Quintessence international最新文献

Objectives: The purpose of this study was to evaluate differences in marginal bone level and survival rates of implants placed in lateral-window sinus floor elevation (LSFE) sites compared to other sites.

Method and materials: Patients with a history of LSFE and subsequent implant placement were identified. Clinical and radiographic data were collected by two calibrated examiners and divided into three cohorts for the analysis, including (1) implants placed in the LSFE-grafted sinus, (2) implants placed in the maxilla at sites other than grafted sinus, and (3) implants placed in the mandible. Implant survival rate and marginal bone level were recorded and calculated. The potential influences of several host-, implant-, and surgery-related factors on implant survival rate and marginal bone level were analyzed using generalized estimating equations.

Results: 427 implants from 99 patients (63.8 ±12.5 years) with an average follow-up period of 32.3 ± 29.2 months were analyzed. The cumulative implant survival rate at the grafted sinuses was 93.63%. Mean marginal bone level was 0.44 ± 0.79 mm, 0.84 ± 1.21 mm, and 0.85 ± 1.16 mm for implants in group 1 (n = 142), group 2 (n = 129), and group 3 (n = 147) (P = .01). The majority of marginal bone loss occurred within the first 12 months after implant placement. The status of smoking and periodontal disease did not impact implant survival rate or marginal bone level for any group (P > .05). Neither sinus membrane perforation nor grafting materials affected marginal bone level (P > .05) in group 1.

Conclusion: The utilization of LSFE and the presence of sinus membrane perforation during LSFE had no negative impact on implant outcomes.

Objectives: This systematic review and meta-analysis aimed to evaluate and compare the comfort levels of custom-made mouthguards and self-adapted mouthguards used by athletes. Key parameters assessed included fit, speech interference, and breathing difficulties.

Method and materials: The review was registered with the Prospective International Registration of Systematic Reviews (PROSPERO). A comprehensive literature search was conducted across PubMed, EBSCOhost, Scopus, and Google Scholar, supplemented by additional citation searches. Two independent reviewers assessed the relevance of the studies, and studies were included based on predefined eligibility criteria. Nine studies were included for qualitative analysis, with the risk of bias assessed using standard NIH and revised JBI tools. Meta-analysis was performed with three studies to synthesize the results.

Results: The analysis demonstrated that custom-made mouthguards significantly outperformed self-adapted types in comfort metrics, particularly in fit (P = .0002) and reducing speech difficulty (P .00001). At the same time, breathing difficulty was also less in custom-made mouthguards (P .00001).

Conclusions: Custom-made mouthguards provide superior comfort (fit and speech) compared to self-adapted alternatives, enhancing their potential for widespread adoption. The findings highlight the need for further research as limited clinical studies were available for meta-analysis.

Objective: To examine the changes in dental practice in response to the COVID-19 pandemic 6 to 12 months after its outbreak.

Method and materials: An electronic survey was disseminated among dental practitioners from Brazil, India, and Israel between August 2020 and April 2021. The questionnaire comprised two sections: 1) participant demographics and participant characteristics, and 2) working conditions during the COVID-19 pandemic.

Results: In total, 979 respondents (72.6% females) completed the questionnaire (56.9% Brazilian, 24.6% Israeli, 18.5% Indian). About two-thirds of Brazilian (62.1%) and Indian respondents (68.4%) and 54.8% of Israeli respondents provided emergency care during the first wave of the pandemic; a fifth or lower treated patients with COVID-19. Most respondents reported changes in their appointment management, along with decreased income compared to the period before the pandemic, attributed to the decrease in the number of treatments together with increased expenses, mainly on equipment, protection, and disinfection. More than half of Indian and Israeli respondents reported that guidelines provided by the Ministry of Health were very clear, compared to 31% of Brazilian dental practitioners. Only 35.8% of Brazilian respondents reported that they had received clear instructions regarding conduct in the clinic compared to 69% and 72% of Indian and Israeli respondents, respectively.

Conclusions: Dental practitioners from three very different countries around the world faced similar challenges in their practices during the first months of the COVID-19 pandemic. Although most participants adjusted to the alterations in their professional routines necessitated by pandemic-related restrictions, these modifications also resulted in shifts in clinicians' workloads, elevated expenditures, and reduced income. Public health guidelines provided to dental practices by the authorities were not always clear. Understanding these challenges and how to deal with them should help cope better with future worldwide crises.

Objectives: To describe the second and third years of 'Smiles,' with the objective of demonstrating feasible, practical, and realistic aspects of enhancement of daily toothbrushing skills and integration of a supportive environment of daily supervised toothbrushing in kindergartens.

Method and materials: In total, 36 out of 180 kindergartens (20%) across Israel that participated in the first year of the program, took part in the second and third years of the program. Eighteen kindergartens served as the study group with a supervised toothbrushing routine, and 18 kindergartens served as controls without a supervised toothbrushing routine. Toothbrushing skills were recorded using the Simmons Index at baseline among 3-year-old children, after 1 year, and finally after 2 years among 5-year-old children. Early childhood caries was evaluated by decayed, missing, and filled tooth (dmft) Index among 5-year-old children at the end of the program. Statistical analysis included the chi-square test, Mann-Whitney test, and a generalized linear model.

Results: 1,028 preschool children (503 of them in the daily toothbrushing kindergartens), their parents, and their educational staff took part in the program. The average number of brushing days per week at the daily supervised toothbrushing kindergartens met the desired threshold of 3 days a week. The average daily percentage of preschool children brushing their teeth exceeded 80%. High levels of program cooperation and satisfaction (> 80%) were recorded. Children in toothbrushing kindergartens demonstrated statistically significant three-fold higher levels of toothbrushing skills improvement as compared to children in control kindergartens (33% compared to 11%, respectively; P .001). Being in the Jewish sector and participation in the daily toothbrushing program were revealed as predictors of low dft scores among 5-year-old children (odds ratio [OR] = 0.320, OR = 0.552, respectively; P .001).

Conclusion: The successful performance and positive atmosphere of 'Smiles' at all its levels (the organization, the staff, the parents, and the children) made this endeavor an example of a large-scale demonstration program with practical and realistic enhancement of daily toothbrushing skills and integration of daily supervised toothbrushing among preschool children in kindergartens. Following the introduction of the 'Smiles' program results to the Ministry of Health in 2017, this service became part of the dental health service for pupils in Israel in 2018.

Morgellons disease is a rare controversial illness in individuals which is characterized by having a fixed, false belief (delusion) in which they are infested by non-living organisms, despite medical evidence which proves the contrary. The symptoms can appear solely in the oral cavity, a condition that had not previously been described in the dental literature. The underlying mechanisms behind these findings remain unclear; moreover, established diagnostic criteria or effective treatments were unsuccessful. This case report highlights the sensations of feeling hair and threads between the teeth of patients with Morgellons disease, as well as an unusual perception of the tongue and saliva that was self-reported. Conventional medical treatments have not been effective in alleviating those oral symptoms. Taking into account the scarcity of cases in the dental literature, the article underscores the importance of interdisciplinary approaches, in order to enhance diagnosis and treatment by integrating oral and mental health care.

Objective: The relationship between periodontitis and rheumatoid arthritis has attracted considerable interest. However, the effect of nonsurgical periodontal treatment (NSPT) on rheumatoid arthritis remains uncertain. This umbrella review aims to consolidate current research to establish a stronger evidence base.

Method and materials: Medline, Embase, and the Cochrane library were searched from inception to August 2024. Two independent reviewers handled study selection, data extraction, and quality assessment (AMSTAR 2). The qualitative analysis covered clinical activity, joint symptoms, inflammatory markers, cytokines, and autoantibodies. Quantitative results for disease activity score 28 (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were reported as mean differences with 95% confidence intervals (CIs).

Results: A total of 2,982 records were screened, with 41 full-text articles assessed for eligibility, and 9 selected for evidence synthesis. Qualitative analysis suggests that NSPT may reduce clinical activity in patients with periodontitis and rheumatoid arthritis. Quantitative analysis provided suggestive evidence on the effects of NSPT on DAS28, with the mean difference ranging from -0.38 (95% CI -0.46 to -0.31) to -1.18 (95% CI -1.43 to -0.93). One-third of the included studies were rated as 'high' quality, while another one-third were 'critically low.'

Conclusions: The present evidence suggests that NSPT may provide benefits in managing rheumatoid arthritis symptoms in patients with periodontitis; however, the potential bias of current evidence calls for further rigorous studies. Clinicians should account for the complex interplay between periodontitis and rheumatoid arthritis when devising treatment strategies.

Objective: This study aimed to evaluate the clinical efficacy of an innovative preparation, honey in orabase (50% in 1:1), for treating atrophic/erosive oral lichen planus compared with triamcinolone acetonide 0.1% ointment.

Method and materials: The study involved a total of 60 patients who were randomly divided into three groups: Group I (honey in orabase 50%, 1:1 paste), Group II (triamcinolone acetonide 0.1% ointment), and the control group, Group III (orabase paste). The primary outcome measure was pain, measured on a visual analog scale, and the secondary outcome was the evaluation of the clinical manifestation through an oral lichen planus reduction score assessment.

Results: Compared to Group III, Groups I and II experienced significant reductions in their pain visual analog scale scores and oral lichen planus scores. Participants in Groups I and II reported minimal to no discomfort, with Group I demonstrating the most substantial pain relief.

Conclusion: In comparison to triamcinolone acetonide 0.1% ointment and the control group, the study showed that honey in orabase 50% paste is effective in the reduction of pain and lesion size in patients with atrophic/erosive oral lichen planus. Therefore, as an alternative to utilizing the traditional triamcinolone acetonide 0.1% ointment to treat atrophic/erosive oral lichen planus, honey in orabase 50% paste may be an effective treatment option.

Objective: To evaluate the long-term dimensional stability of dental ridges 2 years after soft tissue augmentation using a porcine-derived volume-stable collagen matrix (VCMX) at healing abutment connections.

Method and materials: A retrospective study was conducted at a private clinic from 2021 to 2023, involving 13 patients who underwent delayed single implant placement in both maxillae and mandible. Three months after implant placement, the buccal soft tissue adjacent to the abutment was augmented with VCMX. Intraoral scans were taken at three points: at implant placement (baseline), 1-month post-grafting, and 24 months after implant loading. Pre-implant CBCT scans were also obtained. Volumetric and profilometric changes were measured at 1, 2, and 3 mm below the mucosal margin by superimposing intraoral and CBCT scans. The Wilcoxon signed-rank test was used for statistical analysis.

Results: All 13 patients completed the 2-year follow-up. Mean volumetric changes at the graft site were + 18.15 ± 15.34 mm3 initially, decreasing by 11.73 ± 21.91 mm3 over 2 years. Profilometric analysis showed increases of 0.72 ± 0.88 mm, 0.54 ± 0.65 mm, and 0.32 ± 0.65 mm at 1, 2, and 3 mm, respectively, 1-month post-grafting. At 24 months, reductions of -0.17 ± 0.77 mm, -0.45 ± 0.58 mm, and -0.48 ± 0.60 mm were recorded.

Conclusions: VCMX use for soft tissue augmentation shows minimal remodeling after 24 months, supporting its efficacy for soft tissue stability in dental implantology. Further long-term studies are recommended. (Quintessence Int 2025;56:274-283; doi: 10.3290/j.qi.b6094895).

Objective: To evaluate the effectiveness of mandibular exercises in patients with temporomandibular disorders (TMD) diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD).

Method and materials: Thirty-two patients seeking clinical treatment for TMD were randomly assigned to groups based on the treatment modality: conservative therapy, including occlusal splint therapy and counseling; and mandibular exercises. Muscle and joint pain were assessed using a four-point scale (0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain). The maximum unassisted mouth opening (MUMO) was measured in millimeters, both with pain and pain-free. Outcomes were evaluated at baseline (T0) and after a 3-month intervention period (T1).

Results: Both treatments significantly reduced muscle and joint pain intensity at most assessed sites. The reduction in pain with mandibular exercises compared to conservative therapy was statistically significant at the right lateral pole of the temporomandibular joint (P = .048; rank-biserial correlation coefficient [rrb] = 0.348). After 3 months, mandibular exercises resulted in greater pain-free MUMO (T0 vs T1; P = .004; rrb = 0.594), and the increase in MUMO was greater than that observed with conservative therapy (P .001; rrb = 0.742).

Conclusion: Mandibular exercises and conservative therapy similarly reduced palpatory pain, with mandibular exercises showing greater clinical impact at the right lateral pole. Both treatments led to significant improvements in the masseter and temperomandibular joint pole. Mandibular exercises also provided superior, clinically meaningful gains in pain-free MUMO, positioning it as a preferred option when enhancing jaw mobility is a primary goal in TMD management.