Quintessence international最新文献

Objective: To compare the clinical success of esthetic flexible crowns with stainless steel crowns (SSCs) in primary molars over 12 months.

Method and materials: In this randomized split-mouth pilot study, 30 children each received one SSC and one esthetic flexible crown. Clinical parameters were evaluated using modified USPHS Ryge criteria at baseline, 1 week, 1 month, 3 months, 6 months, and 12 months. Procedural time was recorded, and parental satisfaction was assessed at 12 months.

Results: Based on Ryge criteria, SSCs showed significantly better resistance to staining and superior surface integrity at both 6 and 12 months (P = .001 and P = .011, respectively). At 12 months, two esthetic crowns failed, while no SSC failures were recorded. None of the other evaluated clinical parameters showed statistically significant differences between the two crown types over the 12-month follow-up. The mean time required was 12.3 ± 1.53 minutes for SSCs and 10.32 ± 1.48 minutes for esthetic crowns (P .001). However, this approximately 2-minute difference was not clinically significant. Parental preference favored esthetic crowns for appearance.

Conclusion: SSCs outperformed esthetic flexible crowns in key clinical parameters, and failures occurred only in esthetic crowns. While parental preference for esthetics was high, these findings suggest esthetic crowns may have higher failure rates. This pilot study highlights the need for larger, long-term trials to further assess their clinical performance.

Objective: To determine the association between the frequency of supportive periodontal therapy (SPT) and the time to progression of initial Class I and Class II molar furcation involvements, using a time-to-event analysis that accounts for clustered data.

Method and materials: This retrospective cohort study utilized electronic health records from the multi-center BigMouth network (2011 to 2022). The analysis was conducted at the tooth level. Molars with an initial Class I (N = 311) or Class II (N = 154) furcation were followed over time. The exposure was SPT frequency, categorized as regular (≥ 2 visits/year) or irregular ( 2 visits/year). The primary outcome was time to furcation progression (Class I to II, or Class II to III). Mixed-effects Cox proportional hazards models were used to analyze the data, accounting for the clustering of teeth within patients and variable follow-up times. Models were adjusted for baseline furcation grade, patient demographics, smoking, diabetes, hypertension, full-mouth plaque and bleeding scores, and tooth-level clinical parameters.

Results: The incidence of progression for Class I furcations was 8.1 per 100 tooth-years in the irregular SPT group versus 5.9 in the regular SPT group. For Class II furcations, the incidence was 11.2 per 100 tooth-years (irregular) versus 6.8 (regular). After multivariable adjustment, regular SPT was significantly associated with a reduced hazard of progression for both Class I (hazard ratio [HR] = 0.51, 95% CI 0.28-0.92) and Class II (HR = 0.47, 95% CI 0.22-0.99) furcations.

Conclusions: In this time-to-event analysis, adherence to a regular SPT schedule of at least two visits per year is significantly associated with a longer time to progression for molars with initial Class I and Class II furcation involvement. These findings provide quantitative evidence that clinicians can use to emphasize the critical importance of consistent, biannual SPT for preserving the stability of these high-risk teeth.

Objective: The objective of this study was to compare the clinical efficacy of amniotic membrane (AM) and collagen membrane (CM), both used in conjunction with coronally advanced flaps (CAFs), in the treatment of gingival recession, assessing their ability to achieve root coverage and improve periodontal health. The primary outcome measure was the percentage of root coverage. Secondary outcomes included recession height, recession width, keratinized tissue width, probing depth, and clinical attachment level.

Method and materials: A randomized controlled clinical trial was conducted involving 15 patients with bilateral gingival recessions, resulting in 30 recession sites. Each patient was assigned one control site (CAF + CM) and one test site (CAF + AM) using a coin toss for randomization. The primary outcome measure was the percentage of root coverage. Additional clinical parameters including recession height, recession width, keratinized tissue width, probing depth, and clinical attachment level were recorded using a customized stent. Postoperative evaluations were performed at 3 months.

Results: Both groups demonstrated significant improvements in recession height, recession width, keratinized tissue width, probing depth, and clinical attachment level from baseline to 3 months (P .001). At the 3-month follow-up, the test group achieved a mean recession height reduction of 2.8 ± 1.0 mm and a mean recession width reduction of 3.6 ± 1.4 mm, while the control group achieved reductions of 2.7 ± 1.1 mm and 3.6 ± 1.3 mm, respectively. The mean percentage of root coverage was 90.3 ± 14.5% (recession height) and 81.8 ± 23.2% (recession width) in the test group and 90.0 ± 16.7% (recession height) and 83.7 ± 21.9% (recession width) in the control group, with no statistically significant differences between groups (P > .05).

Conclusion: Both amniotic membrane and collagen membrane, when used in combination with coronally advanced flaps, are effective in managing gingival recession, yielding comparable root coverage and periodontal improvements. The study is limited by its short follow-up period and lack of histologic assessment. However, AM may offer practical advantages such as easier handling, reduced patient morbidity, and cost-effectiveness.

Objective: Several patient- and implant-level factors influence the success of dental implants. The present study aims to evaluate the clinical outcomes of peri-implant soft tissue across several types of implant-supported prostheses and anatomical locations at the implant level.

Method and materials: This cross-sectional observational study included a purposive sample of adult patients with at least one dental implant and a variety of implant-supported prosthesis types over a 3-month period. Clinical assessments conducted for each implant included bleeding on probing, presence of suppuration, and implant probing depth. The relationship between the implant-supported prosthesis type and anatomical location on the peri-implant clinical outcomes was analyzed.

Results: Evaluated in this study were 134 participants with 456 implants distributed between the mandible (44%) and maxilla (56%) and the posterior (67%) and the anterior (33%). The clinical assessment revealed that implants with probing depths of ≥ 6 mm had a significantly higher risk of suppuration compared to those with probing depths of ≤ 5 mm (P .001). Full-arch implant-supported fixed dental prostheses were associated with higher rates of bleeding on probing and suppuration compared to single tooth implants (P .001). Anterior implants showed more bleeding than posterior implants (P = .02), whereas implants in the maxilla exhibited less bleeding than those in the mandible (P = .003).

Conclusion: This study highlights the impact of the type of implant-supported prosthesis and anatomical location on peri-implant health, emphasizing the need for monitoring of full-arch implant-supported fixed dental prostheses, implants with probing depths ≥ 6 mm, and implants placed in the anterior or mandible.

Objective: In Alberta, a provincial daily oral hygiene policy for continuing care facilities (CCF) was approved in 2018, and a mouth care training program was implemented in 2015. These initiatives require CCF to provide residents with twice-daily oral hygiene assistance and staff training. This study aimed to evaluate the provincial implementation scope, compliance rates, perceived impact on residents, and areas for improvement.

Method and materials: A web-based survey was distributed to CCF managers across Alberta, with 77 responses representing 11,653 residents.

Results: Overall, 66.2% of CCF managers had implemented the oral hygiene policy, and 50.6% implemented the mouth care training program. Managers implementing these policies showed a 14.3% increase in twice-daily oral hygiene provision, with 31.2% reporting improved oral cleanliness. Notably, 22.1% indicated improved resident quality of life, and 55.2% observed increased staff oral health knowledge. However, reliance on family/caregivers for oral hygiene products (79.2%) and poor attendance at external dental appointments (67.6%) were significant barriers reported by managers.

Conclusion: While policy implementation has positively impacted residents and staff, gaps remain in resource availability and professional support. Future policies should focus on enhancing access to oral health professionals and providing in-house dental resources.

Objectives: This study evaluated the influence of two novel internal retention cavity designs and the presence of a ferrule on stress distribution in endodontically treated maxillary central incisors restored with anatomically shaped fiber posts using finite element analysis (FEA).

Method and materials: The models were divided into ferrule-present and ferrule-free groups and further subdivided according to cavity configuration: no additional retention, retention area 1, and retention area 2. A static oblique load of 100 N at 45 degrees was applied to the palatal surface, 2 mm from the incisal edge. All simulations were conducted in ANSYS under standardized boundary conditions, with dentin stresses prioritized as dentin represents the primary load-bearing structure.

Results: The ferrule-free reference model showed the highest dentin stress (187.54 MPa, σ = 7.40 MPa), indicating increased fracture risk. In the absence of a ferrule, retention area 1 reduced peak dentin stress substantially (62.74 MPa, σ = 4.12 MPa) and produced the most uniform stress distribution, while retention area 2 also lowered stresses compared with the reference (σ = 5.36 MPa). In the ferrule-present groups, stresses were overall lower, confirming the ferrule's protective role; within this group, retention area 1 recorded the lowest dentin stress (82.18 MPa).

Conclusion: The ferrule remains biomechanically critical for preserving cervical dentin. However, in cases where a ferrule cannot be achieved, retention-oriented cavity designs demonstrated potential as a clinically viable alternative, though further validation is required.

Objective: Periodontal diseases can lead to progressive attachment loss and eventual tooth loss if untreated. Following the successful completion of active therapy, periodontal maintenance therapy plays a vital role in preserving periodontal health by controlling inflammation and monitoring conditions. This narrative review and case series evaluates the effectiveness of periodontal maintenance therapy in preserving teeth over long-term follow-up and explores relevant literature to highlight best practices.

Data sources: A search of PubMed was conducted using key terms related to periodontal maintenance therapy, tooth survival, and prognosis. Articles published between 1 January 1978 and 15 December 2024 were reviewed. Inclusion criteria focused on studies written in English and evaluating periodontal maintenance therapy outcomes. Four clinical cases illustrate the role of periodontal maintenance therapy in maintaining periodontal health across different patient profiles.

Conclusion: Periodontal maintenance therapy, when combined with patient compliance and individualized interventions, is effective in preserving teeth in periodontally compromised patients. Collaborative care between general dental practitioners and specialists further optimizes the outcomes. Regular monitoring and patient education are paramount to long-term success.

Background and aim: Mastication plays a major role in a person's life and affects much of their quality of life, from enjoying food to facilitating nutrition. This study aimed to assess the feasibility of evaluating masticatory performance (MP) in schoolchildren during routine dental exams using a validated chewing test.

Materials and methods: Adolescents aged 11-19 from schools in Greifswald, Germany, were recruited. From a population exceeding 3,000, a 40% response rate was expected. A randomization list determined whether consenting participants underwent testing, limited to 50% to avoid selection bias. Data collected included age, sex, and school type. Masticatory performance (MP) was assessed using the two-color chewing gum test (Hue-Check-Gum®), evaluated visually (SA-scale, 1-5) and digitally (Viewgum® VOH, 0-1). Ethical approval Nr. BB129/20 University of Greifswald.

Results: 861 participants were recruited (mean age 13.85 ± 2.02; 48.55% female). Low MP (SA-scale 1 or 2) was observed in 14.59% of participants, indicating potential chewing difficulties impacting daily life. MP improved with age, reflected by a decrease in the VOH value from 0.3 in 11-year-olds to 0.21 in 18-19-year-olds. MP did not differ significantly between sexes: median SA-scale score 3 (IQR 3-4; P = 0.517). Participants with permanent dentition showed higher MP than those with mixed dentition: (3 [3-4] vs 3 [3-3]; P < 0.001).

Conclusion: This study confirms that MP increases with age. Routine implementation of MP testing during school dental screenings is feasible and may help identify children at risk of impaired chewing function.

Objectives: This study aimed to develop and validate the content, form, construct, and reliability of a referral questionnaire for the specialty of temporomandibular disorders (TMD) and orofacial pain in older people.

Method and materials: Using the Delphi technique, an expert panel validated the questionnaire regarding its relevance, question wording, structure, and clarity (content and form). A cognitive debriefing was then conducted on a sample of 30 older adults. For construct validity, a confirmatory factor analysis, principal component analysis, and evaluation of intercorrelated variables were performed, assessing the data's goodness of fit and reliability.

Results: Considering the panel of 24 experts, content validation showed critical content validity ratio, CVR = 0.417, critical N = 17, and content validity index, CVI = 0.47, resulting in 5 questions to assess in terms of form. After four rounds, the necessary agreement in form (at least 70%) was obtained for all questions. The results showed the suitability of the factor analysis (Kaiser-Meyer-Olkin measure, KMO = 0.78, Bartlett's test = 94.698 (P˂.05). Confirmatory factor analysis generally showed high factorial loading values corresponding to their respective domains (pain and physical function). The goodness of fit showed acceptable and perfect fit (Standardized Root Mean Square Residual (SRMR = 0.053), Comparative Fit Index (CFI = 0.964), and Tucker-Lewis Index (TLI = 0.911). Overall reliability was high (KR-20 = 0.818).

Conclusion: The proposed referral questionnaire for the specialty of TMD and orofacial pain in older people presents content, form, and construct validation with high reliability.