Minerva dental and oral science最新文献

Background: Longevity of dental restorations (DR) in the general population is well discussed in the literature. Evaluation of survival of DR in special needs patients (SNP) is less frequently reported especially in long-term. DR in SNP patients is more challenging considering the poorer oral baseline conditions and cooperation during treatment. We provide an assessment of DR survival performed under (GA) in a cohort of uncooperative SNP over a 15-years period.

Methods: Uncooperative SNP requiring dental treatments under GA in our institution during 2018 were collected. Patients who were treated with multiple GA sessions were selected to allow analysis of DR survival (DR performed between 2002-2017). Presence and clinical functionality of DR was assessed during subsequent follow-up visits or GA interventions. DR were considered successful since they were associated with an event (replacement, tooth loss, endodontic treatment). Median survival time (MST) of DR and its 95% confidence interval (CI) were retrieved with Kaplan Meier estimator. Random effect model assessed inter-patient variability.

Results: Survival of 232 dental restorations in 59 patients was assessed. MST was 9 years (IC 8-10) Most relevant steps in survival analysis were seen after 2 and 11 years from last procedure. No considerable variability was observed in our population.

Conclusions: MST of dental restorations performed under GA our cohort resemble previous findings regarding routine conservative treatment in the general population. Lack of variability in our analysis suggest that MST seems not influenced by individual characteristics of patients. Our findings support tooth restoration as a reliable treatment modality in SNP treated under GA in accordance with available literature.

Background: This paper describes pharmacoeconomic analysis of ethanol and benzalkonium chloride disinfectants used in dental institutions to prevent infections. Pathogens can be transmitted to patients via air, items, contact or vectors. The aim of this study is to compare the efficiency and cost-effectiveness of both disinfectants.

Methods: For pharmacoeconomic assessment, cost minimization analysis, cost benefit analysis (CBA), cost effectiveness analysis and cost utility analysis were performed. The cost of disinfectants used in hand disinfection of dental professionals is estimated to be 50 times higher when using ethanol. Compared monthly costs for disinfectants in surface disinfection are 18 times higher when using ethanol.

Results: Results of CBA imply 12 hours as annual time needed for performance of benzalkonium chloride disinfection, and 720 hours for ethanol. Reduction of pathogens on the examined surface after application of benzalkonium chloride was 99-99% for all tested pathogens. The application of the amount of benzalkonium chloride analogous to the cost of ethanol in dental facilities could eliminate the chance of nosocomial infections.

Conclusions: The cost-effectiveness of benzalkonium chloride leads to more agile recovery of the patient. Performed assessments lead to the conclusion that benzalkonium chloride is more efficient in dental facilities than ethanol. Utilization of benzalkonium chloride improves quality of life, significantly decreasing time spent for application and frequent reapplications of the disinfectant.

Social relationships, self-esteem, and one's own view are all greatly impacted by smile aesthetics. Smile harmony can be upset by abnormalities like peg-shaped lateral incisors, which leads patients to look for the least invasive yet effective cosmetic procedures. Direct composite veneers are a conservative way to improve your appearance without requiring a lot of dental preparation. This research investigates clinical application, material improvements, and overall patient satisfaction of direct composite veneers in the context of esthetic smile rehabilitation. The outcomes of recent research on direct composite veneers, with an emphasis on minimally invasive cosmetic rehabilitation methods, are summarized in this narrative overview of the literature. Through extensive searches in PubMed, Scopus, and ScienceDirect, studies were chosen using keywords like "direct composite veneers," "esthetic restoration," and "minimally invasive dentistry." The inclusion of articles was determined by their applicability to patient satisfaction, clinical results, and composite material improvements. According to the review, direct composite veneers are a practical, affordable, and reversible substitute for porcelain veneers. Benefits include instant results, little tooth preparation, and the use of multilayer composite procedures to provide natural-looking results. Nevertheless, drawbacks like staining vulnerability, decreased durability, and upkeep needs highlight the necessity of cautious patient selection. Direct composite veneers are becoming more and more feasible for long-term aesthetic solutions because to recent developments in composite resins, such as nanohybrid and nanofilled technologies, which have improved their polishability, durability, and color stability. Direct composite veneers are a good choice for those looking for a customizable, minimally intrusive method of improving the appearance of their smiles. Composite veneers are a useful and versatile option for improving appearance, even though they could need upkeep over time. To increase their lifetime and expand their use in cosmetic dentistry, more study on material advancements is necessary.

Background: Although uncommon, adverse local and systemic reactions to local anesthetic administration can occurred. The postanesthetic necrosis is a rare complication which usually involved the palatal region. The wound healing is a complex process regulated by a range of growth factors. Concentrated growth factor (CGF) is the latest generation of autologous platelet concentrate which has been widely used in the repair and regeneration of oral soft and hard tissue. The study aims to analyses the clinical benefit of CGF in the treatment of postanesthetic necrosis of the hard palate.

Methods: The study included all patients referred to the Department of Maxillo-Facial Surgery, Marche University General Hospital, between 2020 and 2022, for aseptic ulcer of the hard palate due to local anesthetic administration. For each patient, the surgical debridement of the necrotic tissue and a peripheral blood sample were performed. The CGF was obtained by a centrifuge device and sutured in the affected site. The greasy gauze, placed to prevent the matrix detachment, was removed seven days post-operative.

Results: Seven patients (M:F=4:3, mean age 48.6±5.1 years) were enrolled in the study. After 7 days post-operative, no infection, discomfort, or dysphagia were reported. Moreover, 4 patients (57%) showed a total re-epithelialization, while 3 patients (43%) with larger defects, displayed a partial re-epithelialization. A complete recovery occurred in all cases 15 days after surgery.

Conclusions: CFG represents a promising potential preparation for the oral mucosa wound healing able to promote the granular tissue formation and the mucosa re-epithelialization.

Introduction: Obstructive sleep apnea syndrome (OSAS) is a breathing disorder during sleep, characterized by upper airway obstruction with many subsequent daytime and nocturnal symptoms. Children with OSAS may show abnormalities of the maxillary structure. This review aims to evaluate the effectiveness of rapid maxillary expansion (RME) as a treatment for OSAS in children to reduce apnea/hypopnea index and oxygen saturation.

Evidence acquisition: An electronic search for all articles published in English from January 2004 to February 2022. The study focused on children between 5 and 12 years old and meeting the following inclusion criteria: clinical signs of malocclusion, no syndromic children, adenotonsillar hypertrophy, underwent an otolaryngology evaluation and no previous treatment for OSAS. The device was fixed to the second deciduous molars. After 12 months, the RME was removed.

Evidence synthesis: The investigation recorded a statistically significant reduction in AHI (apnea/hypopnea index) (on average 60-65%) and an increase in oxygen saturation ranging from 95% to 97%.

Conclusions: This review shows that RME, through the enlargement of dental arches and nasal-maxillary structures, may be a helpful approach in children with malocclusion and OSAS.

Background: The purpose of this study was to determine the accuracy of an intraoral scanner to digitally duplicate complete dentures and analyze the effects of mesh reduction of digital files on the surface area and volume accuracy of complete dentures, in vitro.

Methods: A mandibular complete denture was scanned by a desktop scanner to create a digital STL reference file (control). Fifteen identical scans were created by using an intraoral scanner and exported as STL files (test group). These 15 files were saved at 100% of the original scan resolution then reduced to 75%, 50%, 25%, and 10% of their original quality. These 75 scans were statistically analyzed by calculating The Hausdorff Distance (HD) and Dice Similarity Coefficients (DSC) to assess the variation between the mean reduced intraoral scanner files test and the control desktop scanner file and eventual inconsistencies. The volumes of the reduced mesh files were also compared with the 100% resolution intraoral mesh files to evaluate precision and trueness of the intraoral scanner.

Results: Reduced mesh files of 10%, 25%, 50%, 75% of the original scan yielded a percentage similarity average of 99.7%, indicating a very high precision value for the intraoral scanner. Also, the volumes of each associated mesh reduction slightly decreased with non-statistically significant results.

Conclusions: This study concluded that the chosen intraoral scanner for this study provided very high trueness (98.34%) and precision (99.7%), and also the volumes of reduced mesh files slightly decreased but were not statistically significant.

Background: After tooth extraction, inevitable resorption of the postextraction socket occurs. Placing an immediate implant does not fully preserve the bone integrity of the socket. Preservation techniques cannot avoid alveolar resorption. In residual atrophies, bone augmentation techniques are necessary for subsequent rehabilitation with implants. The aim of this study was to propose a protocol of immediate loading in short implants as an alternative to bone augmentation techniques, comparing the immediate versus conventional loading, evaluating peri-implant bone loss, the biological and prosthetic complications, the survival of the implant and prosthesis and the patient satisfaction after one year.

Methods: This study consists of a randomized controlled clinical trial. For implant planning, periapical intraoral radiographs and Cone Beam Computed Tomography will be used. All patients will receive Straumann Group^® (Basel, Switzerland) titanium-zirconia implants with a 4.1mm or 4.8mm diameter and a 4 mm or 6 mm length.

Results: The expected results show similar or even minor bone loss, biological and prosthetic complications, identical or even better survival of the short implants with immediate loading, and greater satisfaction.

Conclusions: Short implants demonstrate similar survival to conventional length implants, with comparable or even minor biological and prosthetic complications and bone loss. Immediate loading gives satisfactory results similar to conventional loading, with similar biological and prosthetic complications, and generally depends on poor hygiene levels. Bone loss is even less, and the satisfaction increases.

Background: This prospective two-center case series feasibility study aimed to investigate the potential of a novel maxillary protraction facemask customized to the patients' anatomy recorded with 3D face scanning and then produced by digital design and additive manufacturing.

Methods: Ten subjects (5 females and 5 males, average age 7.7±1.0 years) with Class III malocclusion were treated with a rapid maxillary expander (RME) and a Petit-type facemask (FM), whose components were digitally designed on a 3D scan of the patient's face. Subjects' face scans were obtained either with a tablet or with face scanner. FM components were modelled with a 3D software. The pads were 3D printed in biocompatible resin, and the bar was printed in stainless steel. A questionnaire investigating the patients' experience was filled in after the first week of treatment and after 3, 6, and 9 months.

Results: The customized FM showed an excellent adaptation to the anatomy of the face. No severe complications were reported during the 9 months of appliance wearing. Some reversible episodes of skin irritation were reported below the pads, mainly in the chin area. The reported time wearing ranged between 8.2±2.3 and 9.5±1.2 hours per day, mainly at night. Reported pain was overall low (maximum after 1 week with an average value of 1.9±1.7 on a visual analog scale [VAS] 0-10) and patients' satisfaction was adequate at the end of the facemask wear after 9 months (8.7±1.4 on a VAS 0-10).

Conclusions: The customized FM was overall well accepted by the patients and represents a valid alternative to conventional ones.

The aim of this study was to analyze clinical strategies supported by validated references during two of the most frequent dental emergencies (i.e. restorative and endodontic treatment) in the COVID-19 pandemic. Coronavirus disease 2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of an emergency in the health system worldwide and a potentially fatal disease. Person-to-person transmission of SARS-CoV-2 through aerosol and droplets led to extensive preventive measures to contain COVID-19 outbreak. Dental care providers have been exposed to a high risk of SARS-CoV-2 infection, due to the face-to-face communication and the exposure to saliva, blood, and other body fluids during routine interventions; this can also contribute to a high risk for cross-infection, even though dentist usually cope with those situations in everyday practice. Restorative and endodontic emergencies represented a high proportion of dental emergencies, with prolonged exposure time for dentists/endodontists in contact with suspected or confirmed infected patients. Lack of knowledge and undefined progression controlled the decision-making in clinical dentistry. The dynamicity of the situation determined change of views and recommendations in dental setting. The implementation of strict restorative and endodontics protocols are aimed at preventing circumstances similar to those observed with COVID-19.

Background: Following an episode of hereditary angioedema (HAE), dental anxiety commonly arises, and many patients find it challenging to access proper care. While the use of virtual reality (VR) for pain and anxiety management in dentistry is on the rise, its application in individuals with angioedema remains largely unexplored. In a case series conducted at a specialized dental clinic, three patients with a history of acute angioedema attacks and dental anxiety engaged with 360° VR videos while seated in the dental chair, utilizing a virtual reality device.

Methods: Three patients with hereditary angioedema were treated by subjecting them to virtual immersion using VR glasses. Intraoperative reactions were analyzed using VAS scales in order to report the patients' level of anxiety and pain.

Results: The outcomes, evaluated through a standard observation tool, surveys, and interviews, encompass the assessment of patient anxiety and pain, responses to VR, and the evaluation of system usability along with its impact on the dental team's workflow Three individuals underwent examination, from which three reliable questionnaires were obtained, demonstrating a success rate of 99.9%. The group included one male and two females, with their ages spanning from 6 to 58 years. The findings revealed an average anxiety score of 1.80 with a standard deviation of 0.6 points, and an average pain score of 1.98 with a standard deviation of 0.3, thus validating full immersion in distraction. Statistical analysis using independent-sample t-tests and ANOVA indicated no significant differences in anxiety levels among the patients based on gender. Both patients wore the VR device throughout the procedure, expressing that it was comfortable, diverting, and held the potential to alleviate anxiety and pain. The dentist noted a positive influence on patient anxiety levels and procedure completion times, expressing an intention to continue employing VR with other angioedema patients and across diverse clinical populations.

Conclusions: Virtual reality can be an excellent distraction tool in patients with hereditary angioedema who present at least one acute attack per year.