BDJ Open最新文献

Objectives: Sodium hypochlorite (NaOCl) gel is an effective additive for white mineral trioxide aggregate (WMTA) that enhances its chemical and physical characteristics and significantly reduces setting time while maintaining biocompatibility. The study sought to compare the outcomes of pulpotomies performed in primary teeth using WMTA mixed with 2.25% NaOCl gel or WMTA mixed with distilled water (DW).

Materials and methods: It was a randomized, triple-blinded, split-mouth, controlled clinical trial. Forty primary second molars from cooperative children aged 5-10 who required pulpotomy were randomly assigned to the control group-WMTA  + DW or experimental group-WMTA + NaOCl gel for clinical and radiographic assessments at 3, 6, and 12 months of follow-up. The clinical evaluation involved checking for spontaneous pain, pain on percussion, tooth mobility, abscesses, sinus tracts, and the exfoliation of the treated tooth. The periapical radiographic evaluation identified whether there was furcal radiolucency, internal or external root resorption, and widening of the periodontal ligament. Canal obliteration was not considered a failure.

Results: The WMTA + NaOCl gel group showed a 90% and 95% clinical and radiographical success rate, respectively, at 3, 6, and 12 months of follow-up. In the control group, the clinical success rate was 90% after 3, 6, and 12 months, whereas the radiographical success rate was 100% at 3 months and decreased to 95% after 6 and to 85% after 12 months. No statistically significant difference was detected between the two groups (p > 0.05).

Conclusions: The present research validated WMTA + NaOCl gel as a potentially effective material for pulpotomy in primary molars.

Objective: Influenza, a respiratory infection caused by the influenza virus, has been associated with good oral hygiene, which correlates with a reduced incidence of the disease. Saliva possesses inherent antiviral properties against the influenza virus. However, the relationship between toothbrushing, a common oral hygiene practice, and the antiviral activity of saliva remains poorly understood. This study aimed to evaluate the effect of toothbrushing on the anti-influenza virus activity of saliva.

Materials and methods: Sixteen adults without oral disease participated in this open-label, single-arm study. Resting saliva and mouth-rinsed water samples were collected before toothbrushing. Participants then brushed their teeth with a toothbrush and toothpaste for five minutes, after which additional saliva and mouth-rinsed water samples were collected at five minutes and one-hour post-brushing. The total bacterial amount in the mouth-rinsed water was measured by qPCR. The anti-influenza virus activity of saliva was determined using the TCID₅₀ method.

Results: Saliva's anti-influenza virus activity increased significantly five minutes after toothbrushing compared to pre-brushing levels, but no significant difference was observed at 1 h, as follows [Δlog, median (min-max)]: Before brushing: 0.625 (-0.25-1.75), at 5 min: 1.25 (0.5-2), and at 1 h: 0.75 (0.5-2). A correlation analysis between total bacterial amount and antiviral activity revealed a negative correlation.

Conclusions: Improving the oral environment through toothbrushing enhances salivary antiviral activity. Maintaining oral hygiene may help prevent influenza virus infection.

Aim: To assess the impact of 980 nm diode laser-activated irrigation with or without EDTA on the adaptability of root canal filling in oval-shaped canals using a scanning electron microscope.

Methodology: Forty-five single-rooted mandibular premolars were assigned into three groups (n = 15) based on the final irrigation protocol: Conventional irrigation without activation; 980 nm diode laser without EDTA; 980 nm diode laser with EDTA. The marginal gap width (μm) and surface area (μm²) between the obturating material and the root canal were measured in the coronal, middle, and apical thirds using SEM software (ImageJ software version 1.53 t). The data was analyzed using Two-way ANOVA and Bonferroni's post hoc tests.

Results: All groups demonstrated statistically significant differences in mean gap width and surface area (p < 0.001) at the coronal, middle and apical root sections. Diode laser with EDTA group had the lowest gap values, followed by the diode laser group, while the conventional group recorded the highest values. Diode laser group exhibited the highest gap value in the coronal section. Additionally, significant differences in mean gap width and surface area were observed at different root levels within each group (p < 0.001). The highest mean gap value observed in the apical section, whereas the lowest value was found in the middle section for both the diode laser with EDTA and diode laser groups. In contrast, the conventional group had its lowest value in the coronal section.

Conclusion: Activation of the 2.6% NaOCl and 17% EDTA using 980 nm diode laser improves the adaptation of the root canal filling to the canal walls.

Background: Autologous platelet concentrates (APCs) have played a significant role in regenerative dentistry, with clinical evidence suggesting its benefits over controls. Particularly, APCs could reduce postoperative pain following tooth extractions.

Aim: To compare patient reported pain after tooth extractions using different autologous platelet concentrates (APCs) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF).

Method: A search on Pubmed, Scopus, Embase and Google Scholar databases was conducted to identify human studies using APC(s) in extraction sockets between January 2014 and June 2024. This review followed the PRISMA guidelines. 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: This review identified 8 studies; with 338 extraction sites in total and 1-15 days pain follow up. Four studies showed no statistically significant difference in postoperative pain reduction between PRP and PRF. One study observed no statistically significant difference between leukocyte-rich PRF (L-PRF) and titanium-prepared PRF (T-PRF). One study indicated that advanced platelet-rich fibrin (A-PRF) is superior to PRF in reducing postoperative pain on day 2 postoperatively. In addition, two studies reported that A-PRF is more effective than L-PRF on day 2. Moderate-to-high risk of bias was identified within 75% of the selected papers. GRADE score for evidence quality assessment was 'Low'.

Conclusion: A-PRF was favoured to reduce postoperative pain on day 2 among the investigated APCs, although the GRADE criteria rate the evidence as "Low". Future trials should directly compare A-PRF with PRF and L-PRF using high-quality randomized controlled designs.

Introduction: Some recent studies have suggested that antioxidants, particularly lycopene, may improve periodontal treatment outcomes. However, conflicting past results regarding its effects highlight the need for further research. This study aimed to evaluate the clinical effects of oral lycopene supplementation as an adjunctive therapy in nonsurgical periodontal treatment for patients with periodontitis.

Methods: In this parallel clinical trial, 42 patients aged 25 to 55 with moderate to severe periodontitis and no recent history of periodontal treatment were randomly assigned to two groups after matching for mean age, sex, periodontal disease severity, and antioxidant capacity. One group received lycopene supplementation (15 mg/day) and phase I periodontal therapy. In contrast, the other group received a placebo (containing 1 g of corn starch) and phase I periodontal therapy. Periodontal parameters, including probing depth (PD), clinical attachment loss (CAL), and bleeding index (BI), as well as serum Malondialdehyde (MDA) levels, were assessed at baseline and after two months.

Results: Both groups showed significant improvements in periodontal parameters after two months. However, the lycopene group demonstrated greater reductions in probing depth (P = 0.009), clinical attachment loss (P = 0.015), bleeding index (P = 0.237), and MDA levels (P = 0.199) compared to the placebo group, confirming its positive effect in reducing oxidative stress and inflammation associated with periodontitis.

Conclusion: Oral lycopene supplementation was associated with better clinical outcomes than the placebo as an adjunct to nonsurgical periodontal therapy. It may be recommended as part of a periodontal treatment plan to enhance periodontitis management.

Objective: Dental caries is defined by the WHO as a multifactorial non-communicable disease. If left untreated, it can progress to abscesses and then head and neck odontogenic cellulitis. It requires immediate, appropriate, and interdisciplinary treatment. The aim of this study was to draw up an epidemiological profile of these children treated at the Lille University Hospital in northern France and to study the impact of self-medication of anti-inflammatory drugs.

Materials and methods: A single-centre retrospective, cross-sectional study was conducted on children with odontogenic cellulitis admitted to the paediatric emergency department of the Lille University Hospital between March 2013 and December 2021.

Results: 15.3% of the 636 children included had taken nonsteroidal anti-inflammatory drugs before going to the emergency department. The frequency of pain and trismus was higher in children who had taken nonsteroidal anti-inflammatory drugs than in those who had not. Frequency of hospitalisation was higher in children who had not taken nonsteroidal anti-inflammatory drugs than for those who had (70% vs. 57%, respectively; p < 0.05). Inversely, the mean length of stay was longer for children who had taken nonsteroidal anti-inflammatory drugs than in those who had not (1.1 vs. 0.8 days, respectively; p < 0.05).

Conclusion: This first French epidemiological study on odontogenic cellulitis in children underlines the need to develop multidisciplinary prevention and patient education.

Background: Occlusal loading refers to a modality in which an implant-supported prosthesis is subjected to functional loading, maintaining contact with the opposing dentition from the onset of prosthetic placement. In contrast, non-occlusal loading represents a non-functional approach, wherein a provisional implant prosthesis is initially placed in infra-occlusion or fully relieved of contact with the opposing dentition, which is subsequently (at a later stage) followed by functional (occlusal) loading with the definitive prosthesis.

Aim: To compare clinical outcomes in partially edentulous cases following an occlusal modality of loading versus non-occlusal modality of loading.

Method: A search on Pubmed, Scopus and Embase databases was conducted to identify randomised controlled trials (RCTs) comparing occlusal versus non-occlusal modalities of implant loading in partially edentulous patients receiving implants with single crowns or fixed bridges, between January 1 (2004) to June 12 (2024), examining implant survival, complications and marginal bone loss (MBL) of implants. The inclusion criteria involved RCTs of evidence level II (Oxford Centre for Evidence-Based Medicine Levels of Evidence). For assessing bias in the included studies, the Cochrane Risk of Bias tool was used.

Results: This review identified seven RCTs investigating 273 implants over 1-3 years follow-up periods. seven studies reported 1-year MBL data and three reported 3-year data. Publication bias was noted at the 1-year follow-up (p < 0.01) but not at 3 years (p > 0.05). Differences in MBL were not statistically significant at both 1 year (Hedges' d = 0.01, p = 0.920, 95% CI: [-0.21, 0.24]) and 3 years (Hedges' d = 0.01, p = 0.952, 95% CI: [-0.28, 0.30]). Differences in complication occurrences were not statistically significant (RR = 0.882, p = 0.759, 95% CI: [0.397, 1.964]). The nature of data on implant survival rates prevented a meaningful meta-analysis.

Conclusion: For short-term periods of 1-3 years, no significant evidence supports clinical superiority in terms of complication rates and MBL between non-occlusal and occlusal modalities of implant loading. Future studies should explore functional and aesthetic aspects, as well as patient reported outcomes to determine any short-term differences or consider long-term follow-up with large sample sizes to detect significant clinical differences.

Introduction: Implementing artificial intelligence (AI) to use patient-provided intra-oral photos to detect possible pathologies represents a significant advancement in oral healthcare. AI algorithms can potentially use photographs to remotely detect issues, including caries, demineralisation, and mucosal abnormalities such as gingivitis.

Aim: This study aims to assess the effectiveness of a newly developed AI model in detecting common oral pathologies from intra-oral images.

Method: A unique AI machine-learning model was built using a convolutional neural network (CNN) model and trained using a dataset of over five thousand images. Ninety different unseen images were selected and presented to the AI model to test the accuracy of disease detection. The AI model's performance was compared with answers provided by fifty-one dentists who reviewed the same ninety images. Both groups identified plaque, calculus, gingivitis, and caries in the images.

Results: Among the 51 participating dentists, clinicians correctly diagnosed 82.09% of pathologies, while AI achieved 81.11%. Clinician diagnoses matched the AI's results 81.02% of the time. Statistical analysis using t-tests at 95% and 99% confidence levels yielded p-values of 0.63 and 0.79 for different comparisons, with mean agreement rates of 81.55% and 95.11%, respectively. The findings support the hypothesis that the average AI answers are the same as average answers by dentists, as all p-values exceeded significance thresholds (p > 0.05).

Conclusion: Despite current limitations, this study highlights the potential of machine learning AI models in the early detection and diagnosis of dental pathologies. AI integration has the scope to enhance clinicians' diagnostic workflows in dentistry, with advancements in neural networks and machine learning poised to solidify its role as a valuable diagnostic aid.

Introduction: Zygomatic implants represent a reliable treatment modality for patients with severe maxillary bone resorption, eliminating the need for bone grafting and enabling immediate loading. This study utilized cone beam computed tomography (CBCT) to identify optimal zygomatic bone regions for implant placement by assessing bone-implant contact (BIC) while minimizing intrusion risks into the infratemporal fossa (ITF). Additionally, differences in zygomatic characteristics between males and females were investigated to address the limited evidence regarding the influence of biological sex on BIC and implant stability.

Methods: This retrospective study analyzed CBCT scans from 20 fully edentulous patients (9 male and 11 female) with severe maxillary resorption. Zygomatic bone thickness, length, and BIC were measured at 12 anatomical points across the superior, middle, and inferior regions using standardized CBCT imaging and Nobel Clinician software. Virtual implants were placed to evaluate intrusion into the infratemporal fossa. Statistical analyses, including Kruskal-Wallis and Mann-Whitney U tests, were conducted to compare zygomatic measurements across regions and between genders.

Results: The greatest bone thicknesses in the superior, middle, and inferior regions were observed at Point A₁ (8.53 ± 1.63 mm), Point B₁ (6.97 ± 1.01 mm), and Point C₀ (6.36 ± 1.02 mm), respectively. Point A₃ (17.65 ± 2.24 mm) in the anterior region and Point B₁ (13.34 ± 2.35 mm) in the posterior region were identified as optimal implant sites, providing the highest BICs while minimizing intrusion risks. Zygomatic thickness and BIC at these optimal sites were significantly greater in males than females (p < 0.01).

Conclusion: Point A₃ and Point B₁ are the most suitable sites for zygomatic implant placement. Quad zygomatic implants may achieve enhanced primary stability in males than in females due to greater zygomatic bone thickness and BIC.

Objective: This study investigates refusal rates of dentists in Damascus, Syria, to manage patients who disclose that they are carriers of tuberculosis, human immunodeficiency virus (HIV), hepatitis B and C (HBV/HCV), and patients with dental phobia, asthma, epilepsy, patients unable to afford dental care, and children. The aims are to identify to what extent dentists refuse patients who are diagnosed carriers of certain blood born viruses, require extra measures, take a lot of time, or do not pay.

Methods: A cross-sectional study was conducted in Damascus by distributing paper and electronic questionnaires to dental clinics based on the administrative divisions of the city.

Results: A total of 246 responses were collected. The average years of dental practice among respondents was 9.39 ± 9.8. Rates of refusal were as follows: children (n = 55, 22.4%), tuberculosis (n = 176, 71.5%), HIV (n = 192, 78.0%), HBV/HCV (n = 98, 39.8%), dental phobia (n = 58, 23.6%), asthma (n = 12, 4.9%), and epilepsy (n = 73, 29.7%). Acceptance of patients with tuberculosis, HIV, and HBV/HCV was positively associated with greater years of experience. Dentists who graduated outside of Syria were more likely to accept treating patients with HIV and HBV/HCV. A significant correlation was found between refusal rates for patients with tuberculosis, HIV and HBV/HCV.

Conclusions: The proportion of dentists in Damascus refusing to treat patients who disclose that they are carriers of tuberculosis, HIV/AIDS, and HBV/HCV was notably high. Managing patients who cannot afford treatment often involved reducing fees. The findings provide valuable insights into the systemic challenges in healthcare delivery and propose possible improvements in managing vulnerable population in resource-constrained settings.