Quintessence international最新文献

Objectives: Mouth breathing is a condition that alters normal skeletal and dental development while also affecting the surrounding orofacial muscles. Electromyography (EMG) provides an objective method to assess these muscular changes. This study aimed to evaluate the activity of the buccinator, orbicularis oris, mentalis, sternocleidomastoid, and trapezius muscles in mouth breathers before and after interceptive therapy and compare these findings with those of nasal breathers.

Method and materials: Children aged 6 to 12 years were selected based on inclusion/exclusion criteria and categorized into two groups: group I (mouth breathers, n = 18) and group II (nasal breathers, n = 18). The electromyographic activity of all the five selected muscles were recorded at rest and during maximal contraction using an EMG Retrainer (Chattanooga Group, DJO), an intraoral device used to measure muscle activity, particularly in the orofacial region. Statistical analysis was performed using SPSS version 22.0 (IBM), with significance set at P < .05. The Mann-Whitney U test was used for intergroup and intragroup comparisons.

Results: Results showed significant differences in muscle activity before and after appliance therapy, particularly in the buccinator, mentalis, orbicularis oris, trapezius, and sternocleidomastoid muscles. Post-therapy, the orbicularis oris and buccinator muscles exhibited notable differences in mouth breathers.

Conclusion: Surface EMG can be a valuable diagnostic and biofeedback tool in pediatric interceptive orthodontics, aiding in treatment assessment and relapse prevention.

Objective: To evaluate parents' knowledge of the Israeli Ministry of Health guidelines on basic oral health practices and appropriate toothpaste usage for different pediatric age groups.

Method and materials: Anonymous questionnaires were distributed to parents attending the Pedodontics Department. The questionnaire included two sections: general questions and questions that were completed for all children in the family, categorizing them into three age groups: under 2 years, 2 to 6 years, and over 6 years.

Results: A total of 242 questionnaires and 410 responses across different age groups were collected. Most respondents knew that teeth should be brushed as soon as the first tooth appears and believed that the first dental visit should be at age 2 (60.5% and 26.9%, respectively). However, only 15% of parents answered both questions correctly. Toothpaste selection was primarily based on age (46.6%), with no significant differences across age groups for correct answer (P = .130). Awareness of the recommended fluoride concentration was low (16.1%), though parents of older children showed better knowledge (P = .040). Appropriate toothpaste amounts were used in 30.2% of the cases, with the 2- to 6-year age group demonstrating the highest awareness (P .001). Only 3.7% of parents correctly answered all three toothpaste-related questions. Overall, the knowledge score for toothpaste guidelines was highest in the middle age group (31.2%, SD = 28.66, P .001).

Conclusion: A minority of parents are familiar with recommended early dental care practices and correct toothpaste usage. The findings emphasize the need to improve parental awareness from the very beginning of a child's development. (Quintessence Int 2025;56:644-653; doi: 10.3290/j.qi.b6287918).

The objective of this case series was to report the outcomes of patients diagnosed with medication-related osteonecrosis of the jaw (MRONJ) and seek a remission through surgical management associated with local and systemic adjuvant therapies. A total of 14 patients were followed for up to 3 years, of whom one had MRONJ stage 0; three with stage I; seven with stage II; and four with stage III. Twelve patients underwent conservative sequestrectomy. In seven of these cases, the surgery was guided by fluorescence, using doxycycline preoperatively to remove necrotic bone tissue more accurately. In four participants, platelet-rich fibrin membranes were positioned at the surgical site before suturing. All 14 patients were instructed to perform daily mouthwashes with 0.12% chlorhexidine, and all underwent weekly sessions of antimicrobial photodynamic therapy according to the following protocol: Pre-irradiation with methylene blue (100 μg/mL) for 60 seconds, followed by irradiation with a low-level laser (600 nm; 100 mW; 214 J/cm2; 6 J/point; 60 s/point). Other adjuvant therapies were employed, such as the prescription of a combination of pentoxifylline and tocopherol, in addition to metronidazole paste. The proposed therapies led to remission in most patients, and although some of the patients did not achieve complete remission, they showed a significant reduction in pain complaints. These results demonstrate that the protocols used in this study are promising for the management of MRONJ in different stages. As such, they offer potential for the practice of surgeons and should be the object of further clinical investigations. (Quintessence Int 2025;56:654-666; doi: 10.3290/j.qi.b6376673).

Background: Periodontitis is a severe oral health condition that damages the supporting bone and soft tissues surrounding the teeth. In recent years, it has become evident that periodontitis could increase systemic inflammatory markers. Some studies showed a potential link between periodontitis and autoinflammatory diseases, including Familial Mediterranean fever (FMF), which is a hereditary autoinflammatory condition. The current study aimed to comprehensively evaluate the association between FMF and periodontitis by analyzing clinical periodontal parameters-Plaque Index (PI), Gingival Index (GI), and Clinical Attachment Loss (CAL)-through a meta-analysis.

Methods: A thorough search was conducted across different databases, including PubMed, Scopus, Web of Science, and Google Scholar, covering publications up to July 2024. Eleven studies were included, consisting of one cohort and ten case controls. Following established methods, we performed data extraction and quality assessment of the selected publications. We conducted a meta-analysis to gather the effect sizes obtained from the eligible publications.

Results: The meta-analysis highlighted a statistically significant increase in PI among FMF patients compared to controls, with a pooled mean difference of 0.1833 (95% CI: 0.0012, 0.3655; p=0.0485), indicating higher plaque accumulation in FMF patients. On the other hand, CAL exhibited a non-significant mean difference of -0.0933 (95% CI: -0.2928 to 0.1062; p = 0.3596), and the GI similarly did not reach statistical significance, presenting a mean difference of 0.3223 (95% CI: -0.0713 to 0.7158; p = 0.1085).

Conclusion: Our investigation underscores a potential association between FMF and periodontitis, as seen by elevated levels of PI in FMF patients. These results suggest that FMF patients experience higher levels of periodontal inflammation, emphasizing the importance of periodontal care in this population.

Objective: To describe how advancements in digital technologies and materials science provide additional restorative alternatives and material combinations for single- and multiple-unit implant-supported restorations, such as those incorporating the clinical use of nitride-coated titanium bases in combination with the two-piece, CAD/CAM, screw-retained, zirconia-ceramic, hybrid implant-supported restoration concept.

Case presentation: Two partially edentulous patients with missing teeth in the maxillary esthetic zone were treated with a novel technical and restorative concept using the two-piece CAD/CAM screw-retained zirconia-ceramic hybrid-abutment crown concept bonded to nitride-coated titanium bases. Biologic outcomes showed that tissues were maintained healthy with the patients showing an adequate oral hygiene level, no detectable plaque present upon probing, and no bleeding on probing. Esthetic evaluation demonstrated an excellent esthetic outcome and peri-implant soft-tissue integration with adjacent natural teeth and pontic tissue areas, together with posttreatment stability of the gingival zenith position. Neither of the two patients showed technical complications such as screw loosening or porcelain chipping/fracture. Radiographic evaluation revealed a precise fit between nitride-coated titanium bases and the implant connecting interfaces, no marginal bone loss, and stable implant osseointegration. The principal advantages of incorporating nitride-coated titanium bases in implant-supported restorations rely on the favorable esthetic outcomes, improved technical, mechanical, and biologic aspects, as well as the physicochemical characteristics of nitride-coated titanium bases' hard thin film coatings and their positive impact on titanium biocompatibility.

Conclusions: The short-term promising clinical outcomes of the two-piece CAD/CAM screw-retained, zirconia-ceramic hybrid-abutment crown concept bonded to nitride-coated titanium bases, indicate the potential clinical benefits of the described restorative alternative. However, additional in vitro investigations and randomized clinical trials are needed to validate these initial observations, especially those evaluating the two-piece CAD/CAM screw-retained, zirconia-ceramic hybrid-abutment crown bonded to nitride-coated titanium bases when compared to the conventional two-piece hybrid design as well as stock/custom, metal/zirconia/lithium disilicate, screw/cemented implant-supported restorations.

Objective: The objectives of this study were to: (1) describe how general dental practitioners (GDPs) in the National Dental Practice-Based Research Network ('Network') classify the severity of postoperative bleeding; and (2) examine the association between bleeding severity classification and whether the GDP had residency training.

Method and materials: An electronic questionnaire was developed to assess GDPs' classification of bleeding severity for various scenarios following scaling or a single-tooth simple extraction, and to collect information about respondents' experience with bleeding scenarios. A total of 1,815 GDP members of the Network were invited to participate.

Results: A total of 866 GDPs responded. Strong agreement (low variability) was observed for scenarios that were classified as 'severe bleeding' (94.7% to 96.8%), and lower agreement (higher variability) was observed for scenarios classified as 'moderate bleeding' (53.2% to 65.2%). The GDP's classification of bleeding severity was not correlated with training in a General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD). A minority of respondents had experience with 'major bleeding' that may lead to hemodynamic emergency (15.5%) or a referral to an emergency department (4.8%).

Conclusion: This study identified scenarios for which there is high agreement and low agreement regarding bleeding severity classification among GDPs in the US. A small percentage of respondents had actual experience with major bleeding in their patients. Based on these results, a new tool is proposed to assess the severity of oral bleeding, intended to foster better communication between dental professionals. The new tool may assist GDPs to standardize documentation and communication with other health care professionals. (Quintessence Int 2025;56:668-679; doi: 10.3290/j.qi.b6376527).

Objectives: To assess the influence of edentulous span length on the accuracy of two intraoral scanner (IOS) devices Primescan (Dentsply Sirona) and Trios 3 (3Shape) in complete-arch scenarios. The hypothesis was that accuracy would decline with increasing span length, with performance differences between scanners.

Method and materials: An in vitro study was conducted using a maxillary complete-arch model with a central incisor implant. Twelve span-length scenarios (FA1 to FA12) were created by sequentially removing adjacent teeth. Each condition was scanned 10 times using both IOS devices (n = 240). A laboratory scanner (Identica blue, Medit) provided reference scans. Trueness (vs reference) and precision (intra-group) were evaluated using root mean square (RMS) error. Scans were aligned via automatic and local best-fit in Medit Design. Statistical analysis included two-way mixed ANOVA, repeated measures ANOVA, and linear regression with Bonferroni correction (α = .004).

Results: Trios 3 demonstrated lower overall RMS values (0.296 ± 0.043 mm) than Primescan (0.338 ± 0.049 mm), with significant differences in 9 of 12 scenarios (P .001). Correlation with span length was stronger for Primescan (R2 = 0.892) than Trios 3 (R2 = 0.674). Both devices showed high reliability.

Conclusions: Increasing edentulous span length negatively impacts scanner accuracy. Devices demonstrating consistent performance are preferable for reliable full-arch digital workflows. (Quintessence Int 2025;56:618-625; doi: 10.3290/j.qi.b639465).

Statement of problem: While intraoral scanners (IOS) demonstrate high accuracy in single-tooth and partial-arch applications, their reliability in full-arch scans with varying edentulous spans remains uncertain. Increasing span length may compromise scanning accuracy and prosthetic outcomes.

Objectives: To assess the influence of edentulous span length on the accuracy of two IOS devices Primescan (Dentsply Sirona) and Trios 3 (3Shape) in complete-arch scenarios. The hypothesis was that accuracy would decline with increasing span length, with performance differences between scanners.

Material and methods: An in vitro study was conducted using a maxillary complete-arch model with a central incisor implant. Twelve span-length scenarios (FA1-FA12) were created by sequentially removing adjacent teeth. Each condition was scanned 10 times using both IOS devices (n = 240). A laboratory scanner (Identica blue, MEDIT) provided reference scans. Trueness (vs. reference) and precision (intra-group) were evaluated using root mean square (RMS) error. Scans were aligned via automatic and local best-fit in Medit Design. Statistical analysis included two-way mixed ANOVA, repeated measures ANOVA, and linear regression with Bonferroni correction (α = 0.004).

Results: Trios 3 demonstrated lower overall RMS values (0.296 ± 0.043 mm) than Primescan (0.338 ± 0.049 mm), with significant differences in 9 of 12 scenarios (p < 0.001). Correlation with span length was stronger for Primescan (R² = 0.892) than Trios 3 (R² = 0.674). Both devices showed high reliability.

Conclusions: Increasing edentulous span length negatively impacts scanner accuracy. Devices demonstrating consistent performance are preferable for reliable full-arch digital workflows.