International Journal of Dentistry最新文献

Objectives: Primary Sjögren's syndrome (pSS) is a chronic autoimmune disorder characterized by dryness of mucous membranes, predominantly the eyes and mouth, following glandular tissue substitution. The onset of oral dryness constitutes a significant source of discomfort that negatively affects overall quality of life. This systematic review aimed at investigating the differences in Oral Health Impact Profile-14 (OHIP-14) questionnaire scores in patients diagnosed with Sjögren's syndrome compared to sicca syndrome, to assess the influence of the two conditions on oral health. Study Design. A systematic electronic and manual search was performed up to December 2023 for studies reporting OHIP-14 questionnaire scores in pSS patients versus sicca syndrome. Two authors independently reviewed, selected, and extracted the data. The outcome was the assessment of OHIP-14 scores in studies comparing pSS- and sicca syndrome-affected patients. Meta-analysis was conducted on available quantitative data.

Results: Literature search retrieved 30 articles, and 3 articles met the criteria for inclusion in the review. Meta-analysis revealed significantly higher scores in patients with sicca syndrome compared to pSS, although salivary flow was markedly reduced in pSS.

Conclusions: While offering supplementary information to standard tests and supporting the assessment of pSS and sicca syndrome patients, further validation is necessary to establish OHIP-14 validity in determining the impact of pSS and sicca syndrome on patients' quality of life.

Objectives: The aims of this study were to assess the morphologic features of peri-implant defects, as measured on 2D intraoral radiographs, and to investigate the possible correlation between such morphology and other parameters related to the position and characteristics of the implant or the implant-supported prosthesis.

Materials and methods: Implants with peri-implantitis were included in this retrospective study. Data collected were related both to the patients and to the position/characteristics of the implants and the implant-supported prosthesis. Measurements of the morphologic defects were performed by two operators on digitalized intraoral periapical radiographs. Results and Conclusion. In total, 73 implants in 27 patients were included. The measurements of the periapical radiograph suggested that the most common defect conformation was crateriform, with both intraosseous and horizontal components. An inverse correlation was found between the extension of the peri-implant lesion and the time between the radiographic assessment and the implant placement. The total lesion area was strongly correlated to oral hygiene levels. No correlations between lesion extension and smoking, diabetes, history of periodontal were found. In conclusion, the results from this 2D radiographic study showed the prevalence of crateriform peri-implant defects, with a hygiene-correlated extension, perceptible on the mesial and distal aspects; 3D imaging could be used when available for further research and clinical investigation.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare, serious, and debilitating disease of unknown cause that can be associated with significant health-related quality of life (HRQOL) impairment. Hematological disease is characterized by a nonhealing exposed jawbone in patients with a history of antiresorptive or antiangiogenic agent use without radiation exposure to the head or neck. Patients and Materials and Methods. This prospective study over the period from May 2020 to December 2021 included a representative sample consisting of 27 patients with at least stage 2 MRONJ lesions who underwent surgical rehabilitation via oral and maxillofacial surgery at the University Medical Center Göttingen, Germany. Quality of life data were collected over a 6-month postoperative period using the Health-Related QOL (SF-12) and Oral Health-Related QOL (OHIP-14) questionnaires.

Results: A total of 27 patients considered in the study had a total of 42 MRONJ lesions, corresponding to a mean of 1.56 necroses per patient. MRONJ lesions were downstaged in 85% of the patients. HRQOL was evaluated with the SF-12 questionnaire. Significant improvements were found in six of the eight categories (General Health (p  < 0.001), Bodily Pain (p < 0.001), Mental Health (p < 0.001), Vitality (p  < 0.001), Role-Emotional (p=0.028), and Social Functioning (p=0.031)). The OHRQOL score also improved significantly after surgical intervention (p < 0.001).

Conclusion: With completed surgical therapy, improvements in HRQOL and OHRQOL are measurable.

Objectives: The aim of this study was to evaluate the 1-day fracture resistance of simulated immature teeth with an apical plug with ProRoot MTA, MTA Angelus, and RetroMTA after calcium hydroxide intracanal medication.

Materials and methods: Sixty extracted, single-rooted human mandibular premolars were randomly divided into six groups of 10 teeth each. Firstly, to standardize the 9 mm root length, the crowns were cut off at and 9 mm below the cementoenamel junction transversely. Simulations for immature apices were carried out by using No. 1-6 Peeso reamers to pass through the apex to obtain a diameter of 1.7 mm at the apical opening. One group served as a negative control without any treatment, while the other groups received 30 days of calcium hydroxide intracanal medication. Four groups were plugs with 4 mm of ProRoot MTA, MTA Angelus, RetroMTA, and gutta-percha, respectively. The last one was served as a positive control group without filling inside. After 1 day of incubation, specimens were vertically loaded in a universal testing machine at a crosshead speed of 1 mm/min until fracture occurred. The peak load to fracture (Newton) and fracture pattern were recorded. A one-way analysis of variance (ANOVA) followed by Tukey's HSD test was used for data analysis.

Results: The highest mean load to fracture was shown in the negative control group (543.33 ± 37.17 N), followed by ProRoot MTA (432.82 ± 68.06 N), MTA Angelus (396.92 ± 59.93 N), RetroMTA (389.08 ± 56.25 N), and gutta-percha (283.28 ± 43.40 N), and the lowest belonged to the positive control group (239.98 ± 27.19 N). The significant differences were found between both the control and experimental groups with an apical plug with calcium silicate cement (p  < 0.05). There were no significant differences among those three apical plugs (p  > 0.05).

Conclusion: Apical plugs with ProRoot MTA, MTA Angelus, and RetroMTA had an immediate strengthening effect on simulated immature teeth after calcium hydroxide intracanal medication had been used.

Material-coated implants are placed in the bone and play an essential role in bone regeneration and rapid healing around implants. Polymeric matrix reinforced with ceramic materials is a promising composite material for coating implants. This study aims to determine the effect of mixing various concentrations of zein with CaSiO₃ on polyetheretherketone (PEEK) as implant material. The coating was performed using the electrospray method. PEEK disks were used as a control group. The coated disks with different concentrations of zein-CaSiO₃ (Group 1: 10% wt, 90% wt), (Group 2: 20% wt, 80% wt), and (Group 3%: 30% wt, 70% wt) were the experimental group. Each group was characterized by atomic force microscopy, field emission scanning electron microscope, Fourier-transform infrared spectroscopy, water contact angle, and adhesion strength. The lowest water contact angle was obtained for Group 1: 10% wt and 90% wt were (26.64° and 27.13°, respectively), and increasing amounts of zein in comparison to quantities of CaSiO₃ resulted in increased adhesion strength of the composite material to the substrate. The current study suggested that the higher amount of zein compared to the amount of CaSiO₃ mixture coating is achieved by electrospraying, a favorable candidate for coating implants compared to uncoated and coated disks with low concentrations of zein compared to concentrations of CaSiO₃.

Background: Financial protection is crucial for attaining universal health coverage. The inclusion of costly dental services in insurance plans poses a significant challenge for all parties involved in the insurance sector. This study aimed to investigate the challenges of covering dental services by complementary insurance in Iran during 2020-2021.

Materials and methods: This qualitative research was conducted in Iran during 2020-2021. A triangulation of methods and data sources were employed to achieve a comprehensive perspective. In-depth semistructured interviews were conducted on an individual basis, and all national documents, rules, regulations, and instructions pertaining to complementary dental insurance were thoroughly reviewed. Purposeful sampling was used to select participants from all stakeholder groups engaged in dental insurance coverage, including (1) health system policymakers, (2) insurers, (3) policyholders, (4) care providers (dentists), and (5) insured people. Six open-ended questions were formulated to explore various facets of dental insurance, including (1) development, (2) management, (3) population coverage, (4) premium calculation, (5) services coverage, and (6) payment and reimbursement mechanisms. With the consent of the participants, all interviews were recorded and transcribed verbatim. The gathered data were evaluated using a framework analysis approach in the MAXQDA20 software. Finally, the primary themes, each encompassing multiple subthemes, were identified and presented.

Results: A total of 26 interviews were conducted with five groups of interviewees, and nine national documents were evaluated. Six themes were extracted, which included 18 codes from the interviews and seven codes from the documents. The extracted themes were as follows: (1) Insurance commitments and service coverage, (2) reimbursement system, (3) information system, (4) economic issues, (5) population coverage, and (6) regulation and supervision. The high cost of dental services was the most frequent challenge, followed by the insurance commitments and service coverage.

Conclusions: The delivery of dental services through complementary insurance in Iran primarily faces economic and service coverage challenges. The resolution hinges on the collaboration between basic and complementary insurance sectors, the development of a unified information system for insured individuals, and the implementation of a risk-adjusted premium plan.

This study aimed to evaluate in vitro the degree of surface smoothness provided by two different polishing techniques and the effect of acid challenge on the alteration of surface roughness (Ra), microhardness (Knoop), and color (ΔE₀₀) of three nanoparticulate composites, simulating 1 year of exposure to hydrochloric acid (HCl). Eighty specimens for each composite were divided into four groups (n = 240), being control without polishing, control with wear, WPC (wear + polishing with Cosmedent Kit), and WPB (wear + BisCover LV liquid polish). Repeated measures ANOVA was applied for Ra and Knoop Microhardness. For the color (ΔE) three-way ANOVA was applied. In cases of statistically significant the Tukey posttest was applied (α = 0.05). Both types of polishing tested resulted in a surface smoothness below the critical value established by the studies (Ra ≥ 0.2 μm), even after immersion. The microhardness of all composite resins decreased after the challenges. The specimens immersed in HCl showed a lower microhardness (42.2 Kgf/mm²) when compared to the specimens immersed in artificial saliva (44.7 Kgf/mm²). Regarding the color change, the composites presented values compatible with clinical acceptability, with a statistically significant difference only between the control group and the other types of polishing for the Z350 XT resin (ΔE₀₀ = 3.78). It was concluded that both mechanical and chemical polishing produced a satisfactory surface smoothness, even after immersions in artificial saliva and HCl. The microhardness of the composites was affected by the challenges and the composites tested were within clinical acceptability with regard to color change.

Mucous membrane pemphigoid (MMP) is an autoimmune-based bullous disease affecting the mucous membranes, mainly oral and ocular. One of the most common clinical manifestations is desquamative gingivitis (DG), characterized by intense symptoms and functional limitations. The dentist is among the first specialists to observe DG and, therefore, must be able to diagnose it. In this regard, the purpose of the present study was to evaluate the efficacy and safety of a clinical protocol for the topical management of patients with DG and MMP buccal lesions. Thirteen patients with clinical and histologic diagnoses of MMP-localized DG in the oral cavity were retrospectively enrolled. Each patient received topical treatment with clobetasol propionate oral gel 0.05%; nicotinamide; oral probiotic (contains Bifidobacterium lactis HN019, Kluyveromyces marxianus fragilis B0399, colostrum, and biotin); and doxycycline. Before and after 3 months of therapy, clinic records were collected for each patient. Seven patients (53.8%) had a complete response to treatment; four patients (30.8%) had a partial response to treatment; and, finally, two patients (15.4%) had no benefit from therapy. Dental management of patients presenting solely with oral manifestations of MMP may involve the use of topical corticosteroids, doxycycline, vitamin supplements, and probiotics and associating professional oral hygiene procedures.

Introduction: The tendency to use dental materials of plant origin is one of the prevailing trends in dentistry to reduce exposure to materials that could have some toxic impact in the long term.

Objective: To evaluate the efficacy of calcium hydroxide combined with gingerols (Ginge-Cal) as a novel obturation material for treating infected primary teeth and decreasing the recurrence of infection.

Materials and methods: The study was conducted on 30 lower primary molars with infected pulp for children aged 4-8 years. The sample was randomly divided into two groups depending on the tested obturation material: Ginge-Cal group and the Metapex group. The evaluation was done by different parameters clinically and radiographically at various intervals up to 12 months.

Results: Based on chi-squared and McNamara's test with a 5% significance level, the clinical results indicated that Ginge-Cal group was more effective than the Metapex group in reducing or eliminating pain (P=0.467) after 1 week, sensitivity to percussion (P=0.090) at 3 months of follow-up, purulent swelling (P=0.444) at 6 and 9 months of follow-up, fistula, and tooth mobility. The radiographic results, based on the periapical and furcation area radiolucency at 12 months of follow-up, favored Ginge-Cal group over the Metapex group (P=0.683), (P=0.456), respectively. There were no statistically significant differences in pathological root resorption and periodontal space. The differences within the Ginge-Cal group were directly influenced by the time intervals in a statistically significant manner, ranging from (P=0.004) to (P < 0.001). The success percentage was 87.5% for Ginge-Cal group and 64.3% for Metapex group.

Conclusions: Ginge-Cal can be considered a promising material for treating the infected root canal when used as an obturation material for the infected root canal. This trial is registered with NCT05181813.

Introduction: The objective of this study was to test the validity and reliability of the Colombian version of the Health Literacy in Dentistry (HeLD-14) in older adults.

Materials and methods: A translation and validation study of HeLD-14 was conducted on 384 non-institutionalized older adults attending the Dental Clinic at Universidad Cooperativa from Pasto, Colombia. A cross-cultural adaptation of a multidimensional HeLD-14 was completed, and the psychometric properties of this scale were evaluated through a cross-validation method using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). Internal consistency was measured with Cronbach's alpha (α) and Omega's McDonald (ɷ). The statistical significance was set at P < 0.05.

Results: The EFA demonstrated that a single-factor structure with 11 items explained a cumulative 59.86% of the overall variance. The CFA confirmed that goodness of fit indices of this questionnaire had optimal adequateness (χ²_S-B = 109.047; χ²_S-B/(44) = 2.478, P=0.001; non-normed fit index = 0.901; comparative fit index = 0.908; root mean square error of approximation = 0.079 (90% CI (0.075, 0.083)); standardized root mean residual = 0.080). The coefficients indicated a high internal consistency for the total scale (α = 0.94; ɷ = 0.96).

Conclusion: The developed adaptation of HeLD-14 for the Colombian population, HeLD-Col, is a unidimensional, reliable, and valid instrument to assess oral health literacy in older adults in Colombia.