Journal of Clinical and Experimental Dentistry最新文献

Background: The present systematic review aimed to identify and summarize the radiographic and histological outcomes of alveolar ridge preservation (ARP) using autogenous particulate dentin (APD) compared with spontaneous healing (SH) or other materials in alveolus post-extraction.

Material and methods: The protocol of this PRISMA systematic review was registered in PROSPERO (CRD42021245740). Clinical trials (CT) fulfilling specific eligibility criteria were included. Screening, data extraction and quality assessment were conducted by two reviewers. Study results were summarized using random effect metanalyses to synthesize the findings of the trials.

Results: Fourteen articles concerning ten Randomized CT were included, involving a total of 304 participants, reporting data from 458 sockets. Most of the studies were considered as "unclear" risk of bias. Metanalyses indicated less horizontal at coronal third (difference in weighted means (WMD) = 2.04 mm; p<0.001) and middle third (WMD = 1.52 mm; p=0.002) bone resorption in ARP with APD compared to spontaneous healing assessed radiographically. However, no statistical significance was reached in the apical third (WMD = 0.33 mm; p=0.435) or in the vertical dimensional changes (at buccal aspect, WMD = 0.19 mm; p=0.789; and at lingual aspect, WMD = 0.44 mm; p=0.271). It was not possible to perform a meta-analysis for histomorphometric.

Conclusions: ARP with APD is an effective therapy to attenuate post-extraction bone resorption and ridge changes, especially in the coronal width of the socket.

Background: Head and neck cancer is a public health problem, and its treatment involves surgery and/or radio/chemotherapy. These procedures reduce the quality of life. To analyze survival in patients with head and neck cancer and survivors, the quality of life over 10 years.

Material and methods: An observational, cross-sectional, retrospective study was carried out on 460 medical records of patients diagnosed with head and neck cancer and treated at a referral hospital. Clinical pathological data were expressed in absolute and percentage frequencies, and the median survival time was calculated with their 95% confidence intervals using Kaplan-Meier curves. The curves were compared using the Log-Rank Mantel-Cox test and Cox regression. In survivors, we applied a quality of life (QoL) questionnaire where means and standard deviations of quality of life domains were calculated and compared using the Friedman/Dunn test and correlated with time after discharge using Spearman's correlation. Quality of life, classified as low or high with an average of 80 points, was associated with other clinical-pathological characteristics during the period of diagnosis using Pearson's chi-square test. All analyses performed adopted a 95% CI in the SPSS software. v20.0 for Windows.

Results: The medical records were analyzed; most of them were male, with a mean age of 61 years and a history of smoking and alcoholism. The most frequent staging was stage IV (T4, N2, M0). The most frequent location was the oropharynx, followed by the mouth. The median overall survival was 26.7 months (95% CI = 19.8-33.7). Of the 173 living patients, 41 (23.7%) responded to the questionnaire. Of the main problems related to QoL, swallowing (n = 10; 25.6%) was the most important, followed by chewing (n = 9; 28.1%) and saliva (n = 12; 42.9%). When QoL was associated with variables, it was observed that smoking (p = 0.014), alcoholism (p = 0.029), and time since discharge (p = 0.044) were associated with worse quality of life.

Conclusions: Cancer treatment has numerous consequences for the quality of life of patients who have survived head and neck cancer. Further studies and differentiated plans are needed for the rehabilitation of these patients.

Background: The purpose of this in vitro study was to evaluate the trueness of three intraoral scanners (IOS) and to assess the impact of geometrical landmarks on the digitization of edentulous mandibular complete-arch casts using a standardized scanning protocol.

Material and methods: A 3D-printed edentulous mandibular cast with five cylindrical landmarks was scanned using three IOS systems (Medit i700, Primescan AC and Trios 5) under two conditions: with and without geometrical landmarks (GL/NG). Each scanner performed 15 scans per condition. A coordinate measuring machine (CMM) provided reference values for cross-arch and inter-cylindrical distances. STL files were analyzed in GOM Inspect to calculate trueness and precision. Statistical evaluation included Shapiro-Wilk tests and paired t-tests ( = 0.05).

Results: Only the Medit i700 scanner showed significantly improved trueness with geometrical landmarks for both cross-arch (P = 0.0011) and inter-cylindrical (P = 0.0060) measurements. Primescan AC and Trios 5 scanners showed no significant differences between GL and NG conditions (P > 0.05). Visual analyses supported these findings, with Medit i700 benefiting from landmarks, while Primescan AC and Trios 5 maintained high trueness regardless of scanning strategy.

Conclusions: The addition of geometrical landmarks improved scan trueness significantly for the Medit i700 scanner but had no measurable effect on Primescan AC or Trios 5. These findings suggest that the influence of auxiliary landmarks is scanner-dependent and should be considered when optimizing scanning protocols for edentulous arches.

Background: Oral candidiasis (OC) is the most common infection in patients wearing polymer-based dentures. Sustained-release systems for delivery (SRSDs) have been proposed as anti-OC therapeutics. Therefore, this systematic review aimed to determine which SRDS showed better antifungal results in in vivo models.

Material and methods: Electronic literature searches were conducted using PubMed/MEDLINE, Web of Science, and Google Scholar databases, limited to January 1, 1989, to May 31, 2025. The MeSH terms (PubMed) utilized included drug delivery systems, phytochemicals, plant extracts, herbal medicines, phytometabolites, antifungal agents, azoles, nystatin, macrolides, Candida spp., oral candidiasis, oral candidosis, Candida albicans, and Candida glabrata. Articles were included whose experimental design was in vivo or ex vivo models and whose objective was to determine the efficacy of sustained release systems as an anti-Candida treatment.

Results: A total of 137 articles were retrieved and 125 were discarded because they did not match the principal objective of the study or did not meet the inclusion criteria. Twelve observational studies involving humans (adults aged 18 years) or animal models exposed to antifungal SRDSs were included. The most frequently used SRDSs were buccal mucoadhesive gel, mucoadhesive buccal tablets, and nanoparticles, while the most commonly used biomaterials were the bioadhesive polymers HPMC, NaCMC, carbopol 934, and sodium alginate. All antifungals incorporated in the SRDSs showed antifungal efficiency.

Conclusions: Chitosan-coated bioadhesive polymers are the most promising options for treating OC.

Background: Dental inclusions are relatively common; however, inclusions in the condylar, subcondylar, or coronoid process regions are extremely rare.

Case description: This paper describes a clinical case of ectopic migration of a third molar to the condylar region of the right mandibular ramus. To update knowledge about this entity, its possible etiology, clinical characteristics, and therapeutic options, a review of the literature from the last 25 years, from 2000 to 2025, was conducted.

Conclusions: Ectopic migration of mandibular third molars to the condylar region is a rare condition. In most cases, it causes pathology that must be treated. Therapeutic treatment should be based on symptoms, radiological findings, and the functional status of the temporomandibular joint. In the absence of symptoms and pathology, conservative treatment with follow-up may be a safe and appropriate option, as in the case presented.

Background: Temporomandibular joint (TMJ) disorders are characterized by alterations in joint structure and function, with disc displacement being one of the most prevalent pathological findings. The frequency, typology, and clinical correlates of these displacements, particularly with regard to intra-articular effusion, remain insufficiently explored.

Material and methods: The retrospective study included 244 MRI examinations of patients with TMJ disorders. Imaging was performed using standardized protocols on 1.5 T MRI scanners. Disc position was classified according to established radiological criteria. The prevalence and distribution of various disc displacement types, as well as the presence and degree of joint effusion, were systematically evaluated.

Results: Anterior disc displacement was identified in 9.84% (right) and 8.61% (left) TMJ of unilateral cases, and in 17.21% (right) and 16.80% (left) TMJ of bilateral cases. Partial anterior disc displacement was observed in 8.61-10.66% of unilateral cases and 15.16-15.57% of bilateral cases. Rotational displacements were found in 6.15-6.56% of unilateral cases and 12.70-13.11% of bilateral cases, while lateral/medial and posterior displacements ranged from 0.41% to 3.69%. A normal disc position was present in 20.90-22.95% of joints. Joint effusion was most often recorded in cases of anterior and partial anterior displacements, predominantly minimal (2.9-5.3%) or small (1.2-2.9%) in degree. In most cases of lateral, posterior, and rotational displacement, as well as with normal disc position, effusion was absent.

Conclusions: Anterior disc displacement is the most prevalent TMJ pathology among symptomatic patients, with a frequency up to 17.2% in bilateral cases. Effusion is most closely associated with anterior and partial anterior displacements but is typically minimal or absent. These findings support a predominantly mechanical, rather than inflammatory, etiology for disc displacement in this patient population.

Background: Buffered local anesthetics are proposed to alleviate injection pain, decrease onset time, and extend the duration of anesthesia. This research sought to evaluate the clinical effectiveness of buffered lidocaine compared to traditional lidocaine in patients having maxillary posterior teeth extraction due to chronic periapical lesions.

Material and methods: This double-blind, prospective, randomized clinical trial involved 100 adult participants (ASA I or II), aged 18 to 60, who needed extraction of maxillary posterior teeth. Participants were randomly assigned into two equal groups: Group A was given standard 2% lidocaine with 1:100,000 adrenaline; Group B was administered buffered 2% lidocaine with 1:100,000 epinephrine combined with 8.4% sodium bicarbonate. Standardized supraperiosteal infiltrative anesthesia was given. Discomfort from the injection was assessed with the Visual Analogue Scale (VAS), and the onset and duration of anesthesia were noted as well. All surgeries were carried out by a surgeon who was unaware of the study, and results evaluated by a second investigator also blinded to the details.

Results: Group B (buffered lidocaine) showed considerably reduced pain scores during injection (VAS 2.8 ± 0.7) in contrast to Group A (4.2 ± 0.9; p < 0.01). The initiation of anesthesia occurred notably quicker in Group B (2.3 minutes compared to 4.7 minutes; p < 0.01). The duration of anesthesia in Group B was notably greater (45.8 ± 7.6 minutes compared to 36.4 ± 8.2 minutes; p < 0.01). The requirement for reinjection was not notably different among the groups (p = 0.678).

Conclusions: Buffered lidocaine offers better anesthetic efficacy than standard lidocaine regarding injection comfort, quicker onset, and extended duration, making it a more effective choice for dental extractions.

Background: Temporomandibular disorders (TMD) are prevalent musculoskeletal conditions affecting the orofacial region, often requiring interdisciplinary management. Social media platforms, particularly TikTok, have become popular sources of health-related information. However, concerns persist regarding the reliability and educational value of user-generated content. Objective: This study aimed to evaluate the reliability and educational value of TikTok videos on TMD and compare content characteristics across three categories of creators: general users, dental care professionals, and other healthcare professionals.

Material and methods: A descriptive observational cross-sectional study was conducted, analyzing TikTok videos related to TMD using predefined inclusion criteria. A total of 98 videos were assessed based on three validated scoring systems: Video Content Score (VCS), Quality Criteria for Consumer Health Information (DISCERN), and Global Quality Score (GQS). Inter-rater reliability was established (Cohen's kappa 0.86). Statistical analyses, including the Kruskal-Walli's test and post-hoc Dunn's test, were performed to compare video characteristics and engagement metrics among content creator groups. It was also performed a quali-quantitative analysis of the scoring systems.

Results: The analyzed TikTok videos on TMD showed low educational quality (VCS = 2.0, GQS = 2.0, median) and poor to fair reliability (DISCERN = 33.0), highlighting their limited and incomplete information. Although no statistically significant differences were found among content creator groups (VCS: p = 0.453; DISCERN: p = 0.239; GQS: p = 0.341), videos by healthcare professionals tended to have higher quality scores, presenting more structured content aligned with scientific guidelines on TMD. The analyzed TikTok videos on TMD exhibit critical deficiencies, including inadequate assessment, classification, and discussion of etiology and risk factors. Low VCS, DISCERN, and GQS scores highlight the lack of evidence-based content, poor reliability, and limited educational value, reinforcing concerns about misinformation.

Conclusions: Despite TikTok's growing role in disseminating health-related information, the overall educational quality of TMD-related videos remains inadequate. While healthcare professionals tend to produce more structured content, the lack of significant differences across creator groups underscores a general deficiency in reliable, evidence-based information on the platform. These findings highlight the need for greater oversight, content validation, and expert-reviewed educational initiatives to improve the credibility of TMD-related information on social media.

Cryosurgery is a treatment method that employs extremely low temperatures to address various diseases. Since the early 1960s, liquid nitrogen has been utilized in dermatology, oral surgery, ophthalmology, gynecology, urology, cardiology, and internal organ surgery. It is the preferred treatment for numerous skin conditions due to its versatility in addressing benign, precancerous, and malignant diseases. The application of cryosurgery as a therapeutic approach for oral mucosal diseases has been shaped by the treatment of analogous dermatological conditions. Considering the potential of cryosurgery applications, it has been utilized as an alternative therapy for various oral lesions. Key words:Cryosurgery, Oral lesions, Liquid nitrogen, Oral mucosal diseases, Cryotherapy mechanisms, Cryogens, Oral medicine.

Background: This study aimed to identify degenerative changes in the mandibular condyle and to evaluate joint space conditions in sagittal and coronal sections using cone beam computed tomography (CBCT). Additionally, it sought to determine the frequency of these changes relative to sex, age, and side of the temporomandibular joint (TMJ).

Material and methods: A cross-sectional study was conducted on 88 CBCT scans meeting inclusion criteria. Degenerative changes were assessed, and joint spaces were measured following standardized tomographic protocols. Statistical analysis included chi-square, Student's t-test, and Mann-Whitney U tests, with significance set at p < 0.05.

Results: The sample consisted of 24 males (27.2%) and 64 females (72.7%), with a mean age of 31.2 ± 14.6 years. Erosion (30.6%) and condylar flattening (29.5%) were the most prevalent degenerative changes. No significant differences were found between right and left sides (p > 0.05) or between sexes (p = 0.445). However, degenerative changes varied significantly with age (p = 0.005), with sclerosis, osteophytes, and subchondral cysts more frequent in older adults. Comparison of joint spaces in sagittal and coronal sections revealed no significant differences between condyles with and without degenerative changes (p > 0.05).

Conclusions: Degenerative changes in the mandibular condyle were common but did not significantly alter joint space dimensions. Erosion and flattening were the predominant findings, and age was associated with specific changes, while sex and side showed no association. CBCT proved effective for detailed assessment of condylar morphology and joint space. Key words:Temporomandibular joint, Mandibular condyle, Temporomandibular joint disorders, Cone-beam computed tomography.