Quintessence international最新文献

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: 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.