Minerva dental and oral science最新文献

Bone adhesives have emerged as a promising adjunct in regenerative medicine due to their potential to enhance fixation, improve osteointegration, and reduce operative time. Their application is particularly relevant in scenarios where traditional mechanical fixation is challenging or invasive, such as in cranial, orthopedic, and maxillofacial procedures. This narrative review explores the current landscape of bone adhesives, with a focus on synthetic and bioadhesive composites. A literature search was conducted across PubMed, Scopus, and Web of Science, including both preclinical and clinical studies published in the last two decades. Key parameters analyzed include adhesive composition, mechanical strength, biocompatibility, degradation behavior, and clinical outcomes. The reviewed evidence highlights that bone adhesives exhibit promising properties for use in bone regeneration. Synthetic adhesives, such as cyanoacrylates and polyurethane-based glues, offer high initial bond strength, while bioadhesives - often based on fibrin, collagen, or dopamine-functionalized polymers - demonstrate superior biocompatibility and osteoconductive potential. Clinical studies suggest their utility in bone graft stabilization, cranial defect repair, and minimally invasive maxillofacial surgery. Additionally, adhesives have been shown to reduce the need for hardware fixation, lower infection risks, and promote faster recovery. Bone adhesives represent a valuable complementary tool in regenerative bone procedures. While their integration into clinical practice is still evolving, current data support their safety and efficacy in selected surgical contexts. Further large-scale, long-term trials are warranted to validate their performance and optimize material formulations for specific applications.

Background: Bone grafting is a surgical procedure that involves the use of bone tissue or bone substitutes to repair damaged bone. In dentistry and maxillofacial surgery, bone graft substitutes from various sources are commonly used. Given their critical role in clinical outcomes, it is essential to thoroughly investigate the biological and mechanical properties of these materials.

Methods: In this in vitro study, we evaluated the biological properties of two equine-derived bone graft substitutes in comparison to β-tricalcium phosphate. The materials included one equine-derived graft containing hydrolyzed type I collagen and another containing preserved type I collagen. To assess their biological performance, we analyzed cell viability, adhesion, osteogenic differentiation, and the expression of genes involved in bone remodeling.

Results: All graft substitutes demonstrated similarly good biocompatibility. However, in the β-tricalcium phosphate group, intergranular tissue fibers or extracellular matrix were absent both before and after osteogenic differentiation. In contrast, cells cultured on the equine-derived graft containing hydrolyzed type I collagen exhibited intergranular tissue fibers and matrix, while those on the graft containing preserved type I collagen showed intergranular tissue fibers, individual cells, and matrix. Gene expression analysis suggested that β-tricalcium phosphate may undergo faster resorption kinetics compared to the equine-derived grafts, which were associated with gene expression patterns indicative of enhanced bone formation.

Conclusions: Our results suggest that both hydrolyzed and preserved type I collagen support bone matrix deposition more effectively than β-tricalcium phosphate, with preserved collagen demonstrating superior performance. From a clinical perspective, preserved collagen appears to be the optimal choice for larger or less contained bone defects, as it promotes faster cell repopulation and may lead to more rapid remodeling with the patient's own vital bone. In contrast, hydrolyzed collagen seems to elicit a slower cellular response and may be better suited for smaller, localized defects where immediate biological activity is less critical. Further research is essential to guide clinicians in selecting the most appropriate bone graft substitute based on the specific clinical context.

Background: The current study aimed to evaluate the effect of aging on the repair bond strength between old composite resin and repaired composite resin and to evaluate which type of repair composite material provides better bond strength in different time durations.

Methods: Eighty nano-hybrid composite specimens were randomly divided into four groups (N.=20) and exposed to accelerated aging from 0 to 2 years. Each group was further divided into two subgroups, A and B, repaired with packable and flowable composite respectively, after micro-abrasion treatment. Shear bond strength was assessed and statistically analyzed.

Results: It was observed that with an increase in aging time, the bond strength of both the composite materials used for repair decreased. The flowable composite's mean bond strength (22.09±0.65, 18.74±2.36, and 17.74±2.38 MPa) was more than the packable composite (21.97±0.84, 17.97±3.85, and 15.97±2.45 MPa) used for repair on aged specimens. In contrast, the bond strength of the packable was more than the flowable composite in control group specimens that were not aged (23.25±0.89 vs. 22.40±1.26).

Conclusions: As restored composites age, their bond strength decreases. Flowable composite displays better repair shear strength than packable composite as aging progresses. Micro abrasion followed by flowable composite bonding can repair aged composite restorations effectively.

Artificial intelligence (AI) is increasingly influencing dental practice, offering advancements in diagnostics, treatment planning, and patient management. This narrative review explores the current applications of AI in dentistry, addressing clinical, technological, and ethical dimensions. A non-systematic narrative approach was employed to synthesize recent literature on AI in dentistry. The focus was on diagnostic tools, treatment planning, decision support systems, teledentistry, ethical implications, and emerging technologies. AI demonstrates high performance in image analysis (e.g., caries detection, periodontal assessment, oral cancer screening), treatment optimization (e.g., orthodontics, implant planning), and patient-specific risk modeling. Clinical decision support systems (CDSS) assist in evidence-based care, while AI-driven chatbots and remote monitoring platforms enhance patient engagement and access. However, challenges persist regarding algorithm transparency, data bias, legal liability, and privacy. Future directions include multimodal data integration, digital twins, and AI-driven precision dentistry. AI represents a paradigm shift in dentistry, supporting clinicians and enabling more accurate, accessible, and personalized care. Successful implementation will depend on ethical deployment, robust regulation, and adequate training to harness its full potential without compromising professional standards.

Background: Oral health is crucial for overall well-being, as conditions like periodontitis are increasingly associated with systemic diseases, including type 2 diabetes, cardiovascular diseases, and neurological disorders. Research in the UK and globally has revealed limited awareness among medical students about these connections, emphasizing the need for curriculum enhancements. This study assessed the awareness of year 3 and 4 medical students about oral-systemic disease connections.

Methods: Following approval from the University of Central Lancashire School of Medicine and Dentistry Ethics Committee, a cross-sectional questionnaire-based survey was conducted. The survey, consisting of multiple-choice questions with multiple answer options, was delivered anonymously via an internal Teams channel to a representative cohort of year 3 and 4 medical students. The questionnaire covered general awareness of oral-systemic health, specific oral disease knowledge, and a focused evaluation of the periodontitis-diabetes relationship. Statistics included descriptive analysis and Chi-square Tests to assess associations between responses. Measures of association, such as Phi and Cramér's V, were also calculated.

Results: A total of 122 students participated (65.67% year 3, 34.33% year 4). Most (91.04%) acknowledged the link between oral and general health. While 80.6% identified periodontitis as gum disease, 8.96% associated it with tooth decay, and 10.45% were unaware. Awareness of the bidirectional relationship with diabetes was limited; 60% recognized that diabetes increases periodontitis risk, but only 29.9% understood the reverse.

Conclusions: This study highlights gaps in medical students' knowledge of oral-systemic health, emphasizing the need for better integration of oral health education in the medical curriculum. Aligning with WHO strategies and European Federation of Periodontology initiatives, improved interprofessional education can enhance patient care through collaboration between medical and dental professionals.

Background: The purpose of the study is to evaluate the use of a magnetodynamic instrument (Magnetic Mallet^®, Metaergonomica, Turbigo, Milan, Italy) to perform a horizontal bone expansion in edentulous sites that need to be rehabilitated with a dental implant.

Methods: A sample of 15 patients, 11 men and 4 women, age between 39 and 78 years, was analyzed. A total of 18 conical-shaped implants with a diameter of 3.80 mm and a length between 10 and 11.5 mm were inserted in the maxillary region in the area between the lateral incisor and the first upper molar. The patients were treated by two different surgeons. Bone thickness was measured through CBCT before treatment and at 3 months post-surgery.

Results: No implant failed and all of them achieved a correct osseointegration. The average pre-surgery bone thickness was 4.36±0.70 mm, it changed to 5.58±1.11 mm after using the Magnetic Mallet^®, finally stabilized at 6.72±1.24 mm with the insertion of the implant. CBCT examination revealed a statistically significant difference in mean bone thickness before treatment and at 3 months post-surgery with a mean bone thickness of respectively 4.39±0.60 mm and 6.97±1.25 mm. Significantly different outcomes were obtained by operators with a different learning curve.

Conclusions: At 3 months of follow-up, the Magnetic Mallet^® proved to be a useful tool in the horizontal expansion of the atrophic upper jaw bone crest, along with the preparation of the implant site. A learning curve is necessary to optimize the clinical outcomes. Further studies are needed with a larger patient cohort and a longer follow-up to confirm the present results.

Background: Enzyme-linked immunosorbent assay (ELISA) kits for BP180-NC16A use different cutoff levels established for cutaneous bullous pemphigoid (BP). However, in oral mucous membrane pemphigoid (OMMP), circulating antibodies are reported to be less readily detectable than cutaneous BP and there is little evidence that these cut-off levels are suitable for OMMP. This study was performed to explore whether the available cutoff values of anti-BP180-NC16A ELISA used for cutaneous BP are equally effective when applied to OMMP or should benefit from an optimized cut-off value.

Methods: Eighty-one patients with oral blistering diseases were divided into two groups based on the results of histological and direct immunofluorescence analyses: the OMMP group (N.=31) and the non-OMMP control group (N.=50). Antibodies against BP180-NC16A were evaluated using manufacturer's cutoff level (Euroimmun 20 U/mL). A preliminary cutoff specific for BP180 in OMMP was identified by receiver operator characteristic (ROC) curve analysis.

Results: A cutoff value of 20 U/mL showed low sensitivity (41.94%) but high specificity (94%). Using ROC curve analysis, a cutoff of 11 U/mL emerged as the optimal cutoff for BP180-OMMP (sensitivity: 70.97%; specificity: 88.7%). Using both cutoff values false-positives cases emerged (pemphigus vulgaris and oral lichen planus).

Conclusions: The BP180-NC16A ELISA cutoff values designed for cutaneous BP may not be equally accurate when applied for the diagnosis of OMMP. The use of cut-off values specific for OMMP and a panel of several antigens specific for OMMP may improve the clinical utility of ELISAs; however, problems deriving from low specificity should be acknowledged.

Background: The precise measurement of the working length (WL) is pivotal for the success of endodontic treatments. Incorrect WL determination can lead to improper reaming and filling of the canal, posing risks of periradicular pathologies onset or failure to heal pre-existing conditions. Presently, apex locators are commonly used for WL determination, available in a variety of characteristics and costs. Alternatively, the traditional method using intraoral radiography remains prevalent.

Methods: This study, conducted partly in vivo and partly in vitro, on teeth designated for extraction, compares three WL measurement methods: 1) radiographic method (zero cost); 2) Apex Locator (inexpensive); and 3) Root ZX II (expensive). The correctness of measurements was verified through visual inspection under a stereomicroscope.

Results: Our data indicate that the precision of apex locators surpasses that of the radiographic method, which relies on visual inspection of the instrument inside the canal and is subject to personal interpretations of the images. No significant differences in precision were observed between the two locators examined, despite their differing price ranges and brand histories in the field of endodontics.

Conclusions: Among the multitude of parameters influencing a dentist's choice of electro-medical equipment, cost remains a significant consideration, particularly when equipment exhibits similar characteristics.

Dental waste, including metal, plastic, and chemical residues, and high energy and water consumption, significantly contribute to environmental degradation. This review highlights the environmental impact of common dental materials and practices, such as amalgam, resin composites, and disposable plastics. The aim is to examine current evidence, emphasizing mercury pollution, microplastic release, and biomedical waste handling. Moreover, it explores the emerging concept of green dentistry and provides an overview of international regulatory efforts. The paper advocates for sustainable practices in dentistry through prevention, innovation, and informed clinical choices, supported by life cycle assessment approaches.

The COVID-19 pandemic, particularly in India, continues to pose a major threat to public health owing to the large number of patients that remain affected. The second wave of COVID-19 has brought with it several opportunistic diseases caused by bacteria and fungi, including mucormycosis, which is a well-known fungal infection primarily encountered in immunocompromised individuals through inhalation. In recent times, mucormycosis has become increasingly common in COVID-19 patients, particularly those with comorbidities such as diabetes, and has been observed to induce secondary infections as it spreads with COVID-19 treatment. Despite its importance, mucormycosis is still poorly studied due to the current priority given to research on treatments, vaccines, and diagnostics. To address this knowledge gap, this study aims to investigate the correlation between mucormycosis and COVID-19 patients and elucidate the molecular mechanism of mucormycosis to improve our understanding of fungal infections in patients who have recently contracted SARS-CoV-2.