate surface morphology and elemental composition.SEM images revealed that healthy teeth exhibited a homogenous, smooth cementum surface, while teeth affected by periodontitis showed an irregular, uneven surface with deep crack lines and resorption areas. EDX analysis indicated significant differences in elemental composition; periodontitis-affected teeth had lower calcium and phosphorus but higher magnesium, sodium, and sulfur levels than healthy teeth.Periodontitis significantly alters the surface characteristics and elemental composition of root cementum, which may contribute to disease progression and impaired periodontal health.

Beta-tricalcium phosphate (β-TCP) is a synthetic graft material with excellent biocompatibility, osteoconductivity, and osteoinductivity. β-TCP may induce adipose-derived mesenchymal stem cells (ADMSCs) osteodifferentiation. This study aims to investigate the osteoinductivity of 300 to 600 and 600 to 1,000μm β-TCP in ADMSCs.ADMSCs were obtained from the visceral adipose tissue of young male rabbits. To determine the osteoinductive ability, bone morphogenic protein 2 (BMP-2), Osterix, runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), osteopontin, and osteonectin expression was examined using an immunochemical assay on ADMSCs conditioned with an osteogenic medium and a β-TCP bioceramic with granule sizes of 300 to 600 and 600 to 1,000 µm (100 ng diluted to 100 nmol as the final concentration). A 3,3'-diaminobenzidine staining kit was used for immunocytochemical staining. Anti-BMP-2, anti-Osterix, anti-Runx2, anti-ALP, anti-osteopontin, and anti-osteonectin monoclonal antibodies were employed at a 1:500 dilution. A light microscope with magnifications of 400× and 1,000× was used to manually observe and examine cultures in five different fields of view.BMP 2, Runx2, Osterix, and ALP expression was higher in ADMSCs + β-TCP 300 to 600 µm compared with the control group (p < 0.05). Osteonectin and osteopontin expression was higher in ADMSCs + 300 to 600 µm β-TCP compared with the control group (p < 0.05) and ADMSCs + 600 to 1,000 µm β-TCP (p < 0.05).ADMSC osteodifferentiation was influenced by β-TCP bioceramic granule size. The considerable difference in osteonectin and osteopontin expression supports the idea that 300 to 600 µm β-TCP induce ADMSCs osteodifferentiation than 600 to 1,000 µm β-TCP.

This study aimed to evaluate whether adopting a horizontal viewpoint, facilitated by a novel digital assistive device, could enhance endodontic file placement accuracy and reduce operator-dependent variability during root canal treatment.A total of 40 modified upper jaw dental stone models, each accommodating a plastic tooth replacing the upper right second molar, were divided into two groups (n = 20 each). The mesiobuccal canal of each tooth was prepared to a standardized working length of 21.0 mm and a working width of size 35. A size 40 file with a stopper preadjusted to 19.0 mm was then inserted. In the first (conventional) group, files were placed without assistance; in the second (device-assisted) group, a horizontal-view digital device was designed, developed, and used to align and insert the file. The second operator, blinded to the device's purpose, performed all insertions under simulated clinical conditions. An intraoral scanner subsequently captured the vertical distance from the stopper's bottom surface to a standardized anatomical landmark. Pairwise comparisons between the two groups were computed using alignment software to account for potential measurement artifacts.Normality in both groups was confirmed via the Shapiro-Wilk test. An independent-samples t-test compared mean vertical distances. Additionally, differences in stopper positioning were calculated for all aligned virtual models in CloudCompare.The device-assisted group exhibited a significantly shorter mean stopper-to-landmark distance (0.425 mm, standard deviation [SD] = 0.225) than the conventional group (0.971 mm, SD = 0.432) (t = -5.014, p = 2.534 × 10^-5). Pairwise analysis highlighted closer apical positioning in the device-assisted group, closely matching pilot study findings that a 26.57° vertical viewing angle can distort perceptions by 0.5 mm. The device's mean intraoral mounting time was 224 s (SD = 35.2), considered negligible over the full treatment duration.Adopting a horizontal perspective with a novel digital assistive device significantly improved file placement accuracy and reduced operator-dependent variability during root canal treatment. Optimizing this device's design and assessing its cost-effectiveness may facilitate broader clinical adoption and further enhance endodontic procedural outcomes.