BDJ Open最新文献

Introduction: Accurate implant placement in edentulous patients remains a clinical challenge, particularly when using mucosa-supported guides, which are prone to positional errors.

Aims: To evaluate the accuracy of implant placement using the Fixed Edentulous Implant Guide (FEIG), a screw-retained guide system, compared with a conventional mucosa-supported guide in an edentulous mandible model.

Materials and methods: Ten anatomical mandibular models with simulated mucosa and bone were used. Forty dummy implants were placed using either the FEIG system or a conventional guide. Implant positions were virtually planned, and deviations were assessed by comparing the planned and actual positions using STL-based alignment and a custom measurement algorithm.

Results: The FEIG system demonstrated significantly lower mean deviations at the coronal (0.45 ± 0.15 mm) and apical (0.28 ± 0.13 mm) levels compared with the conventional guide (1.22 ± 0.61 mm and 0.89 ± 0.39 mm, respectively; p < 0.001). Angular deviation was lower for the FEIG (1.99° ± 0.98) but not statistically significant (p = 0.081).

Conclusions: The FEIG method significantly improved the accuracy of implant placement in vitro compared to a conventional edentulous guide. Further in vivo studies are warranted to confirm its clinical applicability.

Objective: This protocol for scoping review aims to systematically map existing evidence on collaborative approaches between Oral and Maxillofacial Surgery (OMFS) and Prosthodontics in implant therapy, exploring their implementation, influential clinical domains, current methodologies, technologies, and identifying research gaps.

Introduction: Dental implant therapy has revolutionized patient care, but optimal success, especially in complex cases, hinges on precise surgical and prosthetic foresight. The synergy between OMFS and Prosthodontists is crucial. Modern dentistry embraces a prosthetically driven, integrated paradigm, greatly streamlined by digital workflows. Despite advancements, literature remains fragmented, lacking a comprehensive synthesis of collaborative models. This protocol for review seeks to bridge that gap.

Inclusion criteria: Studies on adult (≥18 years) edentulous or partially edentulous patients undergoing implant-based rehabilitation, focusing on OMFS and Prosthodontics interdisciplinary collaboration in planning, surgery, and prosthetics, will be considered. All clinical settings, regions, and study designs (quantitative, qualitative, mixed methods, reviews, text/opinion papers) are included. Studies solely on a single discipline or maxillofacial prosthetics unrelated to tooth replacement via implants will be excluded.

Methods: This protocol for scoping review explains methodology that will follow PRISMA-ScR guidelines. A comprehensive search will be conducted across PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library. Two independent reviewers will screen titles, abstracts, and full texts. Data extraction will use a standardized charting form, followed by descriptive and thematic analysis, presented narratively with tables/figures.

Review registration: Open Science Framework https://doi.org/10.17605/OSF.IO/USZ9V.

Objective: To evaluate a new primary-care based oral surgery service in Plymouth, England using Maxwells' Dimensions of Quality framework.

Methods: A retrospective observational study of referral, service and treatment outcome data.

Results: Over a 35-month period the service received 1165 referrals, with 89% of patients referred receiving treatment within 63 days. Treatment provided was predominantly dento-alevolar surgery accounting for 82% of treatment provided, and soft tissue lesions accounting for 17%. The re-attendance rate for complications was 4%, and antibiotic use was 2%. Sedation was required for 17% of treatment cases. Cost analysis indicated a cost per case of between £138-196.

Conclusion: The service meets the national clinical standards in oral surgery. High ongoing demand for referral of medium-complexity oral surgery cases from primary dental care to specialist providers/services is likely to continue. The opportunity to develop more primary care capacity has the potential to improve accessibility and convenience for patients and optimise use of NHS resources.

Background: Micro-abrasion enables conservative stain removal with tooth preservation, enhancing color and microhardness in line with minimally invasive dentistry principles. The aim of this in vitro study was to compare the effects of three micro-abrasion materials Antivet®, Oplasture®, and a prototype paste (37% phosphoric acid with Aluminum oxide powder) against an untreated control on the color stability and microhardness of simulated stained enamel surfaces.

Methods and material: A total of 120 extracted, caries-free human teeth were utilized. The teeth were randomly allocated into four groups (n = 30). Group 1 (control, no treatment), Group 2 (Antivet®: 21% hydrofluoric acid (HF)), Group 3 (Oplasture®: 6.6% hydrochloric acid (HCl) with silicon carbide), and Group 4 (prototype paste: 37% phosphoric acid with aluminum oxide powder). Specimens were stained by immersion in coffee or cola solutions at 37 °C for 8 h daily over 5 days, with interim storage in artificial saliva, and further subdivided (n = 15) by staining type. Color analysis and microhardness testing were performed at baseline, post-staining, and post-treatment. Data were analyzed using the Shapiro-Wilk test, Levene's test, one-way ANOVA, and Holm's method for multiple comparisons.

Results: Statistically significant differences in enamel color change (ΔE) were observed among micro-abrasion materials versus control (p < 0.001), with the prototype paste inducing the highest ΔE after staining. Only Antivet® showed solution-dependent ΔE differences (p = 0.035). Enamel microhardness decreased significantly post-staining, confirming demineralization. Oplasture® achieved the greatest microhardness recovery, while Antivet® and the prototype paste were moderately effective. The control group exhibited the highest microhardness loss, after cola exposure (p = 0.045), highlighting the protective effect of micro-abrasive treatments.

Conclusions: All tested micro-abrasive materials effectively enhanced tooth color and enamel microhardness. Antivet® appears to be a viable alternative to hydrochloric acid-based products. The prototype paste emerged as a promising, cost-effective alternative for stain management.

Background: Oral lichen planus (OLP) is a chronic mucocutaneous autoimmune skin disease without a proper pathophysiology and approved therapy. As a result, several repurposed drugs have been used in clinical practice, and it remains unclear which one holds greater potential.

Aim: The present study employs a network pharmacology to explore the disease biology and further investigate the target-specific binding efficacy of repurposed drugs.

Materials and methods: Twenty-eight repurposed drug's (D1-D28) efficacies against twelve targets were investigated using PyRx 0.8-AutoDock 4.2 software. Further, drug stability and reactivity were studied using molecular dynamics (MD) simulation at 200 ns, Gibbs free energy, frontier molecular orbital theory, and structural activity relationship.

Results: The above computational investigation suggested betamethasone (D2/BETA) and triamcinolone acetonide (D28/TACA) are two potential drugs, predominantly demonstrating higher binding efficacy against the glucocorticoid receptor (GR). Further, MD simulation, free-energy calculation revealed that D28/TACA was comparatively more stable than D2/BETA.

Conclusion: The network pharmacology explored possible drug targets for drug discovery and showed that D28/TACA is a more effective treatment option among repurposed drugs.

Aim: This prospective controlled clinical study aimed at evaluating the performance of 5.5 mm-long implants to support two-unit fixed prosthesis in the posterior regions of the mandible and the maxilla.

Materials and methods: A total of 44 patients (30 females and 14 males) were included and received 51 test implants (5.5 mm in length) and 51 control implants (≥6.5 mm in length) to support two-unit fixed partial prosthesis in the mandible and the maxilla. Intermediate abutment was used in all cases. The patients were followed for 12 months. Changes in the marginal bone loss, implant survival, and prosthetic complications were compared between the two groups.

Results: The patient's mean age was 64 years (range: 42-48 years). All the implants in the test group were placed at the molars site compared to 26 implants in the control group (p < 0.001). Bone type (p = 0.224) and insertion torque (p = 0.671) were similar between the groups. None of the implants failed. The changes in marginal bone level at mesial (median: 0.3 mm; range: -1.3 to 2.9 mm for control, and 0.2 mm; -0.7 to 1.6 mm for test; p = 0.138) and at distal (median: 0.3 mm; range: -1.3 to 1.5 mm for control, and 0.2 mm; -1.2 to 1.4 mm for test; p = 0.0633) were similar between the study groups. The prostheses were free of technical complications.

Conclusions: This prospective controlled clinical study supports the use of 5.5-mm long implants in the context of fixed partial prosthesis and posterior regions. No statistically significant differences have been observed in marginal bone stability, implant survival and prosthetic complications compared to longer implants. Within the limits of this study, 5.5 mm implants appear to be a predictable option for fixed posterior partial dentures.

Aim: To examine the opportunities and limitations for dental hygienists and therapists (DCPs) delivering periodontal care in primary care settings.

Materials and methods: A cross-sectional survey was conducted among primary care dental providers in the South West of England following University of Bristol ethical approval (number 15281). The survey assessed the current providers' views on utilization of DCPs, including availability, their practice, direct access and provider perspectives on referrals and remuneration.

Results: Thirty-one providers participated, with 30(97%) offering both NHS and private services and 1(3%) private only. Twenty-eight providers (90%) employed a DCP, primarily a hygienist (n = 23,82%). While all providers referred patients to DCPs, 18 (64%) referred only for private care. Three (11%) provided NHS direct access, compared to 18 (64%) for private, citing financial and workload barriers. Remuneration methods varied, with percentage split (n = 16,57%) being most common. Over half of the respondents (n = 18,58%) felt NHS use of DCPs was unfeasible, and 21(68%) doubted that NHS contract reforms would improve DCP employment opportunities.

Conclusion: Current NHS contracts may not sufficiently support DCP involvement in NHS periodontal care, indicating the need for contract reform to facilitate their broader use.