European Journal of Dentistry最新文献

Objectives:  Dental anxiety is a common issue affecting a significant portion of the population, often leading to avoidance of dental care and subsequent oral health problems. Understanding the underlying factors contributing to dental anxiety is a crucial step toward developing an effective intervention. The aim of the study was to assess the prevalence of dental anxiety among students of health-related majors, evaluate their personality traits, and find the correlation between them. Additionally, this study aims to find the predictors of such traits and their relationship with each other.

Materials and methods:  The study was conducted on 163 consented students (124 males and 39 females), selected based on major and year of study at the University of Sharjah medical campus. The questionnaire was sent online through Google Forms. It included questions from the Modified Dental Anxiety Scale (MDAS)and the Big Five personality test. Data analysis was done using SPSS software (IBM Co. version 29) where all descriptive and inferential statistics were conducted with statistical significance set at p < 0.05.

Results:  Moderate level of dental anxiety (12.3 ± 5.8) was observed among students of the medical campus, where nondental students scored higher in mean dental anxiety (13.0 ± 6.2) compared with dental students (10.4 ± 4.5). Males scored higher on the dental anxiety scale (12.5 ± 5.8) compared with females (11.7 ± 5.6). The Big Five personality test results displayed statistical significance association between neuroticism and dental anxiety, compared with other measured parameters (p < 0.05).

Conclusion:  Neuroticism (Big Five characteristics scoring) and dental anxiety (MDAS scoring) exhibit a significant correlation. The Big Five test's characteristics are interrelated, including neuroticism and conscientiousness which, in turn, had a substantial correlation with agreeableness. Subsequently, agreeableness, conscientiousness, and extraversion exhibit substantial correlations with openness. This dynamic between the traits indicates that the adoption of personality tests in dental clinics would lead to improved prediction and management of dental anxiety in health-related students.

Clinical relevance:  Since dentistry relies on patient management to get the best results, understanding the relationship between personality factors and dental anxiety might enhance patient management. This would prevent health care neglect and undiagnosed oral problems.

Objective:  This study compared the flexural strength, surface hardness, and surface roughness of conventional, milled, and three-dimensional (3D)-printed provisional restorations.

Materials and methods:  Bar-shaped polymethyl methacrylate (PMMA) specimens (25 × 2 × 2 mm³) and disc-shaped specimens (9 × 2 mm²) were fabricated using three different techniques (n = 10/group): conventional (SR Ivocron C&B, Ivoclar Vivadent, Schaan, Liechtenstein), milling (Aidite Temp PMMA Blocks, Aidite, Qinhuangdao, China), and 3D printing (Asiga DentaTOOTH, Asiga, Sydney, Australia). Flexural strength was evaluated using a universal testing machine until fracture occurred. Vickers hardness and surface roughness tests were performed on the disc-shaped specimens using a micro-Vickers hardness tester and atomic force microscopy, respectively.

Statistical analysis:  Data were statistically analyzed using one-way ANOVA. The post hoc Tukey's honest significant difference was conducted to compare the differences value between groups (p < 0.05).

Results:  The milled computer-aided design/computer-aided manufacturing (CAD/CAM) provisional restorative material exhibited a significantly higher flexural strength (125.16 ± 6.83 MPa) compared with both the traditional (109.74 ± 14.14 MPa) and 3D-printed (71.09 ± 9.09 MPa) materials (p < 0.05). The conventional material had a higher Vickers hardness (19.27 ± 0.41 kgf/mm²) compared with the milled (18.53 ± 0.32 kgf/mm²) and 3D-printed (17.80 ± 1.85 kgf/mm²) materials, though the difference was statistically significant only between the conventional and 3D-printed groups. The surface roughness of the milled CAD/CAM material (8.80 ± 2.70 nm) was significantly lower than that of the 3D-printed material (24.27 ± 9.82 nm) (p < 0.05).

Conclusion:  The provisional restorations fabricated using milled PMMA technology provide adequate flexural strength, surface hardness, and low surface roughness, offering a viable alternative for creating provisional restorations.

Objectives:  The aim of this research is to evaluate/compare the use of traditional versus sleeve fixed partial denture (PD) designs made from different materials on supporting structures. The comparison included three- and four-unit PD cases.

Materials and methods:  Four finite element models are used in the research. The three-unit PD consists of the mandibular second premolar, first molar (as a pontic), and second molar. The four-unit PD includes the first premolar. The PD materials assessed were zirconia, E-max, and Celtra Duo. Bone has been simplified representing it as two cuboids. Each PD has been loaded to two cases over the pontic's central fossa: 300 N compressive, 150 N obliquely applied with 45 degrees forming 24 cases.

Results:  The three-unit traditional and sleeve PDs material change showed a slight change in cortical bone stress under vertical loading. Under oblique loading, cortical bone Von Mises stresses were higher by about 12 to 15% more than vertical loading. On the other hand, the four-unit PDs showed minor effect by changing PD material, while using sleeve design PD can reduce the cortical bone stresses up to 20% in comparison to traditional PD design. The mucosa and spongy bone were negligibly affected by changing PD material, and the traditional and sleeve designs showed close values to each other. Superiority of sleeve design appeared by reducing cement layer stresses dramatically, while PD body material rigidity affects its response.

Conclusion:  Within the limitations of this study, the higher rigid PD material can dissipate loadings over it more preferably regarding its effect on the underlying structures. Sleeve PD design is equivalent to the traditional one for three-unit PDs, while it showed better performance with four-unit PDs. Zirconia three-unit PDs' bodies received the lowest stresses and redistributed and transferred the applied load to the underneath structures better than the other two tested materials. This finding was reversed with four-unit PDs.

Objectives:  This study aimed to investigate salivary parameters, including pH, flow rate, phosphate levels, and phosphorus intake, to explore potential variations between postmenopausal and premenopausal women.

Material and methods:  This study included 68 postmenopausal and 94 premenopausal women. Inclusion criteria comprised women aged 45 to 65 years with a minimum menopausal duration of 2 years and women aged 21 to 40 years for premenopausal participants. Exclusion criteria involved systemic diseases and any dental treatments received in the last 6 months. Direct observation facilitated the visual detection of intraoral inflammation, ulcers, plaque, calculus, dental mobility, and caries. A questionnaire covering demographic data, dental pain, xerostomia, burning sensation, ulcer etiology and duration, and gingival bleeding etiology was administered. Phosphorus intake was assessed using a semiquantitative food frequency questionnaire. Unstimulated whole saliva, collected by spitting, was analyzed for various salivary parameters, such as pH, flow rate, and phosphate level. The atomic absorption spectrophotometer was used to determine subjects' salivary phosphate level.

Statistical analysis:  The difference in intraoral conditions between groups was analyzed using the chi-square or Fisher's exact test. For the comparison of salivary parameters and phosphorus intake between study groups, the ANOVA: univariate general linear model was utilized. The correlation between salivary phosphate levels and age, body mass index (BMI), blood pressure, and phosphorus intake was examined using Spearman's rank correlation.

Results:  The postmenopausal group demonstrated a significantly higher prevalence (p < 0.005) of gingival swelling, gingival discoloration, gingival recession, plaque, calculus, caries, tooth mobility, xerostomia, and burning sensation. Following adjustments for age, BMI, and blood pressure, a statistically significant difference in salivary flow rate between groups was observed (p = 0.008). No significant differences were found in salivary pH (p = 0.764), salivary phosphate level (p = 0.142), or phosphorus intake (p = 0.323) between the two groups. There was no significant correlation between salivary phosphate levels and age (p = 0.747), BMI (p = 0.308), systolic blood pressure (p = 0.747), diastolic blood pressure (p = 0.622), and phosphorus intake (0.829) in both groups.

Conclusion:  Postmenopausal women exhibited a lower salivary flow rate compared with premenopausal women. No differences or correlations were observed in salivary phosphate level and phosphorus intake between the two groups.

Objective:  The aim of this study was to assess the color stability of two microhybrid composite resins after immersion in different coloring solutions for 4 weeks.

Materials and methods:  Sixty disc-shaped samples (2 mm in thickness and 10 mm in diameter) were prepared according to ISO standard 4049. Two composite resins were used: Filtek Z350 XT (3M ESPE) and Harvard Restore (Harvard Dental International GmbH). After initial color measurements, five samples of each resin were immersed in artificial saliva, Turkish coffee, lemonade, black tea, Coca-Cola 0%, and green tea for 4 weeks. The spectrophotometric measurements were carried out after 24 hours of immersion in the various solutions and then weekly, using a VITA Easyshade Advance 4.0 spectrophotometer (CIE L*a*b* system). Statistical analysis was carried out with SPSS 25.0 software.

Results:  The two composite resins tested revealed discoloration after immersion in all the drinks at a variable immersion period showing different color behaviors. The one-way analysis of variance showed a significant difference in the values of brightness (L), in chromaticity from green to red (a), in chromaticity from blue to yellow (b), and in the color (ΔE) of the two materials at different time intervals. The greatest color change in all the groups was caused by coffee followed by lemonade and black tea followed by green tea, Coca-Cola 0%, and artificial saliva.

Clinical significance:  The importance of color stability of dental restorations is crucial for dental professionals and patients. Indeed, the quality of a restoration is considered from both a functional and esthetic points of view. The information obtained from this study should prove useful for clinicians to make informed decisions in selecting the best materials for their patients' esthetic restorations.

Conclusion:  The Harvard Restore showed a better colorimetric behavior compared with the Filtek Z350. Coffee, black tea, and green tea had the most marked effects on the discoloration of composites, especially on Filtek Z350. Coca-Cola 0% showed a similar behavior to artificial saliva.

Objective:  Intraoral radiographs are used in periodontal therapy to understand interdental bony health and defects. However, identifying three-wall bony defects is challenging due to their variations. Therefore, this study aimed to classify three-wall intrabony defects using deep learning-based convolutional neural network (CNN) models to distinguish between three-wall and non-three-wall bony defects via intraoral radiographs.

Materials and methods:  A total of 1,369 radiographs were obtained from 556 patients who had undergone periodontal surgery. These radiographs, each featuring at least one area of intrabony defect, were categorized into 15 datasets based on the presence of three-wall or non-three-wall intrabony defects. We then trained six CNN models-InceptionV3, InceptionResNetV2, ResNet50V2, MobileNetV3Large, EfficientNetV2B1, and VGG19-using these datasets. Model performance was assessed based on the area under curve (AUC), with an AUC value ≥ 0.7 considered acceptable. Various metrics were thoroughly examined, including accuracy, precision, recall, specificity, negative predictive value (NPV), and F1 score.

Results:  In datasets excluding circumferential defects from bitewing radiographs, InceptionResNetV2, ResNet50V2, MobileNetV3Large, and VGG19 achieved AUC values of 0.70, 0.73, 0.77, and 0.75, respectively. Among these models, the VGG19 model exhibited the best performance, with an accuracy of 0.75, precision of 0.78, recall of 0.82, specificity of 0.67, NPV of 0.88, and an F1 score of 0.75.

Conclusion:  The CNN models used in the study showed an AUC value of 0.7 to 0.77 for classifying three-wall intrabony defects. These values demonstrate the potential clinical application of this approach for periodontal examination, diagnosis, and treatment planning for periodontal surgery.

Objectives:  This study aims to examine the effects of silver diamine fluoride and potassium iodide (SDF/KI) treatment on the possible color changes and the microtensile bond strength of composite restorations to carious dentin in different dentitions.

Material and methods:  A total of 48 sound human teeth were utilized in this study. Twenty-four primary molar teeth were divided into two groups. Each group has 12 teeth; group 1 received no pretreatment, while group 2 received SDF/KI treatment. Also, 24 permanent premolar teeth were divided into two groups. Group 3 received no pretreatment, and group 4 received SDF/KI treatment. For 7 days at 25 °C, every sample was submerged in a demineralizing solution. Following the manufacturer's guidelines for SDF/KI treatments, exposed dentin surfaces were promptly preserved in artificial saliva (pH 7.4) for 14 days. On the prepared teeth surfaces of the nontreated groups, deionized water was administered rather than SDF/KI. A self-etching bonding agent was used, and a 4-mm-thick composite restoration was constructed. Evaluations were conducted on color measurement, microtensile bond strength, and mode of failure.

Statistical analysis:  The groups were compared using a one-way analysis of variance test, and a post hoc test was used for pairwise comparisons.

Result:  Regarding color measurement, in deciduous dentition, there were no statistically significant differences between the groups. Additionally, there is no discernible variation in ΔE values among various pretreatment groups in the permanent dentition. Microtensile bond strength did not differ significantly between permanent and deciduous teeth.

Conclusion:  A 14-day delay in the application of composite restoration can successfully conceal the color of SDF/KI without compromising the microtensile bond strength.

When vertical bone loss results in insufficient crestal height to place standard-length implants without the use of osseous grafting, this poses clinical issues to implant usage. Based on an analysis of the literature and clinical experience, it has been found that it is possible to optimally use the available bone volume of the maxillary and mandibular ridges for implant placement without extensive osseous grafting to increase vertical height. This case report will examine several uses of ultrashort implants utilizing the Bicon system in common clinical situations in the maxillary and mandibular arches without the need for osseous reconstruction to improve the available vertical height of the crest to permit implant placement.

Objectives:  Guided tissue regeneration (GTR) is a widely used technique in contemporary dentistry which helps achieve regeneration of periodontal tissues. This study aims to identify leading countries, authors, institutes, journals, scientific publications, and mostly used keyword regarding role of GTR in treatment for periodontal disease using the Scopus database.

Materials and methods:  A well-curated search through Scopus database for significant literature related to GTR published between 1987 and 2023 was performed. Bibliographical data which comprised of abstracts, title, keywords, references, citations, and other relevant information were composed. The data was analyzed using MS Excel and VOSviewer.

Results:  Scientific literature on GTR was manually scrutinized, and 308 paper were analyzed using the Scopus database. The first paper on GTR was published in 1987. Journal of Periodontology was identified as the leading journal, while the United States and Italy were the top contributing countries. University of Sienna was the most productive organization. Roberto Pontoriero was identified as the highly cited author. A highly cited scientific paper was published by Pintippa Bunyaratavej in 2001.

Conclusion:  The present bibliometric study gives useful information related to the total number of scientific articles published from 1987 to 2023. A rising trend of scientific publication was identified which continued followed by a notable decline after 2004. The analysis also recognized the United States and University of Sienna, from Italy as most active country and organizations, while the Journal of Periodontology as the leading journal.

Clinical relevance:  This study may assist in continuing education and evidence-based practice for clinicians and new researchers by providing knowledge and aiding literature searches in the domain of GTR used in treatment for periodontal conditions.

Objectives:  Fabrication processes affect accuracy of restoration. This study compared marginal accuracy of ceramic veneer metal upon different metal substructure fabrication techniques, ceramic veneering methods, stages, and sites of restoration.

Material and methods:  A prepared premolar metal abutment was used to fabricate 96 metal substructures from 4 techniques: cast metal with traditionally impressed tooth (CmTt), cast metal with digitally milled wax (CmDw), sintered metal with digitally impressed tooth (SmDt), and sintered metal with digitally impressed stone model (SmDm). As-cast (A) substructures were degassed (D), opaqued (O), and contoured (C) with porcelain layering (Pl) or press-on (Pp) methods and glazed (G). Marginal fit was measured at A, D, O, C, and G stages, on buccal (Bu), lingual (Li), mesial (Me), and distal (Di) sites using silicone replica.

Statistical analysis:  Analysis of variance and Bonferroni test were analyzed for significant differences of marginal fit upon different factors (α = 0.05).

Results:  Significantly different accuracy was found upon metal substructures fabrication technique, veneering methods, stages, and sites of restoration (p < 0.05). SmDt and SmDm revealed significantly better accuracy than CmTt and CmDw (p < 0.05). Pp generated significantly better accuracy than Pl (p < 0.05). Significant increasing inaccuracy was found at D stage (p < 0.05). Me and Di sites exhibited larger inaccuracy than Bu and Li sites (p < 0.05). However, marginal inaccuracy for all groups was under clinically acceptable marginal fit.

Conclusions:  Increasing marginal inaccuracies upon stages of fabrication were noticed, with highly observed at the proximal site. Sintered metal provided better accuracy than cast metal, while press-on veneering generated better accuracy than the layering method. Porcelain press-on sintered metal was suggested for fabrication restoration.