European Journal of Dentistry最新文献

Objective:  The aim of this study was to evaluate the accuracy of the Root ZX II (RZX), Raypex 6 (RAY), EPex Pro (EPEX), and CanalPro (CNP) electronic foramen locators (EFLs) in different foraminal morphologies (fully formed foramen, immature foramen with parallel walls, and immature foramen with divergent walls); this article also evaluated the influence of different penetration levels (0.0 mm and -1.0 mm).

Materials and methods:  Thirty single-rooted human premolars were accessed and had their cervical/middle thirds prepared with SX ProTaper files. The apical foramens (AF) were standardized to 250 µm and the initial root canal length (RCL1) was measured under 16x magnification with aid of a digital caliper. Using the alginate model, electronic measurements (EM) were taken 1.0 mm up to AF (EM1/-1) and at AF (EM1/0), always using adjusted hand K-files. The root apexes were then cross-sectioned 3.0 mm from the foramen; then, new RCL (RCL2) and electronic measurements were performed (EM2/-1 and EM2/0.0). Finally, retropreparations were performed with instruments SX ProTaper files introduced 4.0 mm in the apicocervical direction. Then new RCL (RCL3) and electronic measurements (EM3/-1 and EM3/0) were performed.

Statistical analysis:  Values were tabulated and tested for normality using the Shapiro-Wilk test, which yielded nonparametric distributions of the data. Data were subjected to the Kruskal-Wallis and Dunn tests to estimate possible differences between devices as a function of foramen morphology and/or apical limit. The significance level was set at 5.0%.

Results:  In general, the EFLs were accurate in determining the RCL. Statistically significant differences were observed between EPEX and RAY at 0.0, when measuring the divergent AF canals (p < 0.05). Regarding the different foramen morphologies in each EFL, RZX and EPEX showed no interference (p > 0.05), whereas RAY and CNP had lower accuracy levels at 0.0 with divergent AF (p < 0.05).

Conclusion:  The four devices evaluated are accurate to determine the RCL in the conditions tested. The apical limit of penetration did not have significant influence on their accuracy. Conversely, the presence of divergence in the AF walls negatively influenced de RAY and CNP precisions at the foraminal level.

Objectives:  This in vitro study aimed to investigate the impact of bicarbonate air-abrasive powders and ultrasonic scaling with stainless steel tips on the micro- and nanotopography and roughness of three different implant-abutment junction titanium surfaces.

Materials and methods:  Three types of sterile and decontaminated titanium surfaces (RS, UTM, XA) were used for analysis. Nine disks per surface type were subjected to micro- and nanotopography analysis, scanning electron microscopy (SEM), roughness analysis, and fibroblast cultivation. Ultrasonic debridement and air polishing were performed on the surfaces. Human dermal fibroblasts were cultured on the surfaces for 5 days.

Statistical analysis:  Data analysis adhered to ISO 25178 standards for surface texture assessment. SEM micrographs were used to reconstruct areas for extracting roughness parameters. Excel and Mex 6.0 software were utilized for quantitative and stereoscopic analysis.

Results:  The study found varying effects on surface roughness posttreatment. RS Disco samples exhibited higher surface roughness compared with UTM and XA samples, both in average and nanoscale roughness. Decontamination led to increased surface roughness for all samples, particularly RS Disco. Fibroblast growth tests revealed enhanced cell network formation on decontaminated discs, possibly due to increased nanoscale roughness or the presence of bicarbonate salts.

Conclusion:  The study underscores the complex interplay between surface topography, microbial biofilm, and treatment efficacy in peri-implant disease management. While smoother surfaces may resist biofilm accumulation, increased nanoscale roughness postdecontamination can enhance fibroblast attachment and soft tissue integration. This dichotomy highlights the need for tailored treatment protocols that consider material-specific factors, emphasizing that successful implant therapy should balance microbial control with conducive surface characteristics for long-term osseointegration and soft tissue stability.

Photobiomodulation therapy (PBMT) is a non-invasive and the latest form of therapy used in the treatment of non oncological diseases as well as cancers of various types and locations. The aim of this study was to systematically review and assess the efficacy of PBMT in managing oral lichen planus (OLP) compared to the interventions. A systematic review and meta-analysis were implemented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search using PubMed, Scopus, and Cochrane was conducted to retrieve relevant studies published until June 2023. The outcomes evaluated included the reduction in pain score and clinical severity scores (Prospero No CRD42023428626). A total of eight studies were identified for qualitative synthesis. The pooled analysis incorporating six studies revealed that there are no significant differences for both mean pain score (mean difference [MD] = 0.21, 95% confidence interval [CI] = -0.51, 0.93) as well as clinical score (MD = -0.08, 95% CI = -0.4, 0.25) between PBMT and comparison groups. Subgroup analysis based on corticosteroids as controls showed that there was no significant difference in mean reduction in pain score between PBMT and topical steroids (MD = 0.38, 95% CI = -0.54, 1.31). PBMT is as effective as other interventions in the treatment of OLP, though not superior, and can be a promising alternative treatment for cases resistant to steroids or when steroids are contraindicated. Further studies are recommended to standardize the optimal settings for the treatment of OLP.

Objectives:  This study aimed to determine the potency of hyperbaric oxygen therapy (HBOT) to the blood glucose level, amount of lymphocytes, and the expression of antibody anti-Candida in oral candidiasis diabetes mellitus.

Materials and methods:  Thirty Wistar rats were divided into five groups: K1 normal-control group, while K2, P1, P2, and P3 were diabetes induced by streptozotocin 50 mg/kg body weight. Oral candidiasis was induced by inoculation 0.1 mL Candida albicans ATCC 10321 on dorsum of the tongue. P1 was given nystatin oral suspension, P2 was treated by HBOT 2.4 ATA, 3 × 30 minutes each with a 5-minute interval, and P3 was treated by the combination of nystatin and HBOT. All the treatments were performed for 5 consecutive days. Fasting blood glucose level was examined on glucometer strips, lymphocyte was examined from complete blood count, and the expression of antibody anti-Candida was examined on immunohistochemistry staining STATISTICAL ANALYSIS:  Data analyzed by a one-way analysis of variance and least significant difference test with the result of p-value less than 0.05 was considered to be statistically significant.

Results:  HBOT reduced blood glucose level (p > 0.05) increased the amount of lymphocyte (p < 0.05). All treatments reduced the expression of antibody anti-Candida (p < 0.05) with the best result on combination of HBOT with nystatin.

Conclusion:  HBOT decreased the blood glucose level, increased the amount of lymphocytes, and reduced the expression of antibody anti-Candida in oral candidiasis diabetes mellitus.

Objective:  Peri-implantitis is a common complication in implant therapy and it is one of the main contributing factors to implant failure. This can be prevented by regular maintenance with mechanical debridement. One of the recent mechanical debridement methods is air abrasion therapy using different abrasive powders. This study aimed to evaluate the two common abrasive powders of different sizes (sodium bicarbonate and erythritol) for their biofilm cleaning efficacy on dental implant surfaces.

Materials and methods:  In an in vitro setting, a total of 33 implants were divided into three groups: Group 1 (n =11) = no treatment; group 2 (n = 11) = air abrasion therapy treated group using a sodium bicarbonate powder (AIRFLOW Powder Classic Comfort, EMS Electro Medical Systems, Nyon, Switzerland); and group 3 (n = 11) = air abrasion therapy treated group using an erythritol powder (AIRFLOW Powder Plus, EMS Electro Medical Systems, Nyon, Switzerland). The implants in each group were subjected to biofilm formation, and group 2 and group 3 were treated with air abrasion therapy of two different powders having different sizes with the same settings. The particle sizes were sodium bicarbonate (40 µm) and erythritol (14µm). The surface characteristics of the dental implants in three groups were studied from a digital camera and under the scanning electron microscope at different magnifications. The comparison of biofilm-removal efficacy between the three groups was performed by using a one-way analysis of variance with post-hoc Dunnett's T3 test. A p-value less than 0.05 was chosen to indicate statistical significance.

Results:  There were no statistical differences (p > 0.05) between the two powder-treated groups for the biofilm cleaning efficacy. However, both groups showed significantly better biofilm-cleaning efficacy than the control group (p < 0.05).

Conclusion:  This suggests that both powders are effective in removing biofilm from the implant surface under ideal conditions. However, there was no clear distinction between the cleaning potential of the two powders, as both performed in a similar manner.

Objectives:  The aim of this research was to analyze expression of vascular endothelial growth factor (VEGF), blood vessels, and fibroblast cell proliferation in direct pulp capping treatment of Rattus norvegicus using a combination of chitosan and hydroxyapatite paste.

Materials and methods:  The samples were male R. norvegicus strains of Wistar rats, weighing 200 to 250 g and aged between 8 and 16 weeks. The occlusal surface of the molars of R. norvegicus was prepared with class I cavity and then perforated with the tip of an explorer. Sixty male R. Norvegicus rats were divided into the following: control group (KA) in which the cavity was filled with glass ionomer cement; control group (KB), in which the cavity was filled with Ca(OH)2; PA group, in which the cavity was filled with chitosan (CH); PB group, in which the cavity was filled with hydroxyapatite (HA); and PC group, in which the cavity was filled with chitosan and hydroxyapatite (CH-HA). Each group was divided into 3-, 7-, and 14-day observation groups. The mandibular bone of the molar was cut and histopathological examination was performed to analyze the blood vessels and fibroblast cell proliferation. Immunohistochemistry examination was done to examine the expression of VEGF.

Statistical analysis: The data variation was analyzed with One Way Analysis of Variance (ANOVA) test and continued with multiple comparison Least Significant (LSD) test to determine the different pairs of group.

Results:  Analysis of variance (ANOVA) showed a significant increase in the expression of VEGF, blood vessels, and fibroblast cell proliferations (p ≤ 0.05;), especially in the PC group compared to the other four groups. The least significant test (LSD) test showed significant differences between the groups on the expression of VEGF, blood vessels, and fibroblast cell proliferations.

Conclusion:  The combination of chitosan and hydroxyapatite could promote healing of direct pulp capping treatment by increasing the expression of VEGF, blood vessel, and fibroblast cell proliferation.

Osteoporosis is a disease characterized by disruption of the bone microarchitecture. It is observed in both sexes, but to a greater extent in women. It affects the whole body, including the jaws. The main indicator of the presence of osteoporosis accepted by the World Health Organization is bone mineral density. The aim of this article is to find data on the influence of osteoporosis on apical periodontitis, to investigate how the intake of osteoporosis drugs affects apical periodontitis, and to establish various data that may be of benefit to the dental practitioner when treating patients with osteoporosis and apical periodontitis. Open-access publications are included. The presence of osteoporosis is important to the dentist. Apical periodontitis in these patients has a faster progression. They are characterized by inflammation and destruction of the tissues located around the tooth root. Osteoporosis has a destructive effect on bone tissue through different mechanisms: nuclear factor-κβ ligand and NLRP3/Caspase-1/IL-1β cascade. It is also associated with low estrogen levels. Various medications such as corticosteroids, bisphosphonates (alendronate, zoledronate (Zoledronic acid), calcitonin, raloxifene, and strontium used to treat osteoporosis can affect the course of apical periodontitis. When treating patients with periapical lesions, the dentist must take a proper medical history and general medical history. In cases of osteoporosis or taking bisphosphonates and other medications, consideration should be given to whether consultation with a specialist is necessary, what treatment approach would be most appropriate, and what the prognosis will be. Chronic diseases affect both the general state of the body and dental health. It has been found that in patients with osteoporosis, inflammation of the apical periodontium develops with faster bone resorption. Before starting dental treatment, it is important to specify the etiology of osteoporosis, the bone density of each patient, as well as the medications they are taking.

Objectives:  Conventional glass ionomer cements (GICs) have been considered the most prevalent restorative material however; the reduced mechanical qualities and decreased wear resistance have been the main challenges facing their wide clinical application. This study was designed to assess the mechanical properties of fluorinated graphene (FG) oxide-modified conventional GIC.

Materials and methods:  Composites of FG/GIC samples were prepared using (Medifil from PROMEDICA, Germany, shade A3) at different concentrations (0wt%) control group and (1wt%, 2wt% and 3wt% FG) groups using cylindrical molds (3mm × 6mm). FG was prepared using hydrothermal technique and characterized using XPERT-PRO Powder Diffractometer system for X-ray diffraction analysis and JEOL JEM-2100 high resolution transmission electron microscope. Vickers' hardness and wear resistance of GI samples were measured. Mechanical abrasion was performed via three-body tooth brushing wear test using ROBOTA chewing simulator coupled with a thermocycling protocol (Model ACH-09075DC-T, AD-Tech Technology Co., Ltd., Leinfelden-Echterdingen, Germany).

Statistical analysis:  Comparisons between groups with respect to normally distributed numeric variables were performed using one-way analysis of variance test followed by posthoc test. While paired t-test was utilized for comparing data within the same group.

Results: The surface roughness values of GICs (1wt% FG) and (2wt% FG) composites were significantly lower than those of the control and 3wt%FG groups. Vickers' hardness numbers were significantly higher in FG/GICs composites than in the control group (p≤0.05).

Conclusion:  GIC/FG combinations have sufficient strength to resist the occlusion stresses with improved hardness as compared with conventional GIC. GIC/FG appeared to be a promising restorative material.

This review meticulously examined the connection between vitamin C and periodontal disease, as well as the potential of vitamin C to prevent this condition. To gather relevant data, comprehensive electronic searches were conducted across various databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, focusing on studies that explored the relationship between vitamin C and periodontal disease in individuals aged between 18 and above. From an initial pool of 421 articles, 14 were ultimately chosen for detailed analysis. This selection encompassed seven cross-sectional studies, two case-control studies, two cohort studies, and three randomized controlled trials. The analysis of these studies revealed a consistent negative association between vitamin C intake, as well as its levels in the blood, and the incidence of periodontal disease across all seven cross-sectional studies. This indicates that higher vitamin C intake and blood levels are linked to a decreased risk of developing periodontal disease. In the two case-control studies, individuals suffering from periodontitis were found to have both a lower intake of vitamin C and reduced levels of vitamin C in their blood compared to those without the disease, further underscoring the potential protective role of vitamin C against periodontal disease. The progression of periodontal disease was observed to be more rapid in patients with lower dietary intake or blood levels of vitamin C compared to controls. Regarding the effects of vitamin C administration as an intervention, there was an improvement noted in gingival bleeding among patients with gingivitis; however, no significant benefits were observed in cases of periodontitis, specifically concerning alveolar bone absorption. Through the meticulous examination of available studies, this systematic review underscores the notion that adequate vitamin C intake and maintaining sufficient levels of vitamin C in the blood can contribute significantly to reducing the risk of periodontal disease.

Objective:  This double-blind randomized clinical trial assessed the effectiveness of 0.2% hyaluronic acid (HA) gel as an adjunct to scaling and root planning (SRP) in patients with periodontitis and type 2 diabetes mellitus (DM), focusing on changes in clinical periodontal parameters, the expression of inflammatory mediators, and oral pathogens.

Materials and methods:  The randomized clinical trial involved 36 participants, 18 DM patients, and 18 healthy patients. The participants in each group were randomly assigned to receive placebo or HA gel after SRP. Gingival crevicular fluid and subgingival plaque samples were taken before treatment and at 4-week follow-up. Clinical parameters, interleukin-1β (IL-1β) and IL-10 levels, and proportions of Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) were evaluated at baseline and follow-up.

Statistical analysis:  Paired t-test (parametric data) or Wilcoxon signed-rank test (nonparametric data) was used for intragroup comparison between baseline and follow-up, and comparisons between groups one-way analysis of variance test (parametric data) or Kruskal-Wallis test (nonparametric data).

Results:  At 4 weeks, most of the groups showed statistically significant decreases (p ≤ 0.05) in various clinical and biomolecular parameters. However, there were exceptions: the pocket probing depth (PPD) and clinical attachment loss (CAL) parameter did not significantly decrease for the placebo (p > 0.05) non-DM group, and the IL-10 parameter in the DM HA gel group (p = 0.108). Regarding bacterial proportions, the non-DM and DM placebo group exhibited significant test results for Pg after 4 weeks (p ≤ 0.05). In the case of Fn bacteria proportions, they decreased in all groups, but these results were not statistically significant (p ≥ 0.05). An intergroup analysis revealed no significant differences (p ≤ 0.05) for bleeding on probing (BOP), PPD, and both proinflammatory and anti-inflammatory cytokines. Only clinical attachment loss (CAL) exhibited a statistically significant intergroup difference 0.042.

Conclusion:  The use of 0.2% HA gel into periodontal pockets alongside SRP, for both diabetic and healthy individuals, showed no statistically significant variances in clinical, biomolecular, and microbiological measures.