Swiss dental journal最新文献

Oral healthcare among the frail is an underestimated geriatric care element. While neglected oral health (OH) is a well-established risk factor for frailty, frailty can be a risk factor for subsequent OH problems. The cross-sectional investigation nested into the SAPALDIA sub-cohort of citizens aged 52 years and older, aims to stimulate longitudinal research into aspects that accelerate poor OH among frail individuals. The hypothesis investigated was that (pre-) frail individuals are more likely to have missing teeth replaced with removable dental prostheses (RDP) resulting in difficulties with chewing. The study included 1489 participants undergoing geriatric assessments and oral examination. The main predictor was frailty status (non-frail; pre-frail; frail), based on Fried's frailty phenotype. The main outcomes of interest were non-functional dentition (presence of ≤ 19 natural teeth), presence of any RDP and self-reported difficulties with chewing. Pre-frailty and frailty were not associated with the presence of ≤ 19 natural teeth, but were associated with a higher RDP prevalence. The presence of at least one complete denture (CD) had 1.71 fold and 2.54 folds higher odds among pre-frail and frail, respectively, compared to non-frail individuals. Frail individuals with CD reported chewing difficulties 7.8 times more often than non-frail individuals without CD. The results are in line with the hypothesis that (pre-) frail individuals may be more likely to have tooth loss restored by RDPs. Future longitudinal research needs to assess potential barriers to oral hygiene and fixed dental prostheses among (pre-) frail and to study their oral health-related quality of life.

A papilloma is a benign tumor arising from an epithelial surface. Mostly a papilloma appears as an asymptomatic intraoral lesion and is often associated with the human papilloma virus (HPV). In this case report two similar, verrucous papules, sessile bilateral on the back of the tongue, were surgically removed in a 65-year-old male patient. Thereby two different methods of treatment were compared. On the right side of the back of the tongue, excision by scalpel, as the gold standard treatment modality, was performed. On the left side a surgical removal by a CO2 laser was performed. In a photothermal procedure, without direct contact to the tissue, the laser beam is cutting through the mucosa. Secondary wound healing can take place. Both methods were compared in relation to their application, wound healing, quality of the biopsy and morbidity. Postoperative less discomfort and a slightly faster wound healing could be seen after scalpel removal. The histopathological examination was comparable for both methods.

The aim of the treatment of this case was to restore the form, function and aesthetics of all teeth in a patient with amelogenesis imperfecta within the age limit of the disability insurance (IV). Single-tooth zirconia crowns were selected as the treatment of choice and cemented with a conventional glass ionomer cement. For the maintenance of the oral rehabilitation and the protection of the reconstructions a michigan splint was produced and instructed to be carried over night.

GSK-3 inhibitors, such as Tideglusib (TG) and CHIR-99021 (CHIR), show promise in stimulating reparative dentin formation. The aim of this study was to assess the discoloration potential of TG and CHIR in an established in vitro model. Enamel-dentin specimens made from bovine incisors were randomly allocated to five groups (n=15 each): group bovine blood (BB), group dimethyl sulfoxide (DMSO), group TG, group CHIR, and group mineral trioxide aggregate (MTA). Each specimen had a central cavity in which the respective material was applied and sealed with resin-based luting material. Color determination was conducted using a dental spectrophotometer at t0 (before filling), t1 (immediately after filling), t2 (after one week), t3 (after one month), t4 (after three months), t5 (after six months), and t6 (after one year). Statistical analysis involved descriptive statistics, Kruskal-Wallis tests, and analysis of variance (α=0.05). Group BB and group CHIR exhibited the most significant decrease in lightness (ΔL*) after one year (ΔL*-4.7 and ΔL* -5.7, respectively), whereas groups DMSO, TG, and MTA showed minimal changes (DMSO ΔL*: -0.3; TG ΔL*: 1.4; MTA ΔL*: -0.5). Group BB and CHIR exhibited the highest ΔE values (6.4Å}0.6 and 6.5Å}0.8, respectively). Unlike CHIR, TG did not result in discoloration exceeding the threshold of visual perception, defined by a ΔE value of 5.5, during the one-year observation period. This laboratory study therefore suggests that TG could be utilized for indirect or direct pulp capping without major discoloration concerns. However, additional research is required to corroborate these findings.

The objective of this retrospective study was to analyze the effect of the intensity modulated radiotherapy (IMRT) of the head and neck region on root canal-treated teeth and their periapical changes due to radiation. Patients undergoing IMRT of the head and neck region were evaluated. Different types of teeth (molars, premolars, incisors and canines) were compared. Panoramic and dental radiographs were used to assess the periapical region of root canal-treated teeth using the periapical index (PAI) before and after radiotherapy (RT) and put in relation to the radiation dose per tooth. Further parameters (patient-, therapy- and tooth-related factors) were included in this study. One hundred and twenty-four root canal-treated teeth (maxilla and mandible) of 51 patients were observed. A radiolucency in the periapical region was seen in 34.7% of the samples before IMRT and an increasing number of 46% after IMRT (p-value 0.092). Clinical or radiological signs of osteoradionecrosis could not be determined. The only statistically significant difference was detected in regions irradiated with less than 40 Gy (p-value 0.045). In regions irradiated with higher doses (>40 Gy), comparable pathologies increased in non-significant numbers. A statistically significant increase of periapical pathologies was detected in premolars of the maxilla. The observations reported here suggest that a high radiation dose during IMRT has no significant consequences on root canal-treated teeth. To compare the success of endodontic treatment before versus after IMRT, further research needs to be done.

This study aimed to evaluate toothbrushing practices and toothpaste dosing among preschool children aged 0-6 years in Switzerland recruited from the Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, and in daycare centers or in private practices located in the canton of Berne. Three hundred parents of children were surveyed about socioeconomic characteristics, their children's toothbrushing behavior, the use of age-appropriate toothpaste, and whether they were instructed by an oral healthcare professional about appropriate toothbrushing practices and the amount of toothpaste to use. Additionally, the parents were asked to apply toothpaste to two different toothbrushes, one with a narrow and one with a wide brush head, as they usually would at home. The amount of toothpaste was weighed using a portable scale. Over 50% of the parents were not instructed by an oral health care professional on toothbrushing practices and toothpaste dosing. However, nearly all participants used age-appropriate toothpaste. Approximately 50% of the parents of 0- to 2-year-old children applied more than the recommended 0.25 g of fluoridated toothpaste (both brushes, mean ± SD: 0.25 g ± 0.14 g), while two-thirds of the parents of 2- to 3-year-olds (both brushes, mean ± SD: 0.36 g ± 0.23 g) and nearly 90% of the parents of 3- to 6-year-olds applied more than 0.25 g (both brushes, mean ± SD: 0.43 g ± 0.20 g). Overall, parents dispensed more toothpaste on the toothbrush with the wide brush head. The present study suggested that assuming toothpaste as the sole source of fluoride, the amounts generally used are not of concern. However, considering the substantial variation in the amounts of toothpaste applied, oral healthcare professionals should routinely provide instructions on toothbrushing practices and toothpaste dosing during children's dental examinations.

Antimicrobial resistance (AMR) is a significant global health threat that arises from the excessive and incorrect use of antibiotics. As key players in the evolution of AMR, medical and dental practitioners are often questioned on their indications for antibiotic prescription during daily practice. The present survey aimed to evaluate self-reported practices regarding systemic antibiotic prescription among Swiss dentists in Romandy. An electronic questionnaire was sent to 331 dentists working in the French-speaking part of Switzerland and the responses were analyzed on a three-point Likert scale. The response rate was 28%. Results showed that the main indications for antibiotic use were abscesses with systemic symptoms (89%), cellulitis (81.5%), acute sinusitis (62%) and necrotizing periodontitis (52%). Surgical procedures most frequently combined with antibiotics were sinus floor elevation (59.8%) and implant placement (60.9%). Amoxicillin was the first-choice antibiotic, and clindamycin was mostly prescribed for patients with a penicillin allergy (87%). The majority of dentists recommended prophylaxis with 2g of amoxicillin, one hour before the procedure for patients with a high risk of endocarditis (82.6%), immunodeficiency / immunosuppression (50%), or joint replacement during the last year (47.8%). Most participants (76.1%) expressed the need for specific guidelines on the use of antibiotics in dentistry. The research findings suggested antibiotic prescriptions in dentistry could profit from stricter guidelines.

The radicular cyst is the most common odontogenic cyst and is caused by inflammation. It can become atypically large, although the size of the radiographic osteolysis says nothing about the entity of the lesion. This case shows an unusually large multilocular radicular cyst expanding buccally from tooth 46 in a patient with severe autism who can only be treated under general anesthesia. The clinical and radiological picture as well as the intraoperative situation was more indicative of an aggressive cyst or benign tumor. The lesion was surgically completely removed and the teeth 46, 47 and 48 were extracted because of poor compliance and prognosis. Histopathology revealed a radicular cyst. There were no postoperative complications. After eight months, the lesions had almost completely reossified.