Quintessence international最新文献

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.

Objective: The purpose of this study was to analyze and compare the differences in chewing efficiency among patients with different vertical skeletal types of Angle Class I and Angle Class II malocclusions, to provide reference for orthodontic clinical practice.

Method and materials: Sample size estimation revealed a minimum of 53 for each class. Thus, a total of 108 patients with Angle Class I and Angle Class II malocclusions were selected. Lateral skull radiographs were taken, and head measurements were analyzed via geometric tracing software. Chewing efficiency was measured using the gravimetric method to compare between the two groups. The vertical skeletal pattern was classified via Steiner analysis.

Results: Significant statistical differences in chewing efficiency were observed between patients presenting with Angle Class I and Angle Class II malocclusions (P < .05). Additionally, significant differences in chewing efficiency were observed among patients with different vertical skeletal patterns (P < .05). Furthermore, a statistically significant difference in chewing efficiency was found between men and women (P < .05).

Conclusions: Patients with Angle Class I malocclusions exhibited significantly higher chewing efficiency compared to those with Angle Class II malocclusions. Among patients with different vertical facial types, the chewing efficiency followed the order of low angle > normal angle > high angle. Moreover, men demonstrated a higher chewing efficiency than women.

Objective: Periodontitis is characterized by bone resorption. Vertical bone loss results in an intraosseous defect. Multiple surgical approaches for treating intrabony defects have shown different grades of effectiveness. Recently, the entire papilla preservation technique has been proposed, improving clinical parameters, such as pocket depth and clinical attachment level. This series of cases aimed to describe the use of the entire papilla preservation surgical technique without using biomaterials to regenerate periodontal intrabony defects. The influence on the clinical periodontal parameters and radiographic parameters was measured through CBCT, the latter not described until now, and analyzed the possible postoperative complications.

Method and materials: A total of six intrabony periodontal defects associated with at least one periodontal pocket with probing depths equal to or greater than 6 mm were treated with the entire papilla preservation technique. The clinical and radiographic parameters were evaluated at the beginning and 6 months after surgery.

Results: The mean probing pocket depth reduction was 4.00 ± 0.63 mm, the mean clinical attachment level gain was 3.67 ± 1.03 mm, and the mean radiographic intrabony filling was 2.41 ± 2.03 mm. Early healing was uneventful; the mean visual analog scale at 7 days was 0.

Conclusions: This minimally invasive technique results in an improvement in clinical and radiographic parameters, the latter showing a filling of the bone defect observed during the 6-month evaluation after surgical treatment. These results confirm the importance of clot and flap stability in regenerating intraosseous defects.

Objectives: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped.

Method and materials: Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis.

Results: Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%).

Conclusions: CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children.

Clinical significance: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Objective: The purpose of the study was to determine how the maxillary non-impacted third molars impact the distal region of alveolar bone of adjacent second molars.

Method and materials: The periodontal condition of maxillary second molars for which the neighboring third molars were missing (NM3- group) and those with intact non-impacted third molars (NM3+ group) was analyzed in a retrospective study. Using CBCT, the patients were categorized based on the presence or absence of periodontitis, and the alveolar bone resorption parameters in the distal area of the second molars were measured.

Results: A total of 135 patients with 200 maxillary second molars were enrolled in this retrospective study. Compared to the NM3- group, the second molars of the NM3+ group exhibited greater odds of increasing alveolar bone resorption in the distal region (health, OR = 3.60; periodontitis, OR = 7.68), regardless of the presence or absence of periodontitis. In healthy patients, factors such as female sex (OR = 1.48) and age above 25 years old (OR = 2.22) were linked to an elevated risk of alveolar bone resorption in the distal region of the second molars. In patients with periodontitis, male sex (OR = 3.63) and age above 45 years old (OR = 3.97) served as risk factors.

Conclusions: Advanced age, sex, and the presence of non-impacted third molars are risk factors associated with alveolar bone resorption in individuals with adjacent second molars. In addition, the detrimental effects of non-impacted third molars in the population with periodontitis may be exacerbated. From a periodontal perspective, this serves as supportive evidence for the proactive removal of non-impacted third molars.

Advanced digital technologies have rapidly been integrated into prosthodontics to improve the digital workflow for prosthetic rehabilitation. The integration of 3D datasets acquired from various imaging sources such as intraoral scanners and facial optical scanners allows the creation of virtual patients to perform presurgical simulation and prosthetic rehabilitation. The presented technique introduced a straightforward protocol for aligning intraoral scans (Trios 4, 3Shape) to optical face scans (Face Hunter, Zirkonzahn) using a global best-fit algorithm of 3D evaluation software (GOM Inspect). Nasal geometry data were used as the matching reference to produce virtual dental patients. This integration protocol ensured that the intraoral scanner (Trios 4, 3Shape) was used not only to scan dental arches but also used effectively to scan the nose. These scans along with professional facial scans can be successfully aligned to produce virtual dental patients. As only a single fully dentate patient case with an alignment deviation of 243.6 µm was used, further research to evaluate the accuracy of this protocol is needed.

Objective: Mucogingival surgery involving tissue grafts is commonly employed for cosmetic procedures like root coverage, and is increasingly applied in implant therapy to modulate peri-implant soft tissues and enhance implant survival. These procedures involve harvesting autologous connective or epithelial connective tissue, often from the palate or tuber maxillae. However, this can cause patient morbidity due to postoperative pain. Substitute materials, including animal-derived and xenografts, have been developed but lack qualities of autologous grafts.

Method and materials: To address postoperative discomfort, a novel technique, named "palatal shield," using composite resin stabilized on adjacent teeth's palatal surface is proposed as an aid to donor site healing after mucogingival procedures. Two cases are reported where this technique was successfully applied. The first case involves a 53-year-old woman undergoing free gingival graft surgery for peri-implant treatment. The second case features a 58-year-old man receiving subepithelial connective tissue graft surgery for root sensitivity.

Results: Ten days post surgery, both patients reported excellent postoperative comfort. The technique's effectiveness is highlighted in these cases, demonstrating its applicability in various surgical cases involving free gingival graft or connective tissue graft harvesting.

Conclusion: The proposed "palatal shield" technique offers several advantages, including enhanced patient comfort, ease of application, and cost-effectiveness, making it a promising addition to mucogingival surgical procedures.

Objectives: To compare marginal gap width and depth with different cementation systems, excess removal, and after polishing.

Method and materials: In total, 80 composite crowns were milled, divided into ten groups, and cemented on identical artificial teeth. Eight crowns per group were fixed with (i) zinc phosphate cement (ZnOPh), (ii) glass-ionomer cement (GIC), (iii) resin-reinforced glass-ionomer cement (GIC mod), (iv) dual-curing adhesive composite (Comp dual), or (v) dual-curing self-adhesive composite (Comp SE dual). Excess removal was performed with a scaler after brief light-cure (tack-cure), final light-cure, during rubber or gel phase or by wiping with foam pellet. Curing was completed in chemical, dark cure, or light-curing modus. The specimens were polished and stored in water (37°C). The margins were digitized using a 3D laser-scanning microscope (VK-X100 series, Keyence). The width and the depth of the marginal gap were measured at 10 points between the crown margin and the preparation margin.

Results: The width after excess removal varied between 65.1 ± 15.7 µm (Comp dual, wipe, with polishing) and 208.6 ± 266.7 µm (Comp SE dual, dark cure, without polishing). The depth varied between 29.8 ± 22.2 µm (Comp dual, wipe, with polishing) and 89.5 ± 45.2 µm (Comp SE dual, dark cure, without polishing). The impact on gap width and depth was detected for fixation material, excess removal, and polishing.

Conclusion: The gap depth and width depend on the luting material and the mode of access removal. Polishing can improve the gap quality, especially for GIC and resin-based systems.