Quintessence international最新文献

After the development of evidence-based, caries-preventive measures and their implementation, the caries decline varies considerably among different countries, which shifts the focus to the importance of regulations and national health policies. Thus, this study assessed the 45-year longitudinal caries development in seven Western and Eastern European countries for 5-7- and 12-year-olds and the according national health policies, regulations and general economic data. Denmark and Switzerland showed an early and marked caries decline after implementing national or regional regulations (1970s) on caries prevention (~1 DMFT, 12y, 1990), while Germany exhibited a similar pattern after adopting equivalent regulations in 1989 (1.2 DMFT, 2010) resulting in <0.5 DMFT for all three countries in the latest surveys. Slovenia and Austria implemented less regulations and subsequent measures resulting in a less pronounced and documented caries decline in 12-year-olds. Croatia and Serbia were engaged in territorial conflicts in the 1990ies and their caries decline came later and to a lesser extent (> 2 DMFT, 2020). For the primary dentition (5-7-year-olds) the epidemiological basis varies to a greater extent and only Denmark implemented an early national epidemiological and preventive strategy from the first tooth on resulting in <1 dmft in 6-year-olds after 2005, while the other countries had at least twice as high values. In conclusion, the difference in caries decline reflect general economic development and the national regulations on oral prevention, indicating the importance for stakeholders to implement evidence-based caries prevention and its monitoring in the respective national health care system.

Objectives: To investigate the influence of various bonding agents on the fatigue performance and fracture forces of temporary fixed dental prostheses.

Method and materials: Temporary and permanent cements were used to lute temporary fixed dental prostheses (TFDPs) fabricated by CAD/CAM milling and digital light processing (DLP) printing. Thermocycling and mechanical loading (TCML) was conducted, simulating clinical service for a period of two years. Following TCML, all specimens were loaded until failure and fracture forces were measured. TFDPs after water storage (24 h) were investigated as control. Statistics (α=0.95): Shapiro-Wilk test (Box-Cox transformation), Mann-Whitney U test (Holm correction), Fisher-Exact test, Kaplan-Maier survival.

Results: Milled TFDPs showed a survival rate of 100% for all cementations, while additively manufactured restorations featured survival rates between 0% and 63%. For additively fabricated TFDPs, temporary and conventional cements produced significantly (p ≤ 0.001) lower survival rates than self-adhesive or adhesive composite resins. Fracture forces after water storage ranged between 807 N and 2287 N. After TCML, fracture forces ranged between 463 N and 1738 N, with significant differences (p < 0.05).

Conclusion: Additively manufactured TFDPs should be cemented self-adhesively or adhesively if intended for prolonged clinical service, while milled TFDPs might also be cemented temporarily to achieve a similar performance.

Objectives: This randomized controlled trial compared the effectiveness of dexamethasone and cryotherapy as final irrigation protocols in reducing postoperative pain after root canal preparation in mandibular molars with symptomatic irreversible pulpitis.

Method and materials: Ninety patients were randomly divided into three groups (n = 30): control, cryotherapy, and dexamethasone. After standard NaOCl and EDTA irrigation, the control group received 20 mL of normal saline, the cryotherapy group received 20 mL of 2°C saline, and the dexamethasone group received 1 mL of dexamethasone solution (4 mg/mL) per canal following a final saline rinse. The participants were asked to rate the intensity of their postoperative pain via a Visual Analog Scale (VAS) at 6 h, 12 h, 24 h, 48 h, and 72 h. The data were statistically evaluated.

Results: At 6 h, the dexamethasone group demonstrated significantly lower VAS scores compared with the cryotherapy and control groups (p < .05), with a mean absolute difference of approximately 1.4 VAS units versus control. At 12 h, pain scores were similar between the dexamethasone and cryotherapy groups, both being significantly lower than the control group (p < .05). At 24 h, the dexamethasone group maintained significantly lower pain scores compared with control (mean absolute difference ≈ 1.1 VAS units; p < .05). No significant differences were observed among the groups at 48 and 72 h.

Conclusion: Dexamethasone irrigation was found to be more effective than cryotherapy in reducing postoperative pain in the early postoperative period.

Objectives: The aim of this overview is threefold: (1) evaluate whether the evidence available up to 2019 supported the American Academy of Orofacial Pain's (AAOP) critical position on the use of low-level laser therapy (LLLT) for the management of temporomandibular pain; (2) identify and evaluate new evidence published since 2019; and (3) provide updated clinical recommendations.

Methods: A comprehensive PubMed search was conducted (last updated February 2026). Systematic reviews (SRs) and randomized controlled trial (RCT) articles were identified using respective filters. Relevant citations were extracted into a spreadsheet and analyzed.

Results: Thirty SRs associated with 156 distinct publications on LLLT, and 11 RCT articles representing data from 10 studies were included. While studies before 2020 were methodologically weak, more recent evidence demonstrates greater methodological rigor and more consistent positive outcomes. Available SRs reported significant short-term pain reduction and improved maximal jaw opening, preferably with wavelengths between 810 and 1,100 nanometers (nm) and therapy durations exceeding four weeks. Combination therapies (LLLT with splints or physiotherapy) showed enhanced outcomes. However, heterogeneity in study design and laser parameters persists, which limits generalizability.

Conclusion: The extant literature published since 2019 suggests that LLLT is more effective at managing temporomandibular pain than the 2023 AAOP guidelines indicate. This observation is particularly salient in cases of TMJ arthralgia and other intra-articular pathologies. LLLT appears to be a safe, noninvasive, and effective adjunctive therapy within multimodal management. Future studies should standardize therapy-related parameters to strengthen clinical recommendations.

Aim: To identify probabilistic, sequential patterns of periodontal breakdown using Sequential Pattern Mining (SPM) on a large longitudinal cohort.

Materials and methods: Electronic health records from 19,428 patients with periodontitis (2011-2022) were analyzed. A custom SPM algorithm was developed to identify frequent temporal subsequences of tooth mobility and furcation involvement, enforcing strict temporal precedence. "High-risk" states (e.g., generalized clinical attachment loss [CAL] >3.0mm) were evaluated as precursors to localized failure. Association rules were ranked by Confidence (conditional probability).

Results: The analysis revealed distinct biomechanical cascading patterns. In the mandibular anterior sextant, mobility in the central incisors was a strong probabilistic precursor to subsequent failure in the lateral incisors and canines (Confidence: 7.3%). A significant "antagonistic cascade" was identified, where mandibular incisor mobility preceded maxillary incisor instability (Confidence: 8.1%). For molars, furcation involvement acted as a specific temporal sentinel for future mobility (Confidence: ~5-6%). Generalized high CAL was the strongest predictor of localized failure (Confidence: 18.9%), significantly outperforming active inflammation (bleeding on probing) as a driver of mechanical instability.

Conclusion: Progressive biomechanical compromise (such as tooth mobility and advanced furcation involvement) follows predictable, probabilistic sequential patterns. The identification of specific "sentinel events," such as mandibular incisor mobility and molar furcation involvement, allows for a shift from reactive site-by-site management to predictive intervention.

Clinical relevance: These findings underscore the critical role of generalized attachment loss in driving localized mechanical failure cascades.

Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease that can affect multiple organ systems, including the skin, joints, kidneys and oral cavity. In recent years, there has been growing interest in the oral health of patients with SLE, with studies showing that the incidence of dental caries, periodontal disease, oral mucosal lesions and salivary dysfunction is significantly higher in patients with SLE than in the general population. Factors such as immune system abnormalities, long-term use of glucocorticoids and immunosuppressants, and dysbiosis of the oral microbiome all contribute to an increased oral disease burden in patients with SLE. Oral health problems affect not only patients' nutritional intake, social interactions and self-esteem but may also create an inflammatory feedback loop exacerbating the underlying systemic condition. A multidisciplinary management approach involving rheumatology, dentistry and psychological support - with more refined and individualised strategies for prevention, treatment and follow-up - is crucial for patients with SLE. This review distinguishes itself from prior syntheses by systematically integrating the pivotal role of nursing teams within the multidisciplinary framework, and proposing actionable, structured protocols for assessment, referral, and long-term follow-up. Future research should focus on exploring the interaction between the oral microbiome and immune response mechanisms and strive to develop more effective interventions and standardised diagnostic and treatment protocols to improve the oral health and overall quality of life of patients with SLE.

The causes of exostoses, such as mandibular/maxillary torus, include bruxism, occlusal force, genetics, and environmental factors. This study investigated the correlation between mandibular/maxillary torus and periodontitis. A total of 478 patients above 20 years of age who visited the general dental clinic from 2001 to 2014 were enrolled in the study. Clinical data, including PPD, Bop, and DMFT index, were evaluated. The general condition of the patient, including back pain, a stiff shoulder, and a history of smoking, was evaluated via medical interviews. Logistic regression analysis was performed to assess the association between mandibular/maxillary torus and patient characteristics. Apart from sex, no statistically significant differences were observed between the torus and the other patient characteristics. In addition, no significant association was found between the presence of a torus and the number of teeth with a PPD of >6 mm. These findings suggest that the mandibular/maxillary torus does not contribute to periodontitis. Additional longitudinal studies are warranted to elucidate the complex interplay between genetic predisposition, environmental factors, and mechanical stress in the development of the torus and its potential impact on periodontal health.

Objectives: The present narrative review aims to synthesize the current evidence on the release of micro- and nanoplastic particles (MPs/NPs) from oral splints, clear aligners, and mandibular advancement devices (MADs).

Methods: A bibliographic search was conducted in PubMed, supplemented by a search in Consensus, an AI-supported academic search engine (based on Semantic Scholar). The reference lists of relevant articles were manually screened. The final literature search update was updated on March 2026.

Results: MPs/NPs are ubiquitous in the environment and have also been detected in numerous human tissues. Experimental and epidemiological studies suggest that particles measuring less than 10 μm in size may accumulate in organs and induce inflammatory, infectious, hormonal, and DNA-damaging effects. In the field of dentistry, multiple sources of MPs/NPs have been identified, including oral appliances. The mechanical wear of oral splints, clear aligners, and MADs leads to surface degradation and the release of plastic particles, which may be ingested. However, clinical data concerning the quantity, size distribution, and long-term fate of MPs/NPs released from these appliances is very scarce. Most of the available evidence is derived from in vitro or simulated oral environment studies.

Conclusion: Given the widespread use of oral appliances and the subsequent emergence of associated health concerns, there is an imperative for rigorous, human-centered research to elucidate the potential health risks posed by cumulative, low-level exposure to microplastics released from these products.

Objectives: To compare the accuracy of the Raypex-6 apex locator and Cone-beam computed tomography (CBCT) in measuring root canal length under different apical foramen diameters and root canal curvature angles.

Methods and materials: Sixty in vitro root canal specimens were selected. The apical foramen was destroyed retrogradely, and the apical foramen diameter was adjusted artificially to range from 0.2mm to 2.0mm. A stereomicroscope was used to determine the actual root canal length. CBCT and the Raypex-6 apex locator were used to independently measure root canal length. We compared the actual length with that measured by CBCT and the Raypex-6 apex locator. A chi-square test was applied to the data, with measurement differences of 0-0.5mm classified as accurate. Finally, differential analysis and correlation analysis were performed.

Results: CBCT accuracy did not differ significantly across apical foramen diameter or root canal curvature angle groups (P > 0.05). Raypex-6 apex locator accuracy also showed no significant differences among groups stratified by root canal curvature angle (P > 0.05). In contrast, Raypex-6 apex locator accuracy varied significantly with apical foramen diameter and area (P < 0.001).

Conclusion: The accuracy of CBCT and Raypex-6 apex locator for measuring root canal length does not depend on the root canal curvature angle. However, when the apical foramen diameter exceeds 1.6mm, or the apical foramen area exceeds 1.844mm², Raypex-6 apex locator accuracy decreases significantly. Therefore, CBCT is recommended for clinical root canal length measurement under these conditions.

Background: Lesch-Nyhan syndrome (LNS) is a rare X-linked disorder characterized by hyperuricemia, neurological impairment, and severe self-injurious behavior (SIB), frequently involving the oral tissues. Dental management of oral SIB remains challenging, and irreversible tooth extraction is still commonly employed.

Methods: This retrospective case series describes four unrelated patients with LNS (aged 2.5-16 years) treated over a 20-year period using a customized dual-laminate thermoplastic intraoral appliance. The primary outcome was cessation of oral self-injury; secondary outcomes included tissue healing, appliance tolerance, and adverse effects. Follow-up ranged from 16 months to 14 years.

Results: All patients demonstrated complete clinical cessation of oral self-biting, with healing of soft tissues and no need for tooth extraction. The appliances were well tolerated, easily fabricated, and demonstrated durable performance without reported complications during long-term follow-up.

Conclusions: This conservative, fully intraoral approach may represent an effective and reversible alternative to irreversible dental extractions for managing oral SIB in patients with LNS, particularly when implemented in experienced clinical settings. The technique appears most appropriate for dentists trained in special care or hospital-based dentistry to ensure safety, comfort, and long-term functional outcomes.