Journal of Clinical and Experimental Dentistry最新文献

Background: This study aimed to evaluate the effect of surgically assisted rapid maxillary expansion (SARME) with pterygopalatine disjunction (PD) on the nasomaxillary complex structures.

Material and methods: A systematic two-phase review, recorded in the PROSPERO database, was conducted. Search strategies were performed using PubMed, Scopus, Web of Science, COCHRANE, LILACS and DOSS databases, including gray literature (Open Grey, Google Scholar, and ProQuest). The methodological quality and evidence of the included studies were assessed.

Results: Out of 1017 studies, 10 met the inclusion criteria. Generally, a moderate risk of bias was noted. The studies involved 236 adults evaluated preoperatively and postoperatively. Key outcomes assessed included nasal cavity volume, minimum cross-sectional area (MCSA), nasal septum positioning, nasal cavity width, and nose volume (soft tissues).

Conclusions: Although findings indicated increased MCSA, nasal cavity, and nasopharynx volumes, and no changes in nasal septum post-SARME + PD, the current evidence is insufficient for definitive clinical recommendations due to study limitations, particularly the small number of included studies. More clinical studies with robust methodologies and low risk of bias are needed. Key words:Nasal septum, nasal cavity, palatine expansion technique.

Background: The prolonged use of pediatric syrups without adequate control of oral hygiene can cause effects on the physical characteristics of the restoration materials, which in turn can cause deterioration of the material and subsequent carious recurrence. Aim: To evaluate the effect of two long-term use syrups in children on the microhardness and surface roughness of three restorative materials.

Material and methods: Three study groups were formed, consisting of a conventional self-curing ionomer cement, a light-curing ionomer cement, and a light-curing composite resin. Each group had 40 specimens made with the respective restorative material; in addition, these were distributed in 2 subgroups with 20 specimens each, which were immersed in Paracetamol and Ferrous Sulfate in syrup following a protocol that consisted of 2 minutes each day for 28 days.

Results: Over time (0, 7, 14, 21, and 28 days), when evaluating microhardness, the composite resin subgroup exposed to ferrous sulfate (p = 0.027) and the Ketac Molar ionomeric cement subgroup (p = 0.002) exposed to Paracetamol showed statistically significant differences; while, when evaluating surface roughness, the composite resin subgroups (p = 0.032) and Ketac Molar ionomeric cement (p = 0.01) exposed to ferrous sulfate showed a statistically significant difference.

Conclusions: The more days of exposure to ferrous sulphate syrup, the less the microhardness of the composite resin decreases; something similar occurs with the microhardness of Ketac Molar ionomeric cement when exposed to Paracetamol syrup. Meanwhile, the surface roughness of the composite resin and Ketac Molar ionomeric cement increases considerably when exposed to ferrous sulphate. Key words:Ionomeric cement, Microhardness, Composite resins, Surface roughness.

Slow maxillary expansion is a technique used to achieve correction of maxillary transverse deficiency or posterior crossbite in patients where the midpalatal suture has closed. This is mostly achieved by buccal tipping of maxillary posterior teeth. The aim of this case report is to discuss the orthodontic treatment of a 20-year-old patient with bilateral posterior crossbite. The patient had moderate maxillary crowding and severe mandibular crowding, crossbites bilaterally on his posterior teeth, and maxillary lateral incisors. The patient had thin gingival biotype with gingival recession on the mandibular right canine. Orthodontic treatment was done with full fixed appliances, and extraction of a mandibular right lateral incisor. This case report shows that slow maxillary expansion can be used in an adult to achieve the objectives set by both the orthodontist and patient while also considering treatment modalities most agreeable to the patient. Key words:Orthodontic treatment, slow maxillary expansion, maxillary expansion, RPE, Hyrax expander, case report.

Background: The first tooth to erupt is the first mandibular molar, which is the tooth with the highest number of retreatments. Several factors are responsible for the failure of the endodontic success and one of the most important being the particular pulp anatomy of each tooth. To aim was determine the prevalence of the middle mesial (MM) canal in first mandibular molars and to study if there are predisposing factors to the presence of this canal by retrospectively analyzing cone-beam computed tomography (CBCT) images in vivo.

Material and methods: CBCT images of 100 patients were selected. A total of 206 first mandibular molars were examined. The CBCTs were analysed using Careastream CS 3D imaging software. Findings of MM canals were recorded along the variables sex and left/right side. Prevalence was compared using the Chi-square test (P< 0.05) and Cramer's V was used to indicate the effect size between the variables.

Results: Of the 206 teeth analysed, the prevalence of MM canals was 33.11% (49 teeth). There was no statistically significant difference between sex and prevalence of the MM canal. There was a significant difference between sex and the distance between the mesial canals was found, being the most common range in women was 1-2 mm (35.8%) and 2-3 mm (51%) in men. The most common range of distance between the mesial canals where the MM canal was localized was 3-4 mm (50%), being statistically significant (p<0,05).

Conclusions: This cross-sectional study showed a high prevalence of MM canals (33.11%) in first mandibular molars. The prevalence of the MM canal was significantly higher when the distance between mesiobucal and mesiolingual canals was 3-4mm. This knowledge let direct the clinicians in locating MM canal for improving endodontic prognosis. Key words:Cone-beam computed tomography, middle mesial canal, prevalence.

Background: Digital transformation (DT) involves introducing digital technologies into business models in all areas. This research aimed to evaluate the level of implementation of DT using the digital health indicator in private radiology centers in Lima, Perú.

Material and methods: Forty-five randomly selected radiology centers included in a database of 50 registered centers were evaluated. The inclusion criteria were having a web domain and institutional email address. They were digitally surveyed using a digital survey (HIMSS DHI Rapid) measuring four dimensions: interoperability, governance and workforce, predictive analytics, and person-enabled health. These indicators allowed determination of the digital transformation level of a radiological company. The level of implementation was measured quantitatively on a scale from 0 to 400, and the Kruskal Wallis test (p>0.05) was used to compare DT according to the geographical location of the centers.

Results: The digital health indicator obtained was 60.24 ± 43.14 out of 400 achievable points. The dimensional analysis in terms of interoperability was 24 ± 18.09, followed by governance and workforce at 23.44 ± 18.58, person-enabled health at 18.73 ± 15.63, and finally, predictive analysis at 16.18 ± 13.51. No significant differences were found in health indicator dimensions according to the geographical location (p>0.05).

Conclusions: DT in maxillofacial radiology centers in Lima is at an initial level. Radiology centers should take this situation into account to have relevant information for making diagnostic and treatment decisions and to provide better preventive health policies to benefit the population. Key words:Digital transformation, digital health indicator, dental radiology.

Background: Tooth loss and use of a complete denture is still a reality and results in bone loss. Adequate reconstruction of an extremely atrophic edentulous maxilla is a challenge, and different treatment methods have been described for its resolution.

Material and methods: Patients seeking implant placement in edentulous upper jaw with atrophic maxilla were selected in a private clinic in Porto Alegre, Brazil. The bone graft was performed with bilateral sinus lift and horizontal bone graft in anterior region with 0,25-1mm particles of Bio-Oss (Geistlich) covered with a collagen membrane (Bio-Gide, Geistlich). CBCTs were evaluated to verify the need for bone graft, and 6-8 months after bone graft follow-up, to plan implant placement and assess horizontal bone gain.

Results: 124 implants were placed in 19 patients, 76 of those in the sinus region. The survival rate was 95.2%, with six implants lost over a mean implants follow-up time of 47.68 months. The horizontal bone gain ranged from 0.00 to 6.86 mm, a mean gain of 2.85mm. An average of 5.5g of Bio-Oss was used per patient, and in 73.7 % of the cases, a flapless surgery was possible for implant placement, and in 92 implants an immediate loading was possible. Final rehabilitation was accomplished with fixed prosthodontics in 16 patients with a mean follow-up of 38.4 months.

Conclusions: Within the limitations of this study, it is possible to affirm that bone graft with 100% Bio-Oss in atrophic maxilla is a reliable treatment and allow rehabilitation with implants with a high survival rate and the higher the initial bone height, the greater the gain in bone width. Key words:Bone Regeneration, Dental Implants, Prosthodontics, Dentistry.

Background: Diagnosing asymmetries and restoring functional balance are challenges in facial rehabilitation and aesthetic procedures. This cross-sectional observational study aimed to evaluate whether occlusal imbalance and the electromyographic activity of the masseter and temporalis muscles in young women may be associated with facial asymmetry.

Material and methods: Fifty women (mean age ± standard deviation: 22.5 ± 2.7), without temporomandibular dysfunction and with balanced facial profiles, were divided into two groups categorized by receiver operating characteristic analysis: symmetric (n=25) and asymmetric (n=25). The variables included the evaluation of asymmetry through clinical examination, quantification of asymmetry using stereophotogrammetry through the root mean square method, asymmetry of occlusal contacts, and electromyographic activity of the masseter and temporal muscles in both latero-lateral and antero-posterior directions. The mean asymmetry indices were compared using Welch's t-test and the Mann-Whitney test. The impact of occlusal and muscular imbalance on facial asymmetry was assessed through linear regression analysis.

Results: A significant difference was observed between the groups in the asymmetry of occlusal contacts, with a considerable effect size (p<0.01 - Cohen's d=0.73). The imbalance in the electromyographic activities of the masseter and temporal muscles was considered a predictor of facial asymmetry (F=4.00, p<0.02, R²=0.15).

Conclusions: Occlusal imbalance and electromyographic activity of the masseter and temporal muscles are associated with facial asymmetry. Key words:Facial asymmetry, masticatory muscles, stereophotogrammetry, occlusion, electromyography.

Background: Gingiva can be afflicted by several pathological entities apart from gingivitis and periodontitis. There have been limited number of studies on gingival lesions, especially from Thailand. Aim: To analyze the prevalence and distribution of biopsied gingival lesions from Chulalongkorn and Rangsit Dental Schools, Thailand.

Material and methods: Biopsy records of the participating institutions from 1995 to 2020 were reviewed for gingival lesions. The demographic data, site of lesions and diagnoses were collected. Data were analyzed by descriptive statistics.

Results: From a total of 16,207 biopsies, 1,589 cases (10.2%) were diagnosed in the category of gingival lesions. The mean age ± SD of the patients was 42.3 ± 18.6 years with the highest prevalence being in the fourth decade of life (17.4%). A male-to-female ratio was 0.48:1. The most common location was the posterior mandible (27.4%). Regarding the type of gingival lesions, non-neoplastic lesions (88.5%) outnumbered neoplastic lesions (11.5%). The most common lesion was pyogenic granuloma, followed by irritation fibroma and peripheral ossifying fibroma. Among the neoplastic lesions, squamous cell carcinoma was the most prevalent lesion followed by papilloma and lymphoma.

Conclusions: Gingival lesions mostly occur in the fourth decade of life and have a predilection for female patients. The majority of the lesions are located in the posterior mandible. Non-neoplastic lesion, especially the reactive subtype, is the most prevalent group and pyogenic granuloma is the most common gingival lesion. Data from this study represent biopsied gingival lesions from Thailand which may be different from those of other countries. Key words:Gingival lesions, prevalence, demographic, clinico-pathological correlation, gingival biopsy.

Background: 3D-printed permanent resins have recently been introduced to produce permanent restorations. The aim of this study is to evaluate the effect of surface treatment methods on the shear-bond strength (SBS) between 3D-printed permanent resins and adhesive cement.

Material and methods: In this study, samples were produced using digital light projection (DLP) and stereolithography (SLA) 3D printers with two permanent resins (Crowntec, Saremco and Permanent Crown, Formlabs) in accordance with manufacturer guidelines. The samples were separated into three groups: sandblasting, hydrofluoric acid and no surface treatment. The surface profile (Ra, Sa) of the samples was examined with a confocal microscope (Smartproof 5, Zeiss). Then, a self-adhesive resin cement was applied to the samples in a transparent mold (2.38 mm diameter) in accordance with ISO 29022:2013. A universal testing machine was used to perform SBS test. A stereomicroscope was used to analyze the different types of fractures. A two-way analysis of variance (ANOVA) test was used to assess the data (p<0.05).

Results: The samples with sandblasting applied to the surface showed higher surface roughness values than the samples with hydrofluoric acid (p<0.001). 3D printer technology and surface treatment methods affected SBS values (p<0.001). Sandblasting groups higher SBS values were than in the hydrofluoric acid group (p<0.001). Sandblasting revealed cohesion fractures, which indicated a stronger bond, while hydrofluoric acid displayed adhesive and mix fractures.

Conclusions: When sandblasting was applied to the surface of the samples prepared using permanent resins, higher adhesion was achieved with adhesive cement. Key words:3D printing, Shear bond strength, Sandblasting, Stereolithography.

Background: This study aimed to determine the percentage of perfect and acceptable coincidence between the facial and maxillary dental midlines in individuals from Peru.

Material and methods: This was a cross-sectional study of a group of Peruvian individuals gathered from private offices in Lima, Peru, from January to June 2024. A total of 279 patients (133 males and 146 females) aged between 18 and 30 were included. We selected patients with permanent teeth up to their second molars, while those with gaps between their front teeth, ongoing or previous orthodontic treatment, or any craniofacial anomalies were excluded. Using a professional camera, we took frontal photographs of the participants at rest and while smiling. The facial morphological index was used to classify facial biotypes into three categories: mesofacial, dolichofacial, and brachyfacial. We then used the PowerPoint program to analyze perfect and accepted coincidence (deviation to either side of up to 2 mm) between the facial and dental midline. The data was analyzed by chi-square tests and binary logistic regression (p>0.05).

Results: Perfect coincidence of the dental midline was present in 23.3% of the cases, while an accepted coincidence was observed in 95.7% of the individuals. When considering facial structure, the percentage of alignment of the maxillary dental midline (perfect or accepted) with the facial midline did not show a significant association (p=0.145, p=0.870, respectively). Furthermore, there were no significant differences in the percentage of alignment between men and women (p=0.241 for perfect coincidence, p=0.322 for accepted alignment).

Conclusions: Most Peruvian individuals assessed had an accepted coincidence (up to 2 mm) between the facial midline and the maxillary dental midline, although it is not always perfect. In these cases, orthodontic treatment is needed for optimal occlusal relationships and stable facial esthetics. Key words:Esthetics, Facial midline, maxillary dental midline, Peruvian.