International Journal of Dentistry最新文献

Objectives: This study aims to evaluate the color-matching ability of OMNICHROMA composite, a single-shade composite, using the CIE L ^∗ a ^∗ b ^∗ system and determining ΔE values. Materials and Methods: In this in vitro study, 30 intact premolar teeth were collected, cleaned, and disinfected with 0.5% thymol solution. The teeth were stored in distilled water at 37°C. A putty index calibrated the color assessment sites on buccal and lingual surfaces. Two cavities were prepared, one with 1.25 mm depth (enamel) and another with 2.25 mm depth (dentin), and restored using OMNICHROMA composite resin. The putty index measured the color of the cured composite, and ΔE between the composite and original tooth color was calculated. Statistical analysis: Data analysis included t-tests, correlation coefficients, and Fisher's exact test (α = 0.05). Results: The mean ΔE was 2.39 in enamel cavities and 2.32 in dentin cavities, both within the clinically acceptable range (<3.3). In enamel cavities, the composite color was darker than the tooth, shifting toward green and blue shades. In dentin cavities, the composite color was lighter than the tooth, with shifts toward green and yellow shades. Color matching was slightly better in dentin cavities, but the difference was not statistically significant (p=0.719). Conclusion: OMNICHROMA composite resin's color matching falls within the clinically acceptable range, unaffected by cavity depth.

Objective: The purpose of this study is to determine the prevalence and features of oral and maxillofacial lesions found in the residents of Al-Qassim region, Saudi Arabia. Methods: A retrospective study was conducted at King Fahad Specialist Hospital, Buraidah, Qassim, KSA. The data for all biopsied oral and maxillofacial lesions were retrieved from January 2014 until August 2022. All patients' data including age, gender, location of the lesion, and histopathologic diagnosis were reviewed and analyzed using IBM SPSS version 23 and Microsoft Excel. Results: A total of 381 oral pathology biopsies for individuals aged 18 and above were included in a descriptive analysis. One hundred ninety five (51.18%) of patients were male, and 186 (48.82%) were female. The site most commonly biopsied was the oral mucosa (26%). The diagnosis was categorized according to the histopathological diagnosis into 13 categories including all pathological lesions in the oral and maxillofacial area. The frequently biopsied category was soft tissue pathological lesion category (26%), second to that is the odontogenic cyst category (22%), and third is the immunological-mediated lesion category (13%). The sub-diagnosis that was mostly observed was radicular cyst, lichen planus, and focal fibrous hyperplasia with the percentages of 13.6%, 10.8%, and 9.4%, respectively. Conclusion: The findings provide important information about the oral and maxillofacial pathology in Al-Qassim region, Saudi Arabia. This study found that biopsied oral lesions were more prevalent in males and in patients in the fourth decade of life. The oral mucosa was the most biopsied site, and the majority of the biopsies were soft tissue pathological lesions and radicular cyst was the most frequent diagnosis. Knowledge of such demographic and clinical features of oral and maxillofacial pathology cases helps in prediction of disease incidence and subsequent proper patient care in the region.

Introduction: This study investigated the distribution pattern of tenascin-C and syndecan-1 in the dental mesenchyme during root development of immature swine teeth in order to define the differentiation dynamics of both pulp tissue progenitors and apical papilla cells, as well as to assess the adequacy criticize of the apical papilla to induce dentin-pulp regeneration. Methods: Three 7-month-old miniature swine were used in this study. A total of 12 teeth, including two immature permanent incisors and two premolar teeth of each case, were extracted and processed for histological and immunohistochemical analysis. Different populations of mesenchymal cells located at the root apex were morphologically evaluated in hematoxylin-eosin serial sections. Additionally, the distribution patterns of tenascin-C and syndecan-1 were assessed immunohistochemically. Results: Syndecan-1 was strongly expressed in the dental pulp, particularly along the odontoblasts of the root and the newly deposited predentin layer. Tenascin-C was intensely expressed in the dental pulp. The apical papilla and dental follicle showed no expression of either molecule. Conclusions: Cell differentiation potential in the developing swine apex is progressively restricted to the newly formed dental pulp, whereas phenotypic expression of apical papilla cells remains undetermined unless the new microenvironment triggers cell differentiation towards the odontoblastic lineage.

Background: Pain-related temporomandibular joint disorders (TMJD) are a major public health problem, including the diagnoses of disc displacement (DD) with and without reduction (DDwR/DDwoR). Objectives: The study aimed to examine the matrix remodeling and the inflammatory profile in synovial tissues of patients with TMJ-DD, with a view to understand the pathophysiology, and to contribute to the development of tissue-based diagnostic criteria. Methods: This laboratory-based observational case-control study included 30 synovial tissue samples obtained from 30 patients, diagnosed with delayed (DO) or sudden (SO) onset of DDwoR, which were compared against the reference patient material, DDwR (n = 10/diagnosis group). Tissue samples were investigated histologically and via quantitative immunohistochemistry for a panel of antibodies targeted against extracellular matrix proteins and inflammatory markers. The data were analyzed using a generalized linear model with a gamma family distribution (p < 0.05). Results: Quantification of immunostaining revealed significant differences in the distribution of collagen type III (DO, p < 0.001), lumican (DO, p < 0.05), matrix metalloproteinase-2 (DO, p < 0.05), CD4 T-helper cells (DO, p < 0.01; SO, p < 0.001), and CD68 monocytic immune cells (both SO and DO, p < 0.001) in DDwoR groups compared to the reference patient material, DDwR. Conclusions: The observations confirmed differences in matrix remodeling and an increase in local inflammatory activity in the DDwoR diagnosis compared to the reference patient material, DDwR. The study highlighted the importance of synovial tissue characterization to unite micropathology and clinical findings, leading to more reliable diagnostic tools.

Purpose: The aim of this study was to develop a competency framework based on entrustable professional activities (EPAs) in oral cancer management by postgraduate trainees in oral and maxillofacial surgery through expert consensus.

Materials and methods: The study design was based on a modified Delphi technique and involved iterative online surveys with two rounds of data collection and analysis. Initial development of the questionnaire identified five EPAs based on 42 competencies along with supervision level and assessment strategies. The first Delphi round involved administration of the survey questionnaire online to maxillofacial surgeons meeting the inclusion criteria for experts. Consensus was achieved on five EPAs and 36 competencies (≥80% response rate). Six competencies were rephrased and sent again in the Round 2 questionnaire to achieve a consensus.

Results: A total of 45 experts participated in Round 1 followed by input from 27 experts in Round 2 of the Delphi panel. Following two iterative rounds of online surveys and feedback, expert consensus was achieved to develop an EPA framework in five EPA domains focused on the management of oral cancer by postgraduate trainees in maxillofacial surgery including 38 specific competencies, supervision level, and assessment strategies. High content validity of the study was established through a comprehensive literature search, and expert feedback was evidenced by an excellent response rate (93.34%, and 64.28%) and a stringent criteria of response agreement amongst experts (≥80%).

Conclusion: In conclusion, this study employed expert consensus to identify five EPAs with 38 competencies along with the required supervision level of postgraduate maxillofacial trainees for the management of oral cancer. This EPA framework provides a roadmap for training supervisors to map the learning outcomes in oral oncology for postgraduate trainees in oral and maxillofacial surgery.

Background: Phenotype alterations of nociceptive neurons have been shown to be a key step in the pathogenesis of many pain-related diseases. However, it is unclear if the characteristic changes of temporomandibular joint (TMJ) primary afferent neurons are related to the pathogenesis of temporomandibular joint osteoarthritis (TMJOA) chronic pain. This study aimed to determine the morphological and neurochemical changes in trigeminal ganglion (TG) neurons innervating the TMJ in TMJOA chronic pain rats. Materials and Methods: Monosodium iodoacetate (MIA)-induced TMJOA chronic pain rat model was established (n = 6), and saline was injected in rats of the control group (n = 6). TMJ primary afferent neurons were labeled with retrograde tracing (Dil). The spatial distribution and the expression of calcitonin gene-related peptide (CGRP), isolectin B4 (IB4), and neurofilament 200 (NF200) of TMJ primary afferent neurons in TG were investigated using immunofluorescence. Intracellular calcium signaling was recorded by calcium imaging (n = 20). Results: TMJ primary afferent neurons were located only in the V3 region of the TG from both saline- and MIA-injected rats. The number of TG neurons innervating the TMJ was increased in MIA-injected rats. Elevated number and intracellular calcium concentration of small- and medium-sized instead of large-sized Dil+ TG neurons were found in MIA-injected rats. The upregulated expression of CGRP and IB4, but not NF200, in TG neurons innervating the rat TMJs was accompanied by TMJOA chronic pain. Conclusion: This study suggests that sensitization of small- to medium-sized Dil+ TG neurons and CGRP- and IB4-positive Dil+ TG neurons might contribute to the development of TMJOA chronic pain in rats. This will provide valuable information for more efficient control of TMJOA chronic pain.

Aim: The current review aims to explore postoperative neurological complications in third molar extractive surgery.

Materials and methods: The PRISMA protocols were followed when conducting this review. We found a total of 2,250 articles that matched our topic using the Boolean keywords, mandibular nerve complications AND oral surgery, from PubMed (1,083), Scopus (435), and Web of Science (732), with the filters of English language articles, time range January 1, 2003, to September 30, 2023, and human studies. After 762 duplicates were eliminated, there remained 1,488 articles. Eleven final articles were deemed of the highest relevance to our topic by eliminating articles in animals, non-English language, reviews, meta-analysis, and off-topic. A potential risk in the third molar extraction was temporary loss of sensibility often caused by mild compression or irritation of the mandibular nerve. This typically resolves within weeks or months, but in severe cases, recovery might take longer. Permanent loss of sensation can occur, indicating significant nerve damage and lasting effects on touch, temperature, or pain perception.

Conclusions: Various treatments exist for nerve damage, including low-level laser therapy, pain management medications, or physical therapy. While these therapies may improve neurosensory impairment, patients often report a decline in their quality of life.

Purpose: Children's fear of the injection of local anesthetic agents affects their cooperation in pediatric dentistry. Different techniques are available to decrease the injection pain, including the use of precooling agents or vibrators. The present study investigated the effectiveness of Buzzy (Buzzy MMJ Labs, Atlanta, GA, USA). This device transfers cold and external vibration to the injection site during the inferior alveolar nerve block (IANB) injection. Materials and Methods: The present self-control, randomized, and double-blind clinical trial evaluated 30 children aged 6-12, who had bilateral mandibular permanent or primary carious molar teeth. On one side, the BUZZY was applied before and during the IANB injection, and the other side was considered as control. On both sides, a topical anesthetic gel was applied before injection. The pain severity and children's anxiety were determined using Wong-Baker, face, leg, activity, cry, consolability (FLACC) scales, and the heart rate. Results: The mean age of the participants was 7.18 ± 1.5 years, with 12 girls and 18 boys. The Wong-Baker scale and FLACC scale did not show any statistically significant difference between BUZZY and control (p value = 0.9 and 0.15, respectively). In addition, BUZZY tool did not significantly decrease pain and anxiety during injection, assessed through the heart rate difference (p=0.38). Conclusion: Under the limitations of the present study, a combination of precooling and vibration using the BUZZY device did not decrease pain and anxiety in children during the IANB injection.

Objective: The objective was to assess radiographic periodontal bone loss in a population with previously undiagnosed celiac disease, and to compare it to a reference group without celiac disease.

Background: Periodontitis and celiac disease are chronic inflammatory diseases with possible similar features related to immune reactions and microbial dysbiosis. The relationship between these two diseases is not clear.

Methods: Clinical variables, blood samples, and answers to questionnaires were collected from participants in the fourth Trøndelag Health Study (HUNT4). Celiac disease was determined based on transglutaminase 2 (TG2), immunoglobulin A (IgA), and G (IgG) in serum samples. Seropositive individuals were invited to endoscopic examination and tissue sampling. Radiographically assessed bone loss caused by periodontitis in two different levels of severity was applied as outcome, that is, ≥15% and >33% of root length. Bone loss was determined in panoramic images in participants that had attended radiographic examination in the HUNT4 Oral Health Study or in the HUNT4 Coeliac Disease Study. The association between previously undiagnosed celiac disease and radiographic bone loss was estimated by adjusted Poisson regression models.

Results: Radiographic assessment was completed in 485 individuals with celiac disease determined by positive serology and in 4,727 individuals with negative serology (without celiac disease). Compared to nonceliacs, seropositive participants were less likely to present with ≥15% radiographic bone loss (prevalence ratio (PR) 0.89 (95% CI 0.84-0.96). A similar association was also observed after histopathological confirmation of celiac disease (PR 0.89 (95% CI 0.82-0.98). No association between undiagnosed celiac disease and periodontal bone loss was observed when analyses were limited to individuals with severe bone loss (>33%).

Conclusion: In this study of previously undiagnosed celiac disease and periodontal bone loss, newly diagnosed celiac disease was associated with less likelihood of presenting with ≥15% radiographic bone loss compared to a nonceliac reference group.

Aim: The aim of this study was to assess the color changes in artificially induced incipient caries after photodynamic therapy (PDT) using different concentrations of methylene blue and toluidine blue, along with irrigation using water and hypochlorite.

Materials and methods: Forty-two sound human premolar teeth were used to create two artificial incipient carious lesions. One lesion was placed on the buccal surface and the other on the lingual surface. The color of these artificial incipient carious surfaces was determined using the CIE L  ^∗ a  ^∗ b  ^∗ color system. The teeth were then randomly assigned to 12 groups (n = 7) based on the PDT method. These methods included methylene blue with concentrations of 50, 100, and 150 µg/mL, followed by water irrigation, methylene blue with concentrations of 50, 100, and 150 µg/mL, followed by hypochlorite solution irrigation, toluidine blue with concentrations of 50, 100, and 150 µg/mL, followed by water irrigation, and toluidine blue with concentrations of 50, 100, and 150 µg/mL, followed by hypochlorite solution irrigation. The teeth underwent a colorimetry procedure again, and the resulting color changes were calculated. A three-way ANOVA was performed to analyze the effects of laser wavelength, concentration of the light-absorbing material, and irrigation solution on ΔE.

Results: The results showed that the color changes caused by toluidine blue photosensitizer at a concentration of 100 µg/mL, with both water and hypochlorite irrigation, were not noticeable to the naked eye (ΔEwater = 3.04, ΔEhypochlorite = 2.00). However, in the other study groups, the color changes were perceptible (ΔE > 3.3). There were no significant differences in ΔE between different concentrations of methylene blue and toluidine blue when using either water or hypochlorite irrigation (P  > 0.05). A significant difference was observed between methylene blue and toluidine blue at a concentration of 100 µg/mL with water irrigation (P=0.006). Additionally, a significant difference was found between methylene blue and toluidine blue at a concentration of 100 µg/mL with hypochlorite irrigation (P=0.049). However, no significant differences were observed between methylene blue and toluidine blue at other concentrations with either water or hypochlorite irrigation (P  > 0.05).

Conclusion: In conclusion, tooth color in teeth with incipient caries did not change significantly after PDT using toluidine blue (the photosensitizer) at a concentration of 100 µg/mL with either water or 1% hypochlorite solution irrigation for 5 s.