International Journal of Dentistry最新文献

Objective: The purpose of the present study was to evaluate: (i) occlusal plane (OP) changes after clear aligner therapy (CAT) and (ii) whether such changes correlate with the patient's facial divergence.

Materials and methods: Three-dimensional models of 118 patients (49 males and 59 females; mean ± standard deviation age 22.3 ± 3.4 years) treated with clear aligners were analysed retrospectively. Using CAD-CAM software, it was possible to define three planes: the reference palatine plane (PP), the OP and the reference vertical maxillary plane. The PP and OP meet mesially, identifying an angle (α) in the sagittal view. The intersection of the occlusal and vertical maxillary planes creates two angles in the frontal view: an angle (β) for the right side and an angle (γ) for the left side. Using Autodesk Fusion 360, the angles were investigated before treatment (T0) and after treatment (T1) to calculate the change for each angle Δ(T1-T0). Subsequently, lateral cephalograms were analysed and five measurements were made.

Results: One-way analysis of variance (ANOVA), showed a significant difference between hyperdivergent and hypodivergent patients for Δα and Δβ. The post hoc Tukey test showed the following differences: Δα was 3.81° greater in hyperdivergent patients compared with hypodivergent patients, and Δβ was 1.69° greater in hyperdivergent patients compared with hypodivergent patients.

Conclusion: Treatment with aligners did not lead to a clinically significant change in the OP. However, when dividing the sample into groups based on craniofacial divergence, OP orientation change differed significantly between the three groups.

Clinical significance: According to the present study, aligners may be a useful therapeutic option for hyperdivergent patients and a less favourable option for hypodivergent patients and patients with occlusal asymmetries, both structural and functional, who may need particular treatment approaches and diagnostic evaluations.

Objective: To investigate the implications of the COVID-19 pandemic on the lives of dentists in the municipal health network of Manaus.

Methods: A cross-sectional, descriptive, and exploratory study with a quantitative and qualitative approach. Between April and July 2022, an online questionnaire with closed and open questions was applied to dentists. The study included 81 professionals. The collected data were stored in a Microsoft Excel 2007 spreadsheet, generated by Google forms. For categorical data, absolute and relative frequencies were obtained. Content analysis, aided by Atlas ti software, Version 22, was used for textual analysis.

Results: The COVID-19 pandemic represented a constant source of stress and fear for dentists, negatively affecting their mental health.

Conclusions: In view of the above, the Unified Health System (SUS) needs to implement effective measures to protect and promote the mental health of its workers, such as offering specialized psychological support, promoting awareness campaigns on mental health risks, and creating support groups for professionals.

Background: Periodontal disease is polymicrobial in nature and to control the infection we need to target the inflammatory component. Nonsurgical periodontal therapy is used for mechanical debridement. Use of agents along with nonsurgical periodontal therapy is gaining momentum. Locally delivered agents like antibiotics and herbal products are used in nonsurgical and surgical periodontal therapy. Phytotherapy offers antioxidant, antimicrobial action and has less chances of drug resistance.

Objective: This study design compared locally delivered chlorhexidine (CHX) 1% gel and Citrus sinensis peel extract (CSPE) gel in the management localized periodontitis as an adjuvant treatment to scaling and root planing (SRP).

Material and method: Forty-six subjects diagnosed with Grade II/III localized periodontitis were randomly assigned into two groups. After thorough SRP, CSPE gel placement was done in the test group and 1% CHX gel in the control group. Clinical parameters measured were probing pocket depth (PPD), clinical attachment level (CAL) and microbiological analysis (bacterial culture from pocket sample) was done prior to SRP and at 60 days.

Results: Both the 1% CHX and CSPE gel provide comparable outcome (p ≥ 0.05) in improvement of PPD, CAL and bacterial colony count. Statistically significant results were obtained in terms of PPD; p = 0.044 (test group) and p = 0037 (control group). CAL showed statistically significant results in test group with p = 0.044. Inter group and Intra group comparison of plaque index showed no statistical difference. Colony forming units (CFU) between the two groups (p = 0.001) was found statistically significant.

Conclusion: Locally delivered herbal CSPE gel can be an effective, economical,and antibacterial gel as an adjunctive treatment of periodontitis.

Objectives: This study evaluates the changes in subgingival periodontopathogens following access flap surgery (AFS) in Stage III Grade B periodontitis patients.

Materials and methods: This randomized clinical split-mouth study included 20 systemically healthy periodontitis patients. Participants' right and left quadrants were randomly assigned to the control (nonsurgery) or test (AFS) group. Quantities of subgingival periodontopathogens (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) and periodontal measurements (gingival index [GI], plaque index [PI], bleeding on probing [BOP], probing depth [PD], and clinical attachment level [CAL]) were evaluated before and 4 weeks after surgery. Quantitative polymerase chain reaction was utilized for detecting and quantifying periodontopathogens.

Results: A significant reduction in periodontopathogens was observed in the test group, while levels increased in the control group (p  < 0.05). A significant difference was noted between the groups in changes in the quantities of periodontopathogens (p  < 0.05). The reduction in periodontal parameters was significantly greater in the test group 1-month post-AFS (p  < 0.05). Positive correlations were observed between decreases in P. gingivalis levels and reductions in T. denticola and T. forsythia (p  < 0.05).

Conclusions: AFS effectively reduces subgingival periodontopathogens and enhances periodontal health in the early healing phase. It demonstrates significant benefits for patients with advanced periodontitis and deep residual pockets.

Clinical relevance: AFS is an effective treatment option for managing deep residual pockets, as it promotes periodontal health and significantly reduces bacterial burden during the critical early healing phase. These results are particularly valuable for clinicians aiming to prevent disease progression, thereby enhancing patient care and treatment outcomes. Trial Registration: ClinicalTrials.gov identifier: NCT06684288.

Objectives: To analyze the posterior mandible bone ridge shape in relation to gender and tooth loss. Focusing on the accompanied changes and variations in lingual concavities.

Methods: 406 cone-beam computed tomography (CBCT) images with dentulous and edentulous 1st and/or 2nd molars (206 females and 200 males, aged ≥20) were examined. Mandibular morphology was classified into U type (undercut), P type (parallel), and C type (convex). The study examined the ridge morphology and dimensions. Lingual concavities angle, area, and the concavity position were measured/reported.

Results: U type bone shape was the most common bone shape 64.1%, then P type was 24.8%, while C type was 11.2 %. U ridge was more frequent in 2nd molar compared to the 1st molar regions (p = 0.04), while C type was statistically related to long extraction time (p = 0.001). Many bone ridge measurements were higher in males (p < 0.05). Other significant differences in measurements were found at 36, 37, 46, and 47 dentate and missing sites (p < 0.05). Lingual concavities were larger in males (p < 0.001) and relatively larger at 2nd molar dentulous ridges; 37 (p = 0.02). Also, they were more statistically frequent at the level of mandibular canal (MC) or above (p = 0.0001).

Conclusion: The U type ridge was the most common in the studied population, occurring more often in the second molars region. Bone ridge and lingual concavities dimensions were varied by gender, tooth loss, and specific tooth. Lingual concavities were significantly related to MC level.

Background: The repairability of provisional restorative materials affects the duration of the provisional treatment phase. This study evaluated the effects of various silane (Si)-containing universal adhesives on the shear bond strength (SBS) of aged three-dimensional (3D)-printed provisional restorative materials.

Methods: Seventy SBS specimens (20 mm diameter × 15 mm height) and 10 specimens for energy-dispersive X-ray (EDX) analysis (5 mm diameter × 3 mm height) were fabricated. All SBS specimens underwent thermocycling in artificial saliva at 5- 55 °C, with 60 s dwell time, using a thermocycler (SD Mechatronik, Germany). The SBS specimens were randomly divided into seven groups (n = 10 per group) on the basis of the repair method: C group (control), S group (Single Bond 2), SU group (Scotchbond Universal), SUP group (Scotchbond Universal Plus), CUQ group (CLEARFIL TRI-S BOND Universal Quick), GPB group (G-Premio Bond), and Si + S group (Silane Ultradent + Single Bond 2). The SBS test was performed using a universal testing machine (Instron, ElectroPulsTM E1000, England). Failure modes were analyzed for all debonding surfaces. Data was analyzed using one-way analysis of variance (ANOVA) and Tukey's HSD test (p < 0.05).

Results: The highest SBS was observed in the Si + S group (21.06 ± 1.47 MPa), followed by SUP (19.43 ± 1.45 MPa), CUQ (16.14 ± 1.54 MPa), SU (15.71 ± 1.40 MPa), GPB (12.93 ± 1.56 MPa), S (12.59 ± 1.64 MPa), and C (8.20 ± 1.49 MPa). However, no significant difference in the SBS was observed between the Si + S and SUP groups. Additionally, there was no significant difference in SBS between S and GPB. Failure mode analysis revealed a correlation between the type of failure pattern and the SBS results.

Conclusion: The SUP group, a silane-containing universal adhesive, demonstrated high SBS comparable with the separate application of Si, suggesting it as a viable alternative in provisional material repair.

Aim: The greater palatine foramen (GPF) transmits the greater palatine neurovascular bundle, and its position and shape directly affect palatal anesthesia, palatal surgery, and graft harvesting. This study aimed to evaluate variations in the location and morphology of the GPF across different sagittal maxillary growth patterns in an Iranian adult sample.

Methods: Sixty cone beam computed tomography (CBCT) scans were analyzed (20 per Sella-Nasion-A (SNA) angle: deficient, normal, excessive). GPF shape, location relative to the molar teeth, its position with respect to adjacent structures (including distances to the alveolar ridge, mid-palatal suture, contralateral GPF, and incisive foramen [IF]), and the angle between the mid-palatal suture, IF midpoint, and GPF midpoint were assessed and compared among the three sagittal maxillary growth patterns.

Results: The GPF-IF distance differed significantly between sagittal groups (right: p = 0.004; left: p = 0.005), being shorter in the deficient maxillary group. The distribution of the GPF position relative to the molar teeth also differed significantly between groups (both sides: p  < 0.001). Other morphometric parameters showed no significant differences (Table 1).

Conclusion: In this Iranian adult sample sagittal maxillary growth pattern is associated with variations in GPF-IF distance and its anteroposterior position relative to molars; these should be considered during palatal anesthesia and surgical planning. Further clinical correlation is warranted.

Background: Periodontitis is a chronic immune-mediated inflammatory disease characterized by the progressive degradation of periodontal tissues. Conventional therapies, including anti-inflammatory agents and antibiotics, are limited by systemic adverse effects and increased microbial resistance, highlighting the need for safer, multi-targeted treatments.

Objective: This review systematically evaluates the therapeutic potential of plant- and fungal-derived polysaccharides in periodontitis treatment. It focuses on their multifaceted biological activities, including anti-inflammatory, antioxidant, antimicrobial, and osteo-regenerative effects, and elucidates key molecular mechanisms, such as nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), mitogen-activated protein kinase (MAPK), Wnt/β-catenin, and BMP-2/Smad signaling pathways. Additionally, it identifies current research gaps and proposes strategies to facilitate the translational development of polysaccharide-based therapies.

Materials and methods: A systematic literature search was performed across PubMed, Scopus, Web of Science, and Google Scholar databases using a combination of Medical Subject Heading (MeSH) terms and keywords, including "periodontitis," "plant polysaccharides," "fungal polysaccharides," "inflammatory factors," and "bone regeneration." A total of 104 studies were included after screening for relevance to the therapeutic roles and molecular mechanisms of plant- and fungal-derived polysaccharides in periodontitis. The dataset encompassed both in vitro and in vivo investigations, and narrative synthesis was employed to integrate findings owing to the substantial heterogeneity in study designs, endpoints, and methodological approaches.

Conclusion: Plant- and fungal-derived polysaccharides have substantial potential as adjunct or alternative therapies for the treatment of periodontitis. Their multifunctional activities, including modulation of inflammation, inhibition of pathogenic biofilms, and promotion of periodontal tissue regeneration, are mediated through complex multi-pathway interactions. Clinical translation remains limited by structural heterogeneity, a lack of standardized preparation protocols, and insufficient in vivo validation. Future research should prioritize elucidating structure-activity relationships, optimizing extraction and formulation methods, and conducting well-designed clinical trials. Integrating evidence from 104 studies, this review underscores the anti-inflammatory, antimicrobial, and osteo-regenerative effects of these polysaccharides and emphasizes their importance in future clinical applications.

Background: The sealer's penetration into dentinal tubules creates a physical barrier that entombs any remaining bacteria and increases the surface contact with the root canal walls. This study aimed to evaluate the dentinal tubule penetration and push-out bond strength of four sealers and to assess the correlation between penetration depth and bond strength.

Methods: In this in vitro study, 40 human single-rooted anterior teeth were divided into four groups based on the sealer type and obturated using the single cone technique. Three slices of 1 ± 0.1 mm thickness were then prepared from each tooth at three regions-coronal, middle, and apical thirds-perpendicular to the longitudinal axis of the root. The depth and percentage of sealer penetration into the dentinal tubules were measured using confocal laser scanning microscopy (CLSM) on the prepared slices. To assess the bond strength of the sealers to dentin walls, a push-out bond strength test was performed using a universal testing machine. Data were analyzed using SPSS software through ANOVA, Tukey post hoc and Pearson's correlation tests. A p-value of <0.05 was considered statistically significant.

Results: Statistically significant differences were observed in the extent and percentage of penetration, and the push-out bond strength of the studied sealers (p  < 0.001 for all). Additionally, a significant correlation was found between bond strength and penetration percentage for AH Plus (p = 0.046 and r = 0.366), between bond strength and both penetration extent (p = 0.013 and r = 0.448) and penetration percentage (p = 0.001 and r = 0.572) for Endoseal MTA, and between bond strength and penetration extent for Endoseal TCS (p = 0.001 and r = 0.57).

Conclusion: Calcium silicate-based sealers (Endoseal MTA and Endoseal TCS) achieved the greatest penetration, whereas AH Plus demonstrated the highest bond strength. The positive correlations observed suggest that dentinal tubule penetration may contribute to stronger bonding for specific sealers.

Introduction: Majority of the traumatic dental injuries (TDIs) occur at schools. School teachers are the immediate person to come in contact after dental injuries, so it is necessary for them to have knowledge about the first aid management of the injured tooth.

Objective: To determine the knowledge of first aid management of TDIs among primary school teachers of Dharan, Nepal.

Methods: A cross-sectional questionnaire based study was conducted among primary school teachers of Dharan city. A self-administered questionnaire was distributed among 110 school teachers equally from both public (n = 55) and private (n = 55) schools. Descriptive statistics, chi-square test, and logistic regression analysis were used to report the data. The level of significance was set at p  < 0.05.

Results: The mean age of the school teachers participating in the study was 36.38 ± 10.98 years. Majority of them (73.6%) were females. Only few school teachers (23.6%) were informed or trained about dental trauma. The primary source of information was through the internet (57.7%). More than two-third of the school teachers had poor knowledge (85.5%) on first-aid management of TDIs. A statistically significant difference was observed in the primary management of avulsed tooth between teachers of public and private schools (p = 0.007).

Conclusion: The findings of this study concluded that primary school teachers of Dharan city had poor knowledge on first-aid management of TDIs which reflects a need to improve their knowledge on the same.