BDJ Open最新文献

Aim: To determine the factors that affected the complete clinical remission of oral lichen planus (OLP) treated with topical corticosteroids.

Material and methods: We retrospectively evaluated the charts of patients diagnosed as OLP. Age, sex, current medical conditions, medications, type of OLP, Thongprasom score, pain level assessed by a numeric rating scale (NRS), Candida infection, topical steroid treatment preparation, duration of treatment until the first complete clinical remission, and follow-up duration were assessed as variables.

Results: In total 100 patients, after complete remission, 22 patients reported a relapse within 1.5-45 months, with a mean of 15.6 ± 13.2 months. Age, duration, gingiva and vestibule area, hypertension, dyslipidemia, Thongprasom score, preparation and topical corticosteroid potency were factors affecting the remission. Multivariate logistic regression analysis revealed that the patients' age and duration of treatment were significant factors after adjusted for age, sex, and independent factors with a P-value < 0.1 in the univariate analysis. The likelihood of having incomplete remission of the OLP lesion increased by 7.9% for every year increase in age and increased by 2.3% for every month of treatment.

Conclusions: There are many different factors between the complete remission and incomplete remission groups. However, age and duration of treatment were significant factors affecting the remission of OLP.

Introduction

Attitudes towards and willingness to accept alternatives for sustainable dentistry in Trinidad and Tobago have never been assessed. Market research aids in the understanding of the behaviours of people. Since change can be enacted by public pressure, it is worth engaging the public through research to understand their attitudes and which changes they are willing to accept.

Method

A self-administered questionnaire was distributed to private and public dental clinics. The questionnaire assessed attitude towards and willingness to accept alternatives which decrease the effect of dental treatment on the environment.

Results

The study consisted of 1267 participants. Participants were mostly female, older, employed and mainly of African descent. Participants reported a very positive attitude towards sustainable dentistry (Mean = 3.89, SD = 0.8). and were moderately willing to accept alternatives such as a longer appointment time (Mean 3.47, SD = 0.73) and pay more for their dental treatments (Mean=3.00, SD = 0.87). There was a strong positive correlation with attitudes to sustainable dentistry and participants willingness to accept alternatives such as a longer appointment time (r = 0.658, p < 0.05).

Conclusion

The adult population had an overall positive attitude towards sustainable dentistry and was willing to accept alternatives so that their dental treatment would have less impact on the environment.

Objective

In the temporomandibular joint two separate movements of rotation and translation occur in two articular spaces during mouth opening. Over the years, the approach has changed considerably, but it is still subject to controversy as to which of these movement is involved in the initial stage of mouth opening. In the present study, the extent of rotation and translation was investigated in the first 5 mm of mouth opening.

Materials and methods

The study was carried out on 46 volunteers. Anamnesis was taken and patients were examined. For the investigation, an ultrasonic digital motion analyser (KaVo Arcus Digma 2) was applied. The measurements were made after calibration to an arbitrary axis. Each participant performed three open-close movements in succession, starting from maximum intercuspal position.

Results

Data were statistically processed using cubic spline interpolation. Linear regression was then used. The resulting line is significantly (p < 0.0001) different from the horizontal that represents only rotational movement.

Conclusion

The results show that during mouth opening from maximum intercuspal position, translation is present continuously in addition to rotation. Therefore, it might be time to re-evaluate the principle of a pure rotational approach.

Objective

examination of the influence of chemical composition changes on the ability of sealers to withstand a pull-out test.

Materials and methods

Fifty distal or palatal canals of extracted teeth were prepared by Dc Taper files. The teeth were divided into five groups: AH Plus, BJM RCS, Total Fill BC,AH Plus Bioceramic and a group with Gutta Percha with no sealer added. Ten days after obturation, each cone was subjected to the “pull-out test” with the Shimadzo Universal Testing Machine until it was torn or removed from the canal. A force to Stroke graph was generated and the maximum vertex of this graph was recorded. The number of times the cone was torn or removed was recorded.

Results

The amount of force needed to remove or rupture the cone was significantly higher in all sealer groups compared to the AH Plus Bioceramic group. The force needed for the AH Plus group was double that needed for the AH Plus Bioceramic group 4 (1.87 ± 0.53 N vs 0.93 ± 0.48 N, respectively, P < 0.001). All of the cones (n = 10) in the AH Plus Bio Ceramic Sealer group were removed in their entirety (P = 0.01 compared to each of the other groups).

Conclusions

The addition of macromolecules to epoxy sealer does not change the material’s ability to withstand the pull-out test. Decreasing the amount of tri- and di-calcium silicate compounds combined with increasing amounts of zirconium oxide in a Bioceramic sealer significantly decreased the material’s ability to withstand the pull-out test.

Introduction

Cell signaling pathways are the biological reactions that control cell functions and fate. They also directly affect the body reactions to implanted biomaterials. It is well-known that dental implants success depends on a successful integration with the alveolar bone: “osseointegration” which events comprise early and later responses to the implanted biomaterials. The early events are mainly immune-inflammatory responses to the implant considered by its microenvironment as a foreign body. Later reactions are osteogenic aiming to regulate bone formation and remodeling. All these events are controlled by the cell signaling pathways in an incredible harmonious coordination.

Aim

The number of pathways having a role in osseointegration is so big to be reviewed in a single article. So the aim of this review was to study only two of the most relevant ones: the inflammatory Nuclear Factor Kappa B (NF-κB) pathway regulating the early osseointegration events and the osteogenic Wnt pathway regulating later events.

Methods

We conducted a literature review using key databases to provide an overview about the NF-κB and Wnt cell signaling pathways and their mutual relationship with dental implants. A simplified narrative approach was conducted to explain these cell signaling pathways, their mode of activation and how they are related to the cellular events of osseointegration.

Results and conclusion

NF-κB and Wnt cell signaling pathways are important cross-talking pathways that are affected by the implant’s material and surface characteristics. The presence of the implant itself in the bone alters the intracellular events of both pathways in the adjacent implant’s cellular microenvironment. Both pathways have a great role in the success or failure of osseointegration. Such knowledge can offer a new hope to treat failed implants and enhance osseointegration in difficult cases. This is consistent with advances in Omics technologies that can change the paradigm of dental implant therapy.

Objectives

This article examines the efficacy of two bioactive dental composites in preventing demineralization while preserving their mechanical and physical properties.

Materials and methods

The study compares Beautifil Kids and Predicta® Bioactive Bulk-Fill (Predicta) composites with conventional dental composite. Flexural strength and elastic modulus were evaluated using a universal testing machine. A pH-cycling model assessed the composites’ ability to prevent dentin demineralization. Color stability and surface roughness were measured using a spectrophotometer and non-contact profilometer, respectively, before and after pH-cycling, brushing simulation, and thermocycling aging.

Results

Beautifil Kids exhibited the highest flexural strength and elastic modulus among the materials (p < 0.05). Predicta demonstrated the highest increase in dentin surface microhardness following the pH-cycling model (p < 0.05). All groups showed clinically significant color changes after pH-cycling, with no significant differences between them (p > 0.05). Predicta exhibited greater color change after brushing and increased surface roughness after thermocycling aging (p < 0.05). While Beautifil Kids had higher surface roughness after pH-cycling (p < 0.05).

Discussion/Conclusion

Bioactive restorative materials with ion-releasing properties demonstrate excellent resistance to demineralization while maintaining mechanical and physical properties comparable to the control group.

Objective/aim

The absence of a comprehensive understanding of potential anaphylactic reactions to local anesthetics (LAs) and management can result in grave consequences. For this reason we aim to assess Latin American dentists’ knowledge, preparedness, and competency in managing anaphylactic reactions to LAs.

Materials and Methods

Design: A cross-sectional study was conducted from November 2021 to February 2022. Board-certified dentists answered a survey comprising 26 structured questions. Chi-square tests and logistic regression models were performed in Stata 17.0. Setting: Argentina, Brazil, Colombia, Costa Rica, Ecuador, Honduras, Mexico, Peru, Venezuela, and other Latin American countries.

Results

Of 507 respondents, lidocaine was the most frequently used LA (88.1%). While 85.2% could identify dyspnea as a symptom of anaphylaxis, only 50.1% knew the correct route for epinephrine administration, and just 43.5% had epinephrine in their emergency kits. Confidence in managing anaphylactic reactions was low (9.6%). Older age was inversely related to both knowledge of anaphylaxis management and the possession of epinephrine (P = 0.003 and P = 0.0001, respectively).

Discussion

Our study highlights a concerning discrepancy between the practical readiness of Latin American dentists in handling anaphylaxis.

Conclusion

The study’s findings underscore the need for educational interventions to improve the readiness to identify and handle anaphylactic emergencies in dental practice.

Objective: The aim of this study is to develop and validate a questionnaire for dental students in Ecuador to assess their reasons to study dentistry.

Materials and methods: A 25-item questionnaire was developed by the authors based on similar studies and a qualitative study. The questionnaire had five theoretical factors: economic, professional, vocational, social and academic reasons for study. In the first two samples, exploratory factor analysis was performed to identify the structure, and the models obtained were compared with confirmatory factor analysis in the third sample.

Results: Three samples were used, sample A with 201 participants, sample B with 623 participants, and sample C with 596 participants. Two-thirds of the participants were female and almost one-third were from coast region. The EFA applied in sample A resulted in a five-factor model with 18 items; in contrast, a three-factor model was obtained from sample B. According to the CFA in sample C, the best model was explained by three factors: labor, vocational and academic reasons. Considering two items to cross-load in labor and vocational factors, which are theoretically justified.

Conclusion: This study presents a 12-item questionnaire that assesses labor, vocational and academic reasons for studying dentistry in an Ecuadorian population.

Objectives: To assess the attitude and practices of dentists and dental assistants in managing dust particles generated during dental prostheses or appliances grinding and polishing.

Materials and methods: Data were collected from 207 dentists and 125 dental assistants through an online questionnaire. The questionnaire included adjusted prosthesis types, self-protective methods, types and frequency of protective device use, and reasons for non-frequent use.

Results: Protective grinding devices, including dust protective boxes and mounted plastic sheets, were commonly used for substantial acrylic resin adjustments, while air blowing was preferred for minor adjustments. Post-COVID-19, there was a 3-fold increase in the use of protective grinding devices among dentists and a 1.3-fold increase among dental assistants. During try-in procedures, dentists commonly rinsed prostheses with water rather than using disinfectants. Non-frequent users adopted self-protection methods, such as face shields and air filters. Surgical drapes and high-volume evacuators were used for patient's protection.

Conclusion: Despite an increased tendency of the use of protective grinding devices following COVID-19, a significant number still report infrequent use. Identified protective devices in this study have drawbacks not fully meeting dentists' expectations. Invention of a more user-friendly device is necessary to ensure regular use, preventing potential toxicity from dust particles.

Objective

To evaluate the clinical performance of self versus light-cured universal adhesive in non-carious cervical lesions (NCCLs) after 18 months.

Materials and methods

Sixty-eight NCCLs in 28 patients were divided into two equal groups; G1: self-cured universal adhesive (Palfique,Tokuyama,Japan) and G2: light-cured universal adhesive (Single Bond Universal,3 M ESPE,USA). Nanohybrid resin composite (Z350XT, 3 M ESPE, USA) was used as a final restoration. Evaluation for fracture, loss of retention, marginal adaptation and discoloration were done after 1 week, 6,12, and 18 months using FDI criteria. Postoperative sensitivity was assessed after 1 week. Chi-Square and Mann-Whitney tests with statistical significance at (P ≤ 0.05) were used for intergroup comparison,while the intragroup one was performed using the Cochran’s Q and Friedman’s tests. Survival rate was analyzed using Kaplan-meier and Log-rank test.

Results

Both groups exhibited fracture and retention loss, however, there was statistically significant difference favoring the control group at 6 months (p = 0.0114,0.0016). For secondary outcomes, marginal adaptation and discoloration revealed no significant differences. For postoperative sensitivity, there was a significant difference favoring the control group (p = 0.0007, 0.0011). Palfique had 1.5 Relative-Risk (RR) after 6 months (95% CI 0.5659–4.2617; P = 0.3928) and 20% less risk of failure after 18 months (RR 0.8) (95% CI 0.4618–1.3858; P = 0.4260). Tested adhesives showed equal survival rate (P = 0.5685).

Conclusions

Both adhesives revealed similar clinical performance in restoring the NCCLs after 18 m, however, the early failure was more frequent in the self-cured universal adhesive.