Minerva dental and oral science最新文献

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.

Introduction: Dental health and overall well-being are greatly impacted by temporomandibular disorders (TMDs), which encompass a spectrum of illnesses that impact the temporomandibular joint and its surrounding structures. The use of dental prostheses, including complete and partial dentures, is common among individuals with missing teeth. However, the association between denture types and the prevalence of TMD remains a subject of interest and concern in the field of oral health.

Evidence acquisition: Relevant databases were comprehensively searched to identify eligible studies. The search strategy included terms related to Temporomandibular joint disorders and dentures. Studies reporting on the prevalence of TMD in denture wearers, categorized as complete or partial, were included. Quality assessment and data extraction were performed following established guidelines. Two reviewers independently screened articles, conducted data extraction and risk assessment. Meta-analysis was carried out using random-effects models, and subgroup analyses were conducted to explore potential sources of heterogeneity.

Evidence synthesis: A total of three studies were included in the analysis. Two studies reported TMD to be prevalent in partial denture (PD) in higher proportions as compared to Complete Denture (CD) while another showed CD patients exhibiting greater TMD cases. The results remain inconclusive owing to the limited number of studies and evidence. The quality of the included studies ranged from moderate to low risk.

Conclusions: The current evidence regarding the association between denture type and TMD is inconclusive and limited. The heterogeneity of study designs and the lack of standardized assessment tools for TMD diagnosis and denture classification contribute to the variability in findings. This information can help prosthodontists and other dental practitioners improve the general health and oral hygiene of their patients who wear dental prosthesis.

Forensic odontology is essential in medico-legal investigations, aiding in the identification of individuals, particularly in cases involving decomposed or severely damaged remains. Teeth, due to their durability and uniqueness, serve as critical forensic markers. This field also plays a role in age estimation, bite mark analysis, and legal disputes related to dental malpractice. Key forensic dental techniques include comparative dental analysis, radiographic imaging, and DNA extraction from teeth, which offer resistance to environmental degradation. Advanced methods such as aspartic acid racemization, radiocarbon dating, and histological analysis further enhance age estimation accuracy. Bite mark impressions, though controversial, remain relevant in forensic investigations. Additionally, forensic odontology collaborates with anthropology, botany, and entomology to strengthen identification processes. Technological advancements, including digital forensic tools, 3D imaging, and improved DNA analysis, have enhanced the precision of forensic dental identification. Bite mark analysis, while debated, benefits from computer-assisted comparisons. Forensic dentists are increasingly involved in legal cases, particularly in dental malpractice disputes, requiring specialized knowledge to assess liability and damages. Forensic odontology continues to evolve, integrating innovative technologies to improve accuracy and efficiency. Future research will focus on refining identification methods, utilizing AI-driven forensic analysis, and addressing ethical concerns related to DNA usage. Expanding forensic dental expertise in both clinical and legal contexts will be crucial for maintaining the discipline's role in forensic science.

Exfoliative cytology has proven to be a valuable diagnostic tool in the early detection of malignant neoplasms. However, its application in the oral cavity has been met with skepticism and limited investigation due to the perception that clinical examination alone is sufficient for early diagnosis. Nonetheless, recent research efforts have focused on the utility of exfoliative cytology in oral cavity neoplasms, motivated by the high mortality rate associated with oral cancer. This manuscript reviews the historical development of exfoliative cytology in the oral cavity, highlighting key findings and advancements in the field. Early studies demonstrated the presence of neoplastic cells in oral cavity lesions and emphasized the diagnostic potential of cytology. Subsequent research explored different staining methods and observed the differential reaction of oral cavity cells to radiation therapy. The diagnostic accuracy of exfoliative cytology was reported to be as high as 92%, with a significant number of cases diagnosed as carcinomas without any clinical suspicion. The technique also proved valuable in identifying precancerous and dysplastic lesions and obviating the need for unnecessary biopsies. The manuscript delves into the difficulties encountered in sampling techniques and stresses the significance of appropriate specimen collection and handling. Various staining methods, including Papanicolaou and acridine orange, were utilized for cytological analysis. The manuscript emphasizes the extensive use of exfoliative cytology in oral cavity examinations and stresses the importance of recognizing it as a crucial diagnostic tool. Various studies have reported high positivity rates and the detection of clinically unsuspected malignant lesions. The authors recommend extensive use of exfoliative cytology in routine practice and underscore the necessity of proper sampling and evaluation techniques.

Background: To analyse the association between the likelihood of expressing dental anxiety in children based on parental report and the invasiveness of dental treatment history along with the acceptance of the accompanying fluoride treatment.

Methods: A total of 70 healthy children (7.1±1.9 years, 27 female) who presented for a recall visit to the Specialised Pedodontics Department were included in this study. This questionnaire-based study involved parentel assessment of the frequency of the child's expression of dental anxiety at home (always/often/sometimes as frequent dental anxiety expression vs. rarely/never as no history of dental anxiety expression) using 5-point Likert-Scale. The invasive treatment history was based on the child's dental record including extraction, fillings, space maintainer, nitrous oxide sedation and general anaesthesia, while non-invasive therapies included dental prophylactic services and fissure sealant.

Results: According to the parents' report 29 (41.4%) of the 70 children expressed their dental anxiety at home. The majority (N.=27, 93%) of these 29 children had an invasive dental history (P=0.009, Chi-square Test), and showed to be anxious based on their previous dental records (P=0.003, Chi-square Test). Almost all children (18 out of 19 children, 95%) who complained on the taste after applying the fluoride varnish have had previous dental visits with an invasive treatment history (P=0.083, Chi-square Test).

Conclusions: The likelihood of expressing dental anxiety at home in recall children of a specialised dental practice is relatively high, which is clearly associated with history of invasive dental procedures. Dentists should keep in mind that there is a correlation of invasive treatment history and dental anxiety which affects also the children in the recall phase. Additionally, children with a history of non-invasive dental procedures (preventive measures) have an improved acceptance of the taste of fluoride varnish.

Background: Mandibular reposition devices (MRDs) are a viable option for addressing snoring and mild to moderate obstructive sleep apnea syndrome (OSAS) as another possibility to continuous positive airway pressure (CPAP) ventilation during sleep. The aim of the study was to evaluate the efficacy of OSAS MRDs with variation in vertical dimension, considering the OSAS indexes: Apnea Hypopnea Index (AHI), Oxygen Desaturation Index (ODI) and Snoring Index.

Methods: Eleven patients with different level of OSAS were enrolled in this study. The patients in the study were evaluated at three different times (T0, T1, T2). At T0 the patients underwent a basal polysomnography (PSG) without any oral appliance. At T1, the PSG was executed using MRD at 70% of protrusion and a vertical dimension consequent of protrusion. The vertical dimension determined by a protruded position is the one that is caused by the repositioning of the mandible. At the T2, the patients used the same appliance with 70% of protrusion, adding a uniform 6-mm bite resin plane between the existing upper and lower splints of the MRD, in the lateral area. The patients enrolled in this study did not tolerate the CPAP. T-test for paired samples was used to assess the possible statistical differences between AHI and ODI (T0, T1 and T2). The snoring indexes were analyzed through Friedman test for corelated sample.

Results: The mean value of AHI (T0) was 30.17±19.51. The mean AHI of T1 was 10.60±9.35, while the mean value of T2 was 5.41±3.25. The mean value of ODI (T0) was 29.02; SD±20.74. The mean ODI of T1 was 10.46±9.48, while the mean value of T2 was 5.40±3.41. Analyzing AHI and ODI, there was a significant statistical difference between T0 and T1 (P<0.05), between T1 and T2 (P<0.05) and between T0 and T2 (P<0.05). There was not any statistical difference for snoring indexes between T0, T1 and T2. (P>0.05).

Conclusions: According to the results of this study, the major improvement of AHI and ODI is reached through the usage of MRD with an increase of vertical dimension. Considering all the limits of the study, it is possible to affirm that research should still take account of the vertical dimension as a possible factor when treating OSAS with oral appliance.

Introduction: The aim of the present study was to evaluate the opinion of Italian dental hygienists about the use of domiciliary water flosser for the oral hygiene of implant-supported fixed prostheses.

Evidence acquisition: A narrative review of the literature is presented, and a digital questionnaire was shared on Facebook professional groups to be anonymously filled by Italian dental hygienists. A descriptive analysis of the answers was conducted.

Evidence synthesis: Three hundred thirty-three dental hygienists participated of which 34% have worked for 0-5 years, 27.4% for 6-10 years, 26.81 27% for 10-20 years, and 11.14% for more than 20 years. Water flosser was recommended by the 49,7%. A small proportion of respondents, the 7.83%, thought that this intervention could cause emphysema/abscesses, while the 43.98% and the 36.75% believed respectively that it was either ineffective in the plaque removal or even it could push the biofilm under the gums. The 12.35% believed that the water flosser could cause gum recession, was difficult to use (20.48%) and it could damage the prosthodontic and implant components (1.2%). These information were acquired from textbooks (31.63%), web (25%), universities courses (57.23%), companies (25.6%), other courses (38.25%) and personal experience (6.33%). The 48.2% of the hygienists reported that they were often asked from their patients about water flosser, 47.3% rarely, 1.25% always and 3.3% never.

Conclusions: Although the scientific literature supports the use of water flosser in terms of efficacy and safety, Italian dental hygienists rarely recommend it for home oral hygiene of implant-supported prostheses mainly because they consider it ineffective or even dangerous.

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: This in-vitro study aimes to compare the microleakage of different restorative materials namely EQUIA Forte (GC, Japan), Tetric Evoceram (Ivoclar Vivadent, Liechtenstein), and Activa BioACTIVE.

Methods: A standardized class V cavity has been created on the buccal surface of 40 sound premolar teeth. The cavity had the following measurements: 3 mm buccolingual height, 2 mm axial depth, and 4 mm mesiodistal width. The gingival margin was 1mm below the cementoenamel junction, whereas the coronal margin was on the enamel with cavosurface margins were butt joints all around. Four groups of teeth were restored according to the restorative materials. Under a stereomicroscope, the dye penetration test was used to measure the microleakage after thermocycling of the teeth. Data were compared using Kruskal-Wallis H and Mann-Whitney U Tests.

Results: Occlusal and gingival margins did not show statistically significant differences among the four groups, but an intragroup analysis revealed a significant difference.

Conclusions: The type of restorative material did not appear to have a substantial impact on microleakage, according to the findings of the current investigation.

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.