Quintessence international最新文献

Objectives: This retrospective cohort study evaluated the clinical success of pulpectomy in pediatric primary molars using Iodoform/Calcium Hydroxide (Iodoform/Ca(OH)₂) paste and examined procedural and tooth-related factors associated with treatment outcomes over time.

Methods and materials: Records of pediatric patients treated with pulpectomy using Iodoform/Ca(OH)₂ paste were retrospectively reviewed. Of 1,831 screened records, 167 primary molars that met the inclusion criteria and had a minimum follow-up of six months were included in the final analysis. Clinical and radiographic outcomes were assessed longitudinally. Treatment success was analyzed using Kaplan-Meier survival analysis, and factors associated with failure were explored using Cox proportional hazards regression.

Results: Overall clinical success was high, with favorable short- to medium-term outcomes and a gradual decline in survival over time. Immediate placement of stainless-steel crowns (SSC) was significantly associated with improved treatment survival (p = 0.046), as was tooth type, with second primary molars showing superior outcomes (p = 0.024). In contrast, obturation quality and preoperative clinical signs were not significantly associated with treatment failure (p > 0.05).

Conclusion: Pulpectomy of primary molars using Iodoform/Ca(OH)₂ paste demonstrates reliable clinical performance in pediatric patients. Procedural and restorative factors, particularly immediate full-coverage restoration, appear to have a greater influence on longterm outcomes than radiographic obturation characteristics, supporting the material's continued use in pediatric endodontic practice.

Background: Cervical margin relocation (CMR) is a non-invasive technique using composite resin to elevate the interproximal floor beneath indirect restoration, improving margin integrity and tooth vitality.

Objectives: This study evaluated periodontal outcomes of CMR, like pocket depth (PD) and bleeding on probing (BOP), as well as restorative outcomes.

Methods: A systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Scopus, Google Scholar, and Web of Science with keywords like 'Cervical Margin Relocation," "Deep Margin Elevation," and " Proximal Box Elevation,". Meta-analyses assessed PD and BOP, analyzing heterogeneity with I² statistic.

Results: After sensitivity analysis, CMR does not appear to worsen periodontal PD or BOP in periodontally healthy or stabilized patients when proper isolation and restorative protocols are followed. The standardized mean difference for PD is -0.60 (95% CI [-0.94, -0.27], p = 0.001), with heterogeneity reduced to I² = 0%; and BOP also showed (OR: 0.06, 95% CI [0.01, 0.44]), with I² = 0%. These findings reflect the periodontal tolerance to properly executed CMR. Material selection affected marginal adaptation, with glass-ceramic bonding yielding the best outcomes. Composite margin elevation was effective for deep cavities, surpassing ceramic onlays, and subgingival resin composites enhance periodontal health.

Conclusion: CMR is effective for managing subgingival margins and compatible with periodontal health when appropriate materials are used. Material selection impacts marginal adaptation, and long-term follow-up is essential for measuring durability, offering valuable insights for clinical practice.

Objectives: This study compared the prevalence and distribution of developmental dental anomalies between Generation Y (1980-1994) and Generation Z (1995-2015) individuals in Türkiye.

Method and materials: A retrospective analysis was performed using panoramic radiographs of 3,444 systemically healthy individuals between May 1998 and October 2024. Participants were divided by birth year into Generation Z (n = 2,544) and Generation Y (n = 900). Anomalies were categorized as size, shape, number, and position/eruption anomalies. Binary and multiple univariate logistic regression analyses were conducted using SPSS version 26.0 (IBM).

Results: The overall prevalence of developmental dental anomalies was significantly higher in Generation Z (38.9%) compared to Generation Y (13.8%) (P .001). Shape anomalies were more prevalent in Generation Z (64.6%) than in Generation Y (43.4%) (odds ratio [OR] 1.645; 95% CI 1.112-2.432; P = .013), whereas number anomalies were more common in Generation Y (34.6%) than in Generation Z (15.1%) (OR 0.484; 95% CI 0.305-0.770; P = .002). No significant differences were observed for size or position/eruption anomalies (P = .640 and .416, respectively). Among specific anomalies, taurodontism was significantly more prevalent in Generation Z (22.6%) compared to Generation Y (3.7%) (P .001), while hypodontia was more prevalent in Generation Y (30.6%) than Generation Z (10.6%) (P = .002).

Conclusion: This study revealed distinct generational differences in developmental dental anomalies, suggesting possible associations between temporal and environmental factors on dental development. These findings may assist clinicians, researchers, and educators in adopting more generation-specific diagnostic and preventive approaches and in achieving better prediction of potential complications in clinical practice.

Objective: The relationship between stress-induced hyperglycemia and periodontitis is still unclear. The objective of this study was to identify the potential association between stress hyperglycemia ratio (SHR) and periodontitis among diabetes.

Method and materials: A cross-sectional analysis was performed based on diabetic patients who had complete periodontal examination from National Health and Nutrition Examination Survey (NHANES) 2009-2014. Severity of periodontitis was defined by CDC/AAP criteria. The moderate/severe degree was considered as outcome. SHR was calculated based on fasting blood glucose and glycated hemoglobin. Weighted logistic regression analysis was used to explore the association between SHR and moderate/severe periodontitis.

Results: There was a positive correlation between SHR and moderate/severe periodontitis (OR 2.86, 95% CI 1.21-6.79, P = .018) after adjustment of age, sex, race, education, poverty income ratio, hypertension, cardiovascular diseases, smoking status, frequency of using dental floss, bone loss around teeth, and dental caries. The odds for moderate/severe periodontitis in the highest SHR tertile was higher (OR 1.59, 95% CI 1.05-2.41, P = .030) than that in the lowest tertile in the fully adjusted model. Similar results were found in subgroups of poor glycemic control, hypertension, or cardiovascular diseases.

Conclusion: SHR was positively associated with poor periodontal health among diabetes. (Quintessence Int 2026;57:16-23; doi: 10.3290/j.qi.b6740667).

Objective: Periodontitis is a chronic inflammatory condition characterized by clinical attachment loss, periodontal pockets, bleeding on probing, gingival recession, and alveolar bone loss. Nonsurgical periodontal therapy (NSPT) is effective in the periodontal pocket reduction; however, a proportion of residual pockets can be assessed after completion of NSPT. Hyaluronic acid, due to its anti-inflammatory and regenerative properties, has been proposed as a topical adjunct to enhance NSPT outcomes. This review aimed to summarize and evaluate the current evidence on the adjunctive use of hyaluronic acid in NSPT.

Method and materials: An electronic and hand literature search was conducted across MEDLINE, Embase, and Web of Science for clinical studies published in English up to 2024. Randomized controlled trials, retrospective studies, and case series evaluating the adjunctive application of hyaluronic acid in NSPT were included.

Results: Eight clinical studies published between 2013 and 2024 were selected. Most studies showed that the adjunctive use of hyaluronic acid significantly improved probing depth reduction, clinical attachment level gain, and the percentage of pocket closure compared with NSPT alone. The combination of sodium hypochlorite/amino acid gel with cross-linked hyaluronic acid showed the greatest clinical benefits. No study reported adverse events associated with hyaluronic acid use.

Conclusions: Considering the analyzed data, the use of hyaluronic acid, cross-linked formulations in particular, seems to be effective as adjunct to NSPT. Furthermore, the combined application of sodium hypochlorite/amino acids and cross-linked hyaluronic acid appears to enhance clinical outcomes. (Quintessence Int 2026;57:6-14; doi: 10.3290/j.qi.b6689073).

This clinical case report describes the application of a fully digital workflow for the esthetic and functional rehabilitation of a patient presenting severe fluorosis, internal discoloration, and previously inadequate restorations, utilizing multilayered zirconia prostheses. The case integrated intraoral scanning, facial scanning, digital articulators, and CAD/CAM technology to improve treatment accuracy, predictability, and patient-specific adaptation. Initial intraoral and facial scans established functional and esthetic parameters. Occlusal adjustments were performed digitally, simulating condylar movements to ensure optimal occlusal harmony. Digital wax-ups and prototype restorations guided minimally invasive tooth preparations. Multilayered zirconia was selected due to its esthetic qualities, strength, and ability to mimic natural tooth translucency. Restorations were digitally designed, milled, verified intraorally, and bonded under rubber dam isolation. The digital approach enabled precise occlusal adjustments and substantial esthetic improvements, resulting in enhanced function and natural appearance. Posttreatment assessment revealed improved color stability, optimal marginal adaptation, and high patient satisfaction. The patient was scheduled for regular 3-monthly follow-ups and provided with an occlusal guard to ensure prosthetic longevity. Conclusion: This report highlights the clinical effectiveness of digital workflows in complex rehabilitations, underscoring benefits such as improved esthetic predictability, functional integration, and durability. Incorporating digital articulators and facial scans notably enhanced treatment precision. Multilayered zirconia restorations demonstrated superior esthetics and function, representing an effective treatment option for patients with severe discoloration and functional impairment. (Quintessence Int 2026;57:26-35; doi: 10.3290/j.qi.b6628521).

Objectives: The primary objective of this study was to investigate the safety and efficacy of symptomatic treatments-encompassing both active and conservative treatments-for oral emergencies during pregnancy on two key aspects: first, the incidence of adverse pregnancy outcomes; second, the symptom relief rates of oral emergencies during pregnancy.

Method and materials: Pregnant women with oral emergencies (n = 118) who visited the Emergency Department of West China Hospital of Stomatology of Sichuan University, from January 2024 to June 2024, were included in the study. These pregnant women received symptomatic treatment for their oral emergencies. The active treatment group (n = 55) consisted of pregnant women who received invasive oral interventions, and the conservative treatment group (n = 63) comprised those undergoing noninvasive interventions. Data encompassed pregnant women characteristics (age, educational attainment), clinical variables, diagnostic classifications, therapeutic interventions, symptom relief status (complete/partial/no relief), and adverse pregnancy outcomes.

Results: The results demonstrated that the incidence of adverse pregnancy outcomes following symptomatic treatment for oral emergencies during pregnancy was 4.24% (5/118). Although a significantly lower incidence of adverse pregnancy outcomes was observed in the present study (4.24%) compared to the general population (P .001), the statistical power of this finding remains limited. Following symptomatic treatment for oral emergencies, 78.81% (93/118) of pregnant women achieved complete or partial relief. Specifically, 78.18% (43/55) in the active treatment group experienced complete symptom relief, compared with 17.46% (11/63) in the conservative treatment group, and this difference was statistically significant (P .001).

Conclusion: Within the limitations of the present study, symptomatic treatment strategies (encompassing both active and conservative treatment) for oral emergencies during pregnancy were demonstrated to be safe and effective. Furthermore, active treatment demonstrated significant superiority over conservative treatment in achieving complete relief of symptoms for oral emergencies during pregnancy. (Quintessence Int 2026;57:54-63; doi: 10.3290/j.qi.b6546019).

This report describes a case of Mönckeberg medial calcific sclerosis (MCS) presenting with symptoms mimicking temporomandibular disorder (TMD) and giant cell arteritis in a patient, including jaw claudication and headache on mouth opening. Initial evaluation suggested TMD, but temporal artery biopsy revealed fibrous intimal thickening and medial calcification consistent with MCS. This case highlights the diagnostic challenge in older patients and emphasizes that combining Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-based assessment with systemic evaluation facilitates early and accurate diagnosis, enabling timely and appropriate management of potentially serious vascular conditions.

Objectives: The objective of this study was to train, create, and test an artificial intelligence model for automated detection of mandibular canal, mental foramen, and maxillary sinus in panoramic radiographs to evaluate the model's reliability and potential for integration into routine practice.

Method and materials: The study utilized 10,000 panoramic radiographs each carefully annotated to mark the mandibular canal, mental foramen, and maxillary sinus. These images were divided into training and tuning datasets in a 4:1 ratio to train the model, which was subsequently tested on a novel set of 636 panoramic radiographs. The model's performance was assessed by categorizing the results into true positives, true negatives, false positives, and false negatives. Based on these outcomes, key performance metrics like sensitivity, specificity, accuracy, and precision were calculated to evaluate the model's diagnostic effectiveness and clinical applicability.

Results: The model achieved 100.0% sensitivity for the mandibular canal and maxillary sinus, while the mental foramen showed 93.9% sensitivity and 94.8% specificity. Precision was highest for the mandibular canal (100.0%), followed by the mental foramen (99.7%) and maxillary sinus (99.5%). Accuracy was 100.0% for the mandibular canal, 99.5% for the maxillary sinus, and 93.9% for the mental foramen.

Conclusion: The study concluded that the model effectively segments anatomical landmarks like mandibular canal, mental foramen, and maxillary sinus in panoramic radiographs and can be successfully integrated with dental radiographic workflows. With clinical integration and continued validation, these tools could improve diagnostic consistency, and aid in decision-making in general dental practice.