Quintessence international最新文献

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.

Objectives: The aim of this study was to assess the antibacterial efficacy of nanostructured dental implant surfaces against Porphyromonas gingivalis, a crucial bacterium in the progression of peri-implantitis. An additional aim was to evaluate the possible effect of the modified implant surface on the viability of human gingival fibroblasts (HGnFs).

Method and materials: As detailed in prior research, sputtering by helium ions was used to produce nanospiked titanium surfaces with a height of 1,000 nm (Ti1000). Smooth machined (Ti machined) and sand-blasted, large-grit, acid-etched titanium disks (TiSLA) served as controls. The antibacterial characteristics of the samples against P gingivalis were evaluated by conventional culturing and SEM. The vitality of HGnFs was assessed using the MTT assay.

Results: Generally, nanostructured Ti1000 surfaces exhibited lower bacterial counts than the two controls (Ti1000 vs TiSLA -36% and Ti1000 vs Ti machined -37%) without being statistically significant. Moreover, the nanosurface did not affect the vitality of HGnFs.

Conclusion: The nanospikes of the modified titanium implant surface did not hinder gingival fibroblasts' vitality or proliferation characteristics. Optimizing the spacing and height parameters of the nanospikes could further improve the antibacterial effects of this unique remodification approach.

Objectives: This single-arm prospective interventional study evaluated the effectiveness of silver-fluoride combined with potassium-iodide (AgF+KI; Riva Star Aqua, SDI) in decreasing hypersensitivity after its application on permanent molars affected by molar incisor hypomineralization (MIH Treatment Need Index [TNI] 3 and 4) immediately (15 minutes) and after 3 months.

Method and materials: In total, 22 children with 53 hypersensitive MIH-affected permanent molars (MIH TNI 3 or 4) underwent AgF+KI application after isolation with cotton rolls. Teeth included had no prior in-office desensitizing agents or sealants within 1 month before recruitment. Hypersensitivity was assessed using a 1-second air blast stimulus at three intervals: baseline, 15 minutes, and 3 months posttreatment (blinded). The response to the air-stimulus was quantified using the Schiff Cold Air Sensitivity Scale (SCASS), and teeth with grades 2 and 3 only were included. Statistical analysis involved the Wilcoxon signed-rank test, Mann-Whitney U test, and Friedman test.

Results: The reported mean SCASS scores declined significantly from 2.5 (± 0.5) at baseline to 1.2 (± 0.9) after 15 minutes and 1.0 (± 1.0) after 3 months (n = 20 patients, n = 49 molars). Molars with SCASS 2 had a statistically significantly lower mean hypersensitivity score (from n = 26 to n = 24) compared to SCASS 3 teeth (from n = 27 to n = 19) at the subsequent posttreatment evaluation. However, the percentage reduction from baseline was not significant. Additionally, the reduction in hypersensitivity after AgF+KI application was almost identical for treated (desensitizing agent >1 month prior enrolment) and untreated molars.

Conclusion: AgF+KI is an effective and simple desensitizer providing instant and mid-term relief in schoolchildren with hypersensitive MIH-molars.

Objective: Wire syndrome or X-effect/twist-effect describes undesired long-term tooth movements following fixed retainer placement. Since it includes root torque changes that might cause gingival recession, those situations often require periodontal, orthodontic, and conservative treatment. The aim of this study was to assess the effectiveness of fixed orthodontic treatment with completely customized lingual appliances (CCLAs) and continuous archwires for a clinically significant reduction in the dimensions of labial gingival recessions in the anterior mandible, caused by wire syndrome, in a group of consecutive patients treated with the same approach. Moreover, the reduction in root prominence of the affected teeth relative to the two neighboring teeth was evaluated.

Method and materials: This retrospective cohort study from three centers included 20 consecutively recruited patients with labial gingival recession at mandibular incisors and canines due to wire syndrome. A total of 25 teeth were assessed. CCLA treatment with a standardized archwire sequence (0.012″/0.014″ NiTi, 0.016″ × 0.022″ NiTi, 0.018″ × 0.018″ beta-titanium with optional extra-torque) was identical in all three centers. Primary endpoints of recession depth, recession width, and recession surface were assessed on digital models at debonding (T1) and compared to baseline (T0) both as absolute differences (T0 - T1), and as ratios ([T0 - T1]/T0) by one-sample t tests with P .05. As a secondary endpoint, the reduction of root prominence relative to the gingival surface of the alveolar yoke of the two neighboring teeth was measured in millimeters.

Results: Treatment resulted in a significant reduction in all dimensions of gingival recession. The mean reduction in recession depth was 1.86 mm (44.9%) and in recession width 0.70 mm (35.6%). The mean recession surface was reduced from 10.77 mm2 to 3.93 mm2, indicating a mean recession surface reduction of 61.4%. All changes were statistically significant (P .001). The range of recession surface reduction was from 25.4% to 100%, and 18 out of the 25 recessions showed a reduction of more than 50%. The maximum reduction in root prominence amounted to more than 3 mm.

Conclusion: The use of CCLAs to torque roots of the anterior mandibular teeth, exposed by wire syndrome, towards the middle of the alveolar process reduces the area of subsequent labial gingival recession and reduces the root prominence of the affected teeth substantially. This is considered a critical step in optimizing the predictability of surgical recession coverage.

Objectives: To evaluate changes in gingival recessions in periodontitis patients over 10 years of supportive periodontal therapy and to assess the impact of gingival recession on oral health-related quality of life (OHRQoL).

Method and materials: Fifty-one patients with over 10 years of supportive periodontal therapy were followed up (V1) with complete periodontal status including periodontal probing depth (PPD) and clinical attachment level (CAL) at six sites/tooth, oral hygiene indices, and recession status. Patient anamnesis, oral hygiene habits, and orthodontic history were assessed. Data were compared with records from 10 to 11.5 years prior (V0). Gingival recession changes were analyzed at patient level, and for all teeth with deep gingival recession ≥ 3 mm at tooth and site level (midbuccal site). OHRQoL was assessed at V1 (OHIP-G14 questionnaire). Possible risk factors for gingival recession progression and the associations between the number of deep gingival recession and OHRQoL were tested (linear mixed-effects models, linear regression).

Results: The analysis included 45 patients (stage III/IV periodontitis). Patients retained most teeth (V0, 23.87 ± 4.38; V1, 22.53 ± 4.78), with stable mean overall PPD (V0, 2.34 ± 0.35 mm; V1, 2.39 ± 0.26 mm), and CAL (V0, 3.56 ± 0.94 mm; V1, 3.56 ± 0.89 mm). Teeth with deep gingival recessions showed overall only minimal mean gingival recession progression (0.16 ± 0.97 mm). The mean increase at the midbuccal sites was 0.66 ± 1.58 mm. In total, 25% of teeth had > 1 mm gingival recession progression at the midbuccal site. Molars showed less gingival recession progression than anterior teeth. The number of deep gingival recessions did not significantly impact OHRQoL.

Conclusions: Periodontitis patients on regular supportive periodontal therapy showed high periodontal stability with minimal gingival recession progression. The number of deep gingival recessions was not associated with OHRQoL.

Objective: This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment in the management of gingival enlargement during orthodontic treatment.

Method and materials: Forty-five healthy, orthodontic patients with labial gingival enlargement on the six anterior teeth were selected and randomly assigned to one of the groups (conventional, laser, and nonsurgical periodontal treatment). Clinical parameters including clinical crown length, periodontal pocket depth, and Vertical Gingival Overgrowth Index were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1, 3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months.

Results: Statistically significant results were obtained for mean reduction in periodontal pocket depth for conventional, laser, and nonsurgical periodontal treatment groups (-1.43, -1.75, and -0.9 mm, respectively; P .001), clinical crown length gain (1.45, 1.70, and 0.35 mm, respectively; P .001) and mean Vertical Gingival Overgrowth Index score (-1.14, -1.29, and -0.76, respectively; P .001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to nonsurgical periodontal treatment (P .001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with the conventional group showing a statistically significant difference in mean pain score on days 1 and 3 compared to other groups.

Conclusion: Both conventional and laser gingivectomies were more effective in controlling enlargement over nonsurgical periodontal treatment alone at 1, 3, and 6 months.

Clinical significance: Laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to nonsurgical periodontal treatment alone in the treatment of gingival enlargement and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

There is a plethora of studies reporting successful long-term retention of periodontally compromised teeth. However, such teeth are more likely to be extracted during active therapy than during supportive periodontal therapy. With the vastly growing dental implant market, the inclination to extract periodontally compromised teeth has become more pronounced. In this narrative review, relevant literature along with suggested guidelines for dental partitioners are presented, as well as four cases, in which teeth with compromised periodontal prognosis were successfully managed, with follow-ups of up to 36 years. Conclusion: Preserving periodontally compromised teeth should be highly considered, especially because they tend to outlast dental practitioners' expectations as well as the implant alternatives. The decision to replace periodontally compromised teeth with implants should be taken with caution as there is increased evidence that the success rates of implants in treated periodontal disease patients are lower than in patients without the history of periodontitis. Furthermore, there are significantly lower overall costs of treating and maintaining stage III and IV periodontitis-affected teeth with periodontal regeneration than placing and maintaining implants in the long term.

Objective: To evaluate the efficacy of sesame oil pulling in periodontitis with/without type 2 diabetes mellitus (T2DM), compared to chlorhexidine, for its oral and systemic health benefits.

Method and materials: A total of 120 periodontitis patients, without (Group A; 60)/with (Group B; 60) T2DM, underwent control (chlorhexidine 0.12%; Group A1 and B1) and test (sesame oil pulling; Group A2 and B2) interventions. Plaque index, pocket depth, salivary total antioxidant capacity (T-AOC) enzyme-linked-immunosorbent-assay (ELISA), subgingival plaque BANA test, and serum C-reactive protein (CRP) were evaluated at baseline and 30 days post-intervention using analysis of variance (ANOVA) with a significant P value set at .05. Group B serum samples were also analyzed for fructosamine and lipid profile.

Results: Both treatment regimens were equivalent in reduction of plaque, pocket depth, and red complex periodontopathogens in Group A and B. Significant increase in salivary T-AOC post-intervention was observed in Group B with both interventions (P .01). Sesame oil pulling significantly decreased systemic CRP and triglyceride levels, with no difference observed with chlorhexidine in Group B.

Conclusion: Sesame oil pulling is equivalent to chlorhexidine for anti-plaque, antibacterial, and antioxidant effects in periodontitis patients with/without T2DM. Systemic anti-inflammatory, cardio-protective benefits (reduction of CRP and triglycerides) make it a better adjunct to scaling and root planing than chlorhexidine in periodontitis with T2DM.