Frontiers in Dentistry最新文献

Metaphyseal chondrodysplasia is a rare genetic disorder with an incidence of 3-6 cases per one million births. It is characterized by short long bones, cupping of metaphyses and phalanges, and many other variable components. There are over 100 types of identified metaphyseal dysplasia targeting various genes, and many more that are unidentified. This case report describes oral rehabilitation of a 4-year-old child with an unknown type of metaphyseal dysplasia with dental involvement.

Objectives: This study reviewed the efficacy of midazolam, ketamine, and their combination for sedation of uncooperative pediatric dental patients. Materials and Methods: Medline, PubMed, Cochrane Central Register of Controlled Trials, and the World Health Organization International Clinical Trials Registry Platform were searched up to August 31, 2023 for randomized controlled trials (RCTs) comparing midazolam, ketamine, and midazolam-ketamine in pediatric patients. Methodological assessment was conducted using the revised Cochrane ROB-2 tool. A dose-response meta-analysis was performed to analyze the effect of oral midazolam dosage on treatment duration (in minutes). Results: Initially, 2,345 records were identified through database searching. After removing the duplicates, 1,230 records remained. Of which, 941 were excluded after title and abstract screening. Subsequently, 289 full-text articles were reviewed; of which, 269 were excluded for various reasons. The remaining 20 publications underwent detailed screening for qualitative synthesis. Risk of bias assessment categorized eight studies as low risk, six with some concerns, and six as having high risk of bias. The meta-analysis, involving three RCTs with 215 children, indicated an increasing trend in treatment duration up to 0.8 mg/kg dosage of oral midazolam. The combination of midazolam-ketamine was highly successful in providing rapid and effective pain relief and sedation for challenging pediatric patients, outperforming either drug alone, irrespective of the administration method. Conclusion: The findings of this systematic review suggest that when it comes to ease of treatment and clinical efficacy, using a combination of midazolam and ketamine is superior to midazolam or ketamine alone.

Organoids are among the most significant advancements in the past few years that have revolutionized the medical and dental research. These experimental organs have been used to study the developmental processes, pathophysiology, genetic mutations, and drug effects. The organoid technology is an important adjunct to two-dimensional culture methods and animal models. Stem cells are grown in specific environments to develop the organoids, thus, simulating the complexity of the in vivo environment. Oral organoids also recapitulate the architecture and functions of in vivo organs and tissues in the oral and maxillofacial region. Organoids are a promising tool to manipulate human dental stem cell biology for comprehending tooth-regenerative approaches, infectious diseases, genetic anomalies, oral cancer, and drug discovery.

Objectives: Oral hygiene instruction is an important step to promote oral health. Educational health promoting interventions focus on knowledge enhancement and adoption of optimal oral health behaviors. The visual media can greatly help in this respect. This study aimed to compare the effect of an educational film versus practical face-to-face instruction on Oral Hygiene Index-Simplified (OHI-S). Materials and Methods: This parallel-design single-blind clinical trial was conducted on 120 third-graders (9-year-olds) in Hamadan city in 2020 who were selected by convenience sampling from 4 random schools. They were randomly assigned to two groups of educational film and practical face-to-face instruction. An educational film was sent to all students through Shaad mobile application. The second group received practical face-to-face oral hygiene instructions. Next, all students were requested to use their own toothbrush for one month. The OHI-S was calculated for students at the onset of the study and at one month after the intervention. Data were analyzed by ANOVA using SPSS version 24. Results: In the practical instruction group, the OHI-S was 1.55±0.45 at one month after the intervention, showing a reduction by 0.25±0.11 units. In the educational film group, the OHI-S was 1.48±0.39 at one month after the intervention, showing a reduction by 0.29±0.19 units. The two groups had no significant difference regarding the reduction of OHI-S (P=0.10). Conclusion: Both practical instruction and educational film effectively decreased the OHI-S of students. Considering the ongoing COVID-19 pandemic, educational film can serve as a suitable alternative to practical face-to-face oral hygiene instruction.

Objectives: To overcome the drawbacks of the conventional flap surgery, newer surgical techniques like minimally invasive surgery were evolved to optimize the primary closure of the flap. Using a surgical operating microscope is one such technique, enhancing precession with clinical benefits. The current study aimed to compare the efficacy of a surgical operating microscope versus surgical loupes regarding periodontal treatment outcomes. Materials and Methods: In this split-mouth randomized controlled clinical trial, flap surgery was planned for sites with a pocket probing depth (PPD)≥5mm under a surgical operating microscope and surgical loupes. All clinical periodontal parameters were recorded at baseline, and 3, and 6 months. The patients' perception of postoperative pain and wound healing were also assessed. Results: The study comprised of 20 participants with mild to severe periodontitis. The reduction in the mean PPD was significantly greater at the test site than the control site at 3 months (P=0.05) and 6 months (P=0.005). At 3 months, there was a statistically significant difference in clinical attachment level (CAL) between the test and control sites (P=0.001). Flap surgery performed under a surgical operating microscope significantly enhanced early wound healing and caused less postoperative pain compared to flap surgery performed under surgical loupes (P<0.05). Conclusion: All parameters improved at the test and control sites after the procedure. Nonetheless, the clinical parameters were noticeably better at the test site. Also, the test site had lower postoperative pain and enhanced wound healing compared with the test site.

Objectives: Extraction of impacted mandibular third molars is one of the most common procedures in oral and maxillofacial surgery, which is usually associated with significant postoperative pain. This study aimed to evaluate the effect of preemptive amitriptyline on postoperative pain after impacted mandibular third molar extraction. Materials and Methods: This randomized double-blind placebo-controlled clinical trial included 20 patients (n=40 teeth) who referred to the Department of Oral and Maxillofacial Surgery of Tabriz Dental School for bilateral extraction of impacted third molars. After obtaining ethical approval and informed consent, the participants were randomly assigned to two groups: the intervention group received 25 mg amitriptyline preemptively while the control group received a placebo. The primary outcomes included postoperative pain score measured by a visual analog scale (VAS), and the frequency of analgesics taken during the postoperative period. Data were analyzed by paired samples t-test (alpha=0.05). Results: A total of 20 patients (10 males and 10 females) participated in this study, with a mean age of 22.2 years. The mean duration of surgery was almost similar in the two groups (P=0.847). The intervention group consumed significantly lower number of analgesics during the postoperative period than the control group (P<0.001). The time interval from surgery to the first analgesic intake was significantly longer in the amitriptyline group (P<0.001). Conclusion: Preemptive consumption of amitriptyline can effectively reduce postoperative pain and analgesic consumption following impacted mandibular third molar extraction surgery.

Objectives: Objectives: The present research aimed to evaluate the potential of three-dimensional (3D) poly lactic acid (PLA) microstrut scaffolds, surface-modified with nanocomposite gelatin-forsterite fibrous layers possessing porosities of 40% and 70%, to facilitate bone regeneration and angiogenesis in a rat model. Materials and Methods: Thirty-six rats, each with a surgically created cranial defect measuring 4mm in radius, were randomly assigned in a 1:1:1 ratio to one of three experimental groups: A 40% scaffold group (G1), a 70% scaffold group (G2), and a control group receiving no scaffold (G3). Animals were euthanized at either 4 or 8 weeks post-surgery. Histological analysis using hematoxylin and eosin (H&E) staining was performed to observe the tissue response and bone formation within the surgical defects. Histomorphometric assessment was employed to quantify the percentage of newly formed woven and lamellar bone in each group. Results: The mean percentages of total bone formation at 4 weeks were 33.55±4.32%, 37.76±6.20%, and 33.66±2.30% in groups G1, G2, and G3, respectively. At 8 weeks, the corresponding mean percentages were 34.25±1.94%, 37.33±4.30%, and 35.16±3.68% for the same groups. Statical analysis revealed a significant difference in angiogenesis between G1and G2 at 8 weeks (p≤0.01). Conclusion: Our findings demonstrated that the fabricated scaffold exhibited the capacity to facilitate osseous tissue development and promote osteoblast adhesion and infiltration. The scaffolds with 70% porosity showed superior performance in total bone formation compared to those with 40% porosity. This novel scaffold design holds promise for enhancing both angiogenesis and osteogenesis processes.

Objectives: This study aimed to comprehensively evaluate the mechanical and physical properties of six commercially available flowable dental composite resins, providing critical insights for informed material selection. Materials and Methods: Six flowable composite resin materials namely Edge Flow (EDF), Opallis Flow (OPF), Els Flow (ELF), Denfil Flow (DFF), DX Flow (DXF), and Charisma Flow (CHF) were tested according to ISO 4049 standards. Each material underwent evaluation of depth of cure, flexural strength, solubility, water sorption, and radiopacity. Statistical analyses with ANOVA and post-hoc Tukey test were conducted to identify significant differences among the six study groups (alpha=0.05). Results: Significant material-specific differences were noted in depth of cure and flexural strength among the six study groups (P<0.05). Solubility and water sorption profiles were also significantly different among the study groups (P<0.05). All tested composite resins met the required radiopacity standards, ensuring accurate radiographic diagnosis and monitoring. However, none of the composite groups achieved an exact color match with the A2 reference shade. Conclusion: This study revealed significant differences in mechanical properties of flowable composites, particularly in depth of cure and flexural strength, underscoring the importance of selecting the appropriate material. Shade matching presented ongoing challenges, emphasizing the need for careful material selection. Future research should explore long-term clinical performance and standardized methods for handling of pre-test failures.

Unilateral temporomandibular joint (TMJ) dislocation is a rare condition often triggered by yawning, vomiting, or other activities involving wide opening of the mouth, resulting from the forward movement of the condylar head. This case report highlights a longstanding unilateral TMJ dislocation managed by the single injection of local anesthetics into the deep temporal and masseteric nerve peripheries, alleviating muscle spasm and pain to restore TMJ function.

Objectives: This study assessed the corrosion resistance and cytotoxicity of two copper-based alloys and one nickel-chromium (Ni-Cr) alloy used for post and core fabrication. Materials and Methods: In this in vitro study, the corrosion resistance of 9 specimens of dental casting alloys including one Ni-Cr-based (VeraBond) and two copper-based (American Dent-All and Aalbadent NPG) alloys (n=3) was assessed by electrochemical impedance spectroscopy (EIS) in artificial saliva in two different pH levels of 2.5 and 7.1. Their cytotoxicity was evaluated by the methyl thiazolyl tetrazolium (MTT) assay using 15 specimens (n=5). Statistical analysis was performed by one-way ANOVA (alpha=0.05). Results: EIS showed that the Ni-Cr alloy had the highest corrosion resistance. Aalbadent NPG and American Dent-All alloys showed significantly lower corrosion resistance than the Ni-Cr alloy (P<0.05). Aalbadent NPG showed higher corrosion resistance than American Dent-All in early hours, but its corrosion resistance decreased over time and became similar to that of American Dent-All at later time points. Although all groups showed higher corrosion in acidic environment, Ni-Cr showed good corrosion resistance in acidic pH. The cytotoxicity test revealed a significant difference between the copper-based groups (P<0.05). Ni-Cr was the most biocompatible alloy amongst all, followed by Aalbadent NPG. American Dent-All showed a high degree of cytotoxicity. Conclusion: The findings of this study raised some concerns regarding the clinical suitability of copper-based alloys for dental treatments, and the first choice for cast post and core restorations should be Ni-Cr alloys because they are more resistant to corrosion, and are less cytotoxic.