Frontiers in Dentistry最新文献

Objectives: This study aimed to investigate the impact of three different bleaching protocols on tooth discoloration caused by tea. Materials and Methods: Forty extracted sound premolars were cleaned, disinfected, and their initial color parameters were measured (T1). The teeth were then immersed in boiled tea solution for 24 hours, and their color was measured again (T2). The samples were divided into four groups of 10 teeth each. Group A was treated with an in-office bleaching gel followed by 30 seconds of light curing. Groups B, C, and D were respectively treated with 0.24M oxalic acid followed by bleaching gel, 5.25% sodium hypochlorite followed by bleaching gel, and a combination of 0.24M oxalic acid, 5.25% sodium hypochlorite, and bleaching gel. The color was measured once more after the interventions (T3). Data were analyzed using two-way repeated measures ANOVA, paired sample t-test, and Tukey's test. Results: The mean color change (∆E₂) between T2 and T3 was significantly higher in group D compared to group A (P<0.05). However, there was no significant difference in color change between groups A, B, and C. Additionally, there was no significant difference in color change between groups B, C, and D. The groups also showed significant differences in ∆L (P=0.007), with the only significant difference found between groups B and C (P=0.001). Conclusion: The combined use of sodium hypochlorite and oxalic acid followed by in-office bleaching gel is more effective than bleaching alone in correcting tooth discoloration caused by tea. This protocol can further reduce yellow coloration.

Objectives: This study assessed the fracture resistance of zirconia crowns with four framework designs, fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Materials and Methods: In this experimental study, a maxillary central incisor was prepared and scanned with a CAD/CAM scanner, and 40 frameworks with 4 designs (N=10) were fabricated as follows: simple core, dentine core with a design similar to dentine, 3mm trestle design collar in the lingual aspect with proximal buttresses, and monolithic or full-contour. After porcelain applying and 20h immersion in distilled water (37°C), crowns were cemented on metal dies using zinc phosphate cement. Fracture resistance was measured by a universal testing machine. Data were analyzed with one-way ANOVA (alpha=0.05). Results: Fracture resistance was maximum in the monolithic group, followed by the dentine core, trestle design, and simple core groups, respectively. The mean fracture resistance of the monolithic group was significantly higher than that of the simple core group (P<0.005). Conclusion: Zirconia restorations with frameworks that provided higher and more support for porcelain, showed increased fracture resistance.

Objectives: Temporomandibular disorders (TMDs) include a series of signs and symptoms in the temporomandibular joints (TMJ) and muscles of mastication, which are associated with or caused by parafunctional habits. Many of these patients also suffer from lumbar pains. This study aimed to evaluate the effectiveness of treating parafunctional habits in alleviating symptoms of TMD and lower back pain. Materials and Methods: This phase II clinical trial was conducted on 136 patients suffering from TMDs and lumbar pain, who consented to participate in this study. They were provided with instructions on how to discontinue their parafunctional habits including clenching and bruxism. The Helkimo and Rolland Morris questionnaires were used to assess TMD and lower back pain, respectively. Data were statistically analyzed using paired Student's t-test, Wilcoxon, Mann-Whitney, and Spearman correlation tests, with the significance level set at P<0.05. Results: The mean severity score of TMD significantly decreased after the intervention. Following treatment of TMD, the mean severity score of lumbar pain decreased from 8 to 2 (P=0.0001). Conclusion: Based on our findings, it appears that the elimination of parafunctional habits improves TMD and lumbar pain.

Objectives: This study aimed to assess the microtensile bond strength (µTBS) of etch-and-rinse (E&R), self-etch (SE), and universal adhesives to superficial and deep dentin. Materials and Methods: In this in vitro study, 40 sound third molars were randomly divided into two main groups of superficial and deep dentin. Based on our classification, superficial dentin was right beneath the deepest occlusal groove, and deep dentin was 2mm beneath the deepest occlusal groove. Each group was divided into 4 subgroups (n=20) for application of Adper Single Bond 2 (ASB), Clearfil SE Bond (CSE), and Scotchbond Universal (SBU) in E&R and SE modes along with Charisma Smart composite resin on dentin. The specimens were incubated in distilled water at 37°C for 24 hours and their µTBS was then measured. The mode of failure was determined under a stereomicroscope at ×40 magnification. Data were analyzed by one-way ANOVA (alpha=0.05). Results: The highest µTBS belonged to the superficial dentin/SBU/E&R group. The µTBS was significantly higher in superficial dentin than deep dentin for all adhesives (P=0.005). There was no significant difference in mode of failure among the groups. Conclusion: Based on the results obtained in the present study, type of bonding agent and application mode affected µTBS. In use of universal adhesive, E&R mode can improve µTBS.

Objectives: The current study aimed to assess the cyclic fatigue resistance of two nickel-titanium (NiTi) rotary files after immersion in 5% sodium hypochlorite (NaOCl) and Deconex. Materials and Methods: In this in vitro study, 90 new M3 Pro Gold size 25.06 and size F2 SP1 files were tested. Forty-five files of the same brand were randomly distributed into three groups (n=15) and submitted to the following immersion protocol for 5 minutes at room temperature: no immersion (control group), immersion in 5% NaOCl, and immersion in Deconex. The cyclic fatigue resistance of the files was then measured in a custom-made tester. Two-way ANOVA was applied to compare the cyclic fatigue resistance of SP1 and M3 NiTi rotary files based on the type of disinfectant solution. Post-hoc LSD test was used for pairwise comparisons and P<0.05 was considered significant. Results: Two-way ANOVA indicated a significant difference in the mean cyclic fatigue resistance of M3 and SP1 NiTi rotary files. The M3 files immersed in NaOCL displayed the lowest and the SP1 files immersed in Deconex showed the maximum cyclic fatigue resistance. The effect of type of disinfectant solution (P<0.001) and type of NiTi file (P<0.001) on cyclic fatigue resistance was statistically significant. Conclusion: The cyclic fatigue resistance of NiTi rotary instruments can be affected by immersion in disinfectants, and the specific type of file and disinfectant used will ultimately determine the extent of this impact.

Objectives: The durability of composite restorations is directly affected by the mechanical properties of the composite. The aim of this study was to evaluate the hardness and wear resistance of self-adhesive flowable composite (SAF) in comparison with conventional flowable composites. Materials and Methods: In this in vitro study, 50 composite specimens were prepared in brass molds with 10mm ×10mm ×2mm and divided into five groups (n=10). Specimens included three conventional flowable composites (Grandio flow, Filtek flow and Admira fusion flow), one self-adhering flowable composite (SAF, Vertise flow) and a microhybrid composite (filtek z250). After polishing, the micro-hardness of the specimens was measured in a Vickers hardness device, and the specimens were then subjected to 5000, 10000, 20000, 40000, 80000 and 120000 wear cycles in a wear tester. One-way ANOVA/Games-Howell, Kruskal Wallis, and Friedman tests were used for statistical analysis. The significance level was set at P<0.05. Results: The surface micro-hardness of the SAF was significantly lower than that of the microhybrid composite (P=0.01). There was no significant difference between the surface hardness of the different tested flowable composites (P>0.05). Also, the wear resistance of the studied composites was not significantly different in various cycles (P>0.05). Conclusion: Based on our results, SAF would not be an ideal substitute for conventional flowable composites in high-stress areas.

Objectives: The purpose of this randomized parallel clinical trial was to assess and compare the efficacy of 97% Aloe Vera (AV) gel and 94.7% AV juice against an active control (0.05% Clobetasol Propionate) in the treatment of oral lichen planus (OLP). Materials and Methods : Age and sex matched patients with histologically proven OLP were divided into two groups. One group received 97% AV gel for topical application and 10ml 94.7% AV juice to consume twice daily. The active control group received topical 0.05% Clobetasol Propionate ointment twice daily. Treatment lasted two months followed by four months of observation. Monthly evaluation of various clinical features of OLP was done using the OLP disease scoring criteria. Burning sensation was evaluated using Visual Analog Scale (VAS). Mann Whitney-U (followed by Bonferroni adjustment) and Wilcoxon's signed-rank tests were used for intergroup and intragroup comparisons, respectively. Interclass correlation-coefficient test was applied to assess the intra-observer variation (P<0.05). Results: In total, 41 females and 19 males participated in this study. The most common site was the buccal mucosa followed by the gingivobuccal vestibule. The reticular variant was most frequently encountered. Wilcoxon's signed-rank test showed significant differences in both groups between baseline and end-of-treatment for VAS, site-score, reticular/plaque/papular score, erosive/atrophic score and OLP disease score (P<0.05). Mann-Whitney revealed significant difference between both groups in the 2^nd, 3^rd and 4^th months (P<0.0071). Conclusion: Clobetasol Propionate is more effective for OLP management but in our study AV proved to be a safe treatment alternative for OLP management.

Objectives: Dental caries is a common chronic disease amongst children and are typically evaluated using the DMFT/deft index (decayed, missing, and filled teeth for permanent dentition/decayed, extracted, and filled teeth for primary dentition). To address the limitations associated with these indices, alternative assessment tools such as the Caries Assessment Spectrum and Treatment (CAST) index and Ora test have been developed. These methods aim to estimate caries activity within the oral cavity more accurately. The objective of our study was to evaluate and correlate caries activity in 5-to-8-year-old children using Ora test and CAST index. Materials and Methods: Thirty schoolchildren between the ages of 5 and 8 years were selected and allocated into two groups (n=15) with DMFT/deft scores of <5 (group A) and >5 (group B). Two separate blinded examiners administered the assessments by first determining CAST scoring, which was followed by Ora test. Statistical analysis was performed using Pearson correlation test and significance was set at P≤0.05. Results: The mean time for color change of Ora test, was 118.53±23.28 minutes in group A and 53.33±15.07 minutes in group B. CAST severity scores were 3.67±2.08 and 15.7±9.70 for groups A and B, respectively. Time taken for color change in Ora test and CAST scores showed a significant negative linear relationship (P=0.039). Conclusion: Based on the negative correlation between CAST scores and Ora test, it may be postulated that microbial activity is directly related to caries activity in 5-to-8-year-old children.

Objectives: The focused question of this systematic review was "does hyaluronic acid (HA) injection in areas of interdental papillary deficiency reduce black triangles?" Materials and Methods: A systematic literature search was performed to find clinical studies on human patients with a minimum of 6-month follow-up, published in English from 2005 to May 2020. There were two outcome variables: black triangle area (BTA) change after treatment at different measurement time points compared with baseline, and patient reported outcome measures (PROMs), when available. Results: Of eight eligible articles (2 randomized clinical trials (RCTs) and 6 non-randomized, non-placebo controlled clinical studies), seven reported that HA injections had a positive impact on reduction of BTA and subsequent papillary augmentation. Six studies were included in meta-analysis and showed that the intervention led to a pooled reduction percentage of 57.7% in BTA after 6 months. Although there were clinical diversities between the studies, all the studies applied the same concentration of HA (approximately 2%), 2-3 mm apical to the papilla tip in several intervals. Some degrees of relapse were reported in some studies. Conclusion: Within the limits of this study, this systematic review and meta-analysis showed that HA injection can serve as an efficient minimally-invasive treatment for small interdental papillary deficiencies. It is essential to conduct further randomized clinical studies with prolonged follow-ups in order to support this conclusion.

Objectives: To compare the effectiveness of fluoride varnish and two calcium-based fluoride products on the remineralization of primary teeth enamel. Materials and Methods: Surface-microhardness (SMH) of 36 extracted anterior primary teeth was measured by Vickers test (50gr/5 seconds) to provide a baseline for later comparisons. All teeth were immersed in demineralizing solution for 96 hours to create caries-like lesions and SMH was determined for the artificially-induced caries. The teeth were randomly assigned to three groups consisting of 5% fluoride varnish once daily/10 seconds, Clinpro™ 5000 toothpaste once daily/2 minutes, and Remin Pro cream once daily/3 minutes for 28 days. All specimens were kept in artificial saliva with pH cycling during the study period. After remineralization, SMH was evaluated for the last time. Data were analyzed by one-way ANOVA, Mauchly's sphericity, and RM-ANOVA with Bonferroni correction for inter-and- intra-group comparisons at the three stages of the study. Results: Neither the baseline SMH nor the SMH of the artificially created caries showed significant differences among the samples (P>0.05). The post-treatment SMH was highest in the Clinpro group (296.4±73.1kgf/mm²), followed by Remin Pro (283.8±119.3kgf/mm²), and varnish (270.9±78.3 kgf/mm²). There was no significant difference among the groups after treatment (P>0.05). We also did not observe a significant difference among the three different study stages (P>0.05). Conclusion: Within the limitations of this in-vitro study, daily application of low fluoride-calcium compound seems to be as effective as the professional use of fluoride varnish or high-content fluoride toothpaste in remineralizing initial caries of primary teeth.