Quintessence international最新文献

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.

Objectives: infraosseous periodontal defects are a challenge for restoring periodontal health. Regenerative techniques such as Entire Papilla Preservation (EPP) offer valid, minimally invasive alternatives. Platelet concentrates like leukocyte- and platelet-rich fibrin (L-PRF) may enhance the healing process. This pilot study aims to describe and assess the effectiveness of EPP for treating interproximal infra-bony defects, with and without L-PRF, focusing on clinical and radiographic parameters.

Materials and methods: The study included 11 cases from 7 patients treated at University of Los Andes Health Center. Periodontal defects with probing depth ≥6 mm were treated using EPP. L-PRF was added in 5 defects, placed intraosseously. Clinical and radiographic parameters were evaluated at baseline and 6 months post surgery.

Results: Probing depth decreased by a mean of 4.3 mm (p<0.05), with a clinical attachment level gain of 3.63 mm (p<0.05). No significant differences were observed between groups. Gingival margin position tended to recess in the EPP group (variation: -1 mm ± 0.7 mm), but remained stable in the EPP + L-PRF group (variation: 0.3 mm ± 0.5mm). Postoperative pain on the VAS scale was significantly lower at 24 and 72 hours with L-PRF (p<0.03). No complications were reported.

Conclusions: EPP has a positive effect on clinical and radiographic parameters, whether used alone or with L-PRF. L-PRF appears to improve postoperative pain and gingival margin stability in the medium term. This technique offers a low cost, minimally invasive option for periodontal regeneration with minimal complications.

Objective: Despite widespread antiretroviral therapy (ART) use, mild and asymptomatic cognitive impairment (CI) persists in people with HIV (PWH). Poor oral health is also commonly reported among PWH, yet the prevalence of specific oral diseases in the ART era remains uncertain. While CI has been linked to poor dental outcomes in people without HIV (PWoH), particularly older adults, its impact on oral health in PWH is less understood. This study aimed to compare oral health outcomes in PWH and PWoH; and PWH with and without CI.

Methods: A cross-sectional pilot study was conducted among 40 participants: 30 PWH and 10 PWoH. Cognitive function was assessed using the Penn Computerized Neurocognitive Battery (CNB), and oral health was evaluated through dental caries and periodontitis measures.

Results: PWH averagely had poorer battery test outcomes (p<0.0001), with social cognition being the most impaired domain. PWH had significantly worse oral health than PWoH, with higher scores for DMFT (p = 0.001), DFT (p = 0.027), and MT (p = 0.032). Among PWH, those with CI exhibited higher DFT scores (median 12.0 vs 7.0) and periodontal inflammation (with respect to bleeding on probing- 51.04% vs 31.67%) compared to those without CI.

Conclusion: Data suggests that PWH demonstrate poorer oral health compared to PWoH. CI in PWH is associated with worse periodontal and caries outcomes. These findings highlight the need for targeted oral health interventions and consideration of CI screening in dental care settings.

Objectives: The aim of this study was to investigate the factors influencing the success of biopsy quality in oral squamous cell carcinoma (OSCC) of the oral cavity.

Method and materials: This retrospective study included patient records of primary OSCC patients, diagnostic pathology reports of the primary biopsies, and corresponding resection tumor sections. The outcome variable was unsuccessful biopsy, defined as an inconclusive biopsy specimen for proper OSCC diagnosis. The primary predictor variable was the biopsy method used, grouped as punch or scalpel biopsy. Secondary predictor variables were sample area, depth, site, and number of samples. Patient- and tumor-related variables, background of the health care professional, and the health care unit were analyzed as additional predictor variables.

Results: Data from 312 OSCC patients were included in the study. Primary biopsy was inconclusive in 7.7% of the cases. Areas with punch biopsies yielded smaller (P .001) but diagnostically as accurate samples as scalpel biopsies. Biopsies from the floor of the mouth and gingiva had higher failure rates, while tongue and palate biopsies had higher success rates (P = .037). Punch and scalpel biopsies had similar diagnostic reliability. There were deficiencies in the documentation of prognostic features of the OSCC. Inflammation was the most consistently reported (33.3% in biopsies, 43.9% in resection samples), while tumor budding was documented in only one-third of biopsy samples (6.4%) compared to final resection samples (18.6%). Depth of invasion was reported in 55.1% of biopsies, with 6.1% indicating a minimum invasion depth.

Conclusion: General dental practitioners must be both alert and properly trained to perform biopsies. However, considering the internationally varying role of general dental practitioners in biopsy procedures, this requirement must be understood within the context of each country's health care system. OSCC biopsies generally yield high diagnostic success; however, small biopsy size especially impairs diagnostic accuracy. Ensuring larger or several biopsy samples in general and ensuring representative biopsies from particularly challenging areas, such as the gingiva and floor of the mouth, improves the likelihood of conclusive diagnosis in primary OSCC diagnostics. Additionally, clinicians should pay more attention not only to the area but also to biopsy depth. Taken together, there may be a need for more precise biopsy guidelines and protocols for lesions suspicious for OSCC to optimize patient treatment planning.

Objectives: The objectives of this article were to provide a review of published cases of frostbite injuries of the head and neck associated with abuse of nitrous oxide (NO) and to summarize other pathophysiologic consequences.

Method and materials: A literature search was undertaken for articles on the development of frostbite injuries to the head and neck from recreational use of NO, including review papers, clinical investigations, case reports, case series, cohort studies, and letters to the editor. Relevant articles were attained from the electronic databases of PubMed and Google Scholar from 1 January 1985 through 5 July 2025 and from references cited within culled sources.

Results: The search identified 13 articles, involving 16 patients, with NO-related frostbite injuries to the head and neck. Commonly affected sites included the face, palate, lips, and oropharynx. Six patients required hospital admission, including three who were referred to the intensive care unit.

Conclusions: Oral health care practitioners should be aware of contemporary modalities of substance abuse, particularly from the recreational use of NO and the consequent risk of frostbite to the mucocutaneous structures of the head and neck. Attending clinicians are advised to educate their patients about the potential for these injuries from recreational NO abuse.