Quintessence international最新文献

Objectives: The objective was to evaluate the polymerization efficiency of different bulk-fill resin-based composites cured by monowave and polywave light-curing units, by assessment of the degree of conversion and Vickers microhardness at different depths.

Method and materials: Two commercially available bulk-fill resin-based composites were used: Filtek One Bulk Fill Restorative (3M ESPE) and Tetric N-Ceram Bulk Fill (Ivoclar Vivadent). The light-curing units utilized were two LED light-curing units: a monowave LED light-curing unit (BlueLEX LD-105, Monitex) and a polywave LED light-curing unit (Twin Wave GT-2000, Monitex). For each test, 20 cylindrical specimens (4 mm diameter, 4 mm thickness) were prepared from each bulk-fill resin-based composite using a split Teflon mold. Ten specimens were light-cured by the monowave light-curing unit and the other ten were light-cured by the polywave light-curing unit according to the manufacturer's recommendations. Attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) was used to assess the degree of conversion, and a Vickers microhardness tester was used to assess Vickers microhardness. Statistical analysis was performed using three-way ANOVA and Tukey post-hoc tests (P < .05).

Results: The degree of conversion and Vickers microhardness in bulk-fill resin-based composites containing only camphorquinone as photoinitiator were similar when cured with either monowave or polywave light-curing units. However, bulk-fill resin-based composites containing a combination of photoinitiators exhibited significantly higher degree of conversion and Vickers microhardness when cured with a polywave light-curing unit. Although all groups showed statistically significant differences between the top and bottom surfaces regarding degree of conversion and Vickers microhardness, all of them showed bottom/top ratios > 80% regarding degree of conversion and Vickers microhardness.

Conclusion: The polywave light-curing unit enhanced the polymerization efficiency of bulk-fill resin-based composites especially when the latter contained a combination of photoinitiators, but does not prevent the use of a monowave light-curing unit.

Objectives: This case series aimed to assess the efficacy of a novel horizontal ridge augmentation modality using histology. Combinations of "sticky bone" and tenting screws without autologous bone were used as augmentative materials.

Method and materials: Five individuals presenting healed, atrophic, partially edentulous sites that required horizontal bone augmentation before implant placement were enrolled. Patients underwent the same augmentation type and 5 months of postoperative reentry procedures. The first surgery served as implant site development, whereas the biopsy and corresponding implant placement were performed during reentry. The bone was qualitatively analyzed using histology and histomorphometry and quantitatively evaluated using CBCT.

Results: Four individuals healed uneventfully. Early wound dehiscence occurred in one case. Histology showed favorable bone substitute incorporation into the newly formed bone and intimate contact between de novo bone and graft material in most cases. Histomorphometry revealed an average of 48 ± 28% newly formed bone, 19 ± 13% graft material, and 33 ± 26% soft tissue components. The CBCT-based mean alveolar ridge horizontal increase was 3.9 ± 0.6 mm at 5 months postoperatively.

Conclusions: The described augmentation method appears suitable for implant site development resulting in favorable bone quality according to histology. However, clinicians must accommodate 1 to 2 mm of resorption in augmentative material width at the buccal aspect.

Radiation treatment plays a mainstream role in the management of head and neck squamous cell carcinomas (HNSCCs). Adverse effects from radiation therapy include osteoradionecrosis of the jaw, and rarely, pathologic fracture. Immune checkpoint inhibitors (ICI) such as pembrolizumab are of growing relevance to the management of metastatic and recurrent HNSCCs. Adverse impacts on bone secondary to medications such as pembrolizumab and nivolumab have been sporadically documented in the literature. The objective of this manuscript is to raise awareness of possible increase in risk for adverse jaw outcomes in patients with HNSCCs exposed to both radiation treatment to the jaws and ICI therapy. This manuscript documents adverse jaw outcomes including osteonecrosis and pathologic fracture of the mandible in two patients receiving pembrolizumab for management of HNSCC who had received prior radiation treatment. A potential link between immunotherapy and adverse jaw outcomes is consistent with the growing understanding of osteoimmunology, investigating the closely interrelated processes in bone remodeling and immune system function, in health and disease. It is important to ascertain if pembrolizumab poses an incremental risk for such outcomes, beyond the risk from prior radiation, for patients managed with radiation treatment and ICI therapy for HNSCC. The general dental practitioner may encounter such patients either in the context of facilitating dental clearance prior to initiation of chemotherapy, or rarely, with poorly explained jaw symptoms and must be alert to the possibility of occurrence of such adverse jaw events to facilitate timely diagnosis and optimal patient management.

Objective: Currently, there is no established treatment protocol to treat interdental papillary loss. This research aimed to evaluate the outcomes of interdental papillary reconstruction using minimally invasive surgery, with injectable hyaluronic acid gel.

Method and materials: Seventeen patients were included, each with five sites of class 1 papillary recession (40 sites in the maxilla and 45 sites in the mandible). Subperiosteal tunneling was performed through a horizontal incision made apical to the base of the papilla without penetrating it. The free gingival sulcus was sealed by 000 retraction cord. A total of 0.2 to 0.6 mL hyaluronic acid was injected gradually. The incision was sutured with polyglycolic sutures. Treated sites underwent clinical and digital evaluation at three follow-up time points (1 month, 3 months, and 6 months).

Results: The interdental papillary defect height in the maxillary sites significantly reduced by 60%, 66%, and 42% at 1, 3, and 6 months, respectively. In mandibular sites, the reduction was 54%, 55%, and 40% at the same follow-up time points. Regarding interdental papillary defect surface area in the maxilla, the reduction was 65%, 71%, and 45% at 1, 3, and 6 months. In the mandible, a reduction of 60%, 64%, and 48% was noticed at the same time points. Regarding patients' pain level score, during the day of surgery, 16 patients reported pain; the average pain score out of 10 was 3.94, and 11 patients (64.7%) needed to take analgesics. The pain generally subsided in the following days. At the day of treatment, 12 out of the 17 patients (70.6%) reported mild difficulty in speaking and eating. No complication, hypersensitivity, or allergy was noted in any patient.

Conclusion: Subperiosteal tunneling with hyaluronic acid injection demonstrates clinical improvements in papilla height and papillary recession surface area reduction after 3 months of follow-up, with reduction in improvement after 6 months.

Clinical significance: Adjunctive use of hyaluronic acid injection with minimally invasive surgery in interdental papillary management may improve clinical and esthetic outcomes.

Objectives: Sedation is commonly utilized for individuals otherwise unable to receive dental treatment, such as those with disabilities, medically complex conditions, and dentophobics. The aim was to characterize the profiles of patients receiving various types of sedation and assess the corresponding success rates.

Method and materials: This was a 5-year records-based retrospective study. Data regarding the indication for sedation, medical history, sedation type, and treatments performed were recorded.

Results: In total, 103 patients underwent 389 treatment sessions under sedation; 42.7% of the patients were disabled. The most commonly administered sedation was moderate sedation, (49.4%), followed by deep (36.8%) and inhaled sedation (13.9%). Successful treatment results were achieved in 96.1% of sessions, with no adverse effects noted during recovery. The high success rates were independent of patient age, sex, and sedation type. There was a positive association between the indication for sedation and the type of sedation. The medically complex patients and the dentophobic patients received mainly moderate sedation (85.3% and 58.2%, respectively), whereas the disabled patients received deep sedation (51.2%). In total, 94% of patients were returning (re-visiting) patients. A statistically significant association was found between the type of sedation administered and the success rate during the first and last sessions (P < .001). The success rate at the first session may be predictive of the success in subsequent sessions.

Conclusion: A significant positive correlation was found between patient characteristics and the chosen sedation type leading to a high success rate across the various sedation modalities.

Objective: Ideal implant placement in atrophied posterior mandibular regions is challenging due to surgical difficulties and anatomical limitations. This study aimed to evaluate the use of allogeneic bone rings for vertical augmentation of atrophied posterior mandibular regions with simultaneous implants compared to autogenous bone rings, while avoiding donor site morbidity.

Method and materials: A total of 24 vertically atrophied posterior mandibular segments (in 14 patients) were equally randomized into a study group in which mineralized freeze-dried allogeneic bone rings were used, and a control group in which autogenous bone rings with prepared implant osteotomies were harvested from the chin and used. All augmentation sites were prepared before inserting the bone rings. Implants were simultaneously inserted, fixing the bone rings into the native bone. All patients were clinically assessed after 1 week, 2 weeks, and 1 month. Crestal bone level was radiographically assessed after 1 week, 6 months, and 3 months of prosthetic loading.

Results: None of the 24 bone rings showed signs of implant or graft failure. There was no significant difference in the crestal bone level between the groups.

Conclusion: Allogeneic bone rings can be a viable alternative to autogenous bone rings in augmenting the posterior aspect of the mandible, mitigating the concerns associated with donor site complications.

Objectives: This systematic review aimed to search the literature for the answer to the following questions. In human studies: Does the osseodensification technique increase the resonance frequency analysis given in implant stability quotient value and the insertion torque value compared to the conventional technique? In animal studies: Does the osseodensification technique increase implant stability quotient, bone-to-implant contact, and bone area fraction occupancy values over the conventional technique?

Data sources: A search for studies was carried out in eight databases until August 2021. Out of the 447 publications found, 11 were included.

Results: In human studies, osseodensification technique showed better results for implant stability quotient values with a summarized median difference of 8.57. As for secondary stability, there was no significant difference, with summarized median difference of 4.49 in favor of the osseodensification technique. In animal studies, all results were favorable to the osseodensification technique. Regarding insertion torque, bone-to-implant contact, and bone area fraction occupancy between counterclockwise osseodensification technique vs conventional, the mean difference was 46.79 for insertion torque, 2.17 for bone-to-implant contact, and 2.11 for bone area fraction occupancy. High heterogeneity was observed between the studies. The risk of bias in humans was moderate in three studies and low in one; and in animal studies, four presented moderate risk, two low risk, and one high risk. The certainty of evidence ranged from low to moderate.

Conclusion: The osseodensification technique showed improvement concerning the resonance frequency and the insertion torque value of implants in human studies. In addition, it increased the values of bone-to-implant contact, bone area fraction occupancy, and implant stability quotient in animal studies, when compared to the conventional technique.

Objectives: Fractal analysis is a numerical method that indicates the structural patterns and complexity of the trabecular bone on radiographs. The aim of this cross-sectional study was to evaluate the trabecular bone structure in systemically healthy patients and diabetes mellitus patients with periodontitis using fractal analysis.

Method and materials: The study included 125 mandibular first molars of nonsmoker patients. The subjects were divided into five subgroups: diabetes mellitus patients with mild-moderate periodontitis, diabetes mellitus patients with advanced periodontitis, systemically healthy individuals with mild-moderate periodontitis, systemically healthy individuals with advanced periodontitis, and systemically healthy individuals with gingivitis (control group). Clinical periodontal parameters (pocket depth, bleeding on probing, clinical attachment loss, and bone loss) were recorded. Two specific sites located in the mesial-distal regions (n = 250) of the mandibular first molars were identified using periapical radiographs captured with a parallel technique. Fractal analysis values were calculated using the box-counting method. One-way analysis of variance (ANOVA), and Pearson correlation analysis were used for statistical evaluation.

Results: The highest fractal analysis values were observed in systemically healthy with gingivitis patients (mesial fractal analysis: 1.86 ± 0.01; distal fractal analysis: 1.85 ± 0.01). Patients with periodontitis (mesial fractal analysis: 1.78 ± 0.02; distal fractal analysis: 1.79 ± 0.01) exhibited lower fractal analysis values compared to the control group. There was no significant difference in mesial and distal fractal analysis values between all periodontitis groups. No correlation was found between age, sex, clinical attachment loss, bone loss, and fractal analysis (P > .05).

Conclusions: Although fractal analysis values were lower in the periodontitis groups compared to the control group, fractal analysis did not demonstrate any periodontitis-associated changes of bone trabeculation in diabetes at any stage of periodontitis. Furthermore, there was no significant association between fractal analysis values and age, sex, clinical attachment, and bone loss.