Journal of Clinical and Experimental Dentistry最新文献

Background: Some odontogenic cysts (OCs) and odontogenic tumors (OTs) are infiltrative and often recur, causing bone destruction and tooth loss. In the elderly, in particular, these injuries cause significant morbidity, making rehabilitation difficult and compromising the quality of life of these individuals. Objective: To determine the prevalence and demographic characteristics of OCs, non-odontogenic cysts (NOCs), and OTs diagnosed in an elderly Brazilian population (≥60 years).

Material and methods: A retrospective descriptive cross-sectional study was carried out in three Brazilian pathology referral centers (1999-2019). Data regarding age, sex, ethnicity, anatomical location, symptomatology, and histopathological diagnosis were obtained from histopathological records and analyzed. Pearson's Chi-squared and Fisher's exact tests were used to evaluate the association between the different groups of oral lesions and demographic findings, adopting a P-value of ≤ 0.05 and a 95% confidence interval.

Results: A total of 7,476 histopathological records were evaluated, of which 389 (5.2%) cases were classified as OCs, 86 (1.15%) as NOCs, and 83 (1.11%) as OTs. The most common lesions in each group were periapical cysts (n=166; 68.9%), ameloblastomas (n=65; 77.4%), and salivary duct cysts (n=45; 52.3%). Overall, males were slightly more affected (n=279, 50.2%). Most individuals were between 60 and 69 years (n=358; 64.2%). OCs and OTs preferentially affected the mandible (n=280; 62.2%). NOCs occurred more frequently in the lips (n=19; 22.1%), followed by buccal mucosa (n=18; 20.9%). The overall concordance between clinical and histopathologic diagnoses was 47.2% (213 of 451 cases).

Conclusions: OCs were relatively common, whereas NOCs and OTs were rarer among the elderly. The low concordance between clinical and histopathological diagnosis highlights the importance of histopathological analysis to ensure an accurate diagnosis. Dentists and geriatricians must be familiar with these lesions to ensure an early diagnosis, reduce morbidity and improve the quality of life of these individuals. Key words:Odontogenic cysts, Non-odontogenic cysts, Odontogenic tumors, Oral diseases, Older people, Oral lesions.

Background: Treatment of acid-resistance high-translucent zirconia prior to luting procedures is usually carried out with sandblasting. Considering that this process could lead to the formation of cracks on the zirconia surface, laser irradiation became an alternative to sandblasting. The effect of diode laser, however, was never investigated under this context. Therefore, this study aimed to evaluate the effect diode laser irradiation on the bond strength between zirconia and two resin cements after 48-hour and 12-month water aging.

Material and methods: Slabs of high-translucent zirconia were sandblasted with 50-µm Al2O3 particles (SB), irradiated with diode laser (DL), or SB+DL. All slabs were etched with 10% hydrofluoric acid and layered with a universal adhesive. Plastic tubes with 0.8-mm internal diameter positioned on treated zirconia surfaces were used as matrices to insert a dual- (DUAL) or a light-cure (LC) resin cement. All specimens were light-cured for 40 seconds at 1000 mW/cm2 and submitted to the µSBS test after 48-hour or 12-month water storage. Data were statistically analyzed with a three-way analysis of variance (p<0.05).

Results: The µSBS of DUAL was higher than LC only after 12 months for SB or SB+DL-treated zirconia (p<0.05); in addition, SB+DL resulted in higher µSBS than DL only for DUAL resin cement (p<0.05). The 12-month aging resulted in higher µSBS for DUAL resin cement luted on SB or SB+DL-treated zirconia, as well as for LC luted on DL-treated zirconia (p<0.05). Most of the DUAL specimens presented adhesive failures after 48 hours. After 12 months, the majority of DUAL specimens luted on DL or SB+DL-treated zirconia presented adhesive failures.

Conclusions: The use of dual-cure resin cement on sandblasted or sandblasted and diode laser-irradiated zirconia exhibited superior bond strength after aging. Key words:Microshear bond strength, Resin cement, Diode laser, Zirconia, Sandblasting.

Background: During the past years, a bidirectional relationship has been proved between periodontitis and some systemic disorders, such as diabetes mellitus (DM) and cardiovascular diseases (CVDs). The aim of this study was to compare the general health status between patients with and without periodontitis from a Spanish university dental clinic.

Material and methods: A retrospective observational case-control study was conducted to achieve the research objective. The random sampling was extracted from the patients who attended to the university dental clinic between January 2017 and December 2020.

Results: A total of 2,714 (44.6% males and 55.4% females, 49 [38-60] years old) were included: 1,363 cases (patients with periodontitis; 47.2% males and 52.8% females; 54.6 ± 13.4 years old) and 1,351 controls (patients without periodontitis; 41.9% males and 58.1% females; 44.2 ± 13.4 years old). Patients with periodontitis had lower oral hygiene habits than controls: the 28.9% vs 7.0% (p-value <0.001) brushed their teeth once a day, 94.9% vs 69.6% (p-value <0.001) did not use interproximal cleaning. 31.0% of periodontal patients were smokers vs 21.2% of the control group (p-value <0.001). 51.8% of patients with periodontitis were taking medication vs 31.2% of the controls (p-value <0.001). Regarding their general health status, 8.2% periodontitis patients had DM vs 3.9% of the controls (p-value <0.001) and 21.3% of the cases suffered from high blood pressure (HBP) vs 10.6% (p-value <0.001). In addition, a multivariable regression analysis was performed, where the variables with more strength were age, number of cigarettes and oral hygiene habits.

Conclusions: In the present research, statistically significant differences have observed between patients with and without periodontitis, regarding medication, health problems such as DM, HBP, CVD and cholesterol. Key words:Periodontitis, systemic diseases, health status, university dental clinic.

Background: To compare self-reported empathy scores, clinical performance between National Service Scheme (NSS) volunteers and non-volunteers in dental schools; and to predict clinical performance score using self-reported empathy score.

Material and methods: A cross sectional survey of 336 undergraduates from 16 dental schools in Andhra Pradesh state, India was conducted using Google forms. The questionnaire was divided into four sections. Section A consists of a single question asking whether a graduate is a NSS volunteer or not. Section B consisted of Jefferson Scale of Empathy Health Profession Students' Version (JSPE-HPS) with 20 items based on a 7-point Likert scale. Section C was designed to investigate students' self-confidence in performing 35 clinical procedures on a 5-point Likert scale. Section D gathered information related to clinical exam score in external practical assessment during final year. The data collected were subjected to appropriate statistical tests.

Results: The JSPE-HPS score between NSS volunteers (91.52+7.35) and non-volunteers (76.21+5.42) was significantly different. The overall self-reported clinical score was 3.57+.34 and 3.08+.43 for NSS volunteers and non-volunteers respectively (p=0.000). Also, the mean clinical performance score was higher for NSS volunteers (501.15+53.97) compared to non-volunteers (445.03+34.94). The JSPE-HPS scoreswere positively associated with clinical performance scores (r=0.559). Furthermore, we discovered that JSPE-HPS scoresignificantly predicted clinical exam score (β = 2.959, p< .000).

Conclusions: NSS training enabled dental undergraduate students acquire empathy and clinical skills during their education. Key words:Clinical Skills, Dental Education, Empathy, National Service SchemeCare Team.

Background: The aim of this study was to investigate how different scanning protocols affect the accuracy (trueness and precision) of intraoral scanning of complete arches with implant cylinders.

Material and methods: A master model was designed with five cylinders. One scanner, TRIOS2 (3shape), was used to scan the model with four different scan protocols: ROCK (wavelike scanning in a pendulum movement), ZIGZAG (wavelike scanning technique), OBP (occlusal, buccal, and palatal), and OWBP (occlusal, wiggling, buccal, and palatal). A total of 30 scans were performed using each of the four protocols. The master model was digitized with an industrial ISO-certified ATOS scanner. GOM inspect software was used to compare the scans to the master model and evaluate any deviation between the scan protocols and the master model. The data was analyzed using the One Sample t-test (p=0,05).

Results: The precision (standard deviation) ranged from 23-83μm for protocol ROCK, 22-147μm for ZIGZAG, 21-170μm for OBP, and 23-116μm for OWBP. The trueness (mean deviation from master model) was 5-41μm for ROCK, 7-97μm for ZIGZAG, -21-29μm for OBP, and 1-24μm for OWBP. All protocols showed statistically significant differences to the master model in multiple distances, except OWBP, which had a single significant difference in comparison to the master model.

Conclusions: Protocol OWBP has a higher trueness than other tested protocols. All tested protocols have higher trueness and precision when scanning smaller distances than inter-arch measurement. Clinical significance;The trueness and precision of intraoral scanning is generally better in smaller spans due to less deviation. The protocol OWBP, that is recommended by the manufacturer, has the least deviating trueness in comparison to the master model. Key words:Accuracy, trueness, precision, intraoral scanner, digital impression, scanning protocol.

Background: This systematic review evaluated the long-term clinical effectiveness of Biodentine in vital pulp therapy procedures.

Material and methods: Two independent reviewers searched the PubMed, Scopus, Web of Science, Cochrane, LILACS, and DOSS databases for articles published until August 2023. Review Manager and GRADEpro software were used for the analysis, and the Revman5.3 program was used for the meta-analysis. Initially, 297 publications were found, of which 12 studies, including 1385 clinical evaluations and 881 radiographic evaluations, were considered for qualitative and quantitative analysis.

Results: Regarding the therapeutic indication, Biodentine presented a clinical success rate of: 96.38% for primary teeth submitted to pulpotomy, in a follow-up of 3-24 months, 97.18% for permanent teeth submitted to direct pulp capping in a follow-up of 3-54 months and 99.24% for primary teeth submitted to indirect pulp capping at a follow-up of 3-12 months. In radiographic analyses, a success rate of: 89.82% was observed for primary teeth submitted to pulpotomy at a follow-up of 3-24 months and for permanent teeth submitted to indirect pulp capping at a follow-up of 3-12 months.

Conclusions: Biodentine is a reliable material for applications similar to that of mineral trioxide aggregate, with high long-term clinical and radiographic success rates, in primary and permanent teeth, regardless of the therapeutic indication. The efficacy and benefits of Biodentine, make it a promising endodontic material. Key words:Systematic review, Dental materials, Pulpotomy.

Background: Sintering technique impacted color of zirconia. This study examined the effect of glass infiltration and altering cooling rate on color alteration of monochrome (Mo) and multilayer (Mu) 5 mol% yttria-partially stabilized zirconia (5Y-PSZ).

Material and methods: 180 specimens (width, length, thickness = 10, 20, 2 mm) were prepared from Mo and Mu (comprising cervical (C) and incisal (I) zone) 5Y-PSZ shade VITA-A2. Unintentionally categorized samples (n=15/group) were sintered with traditional (T) versus glass infiltrated (G) technique and cooled down with slow (S: 5°C/min), normal (N: 35°C/min), and fast (F: 70°C/min). CIE-L*a*b* color characteristics were determined for translucency parameter (TP), contrast ratio (CR), opalescence parameter (OP), and color difference (∆Ediff). Microstructures were investigated with SEM and XRD. ANOVA and Tamhane's comparisons were determined for significant differences (p<0.05).

Results: TP and OP were significantly higher for Mo than MuC and MuI, but no significant difference in CR among them. Comparable ΔEdiff between Mo and MuC were indicated, but both were significantly lesser than MuL. Glass infiltration and raising cooling rate significantly decreased TP and OP, whereas increased CR and ΔEdiff, which amplified color alteration.

Conclusions: Glass infiltration sintering and modified cooling rate significantly altered color parameters of 5Y-PSZ. Monochrome demonstrated higher translucency and opalescence than multilayer, possibly due to colorant additives. Glass infiltration decreased translucency and opalescence due to different refractive indices. Increased cooling rate resulted in decreasing translucency and opalescence due to smaller grain size and t→m transformation. Nevertheless, altered sintering and cooling rates still rendered an acceptable color alteration. Key words:Cooling rate, glass infiltration, optical characteristics, translucency.

Recurrence is a well-known feature of odontogenic keratocyst (OKC). Compared with other odontogenic cysts, OKC is characterized by an infiltrating growth, aggressive biological behavior, and a greater tendency towards recurrence once removed, particularly when simple enucleation has been carried out. The recurrence rate is largely dependent upon the type of treatment applied; consequently, the planning of management must take into account the possible reasons why the cyst may recur. The present article describes the 25-year follow-up of a large multilocular OKC and discuss the possible causes of its multiple recurrences, as well as the treatments applied, with special attention on the last management approach adopted. Key words:Odontogenic keratocyst, treatment, recurrences, long-term follow-up.

Background: Compared to high modulus repair materials such as zirconia and alumina, hybrid polymer-ceramic materials have lower stress concentrations in the tooth structure and bonding interface. The aim of this study is to evaluate viable cementation protocols through an integrative review and meta-analysis.

Material and methods: This systematic review was based on the PRISMA criteria. An electronic search was carried out in seven databases: Web of Science, Embase, PubMed, Clinical Trials, Scopus, Cochrane, Periodicals of Capes. The following inclusion criteria were used: hybrid ceramics, surface treatment protocol and which union test was presented, discarding duplicate articles and studies that did not meet the inclusion criteria. The articles were analyzed and selected through the RayYan platform.

Results: Of the 160 articles identified, 24 studies were included in this review. The materials used by the authors were the hybrid ceramics: Vita ENAMIC, LAVA ULTIMATE, Cerasmart, Shofu Block, and the possible surface treatment protocols presented involving the use of: HF, Alumina blasting with or without silica, Silane, Laser and adhesive. The tests were carried out at different times and concentrations of the analyzed materials.

Conclusions: With the studies that were included in this review, it was possible to show that the corrosion made by HF continues to be the gold standard for the treatment of surfaces in hybrid ceramics. Key words:Hybrid ceramic, Bond Strength, Cementation.

Background: Considering the development of new 3D printing technologies that use different printing techniques, further studies must be conducted to evaluate the impact of different printing systems on the mechanical properties of 3D-printed materials. This study aimed to evaluate the mechanical properties of 3D-printed materials for occlusal devices using different 3D printers and printing layer thicknesses.

Material and methods: Ninety rectangular samples were manufactured and divided into nine groups according to the 3D printer model they were printed on (AnyCubic Mono X, Elegoo Mars 2, or FlashForge Hunter) and the layer thickness (20, 50, or 100 µm) and were subjected to superficial microhardness, flexural resistance, and elasticity modulus tests. The results were analyzed using two-way analysis of variance and Tukey's statistical tests, with a significance level of 5%.

Results: The type of 3D printer significantly affected superficial microhardness (p = 0.007). Flexural strength showed a significant interaction between the 3D printer and layer thickness (p = 0.005), with both factors independently influencing flexural strength (printer: p< 0.001, layer thickness: p< 0.001). Elasticity modulus was significantly influenced by the 3D printer type (p< 0.001) and the interaction between both factors (p = 0.004). The AnyCubic Mono X 3D printer with a 20 µm layer thickness exhibited more consistent mechanical properties than the other printers.

Conclusions: Variations in printing systems and layer thicknesses can impact the mechanical properties of 3D-printed materials. Key words:CAD-CAM. Bruxism. Temporomandibular disorders. Mechanical tests; 3-D printing.Care Team.