Minerva dental and oral science最新文献

Background: According to Centers for Medicare and Medicaid Services HHS 2017, when a medical disease suddenly manifests itself with acute symptoms of sufficient intensity (including extreme pain) endangering the patient's health, seriously impairing body functions or bringing an organ or its portion to be seriously dysfunctional, a medical emergency has occurred. Therefore, this study aimed to assess the knowledge, attitude, and perceived confidence in handling medical emergencies among dental students by the means of conducting this investigation.

Methods: This is a cross-sectional study conducted among the different hierarchies of dentists of Riyadh using an online survey; 387 dentists from varying clinical levels (9 to 12) were included in this study. The questionnaire used for this study consisted of questions related to demographic data followed by questions including knowledge, attitude, and confidence towards handling medical emergencies in clinics.

Results: In this study, male participants represented 64.4% and female subjects represented 35.6% of the total population. Most of the undergraduates were in their 5^th year of dentistry school and accounted for 36.9%, followed by 6^th year 36.2% and 4^th year 26.8%. 67.1% of the undergraduates never encountered any medical emergency during their study, while 32.9% encountered an emergency. Furthermore, 58.4% of the analyzed subjects recorded medical history thoroughly, while priority in an emergency was adrenaline, with a percentage of 45%. For the patient suffering syncope the Trendelenburg position was chosen. Also, the first action choice with unresponsive patients was CPR.

Conclusions: In the present study, the findings revealed that the majority of the population never encountered an emergency in their career, but their knowledge about drug priority and patient's position was good. Most of them do not measure vital signs routinely; specifically, females do not usually measure, while males measure when needed. About Basic Life Support (BLS), participants took BLS or were interested in taking it in the future; furthermore, in group population, both have taken it and are interested in further carrying it.

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: The number of retracted articles in the bio-medical field, including dentistry, is increasing. The objective of this study was to identify retracted articles in endodontic-related literature and outline their main characteristics.

Evidence acquisition: The Medline and Scopus databases were searched in January 2024. Additional records were identified by consulting the online database www.retractiondatabase.org. Retracted articles concerning endodontic topics and the relative retraction notes were retrieved and relevant data extracted.

Evidence synthesis: Sixty articles were identified, published between 2004 and 2022, with a mean of 3.0±2.3 retracted articles per year. The number of retracted articles per year did not significantly grow over time. The average time between the article and retraction note publication was 36.1±22.3 months. The majority of articles originated from Asia and were in-vitro studies. Only 6.7% of the articles were retracted due to honest errors. The main reasons of retraction were image/data manipulation (20%), plagiarism (18%), unavailability of raw data (10%), authorship issues (10%) and publication process issues (10%). A single research group accounted for 17 retractions.

Conclusions: Unlike the dental field, the number of retracted articles in endodontics has not increased significantly over the time period considered. Despite this, controls against research misconduct must be increased to preserve the credibility of scientific research.

Background: The objective of the in vitro study was to evaluate the impact of two adhesive removal techniques on the surface roughness of the human enamel surface using laser scanning confocal microscopy (LSCM).

Methods: Forty healthy first upper molar teeth were included in this experiment (20 teeth per each group). T0 measurement of surface roughness parameter of the teeth were conducted using LSCM. The teeth were bonded with metal brackets. Following 24 hours of sample storage in distilled water, the brackets were debonded. A modified adhesive remnant index (ARI) was used to exclude samples with below 90% adhesive remnants on their surface. The remaining 36 teeth were then randomly divided into two groups (18 teeth per group) with the following debonding procedures: group TC (single stage method using a Smoozie tungsten carbide bur) and group TCP (two stage method using a Smoozie tungsten carbide bur, followed by a Smoozie polisher). The time needed for complete adhesive removal was recorded and T1 surface roughness measurements were conducted again after adhesive removal using LSCM.

Results: Significantly higher surface roughness values were recorded in group TC, compared to group TCP (P<0.01). Method TCP, on the other hand, was significantly more time-consuming than method TC (P<0.01).

Conclusions: Despite the fact that the two-stage method (group TCP) was more time consuming, the lower level of enamel surface roughness in this method suggests the superiority of this method.

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.

The aims of the present case report are to describe the non-surgical management in addition to hyaluronic acid application of two gingival recessions with cleft and to perform a narrative review on the newest evidence of non-surgical treatment of gingival recessions. A 47-year-old female patient with dentine hypersensitivity and pain during brushing has type 1 gingival recession with red Stillman's cleft on 1.4 and 1.5. The gingival defects have been treated with a Gracey curette n° 7/8 to cause bleeding. Sodium hyaluronate gel has been applied in the gingival sulcus of both elements affected. Three months after treatment the gingival tissue on 1.5 and 1.4 revealed complete healing of the Stillman's cleft and the mean value of REC depth reduced by 0.50 mm. Furthermore, four articles about this topic were selected for a narrative review. Based on the recent literature, the non-surgical treatment of Stillman's clefts and gingival recessions is not highly rated. The clinical result of this case report suggests a non-surgical method to treat Stillman's cleft. However, the evidence from a single case report is weak and more clinical trials are required to deepen the knowledge on the topic.

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.

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.