BDJ Open最新文献

Background: The Democratic Republic of Congo (DRC) has one of the highest maternal and neonatal mortality rates in Africa. There is a growing body of evidence about the relationship between poor oral health and adverse pregnancy outcomes. However, there is a lack of information about oral health status during pregnancy in the DRC. This study aimed to identify the factors related to the utilization of oral health care services among pregnant women.

Methods: A hospital-based cross-sectional study was conducted in four health facilities representing each administrative district of the city of Kinshasa, between March and May, 2021. The study population comprised pregnant women aged at least 18 or over attending antenatal care (ANC), selected using a simple random sampling technique. Data were collected using a structured questionnaire. Multivariable logistic regression was employed to identify factors associated with the outcome variable using the adjusted odds ratio (AOR) with its 95% confidence interval (95% CI) and p value  <  0.05.

Results: A total of 5% of the 500 pregnant women who participated in the study were identified as users of oral healthcare services. 15% of pregnant women were aware of the necessity of oral health care during pregnancy, while 58% indicated that dental visits for routine and/or treatment purposes were not a priority during pregnancy. Factors associated with its utilization were knowledge of the need for oral health care during pregnancy (AOR:3.62, 95% CI: 1.42-9.26), knowledge of the importance of routine visits or dental treatment for oral diseases during pregnancy (AOR: 4.94, 95% CI: 1.70-16.73), and having experience oral health problem during the current pregnancy (AOR: 3.13, 95% CI: 1.22-8.21).

Conclusion: The utilization of oral health care services during pregnancy is very low. Appropriate public health initiatives are urgently needed to facilitate collaboration between health professionals to integrate oral and dental consultations, oral health counseling, and check-ups as an essential component of routine ANC.

Objective: This study aims to compare the utilization of intraoral scanners and laboratory scanners as an alternative impression method in fully and partially edentulous cases.

Materials and methods: This scoping review that implemented the PRISMA-ScR instrument and the methodological approach by Arksey and O'Malley. A comprehensive search was conducted across four databases (PubMed, Scopus, SpringerLink, and ScienceDirect) to retrieve articles published within the last decade. Inclusion criteria were established to identify articles that analyzed the accuracy of both intraoral scanners and laboratory scanners in edentulous cases. Data extraction was performed and results were presented in tables. Subsequently, a thematic analysis was conducted to conclude the accuracy of the intraoral scanners and laboratory scanners in edentulous cases.

Results: A total of 312 articles were retrieved from four databases. After eliminating duplicates and screening based on titles, abstracts, and eligibility criteria, eight articles were selected for detailed analysis of the accuracy of each technology. Most studies investigated fully and partially edentulous arches and demonstrated the utilization of intraoral scanners and laboratory scanners. Some studies additionally analyzed the correlation between various factors influencing digital scans and the condition of edentulous arch. Evaluations of edentulous digital impressions have been conducted, with an assessment of the reliability of intraoral scanners and laboratory scanners.

Conclusion: Intraoral scanners are extensively utilized and demonstrate considerable promise for edentulous impression procedures. However, morphological differences may impact scanning outcomes.

Objectives: The present study aimed to assess parental acceptance of silver diamine fluoride (SDF) treatment for dental caries in children in Najaf city, Iraq.

Methods: A cross-sectional design was used, involving 670 parents of children aged 6-7 years from primary schools in Najaf city, Iraq, during the academic year 2023-2024. The participants were selected via a multistage random sampling method. A structured questionnaire was administered to gather the participants' views on tooth staining caused by SDF application to cavitated teeth. Statistical procedures included descriptive analysis, chi-square tests, and ordinal logistic regression.

Results: In total, 670 parents were recruited for this study. The mean age of the participants was 34.47 ± 8.2 Approximately half of the respondents were male and aged 31-50 years, and approximately three-fourths of the parents reported having a low education level and were in the low-income category. Parental acceptance of SDF treatment was greater for posterior teeth, with 51.2% agreeing, and 24.2% strongly agree. For anterior teeth, acceptance was lower, with only 23.3% agreeing and 10.7% strongly agreeing. Parental age (p = 0.008), education level (p < 0.001), and income (p = 0.003) were significantly associated with acceptance of SDF treatment for posterior teeth. However, for anterior teeth, parental education (p < 0.001) and income (p = 0.029) were significantly associated with acceptance of SDF treatment.

Conclusion: Parents showed high acceptance of SDF treatment, particularly for posterior teeth, although concerns about aesthetics affected their views of anterior teeth. Improving parents' awareness and addressing their apprehensions could increase the adoption of this evidence-based caries management approach for children.

Background and objectives: There are various methods to improve the patient's quality of life and alleviate complications after surgical extraction of the lower third molar. The use of Kinesiotape is one of the most important methods used recently. This study aimed to assess the effectiveness of Kinesiotape in alleviating complications after surgical extraction of the lower third molar compared to cryotherapy.

Methods: The study was designed as a randomized controlled clinical study according to the split-mouth technique and included 25 patients who had radially symmetrical lower third molars. The patients were divided randomly into two groups, and Kinesiotape (KT) using the Web-strip technique was applied in the study group (KT), while cold packs were applied in the control group Non-Kinesiotape (N-KT). The studied variables were pain, and analgesic pills consumption. These measurements were evaluated in the first five days after surgery using the visual analog scale (VAS) and the number of consumed analgesic pills.

Results: The pain index value in the KT group was (60.4 ± 19.8) on the first day, and (60.4 ± 17.8) in the N-KT group. The number of analgesic pills consumed in the KT group was (3.3 ± 1.3) on the first day, and (3.4 ± 1.3) in the N-KT group. No significant statistical difference was found in pain scores according to the VAS index and the number of consumed analgesic pills between the two groups.

Conclusion: The current study concluded that pain and analgesic pills consumed were similar between the two study groups, without one being superior to the other.

Background: Socket preservation is a proactive approach that limits bone loss after tooth extraction to maintain adequate bone volume, height and width. Many methods have proven effective in achieving socket preservation, including using various bone grafts and autologous platelet concentrates (APCs). Combining these two methods may lead to improved results in socket preservation and patient outcomes.

Aims: To compare the combined use of APCs and bone grafts in socket preservation, with the use of bone grafts alone. Primary outcomes were radiographic vertical bone loss (VBL) and horizontal bone loss (HBL).

Methods: A search on Pubmed, Scopus, Embase and Google Scholar databases was conducted to identify human studies using APCs in extraction sockets between January 2014 and August 2024. The inclusion criteria involved comparative human studies ranging from evidence levels II to III (Oxford Centre for Evidence-Based Medicine Levels of Evidence). For assessing bias in the included studies, the Cochrane Risk of Bias tools were used. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the quality of evidence available.

Results: A total of five randomised controlled trials (RCTs) were included in the analysis. Studies included the use of platelet rich fibrin (PRF), injectable platelet rich fibrin (i-PRF), advanced platelet rich fibrin (A-PRF), advanced platelet rich fibrin plus (A-PRF+) and concentrated growth factors (CGF). The risk of bias was judged high and moderate for two out of five RCTs. The analysis revealed a combined effect size for VBL reduction, with a standardized mean difference (SMD) of -0.83 (p < 0.001; 95% confidence interval (CI) = [-1.2, -0.57]; I² = 73.13%). For HBL reduction, the combined effect size was SMD = -0.72 (p < 0.001; 95% CI = [-1.08, -0.37]; I² = 68.34%). The overall evidence quality rating for the use of APCs in combination with bone grafts to reduce VBL during socket preservation was assessed as moderate, whereas to reduce HBL it was determined to be low.

Conclusion: The current literature demonstrates the added benefits of APCs combined with bone grafts in alveolar socket preservation compared to bone grafts alone in reducing vertical and horizontal bone loss. However, based on the GRADE assessment, the quality of evidence was judged low-to-moderate. Further randomised clinical studies would increase the certainty of the evidence.

Aim: This study aimed to compare the potential of two regenerative endodontic procedures, platelet-rich fibrin (PRF) and concentrated growth factor (CGF), in the treatment of mature permanent teeth with necrotic pulps and periapical radiolucency.

Methods: This randomized clinical trial was written according to the Preferred Reporting Items for Randomized Trials in Endodontics 2020 guidelines. The study was registered in the Clinical Trials Registry ( ClinicalTrials.gov ) with identifier number NCT06227533. Eighteen patients with mature necrotic maxillary incisors with periapical lesions were randomly divided into two groups, one group received treatment with PRF (n = 9), while the other received CGF (n = 9). Radiographs were taken at the beginning, 6 and 12 months after treatment, and confirmed with CBCT to assess periradicular healing. An electric pulp tester and cold test were used to determine whether pulp sensibility had been regained during the follow-up period. The statistical analysis used an independent t-test to compare different groups. Repeated measures ANOVA to compare pre-operative, after 6 months, and after 1 year in the same group.

Results: Both groups experienced a considerable increase in healing at 6 and 12 months compared to baseline, with no significant differences seen regarding lesion size (p-value was 0.34) and relative bone density (p-value was 0.27). There was no substantial change in the tooth sensibility reading between both groups at 6 months (p-value = 0.34), After 1 year, both groups exhibited identical patterns.

Conclusion: Revascularization using PRF or CGF successfully preserved mature teeth with necrotic pulps.

Objective: The objective of this study is to disperse europium oxide (Eu₂O₃₎ in a resin composite (RC) using a planetary centrifugal mixer and assess its effects on photoluminescence and mechanical properties.

Materials and methods: A commercially available RC was mixed with Eu₂O₃ at various concentrations using a planetary centrifugal mixer. The fabricated samples were evaluated using scanning electron microscopy and a spectrofluorometer to assess their crystal structures, particle sizes, and photoluminescence properties. Vickers microhardness measurements were performed, along with a three-point bending test. Statistical analyses were performed to assess the mechanical properties.

Results: The intensity of red fluorescence increased with the increase of europium oxide concentration. The fluorescence spectra at 613 and 620 nm exhibited higher intensities under excitation at 254 nm. Eu₂O₃ was dispersed in RC regardless of the Eu₂O₃ concentration, and no aggregation was observed. Regarding the mechanical properties, there were no significant differences in the flexural strength or modulus, and the Vickers hardness gradually increased with increasing Eu₂O₃ concentration.

Conclusion: To mix Eu₂O₃ with RC, visible fluorescence emission was observed even with increasing the Eu₂O₃ concentration, and the mechanical properties of RC were unaffected. Based on our study, a 15 wt% concentration of Eu₂O₃ is the appropriate concentration, as it achieves strong fluorescence emission without compromising the mechanical properties or color tone of the RC.

Objective: This study aimed to create a 3D-printed customized transfer key and evaluate the accuracy of the virtual patient model with maxillomandibular relationship at centric occlusion using the transfer key.

Methods: A 3D-printed transfer key was designed, combining facial and intraoral (IOS) scans. The design included components that recorded the 3D upper and lower arch at centric occlusion. The virtual patient model image was generated in-vitro using a phantom head with soft tissue simulation. Accuracy was assessed by superimposing the 3D scans with reference CBCT images and analyzing trueness and precision using root mean square (RMS) deviations.

Results: The transfer key included an intra-oral part that acts as an anterior deprogrammer to record the relationship of two dental arches at centric occlusion (CO) and an extra-oral with a rotatable cross-shaped design with two arms for locating the facial midline and the two pupils connecting line. Superimposition demonstrated high trueness (RMS: 0.51 mm for the arch regions, 0.69 mm for the whole head region, 0.85 mm in the face region) and precision (RMS: 0.41 mm for the arch regions, 0.52 mm for the entire head, 0.63 mm in the face region) significantly (p < 0.05). Minimal deviations were observed in critical areas, including the tooth and lip position, indicating that the virtual patient model was closely aligned with the CBCT reference. The dental arches achieved the highest accuracy, while slight deviations were noted in the facial regions.

Conclusions: The 3D-printed customized transfer key effectively enhanced the virtual patient model's accuracy, surpassing traditional trueness and precision methods. This novel approach offers a streamlined, patient-friendly solution for digital dental workflows.

Objective: Peri-implant diseases (peri-implant mucositis and peri-implantitis) are inflammatory conditions that affect the peri-implant tissues and are induced by microbial biofilms (dental plaque) formed around the implant. Removal of biofilm is the fundamental step in managing peri-implant diseases. Interdental cleaning aids such as interdental brush, unitufted brush, or oral irrigation along with regular toothbrushing are recommended for effective plaque control around implants. The present systematic review aims to evaluate the efficacy of home use of oral irrigators compared to other plaque control methods for managing peri-implant diseases.

Method: This systematic review has been prepared using the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) checklist. Five databases were searched using the following keywords: "Peri-implantitis" OR Periimplantitis OR "Peri-implant disease" OR "Peri-implant Mucositis" AND "Oral irrigation" OR "Oral Irrigator" OR Waterpik OR "Interdental irrigation" OR "Oral Spray" OR "Oral Irrigants".

Results: Oral irrigator along with mechanical brushing was found to be more effective than mechanical brushing alone in reducing the plaque index (PI), gingival index (GI), and bleeding on probing (BOP). No statistically significant difference in improvement in quality of life and patient satisfaction with regard to comfort and ease of use was noted upon using mechanical toothbrushing alone and an oral irrigator. Implant sites where an oral irrigator was used showed more reduction in BOP (81.8% vs 33.35%) compared to sites where the floss was used (P = 0.0018). The levels of the red and orange complex bacteria in the peri-implant biofilm were lower with the use of an oral irrigator than with toothbrushing alone.

Conclusion: Oral irrigators along with toothbrushing were found to be more effective in removing microbial plaque around implants and controlling peri-implant inflammation compared to mechanical brushing alone. The reduction in BOP was better with the use of oral irrigation compared to floss and interdental brush.

Objectives: The aim of the present study was to compare the accuracy of fully guided implant insertion in vitro achieved by two fabrication methods in a cohort of undergraduates. We hypothesized that both methods achieve a comparable accuracy.

Methods: Surface scans and cone beam computed tomography images of 48 mandibular models were matched. For each model, two surgical guides enabling a fully guided implant insertion in the region of the first molar on the left or the right side were virtually designed. Fabrication by either Digital Light Processing (DLP) or Fused Filament Fabrication (FFF) followed. Subsequently, 96 implants using the guides were inserted into the models by 48 undergraduate students. The accuracy of the implant insertion was assessed radiographically, followed by statistical analysis. Additionally, all participants completed a questionnaire.

Results: The implants inserted using guides made by DLP showed a higher accuracy compared to guides made by FFF. The mean three-dimensional deviation was 1.94 ± 1.05 vs. 3.35 ± 2.03 degrees (p < 0.001). The evaluation of the questionnaires revealed mainly theoretical knowledge and a pronounced interest in implant dentistry.

Discussion: The main hypothesis has to be rejected as there were statistically significant differences in accuracy. However, it is possible to teach students the principles of guided implant dentistry and the digital workflow. Furthermore, the initial and running costs for the FFF workflow are substantially lower enabling a higher practicability for undergraduate education.

Conclusion: Despite the lower accuracy of the templates made from FFF the method seems to be suitable for laboratory hands-on courses for undergraduates.