Quintessence international最新文献

Objective: This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment (NSPT) in the management of gingival enlargement (GE) during orthodontic treatment.

Materials and methods: forty-five healthy, orthodontic patients with labial gingival enlargement on the 6 anterior teeth were selected and randomly assigned to one of the groups (Conventional, Laser, and NSPT). Clinical parameters including clinical crown length (CCL) , periodontal pocket depth (PPD), and vertical gingival overgrowth index (vGOi) were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1,3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months.

Results: Statistically significant results were obtained for mean reduction in PPD for conventional, laser, and NSPT groups (-1.43, -.1.75, and -0.9 mm, respectively; P < 0.001), CCL gain (1.45, 1.7, and 0.38 mm, respectively; P<0.001) and mean vGOi score (-1.14, -1.29 and -0.76, respectively; P<0.001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to NSPT (P<0.001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with conventional group showing statistical difference in mean pain score on days 1 and 3 compared to other groups.

Conclusion: Both conventional and laser gingivectomies were more effective in controlling enlargement over non-surgical periodontal treatment alone at 1, 3, and 6 months.

Clinical significance: laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to NSPT alone in the treatment of GE and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

Objectives: This study aims to investigate the impact of photobiomodulation (PBM) and/or azithromycin (AZM) therapy in combination with full-mouth subgingival instrumentation (FSI) on receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) levels and RANKL/OPG ratios in gingival crevicular fluid (GCF) on patients with stage III-IV grade C periodontitis.

Materials and methods: The study was conducted on 77 stage III-IV grade C periodontitis patients and 20 periodontally healthy controls. Patients with stage III-IV grade C periodontitis were categorized into four treatment groups: 1) only FSI (FSI) group; 2) FSI+AZM (AZM) group; 3)FSI+PBM (PBM) group and 4) FSI+PBM+AZM (AZM+PBM) group. Clinical periodontalparameters and RANKL and OPG levels and RANKL/OPG ratios in GCF were measured at thebaseline and month 3rd of the therapy.

Results: Compared with the periodontally healthy controls,all the baseline clinical parameters were higher in the Stage III-IV grade C periodontitis groups (P< 0.05); however, there were no statistically significant differences between the Stage III-IV gradeC periodontitis groups (P>0.05). In month 3rd, the lowest values in all clinical parameters weregenerally observed in the antibiotics groups whereas the highest values were observed in the FSIgroup. Furthermore, the highest RANKL and OPG values in antibiotic groups and the highestRANKL/OPG ratio in PBM group were observed in the third months. RANKL/OPG ratios did notchange in the FSI and antibiotics groups after the treatment, but it increased significantly in thePBM group.

Conclusion: While PBM treatment combined with FSI increases the RANKL levels,AZM increases OPG levels. Also, PBM+AZM treatment shows additional clinical andimmunological beneficial efficacy.

Objective: The study aims to evaluate the stress distribution on tooth and restoration of zirconia endocrowns with pulp chamber or intracanal extension and zirconia post performed maxillary first molar using finite element analysis.

Method and materials: Three three-dimensional endodontically treated maxillary molars were modeled. Cortical bone and cementum were modeled 2 mm and 200 μm in thickness. Periodontal ligament at 250 μm thickness was constructed. Zirconia endocrown with pulp chamber extension of 2 mm (Model E+PCE), zirconia endocrown with intracanal extension of 4 mm (Model E+ICE), and zirconia post of 4 mm and crown (ZP) were modeled using software. All restoration models were placed on the maxillary molars. Models were subjected to 400 N loading from the three occlusal contact points. Von Mises stress was recorded.

Results: Expectingly, points where the stress was applied showed high stress compared to other regions of the models. The stress did not occur at the trifurcation in any of the models. For the stresses occurring in the restoration material, there were 14.67 MPa, 57.79 MPa, and 155.56 MPa, in Models E+PCE, E+ICE, and ZP, respectively. At the remaining dentin, these values were 47.04 MPa, 32.85 MPa, and 33.42 MPa in Models E+PCE, E+ICE, and ZP, respectively.

Conclusions: Within the limitation of the study, zirconia endocrowns with intracanal extension exhibit more favorable stress distribution in both restoration material and dentin compared to zirconia posts and pulpal extension endocrowns. These findings suggest that endocrown with intracanal extension may be a better restorative option for reducing stress.

Objectives: To evaluate clasp-retained removable partial dentures (C-RPDs) with a metal framework for survival, maintenance requirements, and biologic implications.

Method and materials: C-RPDs were retrospectively analyzed based on patient records. Treatment failure was defined as fracture of a framework component (metal base or connector) or loss of an abutment tooth. Other outcome variables included factors that might conceivably impact C-RPD survival (maxilla vs mandible, Kennedy classes, opposing dentitions, treatment by students vs certified dental practitioners), mobility and caries of abutment teeth (in relation to clasp designs), and maintenance requirements (relining, clasp or resin fractures). Differences were evaluated by appropriate statistical tests at the P ≤ .05 level.

Results: A total of 612 patients (339 men, 273 women) 60.0 ± 11.5 years old at delivery were included, covering 842 C-RPDs and a mean observation period of 42.1 ± 33.2 months. Kaplan-Meier C-RPD survival was 76.2% after 5 years and 49.5% after 10 years. Biologic complications (ie, loss of abutment teeth) accounted for the vast majority (95.6%) of C-RPD failures, and Kaplan-Meier C-RPD survival was significantly better in the mandible (P = .015). Some clasp designs contributed significantly to caries and removal of abutment teeth (both P .05). No other significant differences were noted.

Conclusion: Tooth loss both emerges as the main cause of C-RPD failure and might be amenable to careful selection of clasp designs. Overall, better C-RPD survival should be expected in the mandible. A noncontributory role of Kennedy classes and opposing dentitions is tentatively suggested based on numerically heterogenous subgroups.

Objectives: The study examines the impact of changes on dental education and practice in Europe, including the development of new practice models such as investor-owned dental centers and practice chains.

Method and materials: This study aimed to collect and critically examine data regarding the care environment, education, and organizational structures of the dental profession across European Regional Organization of the FDI World Dental Federation (ERO) member states and other countries in the World Health Organization European region. A questionnaire from the ERO was used.

Results: National dental associations across 45 countries participated. An average of 1,459.79 (SD ± 800.80) inhabitants per dental practitioner was found, with independent practices being the most prevalent form of dental practice (48.65% ± 28.28%) followed by employment in private practice (24.32% ± 20.33%), and joint practices (15.27% ± 20.39%). There are statistically significantly more state universities than private universities (P .01); the percentage of females attending dental schools was statistically significantly higher than males (P .01). Two-thirds of the participating countries (n = 30, 66.67%) have legal frameworks allowing various stakeholders, including investors, and local communities, to establish dental health care centers.

Conclusions: The findings highlight the evolving landscape of the dental profession in Europe and its regulatory context. There is a clear need for ongoing evaluations and adjustments in educational and practice frameworks to ensure and maintain high-quality oral health care. Future research should delve into the various professional dental practice forms and incorporate qualitative, care-related, and patient-centered considerations for a more thorough understanding of Europe's oral health care dynamics. (Quintessence Int 2024;55:744-755; doi: 10.3290/j.qi.b5714883).

Two cases of pain evoked by cold food ingestion, following root canal therapy, are presented. The source of pain was detected when cold application to the vestibular, periapical area corresponding to the teeth involved evoked strong pain of about 30-second durations. In the first case, the patient suffered from strong pain in the mandibular right area over the last 4 months. After successive root canal therapy of three mandibular right teeth, the spontaneous pain eased significantly, but strong pain evoked by cold food ingestion persisted. Cold application to the vestibular periapical area of teeth involved identified the source of pain, which was abolished by 80 mg/day of slow-release propranolol. In the second case, cold allodynia developed after root canal therapy. The root canal therapy was performed for prosthetic reasons with no prior pain. Pain could be duplicated by cold application to the vestibular area of the treated tooth. The patient preferred no treatment when the source of pain was explained. In both cases cold application did not produce any pain in other intraoral locations, including the contralateral vestibular area or the mid soft or hard palate. Pain mechanisms, neurovascular and neuropathic, which differ for each case are discussed.

Objective: The aim of this study was to identify the relationship between preventative dental practices and cardiometabolic health in adolescents.

Method and materials: Analysis included children aged 13 to 17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 who completed an Oral Health Examination and Questionnaire. Deferred dental care was defined as not having a dental visit in the past year. Financial barriers to seeking dental care (vs no financial barriers) were assessed among those with deferred dental care in the past year. Primary cardiometabolic outcomes included obesity, elevated blood pressure, and hypertensive blood pressure. Secondary outcomes included dyslipidemia, glucose intolerance, uric acid, glomerular hyperfiltration, and albuminuria. Regression models adjusted for age, sex, race/ethnicity, household income, food insecurity, health insurance status, household education, and body mass index z-score examined associations using complex survey design procedures.

Results: Of 2,861 adolescents, 17.6% (SE 0.9%) did not receive dental care in the past year and 20.2% (SE 1.9%) had a financial barrier to accessing dental care. In adjusted regression models, adolescents with deferred dental care had higher odds of dyslipidemia (odds ratio [OR]= 1.51, 95% CI 1.07 to 2.11, P = .020). Having a financial barrier was associated with lower odds of dyslipidemia (OR = 0.35, 95% CI 0.14 to 0.89, P = .03). Financial barriers were associated with lower non-high-density lipoprotein cholesterol (b = -7.95, 95% CI -14.87 to -1.05, P = .03) and higher high-density lipoprotein cholesterol (b = 3.06, 95% CI 0.37 to 5.75, P = .03) in adjusted models. Deferred dental care and financial barriers were not associated with any other cardiometabolic parameters.

Conclusion: In this nationally representative cohort of adolescents, there was an association between lack of preventative dental care and the cardiometabolic health marker of dyslipidemia. However, financial barriers to dental care were surprisingly associated with higher high-density lipoprotein cholesterol levels and lower odds of dyslipidemia.

Objectives: Diode laser represents a practical clinical strategy for treating gingival hyperpigmentation. However, its effectiveness remains controversial. The aim of this meta-analysis was to evaluate the quantitative effects of diode laser therapy on gingival hyperpigmentation.

Method and materials: PubMed, Embase, Web of Science, and Cochrane Library were systematically searched for the use of diode laser in gingival hyperpigmentation. The primary outcomes assessed were the Dummett-Gupta Oral Pigmentation Index (DOPI), visual analog scale pain scores, and the Wound Healing Index (WHI) for overall evaluation. The I2 index was calculated to identify heterogeneity, and sensitivity analyses were performed to identify sources of heterogeneity. Funnel plots and the Egger test were utilized to evaluate publication bias.

Results: Thirteen randomized controlled trials involving a total of 233 participants were included in the study. The analysis demonstrated that diode laser had a significant effect on DOPI (standard mean difference [SMD] = -0.245, 95% CI -0.451 to -0.040, P = .019) and pain (SMD = -0.809, 95% CI -1.332 to -0.285, P = .002), with no significant effect on WHI (SMD = -0.224, 95% CI -1.100 to 0.653, P = .617). Despite the significant heterogeneity in VAS and WHI indicated by the I2 index statistic, the sensitivity analyses' results demonstrated the main findings' reliability. While no significant publication bias was detected for DOPI and WHI, the pain results exhibited notable publication bias.

Conclusion: The study demonstrated that diode laser prolongs gingival repigmentation time and reduces pain compared to other treatments. However, efficacy in wound healing was not significantly affected.

Objectives: Prevalence of work-related musculoskeletal disorders (WRMSDs) among general dental practitioners and orthodontists is approximated to range between 64% and 93%. Etiology of WRMSDs in the mentally and physically demanding occupation remains unclear, for which reason the aim of the study was to clarify the interplay of physical, psychological, and mental factors on WRMSDs.

Method and materials: Of 94 orthodontists and 187 general dental practitioners (mean age = 35 years) questioned using an online survey, 84% reported persisting tension or pain in the back, neck, or shoulders. While 71% of females were employed (29% self-employed), only 39% of male participants were employed. Cluster analysis was used to characterize dental practitioners according to their movement profile and the moderating effect of stress on certain WRMSDs.

Results: Three movement profiles of general dental practitioners and orthodontists were significantly predictive of WRMSD. The minority could be characterized as healthy (n = 45), whereas twice as many reported nearly twice as much pain (n = 90). Stress proved to be a strong, significant moderator of WRMSDs in relation to sex, employment status, and body mass index.

Conclusion: The prevalence of WRMSDs found was alarming. Given the feminization of dentistry, and that being female, stressed, and an employee (rather than self-employed) is a significant predictor of WRMSDs, this represents a danger to the German health system.

Objectives: Although early-life dental care is crucial for preventing early childhood caries and has numerous benefits, the utilization rate of such care remains remarkably low worldwide, especially in families of low socioeconomic status. The aim of this study was to systematically review the scientific evidence relating to the effectiveness of interventions on improving early-life dental care utilization of very young children.

Method and materials: Scientific evidence relating to these positive changes was reviewed, with seven randomized controlled trials after qualitative evaluation. Interventions assessed included prenatal oral health promotion, motivational interviewing, intra-oral camera use alongside social work consultations to aid in decreasing barriers to care, monetary incentives for tooth brushing, fluoride varnish applications, and probiotic usage.

Results: The intervention was significantly effective in reducing the incidence of dental caries among children, especially in caries risk. Caries reduction was significant when oral health information was provided at frequent intervals prenatally. Caries increment was also reduced when probiotics were introduced when administered daily. Interventions that attempted to increase parental involvement in oral health care by increasing motivation and decreasing barriers had inconclusive results within the study groups.

Conclusions: Considering high rates of early childhood caries, early establishment and preservation of a dental home should be a focus in public health measures. Continuous monitoring and parental involvement are key components to maintaining healthy oral conditions. Future studies could explore and test various innovative strategies that utilize technological platforms to engage with parents and promote early-life dental care utilization among the underserved population.