Frontiers in Dentistry最新文献

Objectives: This paper presents a systematic review and meta-analysis of the effect of different finishing and polishing (F/P) systems on surface roughness (SR) and microbial adhesion to bulk fill (BF) composites. Materials and Methods: An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Only in vitro studies that evaluated SR and microbial adhesion to BF composites were included. The included studies were individually evaluated for the risk of bias following predetermined criteria. A meta-analysis of the reviewed studies was conducted to compare the SR values of both Filtek Bulk Fill and Tetric EvoCeram Bulk Fill with and without F/P using the Comprehensive Meta-Analysis software. Results: A total of 12 studies fulfilled the inclusion criteria. The meta-analysis showed no significant difference between Filtek Bulk Fill and Tetric EvoCeram Bulk Fill without F/P or after F/P using multi-step systems. Different F/P systems affected the SR values, on the other hand, did not affect microbial adhesion values. Conclusion: Both Filtek Bulk Fill and Tetric EvoCeram Bulk Fill had comparable roughness results. Multi-step systems may be preferable for F/P of BF composites.

Objectives: This study aimed to assess the efficacy of oral mucoadhesive N-acetylcysteine (NAC) tablets for treatment of recurrent aphthous stomatitis (RAS). Materials and Methods: Forty-nine patients with RAS were randomized to receive mucoadhesive NAC tablets (n=25) or placebo (n=24). Tablets were prescribed three times a day for 7 days in each group. Pain intensity was evaluated with visual analog scale (VAS) three times a day from day 1 to day 7. Also, patients were clinically examined on days 0 (before entering the study), 3, 5, and 7 using a metal caliper to measure the diameter of the lesions. The data were statistically analyzed and P<0.05 was considered statistically significant. Results: Regarding the VAS score, all participants in the treatment group showed complete recovery on day 7 (P<0.01). Also, the diameter of the lesions was significantly smaller in the treatment group than the placebo group at the end of the study (P<0.001). Conclusion: The results of this clinical trial showed for the first time that mucoadhesive NAC tablets can significantly decrease pain and the diameter of RAS lesions without any systemic complications.

Objectives: This study was performed to find the most common types of maxillofacial fractures and their management in 3 to 18-year-old individuals referred to the Department of Oral and Maxillofacial Surgery at Shariati Hospital in Tehran, during a 9-year period. Materials and Methods: This retrospective study evaluated the records of 319 patients with maxillofacial fractures between 2012-2020, ranging in age from 3 to 18 years. Data regarding the etiology and location of the fracture, age, gender, and treatment approach were retrieved from the archival records and analyzed. Results: A total of 319 patients were included in the study, out of which, 255 (79.9%) were males and 64 (20.1%) were females. Motor-vehicle accidents were the most common cause of trauma (N=124, 38.9%). We recorded 605 fractures and among them, the parasymphysis (N=131, 21.6%) was the most common site of isolated fractures. Type of treatment varied depending on the fracture type and degree of displacement of the broken segments. It consisted of open reduction and internal fixation, and closed reduction procedures, which included the use of arch bars, ivy loops, lingual splints, and circummandibular wirings. Conclusion: Analysis of the results revealed that the severity of injury increased with age. Older individuals had higher a number of fracture sites and experienced greater displacement of the broken segments.

Objectives: The present study aimed to evaluate the efficacy of ginger essential oil spray for elimination of Candida albicans (C. albicans) adhering to self-cure acrylic plates. Materials and Methods: In this experimental study, 120 self-cure acrylic discs were contaminated with C. albicans and randomly divided into four main groups: exposure to ginger essential oil, nystatin (positive control), distilled water (negative control), and no exposure. The minimum inhibitory concentration (MIC) of ginger oil and nystatin was determined by the microdilution test. The stability of C. albicans was determined by culturing the samples of treated acrylic plates and comparing the mean number of remaining colonies. Data were analyzed using the Kruskal-Wallis test followed by Dunn test with Bonferroni correction. P<0.05 was considered significant Results: The MIC of ginger essential oil and nystatin was found to be 1560µg/mL and 4µg/mL, respectively. The differences between the mean count of C. albicans colonies before (10175±10730.25) and after the exposure to ginger essential oil (542.86±464.81) and nystatin (257.14±247.67) was statistically significant (P<0.001). The mean number of C. albicans colonies after spraying with nystatin was not significantly different compared with ginger essential oil (P=0.204). The efficacy of nystatin and ginger essential oil at each time was significantly more than distilled water (P<0.001). At 10 and 15min, there was no significant difference between nystatin and ginger essential oil groups (P=0.05). Conclusion: Ginger essential oil spray was found to be a simple and effective method for elimination of C. albicans adhering to acrylic discs.

Objectives: This study aimed to evaluate the pH changes and penetration of hydrogen peroxide into radicular dentin when different protective bases were used with and without a bonding agent. Materials and Methods: In this in-vitro experimental study, 70 single-rooted bovine teeth were instrumented and obturated with gutta-percha. The gutta-percha was removed 3mm below the cementoenamel junction (CEJ) and the teeth were divided into seven groups (n=10). In each group, 2mm base (1mm apical to the CEJ) was applied as follows: TheraCal LC, TheraCal LC plus SE Bond, Lime-Lite, Lime-Lite plus SE Bond, Ionoseal, Ionoseal plus SE Bond, and resin-modified glass ionomer (RMGI). The teeth were placed in vials containing distilled water, and pH values and molar concentration of the medium surrounding the teeth were recorded immediately after internal bleaching with 35% hydrogen peroxide. The pH values were also recorded at 1, 7, and 14 days following renewal of the medium. Data were analyzed with t-test, one-way ANOVA, and Kruskal-Wallis test. Results: After bleaching, the medium pH became acidic in all groups. There were no significant differences among groups in the mean pH of the medium after bleaching (P=0.189). Moreover, there were no significant differences among the study groups with respect to hydrogen peroxide concentration (P=0.895). Conclusion: Intra-orifice barriers such as light-cure resin-modified calcium hydroxide, light-cure resin-reinforced glass ionomer, and light-cure calcium silicate can be as effective as RMGI in providing coronal seal during intracoronal bleaching.

Objectives: Professionalism is essential to a strong and trusted patient-doctor relationship, which is believed to potentially enhance patient compliance and treatment outcomes. The purpose of our study was to develop and conduct a psychometric analysis of an assessment tool to evaluate the professional behavior of dental students. Materials and Methods: The study was performed in the School of Dentistry, Tehran University of Medical Sciences. After providing a pool of various criteria to assess professionalism, an expert panel prepared the primary version of the tool. The tool was set in a questionnaire frame to explore the significance level and evaluation feasibility of each criterion. The questionnaire was completed by tutors of the "Medical Ethics" course (n=6). After necessary revisions, face and content validity were evaluated by giving the checklist to eight experienced dental educators to determine the relevance, clarity, and simplicity of the questions. In the second stage, the final checklist (37 items) was given to dental educators to evaluate twenty students. To assess the reliability of this checklist, at least two professors evaluated each student, and weighted-κ was calculated. Minor revisions were made based on the received feedback. Results: According to our data, the total validity of the tool (S-CVI) was 100%. For all items except one, the weighted-κ coefficient was ≥ 0.5, indicating sufficient reliability for these items. Conclusion: Despite the limitations of the present study, the designed tool to evaluate professionalism among dental students in different clinical departments seems to be both valid and reliable.

Objectives: Hardness is relevant to the degree of conversion (DC) and depth of cure (DoC). The aim of this study was to determine the micro-hardness and DoC of conventional and bulk-fill composite resins in class II restorations using metal and clear matrix bands. Materials and Methods: Twelve specimens of each of the two composite resins, i.e., Filtek Z350 XT bulk-fill and Gradia posterior conventional composite, were prepared in the form of a class II cavity in a tooth mold, using a clear or metal matrix band. All specimens were cured and stored at 37°C for 24 hours. Vickers hardness was measured as a function of DoC at 2mm intervals. Data were analyzed by two-way ANOVA (alpha=0.05). Results: The bulk-fill composite exhibited significantly higher hardness levels than the conventional composite in all tested surfaces (P<0.001). However, while the metal matrix band had a significant impact on the bottom surface (P=0.059) and also on the furthest surface from the matrix and light source (P=0.04), it did not have a consistent effect across all tested surfaces. The simultaneous interaction of the composites and matrix band types in all surfaces, did not show significant differences in hardness values. The highest bottom-to-top surface hardness ratio (73%) was observed in the conventional composite near the metal matrix band. Conclusion: In deep class II cavities, the bottom-to-top surface hardness ratio did not reach the maximum of 80%, neither for bulk-fill nor conventional posterior composites. Therefore, in such cavities extended light-curing and more incremental composite placement is needed.

Objectives: Registries are powerful tools for the collection and distribution of valid and reliable data. The initial step in health information management is to design a minimum data set that can improve the collection of high-quality data from the registry. The present pilot study aimed to determine the optimal minimum data set for dental implants to effectively utilize at Tehran University of Medical Sciences, Tehran, Iran. Materials and Methods: This descriptive cross-sectional study was conducted in 2019 at Tehran University of Medical Sciences. A minimum data set checklist was developed based on our previous systematic review. The content validity of the minimum data set was approved by the recruited experts and the final minimum data set was established using the Delphi technique. Results: The minimum data set for dental implants consists of two separate sections - administrative and clinical data. The administrative portion includes two main segments: patient demographic data and clinic data, consisting of 12 data elements. The clinical part includes five main segments (patient clinical data, implant data, implant complications, implant loss, and implant follow-up), and contains 96 data elements. Conclusion: This study suggests a minimum set of data for dental implants that can aid in efficient management of information, facilitate evidence-based decision-making, and enable high-quality clinical research, evaluation of treatment results, monitoring, and benchmarking of care.

Objectives: Oral health literacy (OHL) is an interplay of cultural, social and individual factors and plays an effective role in public health promotion. This study aimed to assess OHL and its socioeconomic and demographic determinants among young couples. Materials and Methods: This analytical cross-sectional study was conducted on 828 adults between 15 to 35 years in 2018 in Zanjan city. Data regarding their OHL were collected by using a 17-item Oral Health Literacy-Adult Questionnaire (OHL-AQ) that was filled out by a combination of self-report and interview. OHL was categorized as adequate, marginal, and inadequate. The effects of age and gender as demographic variables, and floor area per person as a proxy of financial status on OHL were also assessed. Data were analyzed using the linear and multinomial logistic regression models. Results: The mean OHL score was 7.86±3.83 out of 17 in equal number of males and females. Only 21% of the couples had adequate OHL. The socioeconomic, but not demographic variables had significant correlations with the qualitative and quantitative variables of OHL even after controlling for the effect of confounders. A correlation was particularly found between inadequate OHL and years of education [odds ratio:6.00; 95% CI: 3.86-9.28); P<0.001]. Conclusion: Socioeconomic factors had independent correlations with inadequate OHL. Participants with higher levels of education, those living in urban areas, and individuals with better financial status had higher levels of OHL and lower odds of inadequate OHL.

Objectives: One of the most common methods used for the reconstruction of endodontically treated teeth is post and core and crown. Various factors such as the remaining tissue above the cutting margin (ferrule) affect the fracture resistance of teeth restored with post and core and crown. This study aimed to investigate the effect of ferrule/crown ratio (FCR) on the strength of maxillary anterior central teeth using finite element analysis. Materials and Methods: A 3D scan of a central incisor was obtained, and the data were transferred to Mimics software. Then, a 3D model of the tooth was designed. Next, 300N load was applied at a 135° angle to the tooth model. Force was applied to the model both horizontally and vertically. Ferrule height was considered to be 5%, 10%, 15%, 20%, and 25% in the palatal surface and 50% in the buccal surface. The length of post in the model was 11, 13, and 15mm. Results: By increasing the FCR, stress and strain distribution increased in the dental model and decreased in the post itself. As the horizontal angle of load application increased, the level of stress and strain created in the dental model increased as well. The closer the force application site to the incisal area, the higher the stress and strain would be. Conclusion: Maximum stress was inversely correlated with FCR and post length. In ratios of 20% and higher, insignificant changes occurred in stress and strain patterns in the dental model.