European Journal of Dentistry最新文献

Objectives:  To compare the retention and patient satisfaction of attachment-retained versus clasp-retained removable partial dentures (RPDs) over time and to evaluate the impact of retention force on patient satisfaction.

Materials and methods:  This study included 107 patients with 130 RPDs at the University Dentistry Clinical Center, Prishtina, Kosovo. Patients were divided into two groups: clasp-retained RPDs (n = 79) and attachment-retained RPDs (n = 51). RPD retention forces were measured using a dynamometer, and satisfaction was evaluated using a questionnaire covering retention, stability, chewing ability, aesthetics, oral hygiene maintenance, speech, and pain/discomfort on a Likert scale from 1 (complete dissatisfaction) to 5 (complete satisfaction). Reliability was assessed using Cronbach's α. Descriptive statistics and the independent-samples Kruskal-Wallis test were used for analysis, with pairwise comparisons and Spearman's rho correlation for additional insights.

Results:  Attachment-retained RPDs demonstrated superior retention, with mean scores decreasing from 5.43 to 4.40 over 3 months, compared with clasp-retained RPDs, which decreased from 4.02 to 3.23. Satisfaction scores also favored attachment-retained RPDs, dropping from 4.96 to 3.96, while clasp-retained RPDs decreased from 4.05 to 3.44. Cronbach's α indicated high reliability (α = 0.952). The Kruskal-Wallis test showed significant differences in retention and satisfaction between the two RPD types (p < 0.0001). Pairwise comparisons indicated significant declines over time for both types. Spearman's rho correlation analysis revealed strong positive relationships between retention force and satisfaction scores, with correlation coefficients of 0.574 for clasp-retained and 0.522 for attachment-retained RPDs (p < 0.0001).

Conclusion:  Attachment-retained RPDs offer higher and more stable retention and greater patient satisfaction compared with clasp-retained RPDs over the initial months of use. The significant positive correlation between retention force and patient satisfaction underscores the importance of optimizing retention in RPD design.

Objectives:  This study aims to detect early class I, II, and III malocclusions through the muscle strength of the lips, tongue, masseter, and temporalis.

Materials and methods:  The study subjects were 30 pediatric patients with predetermined criteria. The subjects were divided into class I, II, and III malocclusions where each classification of malocclusion amounted to 10 people. Subjects were differentiated according to gender and age. Tongue pressure during swallowing was recorded by a palatal measurement sensor system. The strength of the activity was assessed when the lip muscles resisted as hard as possible the traction plate placed between the teeth and the lips, then the force was connected to an electromyograph (EMG) to be measured. Temporal and masseter muscle contractions were assessed when the muscles performed swallowing, chewing, mouth opening, resting, mouth closing, and biting movements.

Statistical analysis:  Data analysis using the SPSS application was performed with the ANOVA test if the data distribution was normal, and if the data distribution was not normal, then the Kruskal-Wallis test was used. Significant data were evaluated by post-hoc tests using least significant difference if the data distribution was normal or the Mann-Whitney test if the data distribution was not normal.

Results:  It was found that there was a significant difference in the left masseter muscle and left temporalis muscle.

Conclusion:  EMG can be considered as a tool to detect class I, II, and III malocclusions through muscle contraction. Biting and chewing positions have satisfactory EMG examination results for malocclusion detection. Age and gender of the child may affect the results of EMG examination in certain conditions.

Objectives:  In the context of military health, removable partial acrylic dentures (RPADs) are crucial for the quality of life and performance of Indonesian National Armed Forces (TNI) soldiers. Given the demanding and unpredictable military environment, RPADs provide a solution for soldiers experiencing tooth loss. This research aims to identify behavioral factors influencing the lifespan of RPADs among TNI soldiers.

Materials and methods:  This study employed an observational cross-sectional design with an analytical approach. The study population consisted of all patients fitted with RPADs at Ladokgi RE Martadinata from 2017 to 2019. The inclusion criteria included TNI soldiers using good functionality RPADs from 2017 to 2019. Data were collected through a valid questionnaire (Cronbach's alpha = 0.738) and analyzed using Spearman's rank correlation and multiple linear regression.

Results:  In total, 46 respondents (84.8% males, aged 50-59 years) participated in this study. The average behavioral score was 153.72, with a standard deviation of 1.13. The average lifespan of RPADs was 5.33 years. The correlation analysis showed a moderate positive correlation between behavioral scores and RPAD lifespan (r = 0.463, p = 0.001). Multiple regression analysis indicated a significant association between behavioral scores and RPAD lifespan, with a coefficient B-value of 0.259 (p = 0.012).

Conclusion:  Good RPAD maintenance behavior correlates with a longer RPAD lifespan. Socialization programs and instructions for RPAD care need enhancement to ensure optimal quality of life and performance among TNI soldiers.

Objective:  The present study evaluated the effect of chemical disinfectants and microwave sterilization on the removal of biofilm containing Pseudomonas aeruginosa, Streptococcus mutans, and Candida albicans from type IV dental stone.

Materials and methods:  One hundred twenty-eight (N = 128) type IV dental cast stone specimens were prepared, and biofilms of microorganisms were cultured. Dental stone samples were subjected to disinfection protocols, including 0.5% chlorhexidine (CHX), 0.5% sodium hypochlorite (NaOCl), 20% neem extract, and microwave irradiation for 1 to 5 minutes. Colony forming unit (CFU) counts and scanning electron microscopy were utilized to witness changes in the biofilm, pre- and postdisinfection/sterilization.

Results:  For P. aeruginosa, significant (p < 0.05) decrease in CFU counts after 1 minute (from 233 to -215) and 2, 3, and 5 minutes (from 233 to -233) were observed after CHX treatment. After microwave radiation, a significant decrease in CFU counts was also observed after 1 minute (from 233 to -130.3), 2 minutes (from 233 to -229), and 3 and 5 minutes (from 233 to -233). For S. mutans, a significant (p < 0.05) decrease in CFU counts was observed after 1, 2, 3, and 5 minutes (from 212 to -268) after NaOCl treatment and microwave radiation (from 212 to -271 after 1 minute and from 212 to -274.3 after 2, 3, and 5 minutes). For C. albicans, significant (p < 0.05) decrease in the CFU counts (1-5 minutes) was observed after CHX exposure, while NaOCl and microwave radiation demonstrated equal disinfection potency. Neem extract was effective to disinfect the dental stone; however, it was not as potent as the other disinfectants and microwave radiation.

Conclusion:  It was observed that exposure to CHX, NaOCl, and microwave radiation significantly reduced the microbial CFU counts. Although the use of neem extract also significantly reduced these CFU counts, this reduction was not as much as the other three tested materials. Further research exploring other chemical disinfectants with various concentrations is recommended.

Soft skills encompass interpersonal abilities and values that enable individuals to adapt to diverse circumstances. In dentistry, a combination of soft and hard skills is crucial for successful practice and for achieving health care organization goals. However, dental schools face significant challenges in teaching and evaluating soft skills, including the subjective nature of assessment, variability in student engagement, and the lack of standardized curricula. The development of ethical and critical thinking skills is essential for students to balance competing interests in the profession while maintaining professionalism, such as dedication, accountability, competence, dependability, and respect for others. Health care professionals, including dentists, must cultivate soft skills to effectively guide and treat patients. This study aims to raise awareness of the importance of soft skills in dental education, specifically highlighting challenges in instruction and evaluation. Key conclusions include the need for a more structured approach to teaching soft skills, integrating them into the broader curriculum, and developing more objective assessment tools. By addressing these issues, dental education can better equip future dentists with the necessary skills for efficient patient care.

Aim:  This study aimed to evaluate the diagnostic sensitivity and specificity of the active matrix metalloproteinase-8 (aMMP-8) quantitative chairside point-of-care (PoC) lateral flow immunotest for peri-implant diseases, and it sought to correlate aMMP-8 levels with clinical parameters to determine its effectiveness as a biomarker for peri-implantitis.

Materials and methods:  A cross-sectional study was conducted at the Department of Periodontology and Implant Biology, Aristotle University of Thessaloniki, Greece. Participants included systemically healthy individuals with at least one implant loaded for more than 1 year, who had not received periodontal treatment or antibiotics in the preceding 6 months. Exclusion criteria included diabetes and immune-compromising conditions. Peri-implant sulcular fluid (PISF) samples were collected from the mesiobuccal or distobuccal site of the implant. The quantitative chairside PoC lateral flow immunotest for peri-implant diseases (ImplantSafe test) and ORALyzer digital reader were used to analyze PISF, with results expressed in ng/mL. Clinical parameters such as bleeding on probing (BOP), probing depth (PD), recession (REC), and clinical attachment level (CAL) were measured at six sites per implant using a 15-mm scale periodontal probe.

Results:  No significant differences were found in age, gender distribution, or smoking status between the healthy/mucositis and peri-implantitis groups. The peri-implantitis group showed significantly higher mean percentages of BOP (57.58 ± 31.73 vs. 18.79 ± 24.17), PD (4.59 ± 1.22 mm vs. 2.94 ± 0.78 mm), and CAL (5.21 ± 1.72 mm vs. 3.05 ± 0.81 mm). aMMP-8 levels were also significantly higher in the peri-implantitis group (53.39 ± 49.70 vs. 22.03 ± 32.87). The diagnostic test demonstrated a sensitivity of 81.25% and specificity of 74.07%, with an area under the curve of 79.6%, indicating overall good accuracy in distinguishing between positive and negative conditions.

Conclusion:  The aMMP-8 is a promising biomarker for peri-implantitis, showing elevated levels in affected patients. The aMMP-8 chairside test demonstrates high diagnostic sensitivity and specificity, supporting its use in early detection and monitoring of peri-implant diseases. Further research is needed to establish standardized protocols for its clinical application and to explore its long-term predictive value in implant care.

Objectives:  This randomized, controlled, single-blind, split-mouth clinical study evaluated the effect of the application of a glutaraldehyde-based desensitizer on the prevention of tooth sensitivity (TS) and the changes in the color of the teeth after bleaching.

Materials and methods:  Twenty-five patients were selected for participation in the study according to the inclusion and exclusion criteria. The patients' right and left hemiarches were randomized into two groups: the placebo group, which received distilled water application and whitening treatment, and the Gluma group, which received Gluma application, followed by whitening treatment. The patients were examined after three bleaching sessions with 35% hydrogen peroxide. TS was measured using a numerical rating scale for 21 days from the beginning of bleaching. The tooth color was monitored using a spectrophotometer at times T0 (baseline) and T1 (after 21 days). The color analysis results were recorded using the CieLab system; the CIEDE2000 formula was applied to obtain the ΔE⁰⁰ and ΔL values.

Statistical analysis:  For statistical analysis, the Friedman analysis of variance test was used for intragroup evaluation, and the Wilcoxon test was used for a between-group comparison of the TS results. Student's t-test paired the ΔE⁰⁰ and ΔL values of the groups. A 5% significance level was adopted.

Results:  Intragroup analysis of the sensitivity results showed a statistically significant difference between the pain levels evaluated through days 1 to 21 (p < 0.001), and the highest median values were observed on the days when the whitening sessions were performed (days 1, 8, and 15) and right after the sessions (days 2, 9, and 16). However, in the intergroup analysis, no statistical difference in sensitivity was found between the placebo and Gluma. No statistical difference was found between the influences of the placebo and Gluma treatments on the color obtained after tooth whitening using parameters ᐃE⁰⁰ and ᐃL (p > 0.05).

Conclusion:  The use of Gluma prior to bleaching does not prevent TS and does not interfere with the color results obtained by tooth bleaching.

Objective:  The purpose of the study was to evaluate the efficacy of calcium hydroxide (Ca(OH)₂) and propolis in pulp capping for dental caries treatment, focusing on dentin growth parameters. The study also aims to determine the role of propolis as a natural adjuvant therapy in enhancing reparative dentin development while emphasizing the importance of proper technique and material preparation with markers for the expression of beta-catenin, bFGF, CD105, and BMP4.

Materials and methods:  The left bottom molar teeth from 28 Wistar rats were divided into four groups. The first group, the control group, was given only aqua dest, and the second group received drilling treatment and additional therapies with Ca(OH)₂ (Ca(OH)₂) 0.625 μg. The third group was given drilling treatment and additional therapies with a combination of propolis with Ca(OH)₂ 0.781 μg until day 7. Finally, the fourth group received a combination of propolis with Ca(OH)₂ 0.781 μg until day 14. This research analyzed the expression of essential basic fibroblast growth factor (bFGF), CD105, beta-catenin, and bone morphogenetic protein 4 (BMP4).

Results:  This research reports that the average expression of BMP4 and bFGF showed a significant result in treatment with additional therapies with propolis and Ca(OH)₂. The experiment indicates that propolis and Ca(OH)₂ could induce reparative dentine on days 7 and 14.

Conclusion:  Propolis as an adjuvant shows better reparative dental formation with improvement in the expression of bFGF and BMP4 in 14 days of therapy.

Periodontitis is a chronic, multifactorial inflammatory condition linked to dysbiotic plaque biofilms and characterized by the gradual destruction of the structures supporting the teeth owing to compromised immune system function. Hemorrhagic stroke, which primarily occurs within the brain tissue or in the subarachnoid space as a blood leak of ruptured vessels, is a sudden neurological impairment caused by vascular damage in the central nervous system, resulting in focal neurological deficits. Chronic periodontitis (CP) and hemorrhagic stroke may share common pathogenic features involving inflammation and immune system activation, prompting researchers to investigate their potential connection. The aim of the study is to systematically review the literature on the epidemiological association between CP and hemorrhagic stroke in adults. The study protocol adhered to the PRISMA 2020 guidelines, and the design followed the Cochrane methodology. A thorough literature search encompassing PubMed, Scopus, and Web of Science databases and a manual search and evaluation of gray literature was conducted. Meta-analysis was performed using Review Manager (RevMan) 5.4, with the effect size represented by the odds ratio (OR) and a 95% confidence interval (CI). Heterogeneity was assessed using the chi-squared and I ² statistics. The selected articles, written in English without time constraints, focused on observational studies involving patients and controls and included disease diagnostic criteria. Duplicate entries were eliminated. The reliability of each study's results was evaluated using the Newcastle-Ottawa Scale and GRADE tools. Two reviewers conducted the assessments, and a third reviewer resolved any disagreements. The meta-analysis comprised four observational studies involving 1,882 individuals. It revealed that individuals diagnosed with hemorrhagic stroke were notably more likely to have concurrent CP (OR: 6.32; 95% CI: 1.35-29.49; p = 0.02) or severe CP (OR: 3.08; 95% CI: 1.56-6.06; p = 0.001) compared with healthy controls. A notable occurrence of CP was detected in patients with hemorrhagic stroke compared with controls. Health care professionals need to acknowledge the connection between the two conditions, as it allows them to provide optimal holistic care through a thorough approach to diagnosis and treatment.

Objectives:  This study aimed to evaluate the expression levels of hypoxia-inducible factor 1-α (HIF-1α) and vascular endothelial growth factor (VEGF) in radicular cysts and periapical granulomas, thereby contributing to the understanding of their potential significance in the differential diagnosis and treatment of these lesions.

Materials and methods:  In the present cross-sectional study, 51 samples of periapical lesions were included. Of them, 24 samples were radicular cysts, and 27 samples were periapical granulomas. Samples were immunohistochemically analyzed for HIF-1α and VEGF proteins expression. Chi-square tests and Spearman's rank correlation coefficient tests were used to detect differences and correlations among the parameters, respectively.

Results:  In radicular cysts, HIF-1α expression was absent in 1 (4.2%), weak in 5 (20.8%), mild in 7 (29.2%), and strong in 11 (45.8%) cases, while VEGF expression was absent in 1 (4.2%), weak in 6 (25.0%), mild in 9 (37.5%), and strong in 8 (33.3%) of the cases; nevertheless, in periapical granulomas, HIF-1α expression was absent in 8 (29.6%), weak in 6 (22.2%), mild in 9 (33.3%), and strong in 4 (14.8%) of the cases, whereas VEGF expression was absent in 4 (14.8%), weak in 16 (59.3%), mild in 4 (14.8%), and strong in 3 (11.1%) of the cases. Chi-square test revealed a significant difference in the expression of HIF-1α and VEGF between radicular cysts and periapical granuloma (chi-square test = 8.906, p = 0.031; chi-square test = 10.401, p = 0.015, respectively). Spearman's correlation test showed a significant correlation between HIF-1α and VEGF in the total samples of both radicular cysts and periapical granulomas (rho = 0.385, p = 0.005).

Conclusion:  There is high expression of both HIF-1α and VEGF throughout the odontogenic epithelium and connective tissue of the radicular cyst and periapical granuloma. Both HIF-1α and VEGF are more highly expressed in radicular cysts than in periapical granulomas. These findings may aid in the diagnosis and management of suspected periapical lesions, suggesting that radicular cysts exhibit more advanced hypoxic conditions and associated pathways compared with periapical granulomas.