Journal of Clinical and Experimental Dentistry最新文献

Brain abscess is a rare infectious condition, affecting 0.4 to 0.9 per 100,000 individuals annually, with classic symptoms of fever, headache, and neurological deficits. The origin can be contiguous, hematogenous, due to ruptures of brain barriers, or cryptogenic. Dental infections, such as those related to Gemella morbillorum, are atypical, and when related to odontogenic sinusitis, it is normally unilateral. This report describes a case of peculiar brain abscess, of unconfirmed source, possibly involving sinusitis or periapical odontogenic lesion in an immunocompetent young woman. A 22-year-old patient presented with sinusitis showed by computed tomography, progressing to a brain abscess caused by multidrug-resistant Streptococcus sanguis. Additional cultures revealed Gemella morbillorum in maxillary sinusitis. Treatment involved stereotactic drainage, sinusotomy, and prolonged antibiotic therapy, with recurrence and surgical reintervention, in addition to prophylactic dental extraction and exerese of the brain cyst capsule. Brain abscess represents a significant medical challenge, often posing difficulties in pinpointing its primary infectious source despite the aid of comprehensive laboratory and imaging diagnostics, as evidenced in this case. Timely and targeted intervention in preceding infections assumes paramount importance for effective management, underscoring the indispensable role of a multidisciplinary healthcare team. Active patient engagement and adherence to treatment protocols are imperative to mitigate complications and foster favorable disease progression. Key words:Brain Abscess, Dental Focal Infection, Gemella, Sinusitis, Streptococcus sanguis.

Bone tissue engineering has been very promising. The use of scaffolds of synthetic and natural materials is an alternative to combine the advantages of both types of materials. This study aimed to evaluate electrospun polymeric matrices of pure PLLA or associated with 5% or 10% of chitosan particles loaded or not with DCPA in bone proliferation and differentiation of periodontal ligament stem cells (PDLSC). The particles and matrices were characterized by scanning electron microscopy. PDLSC were isolated from periodontal ligament fragments of human permanent teeth using the explant technique. Cell proliferation assay (Alamar Blue) was performed from 1 to 21 days of culture in clonogenic medium and Alizarin Red assay was performed after 21 days of culture in osteogenic medium. The data were analyzed using Kruskal-Wallis test, and the comparison between media was given by the Student-Newman-Keuls test (α = 0.05). On days 1 and 7 there were no statistical difference between materials regarding cell proliferation (p>0.05). The materials with 5 and 10% chitosan / DCPA showed greater proliferation than PLLA control on days 14 and 21 and the material with 10% pure chitosan was greater than the control in 21 days. Regarding the alizarin red assay, PLLA 5% chitosan, PLLA 5 and 10% chitosan / DCPA showed a greater degree of mineralization than the control and the PLLA 10% chitosan material, and they were similar to each other. We conclude that PLLA 5 and 10% chitosan / DCPA materials were able to increase both, cell proliferation and differentiation of PDLSC in bone cells. Key words:Chitosan, PLLA, polymeric matrix, electrospinning.

Background: This research aimed to evaluate the marginal and internal gaps of crowns, which were produced using both digital and conventional impression techniques and cemented with various types of cement.

Material and methods: For the full ceramic crown restoration, an anatomically prepared acrylic first molar phantom tooth (Frasaco GmbH, Germany) was scanned with Scanner S600 ARTI (Zirkonzahn). 160 PMMA analogues produced from the milling unit. Two impression methods were used: digital impressions by intraoral scanner (Aadva Intra Oral 3D Scanner, GC) and PVS impression. Cerasmart, Initial LRF Block, Zirconia Prettau and ICE Zircon monolithic blocks milled with M1 Milling Unit (Zirkonzahn). Restorations cemented with light-cured and dual-cured cements. (n = 10) Pre and post-cementation 3D images overlap was performed using Geomagic Control X (3D Systems, NC, USA). Data were analysed by using SPSS 25.0. p<0.05 difference was considered significant.

Results: Digital impressions were significantly higher than PVS impressions in all groups (p<0.05). A significant difference was found between the materials (p<0.05). Cerasmart showed a significantly more marginal gap than the other groups. Prettau and ICE Zircon crowns with the conventional impression group showed a significantly smaller marginal gap than the others.

Conclusions: Monolithic crowns fabricated by CAD-CAM using the digital and conventional impression methods had clinically acceptable marginal and internal gaps. Crowns cemented with dual-cured cements showed significantly more marginal gap than light-cure groups. Key words:3D scanning, Marginal accuracy, Marginal fit, Monolithic crown.

Background: This research aimed to analyze the influence of root canal taper on the accuracy of two Electronic Apex Locators (EALs).

Material and methods: Twenty-five disto-vestibular roots from extracted human upper molars belonging to the tooth bank were used in this study. To determine the File Position (FP), access was made using a spherical diamond tip #1014, and the crowns were sectioned using a diamond tip #3080. The initial anatomic file used was a size K #10, which was introduced into the root canal until its tip was visualized (foraminal patency) with the aid of a clinical microscope (16X magnification). Teeth without foraminal patency and calcifications were excluded from the study. Odontometric readings were performed using two different EALs (Root ZX II and Romiapex A-15), considering the electronic reference point 0.0 (apex) for each device. All measurements were taken in triplicate, and the arithmetic mean of the three values was used. Digital calipers were used to record the measurements, which were then entered into an Excel spreadsheet. After visual verification using file K #10, the canals were instrumented with a #25.01 file to standardize the apical region, then successively instrumented with files #25.02, #25.04, #25.06, #25.08, #25.10, and #25.12, with electronic odontometry checked after each instrumentation using #25.02. Measurement 0.0 was adopted, with error margins of ±0.5 and ±1.0. Discrepancies between visual and electronic readings were statistically analyzed using ANOVA and Bonferroni tests, with significance considered when P<0.05.

Results: Using the 0.0 mark and a ±1.0 error margin, it was observed that readings from the devices were similar in canals with different tapers (P>0.05), showing a tendency towards underestimation. However, when using the measurement variation margin of ±0.50, a statistically significant difference was found in the Romiapex A-15 group (P=0.0248) when comparing the results of the two EALs.

Conclusions: Therefore, it was concluded that the canal taper did not significantly influence the accuracy of the evaluated EALs, using the reference point 0.0. When using the ±0.5 variation margin, the Romiapex A-15 device showed greater accuracy, and finally, at the ±1.0 error margin, both EALs exhibited excellent precision. Key words:Endodontics, Odontometry, Eletronic Apex Locator, Root Canal Preparation.

Background: Initial management of temporomandibular disorders (TMD) based on self-management (SM) is strongly recommended by literature, nevertheless, research is needed to investigate the efficacy of different types of interventions under each component of SM against each other for the management of particular subtypes of TMD. The present study aimed to compare the clinical effectiveness of SM and SM with additional mandibular home exercises for the management of myalgia of masticatory muscles.

Material and methods: A clinical trial was conducted with 54 subjects with a diagnosis of myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which were randomised into two groups: treated with SM (SM group) and treated with SM and mandibular home exercises (SM+EX group). Follow-ups were carried out at 2, 6, and 10 weeks, where it was evaluated: pain in the masticatory muscles, jaw opening range of motion, and mandibular functional limitation. Data were analysed using Wilcoxon signed-rank test for comparisons between periods (baseline, and weeks 2, 6, and 10) and Wilcoxon rank-sum test for comparison between groups (p=0.05).

Results: All the variables showed significant improvement (p<0.05) from baseline to the first follow-up and were maintained later, i.e. both groups were able to reduce pain, increase the jaw opening range of motion, and improve the mandibular functional limitation, although no significant differences were found between groups (p>0.05).

Conclusions: The self-management program was able to reduce pain intensity, increase the jaw opening range of motion and improve functional limitation, but the addition of mandibular home exercises do not have a significant impact on myalgia of the masticatory muscles in the short-term. Key words:Myalgia, Self-care, Self-management, Temporomandibular joint disorders.

Background: This study aimed to evaluate the effect of the Nd: YAG laser on the tensile bond strength of composite resin to dentin with hypersensitivity using different universal bonding systems.

Material and methods: After cutting the crown of 252 molars, buccal cervical enamel was removed at a thickness of approximately 2 mm, and 252 smooth dentin surfaces were exposed. Then they were etched with 0.5 M ethylenediaminetetraacetic acid (pH = 7.4) to stimulate hypersensitivity. The specimens were then randomly divided into 12 groups (n= 21) according to the surface treatments performed. After etching and bonding according to the manufacturer's recommendations in each group, the entire dentin surface was restored with Valux Plus composite resin. The samples were thermocycled and a universal test machine was used to measure the microtensile bond strength. The failure mode for each sample was observed under a stereomicroscope. For data analysis, the Bonferroni test, the independent t-test and the three-way anova test were used.

Results: The average microtensile bond strength in non-laser samples was higher than the average in laser samples (P<0.001). In comparison with the bonding agent type in both cases with and without laser, the highest average microtensile bond strength was related to ALL-BOND (P<0.001), meanwhile the lowest average tensile strength in samples without laser was related to G-Premio universal adhesive (P<0.001), and the lowest average microtensile strength in samples with laser belonged to Prime and Bond Elect group (P<0.001).

Conclusions: Nd: YAG laser irradiation of the dentin surface before applying the adhesive significantly decreased the microtensile bond strength of the composite resin to the dentin surface. Key words:Nd:YAG laser, Bond strength, Dentin, hypersensitivity, Universal adhesives.

Background: Different restoration materials have different optical characteristics that influence the intraoral scanner's (IOS) image accuracy. The purpose of this in-vitro investigation was to investigate how composite translucency affected the accuracy of IOS.

Material and methods: GC G-aenial Universal Injectable JE composite plates were used for the study at 3 thicknesses (1-2-3mm). A lab scanner (3Shape E1) obtained 1 reference scan, whereas IOS (Trios3) was used to conduct 10 experimental scans per group. After 3D superimposition, deviation values were used to assess the accuracy (trueness and precision) outcomes for the corresponding groups. Using an LS170 V2.0 colorimeter, the translucency parameter (TP) of the plates was determined from L*a*b* values of CIELAB color space.

Results: The composite translucency resulted in a decrease in the scale of digital impressions. The 1mm group had the largest scale reduction (0.02mm) significantly, followed by the 2mm and 3mm groups (0.01mm). No difference was found in mean precision. The colorimeter detects the L*a*b* values and showed that 1mm composite plate expressed the highest TP value, then 2mm and 3mm groups (28.90, 14.26 and 6.49 respectively). The thinner composite, the higher translucency and TP were highly positively correlated to IOS trueness of composite plates.

Conclusions: Composite translucency has an impact on optical impression accuracy. In correlation, the optical impression becomes less accurate the more translucent the composite is. This implies that in the digital process, the dentist should specify the appropriate optical properties of composite materials concerning both their mechanical and aesthetic qualities. Key words:Accuracy, translucency, resin composite, digital dentistry, intraoral-scanner.

Background: To evaluate the effectiveness of an experimental toothpaste based on Hypericum laricifolium Juss. essential oil against a bacterial consortium associated with dental caries.

Material and methods: The antibacterial activity of the essential oil was evaluated by the disk diffusion and microdilution tests against Streptococcus mutans, Streptococcus sanguinis and Streptococcus salivarius. Petri dishes were incubated at 37°C for 24 h. An experimental toothpaste was prepared at a concentration of 201.76 mg/mL. The antibacterial activity of the experimental and six commercial toothpastes were evaluated by agar well-diffusion method. Petri dishes were inoculated with a bacterial consortium prepared with the three strains. 80 mg of the toothpastes were placed in the wells and the Petri dishes were incubated at 37°C for 24 h. The inhibition zones were measured with a digital compass. The differences between the pastas were evaluated with the one-way ANOVA test, with a 5% level of significance.

Results: The essential oil was more effective than 0.12% chlorhexidine in inhibiting the growth of S. mutans (29.02±1.74 mm) and S. sanguinis (21.92±3.43 mm), being more moderate for S. salivarius (17.66±1.11 mm) . In MBC tests, the EO showed complete inhibition of the growth of S. mutans at a concentration of 5% (50.44 mg/mL), 10% (100.88 mg/mL) for S. sanguinis and 2.5% (25.22 mg/mL) for S. salivarius. The experimental toothpaste was effective in inhibiting the growth of the bacterial consortium (31.88±66 mm), having a similar performance to Total Dent, Colgate Total 12, Kolynos® Herbal and Colgate® Herbal (p> 0.05).

Conclusions: The development of an experimental paste based on H. laricifolium Juss. essential oil (0.28% v/v) showed an important antibacterial activity similar to commercial toothpastes against a bacterial consortium of S. mutans, S. sanguinis and S. salivarius. Key words:Antibacterial agents, toothpastes, medicinal plants, Streptococcus mutans, Streptococcus sanguinis, Streptococcus salivarius.

Dens Invaginatus (DI) is a developmental anomaly which eventually leads to pulp necrosis and has several clinical implications in sufficient instrumentation and obturation of the root canal system. The present clinical report presents a rare case of a maxillary canine affected with DI leading to pulp necrosis combined with a previous dental trauma, which also led to irreversible pulp damage of the adjacent lateral incisor. A 14-year-old male patient with a history of dental trauma at the right maxillary region, one year earlier, was referred with pain and swelling at the apical area of the right maxillary canine. After CBCT evaluation, complete removal of the invagination was decided. All the procedures were performed under operating microscope and canal obturation was done with apical plug technique using MTA. Two-year follow-up radiographic assessment confirmed complete healing of the periapical tissues for both teeth. The present case describes a rare case of dens invaginatus in a maxillary canine pointing out the importance of obtaining a thorough dental history upon diagnosis, performing also a careful clinical and radiographic evaluation and subsequent treatment planning, especially when addressing complex pathologies and unusual dental malformations. In such cases with high degree of complexity, preoperative CBCT examination is required for decision making and subsequent appropriate management. Key words:Dens Invaginatus, maxillary canine, endodontic treatment.

Background: This systematic review and meta-analysis aimed to evaluate if rapid maxillary expansion improves the activity of the masticatory muscles (masseter and temporal) in patients with unilateral posterior crossbite.

Material and methods: Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and grey literature. A manual search of orthodontic journals was also performed. Randomized clinical trials or longitudinal prospective studies were eligibles. Meta-analyses were conducted using R software with the "Meta" package, applying mean differences with a 95% confidence interval. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was evaluated using GRADE.

Results: Nine articles were included. Qualitative analysis showed that RME treatment in patients with unilateral posterior crossbite showed a positive correlation with improvement in masseter and temporalis muscle activity. Meta-analyses indicated a significant difference for all models of muscle activity after treatment with rapid maxillary expansion, except for the temporal muscle in the force exerted on the maximum voluntary clenching on cotton rolls. The studies showed low bias risk, and the evidence certainty for each analysis was generally low to very low.

Conclusions: This investigation demonstrated the benefits of R rapid maxillary expansion in treating unilateral posterior crossbite and its potential therapeutic effects on the masticatory muscles. Key words:Rapid maxillary expansion, masticatory muscles, unilateral posterior crossbite, systematic review, meta-analysis.