Quintessence international最新文献

Objectives: The goal of this systematic review was to critically appraise the existing evidence evaluating osteoporosis' effects on dental implant osseointegration and survival rate.

Data source: A search was conducted in two databases, PubMed/MEDLINE and Scopus, until October 2024, using the keywords 'osteoporosis,' 'osteopenia,' 'osseointegration,' and 'dental implants'. The inclusion criteria were clinical studies that evaluated the implant placement, complications, and osseointegration results in patients with osteoporosis; literature reviews and clinical studies addressing the outcome were considered; and articles written in English and published since 2000. Descriptive data analysis included author, year of publication, study design, number of patients, osteoporosis assessment, follow-up, and main findings. JBI quality assessment was performed. 24 articles were included with a total of 2,102 patients; 5954 dental implants were considered and evaluated. Most studies evaluated bone density for osteoporosis by dual-energy x-ray technology. The follow-up ranged from 1 month to 25 years. Four studies evaluated implants with over 10 years of follow-up. All studies' survival rate was higher than 90%, even for osteoporotic patients. Most studies indicated no differences between osteoporotic and healthy patients regarding marginal bone loss (MBL), bone-to-implant contact, cytokine levels, and mineral bone density. A prospective cohort study found a small MBL (-0.34 mm) in osteoporotic female patients, but there was insufficient evidence to prove any causal relationship between MBL and osteoporosis. Another study showed no clinical differences between implants placed in osteoporotic and healthy individuals. In contrast, other studies showed lower stability scores for implants placed in osteoporotic sites and a higher risk of failure for implant placement. Osteoporosis status was not a risk factor for dental implant failure, which was also confirmed by histological studies. Three studies had a medium risk of bias and 21 a low risk.

Conclusion: Osteoporosis is not a contraindication for dental implant placement. Osseointegration in patients with osteoporosis is feasible; however, planning must be cautious and personalized for the installation of dental implants.

Aim: To evaluate the efficacy of sesame oil-pulling in periodontitis with/without Type2 Diabetes Mellitus (T2DM), compared to Chlorhexidine, for its oral and systemic health benefits.

Material and methods: Total of 120 periodontitis patients, without (Group A; 60)/with (Group B; 60) T2DM, underwent control (chlorhexidine 0.12%; Group A1 & B1) and test (sesame oil-pulling; Group A2 & B2) interventions. Plaque index, pocket depth, salivary total antioxidant capacity (T-AOC) enzyme-linked-immunosorbent-assay (ELISA), subgingival plaque BANA test, and serum CRP were evaluated at baseline and 30 days post-intervention using analysis of variance (ANOVA) with a significant p-value set at 0.05. Group B serum samples also analyzed for Fructosamine and lipid profile.

Results: Both treatment regimens were equivalent in reduction of plaque, pocket depth, red complex periodontopathogens in Group A & B. Significant increase in salivary T-AOC post-intervention observed in Group B with both interventions (p<0.01). Sesame oil-pulling significantly decreased systemic CRP and triglyceride levels, with no difference observed with Chlorhexidine in Group B.

Conclusion: Sesame oil-pulling is equivalent to Chlorhexidine for anti-plaque, antibacterial, and antioxidant effects in periodontitis patients with/without T2DM. Systemic anti-inflammatory, cardio-protective benefits (reduction of CRP and triglycerides) make it better adjunct to Chlorhexidine in periodontitis with T2DM.

Proper alignment of the teeth not only aids in functional occlusion but also promotes harmonious gingival contours, potentially reducing the risk of inflammation and gingival recession. This case series aimed to evaluate the effectiveness of optimizing axial inclination through clear aligner orthodontic treatment in addressing gingival recession defects. This case series included nine patients, aged 20-36 years, who presented with varying degrees of gingival recession on 12 mandibular incisors. All patients had undergone orthodontic treatment during childhood and were maintained with a fixed stainless-steel canine-to-canine retainer. The exhibited gingival recessions were potentially caused by inadvertent torque discrepancies in the teeth induced by the retention wire. Prior to treatment, a comprehensive radiographic and periodontal evaluation was performed, and clear aligner orthodontic treatment was used to correct the axial inclination of the affected teeth. Following the completion of the orthodontic treatment, patients were re-evaluated to assess changes in recession depth and width; those with remaining recession were considered for soft tissue grafting. The average treatment duration was 21.6 ± 3.7 months, ranging from 18 to 29 months. Root torque adjustments averaged 12 ± 9 degrees, ranging from a correction of 14 degrees lingually to 33 degrees labially, while bucco-lingual crown movement averaged 1.7 ± 1.2 mm, with a range from 3.4 mm lingually to 0.6 mm labially. All cases showed improvement in gingival recession, with complete recovery in one tooth and an average of 58 ± 21% reduction in recession depth and width for the remaining 11 teeth. Surgical intervention, consisting of soft tissue grafting, was required in four cases, while the remaining 8 teeth showed sufficient improvement and were monitored with follow-up care. Correcting axial inclination with clear aligner orthodontic treatment positively impacts both tooth alignment and gingival recession. These findings propose a new approach: initiating orthodontic treatment before periodontal surgery to streamline treatment and reduce the need for invasive procedures. Orthodontists, general dentists, and patients should be aware of the potential complications of fixed retainers and their possible orthodontic adjustments correction.

Objective: Allergic reactions during dental procedures are suspected frequently. Still, data on the confirmed allergens are rare. This study aims to identify allergens in dentistry and potential cofactors in sensitization.

Method and materials: Patients with suspected allergic reactions in context of dental (study group) or surgical (control group) procedures were analyzed in a monocentric 3-year retrospective and 2-year prospective file chart analysis between 2018 to 2023. Descriptive statistics and multiple logistic regression analysis were performed.

Results: 129 patients were allocated to the study group and 123 to the control group. Confirmed allergy was less frequent in study group (10%) than in control group (28%, P < .001). Local anesthetics (LA) triggered most dental reactions, but rarely confirmed allergic (1 of 55 cases). Dental materials (DM) and implant material (IM) in the control group were confirmed in 16% and 15% clinically relevant sensitizations, respectively. Multiple logistic regression identified reactions to LA or DM/IM with 33.33 or 2.63-fold lower risk of sensitization. A concomitant immune disease was associated with higher risk for a confirmed allergic reaction in dentistry in our cohort (OR 9.12, 95% CI 2.4-35.1).

Conclusion: Allergy to dentally administered drugs is rare. Most LA triggered reactions were unspecific. Reactions to dental materials resulting in objective symptoms require allergy diagnostics.

This pilot study aimed to evaluate the quality of legends associated with diagnostic images in the published oral and maxillofacial radiology literature using a novel rating scale. Images and their corresponding legends were randomly selected from published manuscripts over the last ten years in the Oral Radiology journals, namely Dentomaxillofacial Radiology, Imaging Science in Dentistry, Oral Radiology, and Oral Surgery Oral Medicine Oral Pathology Oral Radiology. An Image Legend Quality Scale (ILQS) was introduced to assess the quality of the legends associated with images. A program was developed for the rating scale form using Google Apps Script API to gather and analyze the data. The rating scale ranged from 1 to 5, with 5 as the highest rating. The highest average IQRS rating for one journal was 3.04. The overall IQRS rating average across all four journals was 2.87, which is a 2.13 rating score lower than the ideal score of 5. There is room for improvement in the legends that accompany diagnostic images and figures in the oral and maxillofacial radiology literature. A proper legend provides an excellent diagnostic teaching opportunity for the reader and enhances the quality of a publication.

Objectives: Combined oral contraceptives are used for the management of hyperandrogenism and menstrual abnormalities in polycystic ovary syndrome (PCOS). There is a dearth of literature addressing the effect of ethinyl estradiol/norethisterone acetate (EE/NETA) on gingival and systemic inflammation in these patients. This randomized trial aimed to evaluate the effect of EE/NETA with and without scaling on periodontium and high-sensitivity C-reactive protein (hsCRP) levels in women with PCOS having gingivitis.

Method and materials: Women having PCOS along with gingivitis were randomly divided into two groups: test group (n = 30) received EE/NETA + scaling with oral hygiene instructions, and control group 1 (n = 30) received EE/NETA with oral hygiene instructions. Another control group (control group 2, n = 30) consisting of systemically healthy females having gingivitis and who were age- and BMI-matched with the test group participants received scaling along with oral hygiene instructions. Periodontal and anthropometric parameters were measured at baseline, and 3 months and 6 months follow-up. Serum hsCRP levels were also estimated.

Results: Serum hsCRP levels and periodontal parameters were significantly decreased in all the groups after 6 months (P ≤ .05). The decrease in hsCRP levels was similar among the groups (P > .05). Significantly more reduction in gingival inflammation was observed in the test group compared to control group 1 (P ≤ .05).

Conclusion: EE/NETA used alone and with scaling showed no detrimental effect on gingiva and could reduce systemic and gingival inflammation in women with PCOS having gingivitis.

Stabilization appliances (Michigan splints) are well studied and widely adopted for managing bruxism and temporomandibular disorders (TMDs). Traditionally, these appliances have been fabricated by wax modeling and pressing resin onto casts made from irreversible hydrocolloid or silicone impressions. This article provides a detailed description of an all-digital workflow that uses intraoral scanning and computer-aided design (CAD) software to design a stabilization splint on a digital cast that can be manufactured autonomously by a computer-aided manufacturing (CAM) grinding machine in a subtractive procedure. The workflow is applicable to both dental practitioners and technicians. Special attention is given to aspects and procedures that are important for the successful fabrication of the splint. Working without a cast can save time and money, and the use of CAD/CAM technology provides a homogenous splint material quality.

Objective: Occlusal splints are commonly used in the management of temporomandibular joint disorders. However, it is unclear if it should be used after a second-line therapy like arthrocentesis. The evidence on the efficacy of post-arthrocentesis splint therapy in the management of temporomandibular joint disorders was systematically reviewed.

Method and materials: PubMed, Embase, Scopus, Web of Science, CENTRAL, and Google Scholar were searched for studies published until 5 August 2024. The outcomes assessed were pain and maximal mouth opening.

Results: Eight studies were included. Five studies reported data for the meta-analysis. The pooled analysis found that there was no statistically significant difference in pain scores in the arthrocentesis + splint group vs arthrocentesis group at 1 month (mean difference [MD] -0.01, 95% CI -0.46 to 0.44), 3 months (MS -0.02, 95% CI -0.67 to 0.63), and 6 months (MD 0.06, 95% CI -0.25 to 0.37). The pooled analysis also showed that splint therapy after arthrocentesis may not significantly improve maximal mouth opening as compared to no splint therapy at 1 month (MD 0.08, 95% CI -2.11 to 2.27), 3 months (MD 0.76, 95% CI -0.84 to 2.35), and 6 months (MD 0.56, 95% CI -0.65 to 1.78). Descriptive analysis of three studies showed that two supported the use of splints while one found no added improvement in outcomes.

Conclusions: Limited evidence from low-quality studies shows that the use of splint therapy after arthrocentesis may not improve pain and maximal mouth opening in patients with temporomandibular joint disorders. High-quality randomized controlled trials are needed to improve evidence.

Objective: This prospective case series aimed to clinically evaluate the bleaching effect, spontaneous tooth sensitivity, and variation in the thermal sensation threshold of different groups of teeth undergoing in-office bleaching.

Method and materials: Ten patients received conventional bleaching treatment: 35% hydrogen peroxide with three bleaching sessions of 45 minutes, evaluating color change (∆E and ∆E00), Whitening Index (WID), and tooth sensitivity (visual analog scale). Thermal stimulus-generating devices were used to simulate sensitivity caused by low temperatures through quantitative sensory tests. Analyses were conducted individually on different teeth groups (n = 20) (mandibular incisors, maxillary incisors, canines, maxillary first premolars).

Results: Regarding color change, mandibular and maxillary incisors did not statistically differ from each other but showed significant difference and greater bleaching potential compared to canines and maxillary first premolars (P = .018). Regarding sensitivity, mandibular and maxillary incisors presented the highest spontaneous sensitivity values (P = .032), while maxillary first premolars did not display painful symptoms, also observed in provoked sensitivity analysis (P = .025).

Conclusions: The general analysis of the results indicates that the tooth type affects the response to the whitening treatment, both in relation to the esthetic benefit and the occurrence of tooth sensitivity. It was observed that mandibular incisors reach the degree of chromatic saturation before canines and premolars, in addition to presenting greater bleaching sensitivity. Personalizing the treatment, based on prior knowledge of the degree of saturation, anatomical factors, and the risk of sensitivity, can provide considerable advantages in the whitening technique.

Objective: To evaluate two methods for assessing the changes in periodontitis grading in patients undergoing supportive periodontal therapy 10 years (T10) after retrospective baseline grading.

Method and materials: The periodontitis grade of 51 supportive periodontal therapy patients was assessed using indirect evidence as the primary criterion for periodontitis progression at baseline and T10 (radiographic bone loss/age index, periodontitis phenotype). Grading at T10 was also performed using the direct evidence for periodontitis progression (clinical attachment loss over the previous 5 years). The use of indirect evidence for periodontal progression at baseline and T10 was defined as method 1 to assess the changes in periodontitis grading. The use of indirect evidence at baseline and direct evidence at T10 was defined as method 2. Changes in periodontitis grading using methods 1 and 2 were evaluated (Wilcoxon signed-rank test). Agreement between methods 1 and 2 was assessed (Cohen kappa).

Results: Indirect baseline grading revealed five grade B and 46 grade C patients. The indirect grading at T10 revealed 17 grade B and 34 grade C patients. The direct T10-grading classified all patients as grade C. Method 1 led to an overall improvement in periodontitis grading after 10 years of supportive periodontal therapy (P = .0030), whereas method 2 led to a deterioration (P = .0369). The comparison between methods 1 and 2 showed that they led to different results in terms of grading (Cohen kappa = 0.116208).

Conclusions: Periodontitis grading may change during supportive periodontal therapy. Using indirect or direct evidence as the primary grading criterion during supportive periodontal therapy may lead to different results.