Swiss dental journal最新文献

Two forms of non-carious dental disorder - ero- sive tooth hard tissue loss and dental erosion - have been increasingly observed in recent years. Dental erosion is the chemical loss of dental hard substances caused by exposure to acids not de- rived from oral bacteria. Mechanical forces from, for example, the tongue, the cheeks or tooth- brushing, increase loss of partly demineralized tooth surfaces and the cumulative loss of dental hard tissue is defined as erosive tooth wear (ETW). Dental hard tissue losses that occur be- cause of very frequent acid exposure, such as through increased vomiting, but without me- chanical stress, are also assigned to tooth erosion. Without prior softening, practically no loss of enamel takes place due to abrasion with the modern Western diet. The present work is a con- tinuation of earlier work. A total of 226 beverag-es, foods, stimulants as well as medicines and mouthwashes were tested for their erosive po- tential on premolars and deciduous molars covered with a human pellicle. The influence of temperature, phosphate and calcium was also investigated in additional experiments. The change in hardness before and after immersion in the respective test substance was measured, and the erosive potential was classified. For each test product, we determined pH and other properties which were possibly related to erosive potential. There were considerable and sometimes surpris- ing differences between the tested products. The addition of phosphate did not influence the ero- sive potential of the liquids, but calcium did. A modified erosion scheme that incorporates these and other new findings is presented.

The restorative treatment of dental hard tissue loss, e.g., due to erosion, and the rehabilitation of the original vertical bite dimension confronts the dentist with problems when implementing the therapy. Traditionally, this therapy is conducted with laboratory-fabricated workpieces made of ceramics which usually require a preparation of the remaining tooth substance and also causes high costs for the patient. Therefore, alternative methods should be considered. This article presents the use of direct adhesive composite restorations as a way of reconstructing a dentition severely altered by erosion. To reconstruct the occlusal surfaces, transfer splints are used that are made on the basis of individual wax-up models. The procedure described is a well-researched and proven method for restoring teeth with erosion-related loss of hard tooth substance. As with all new procedures, there will be a certain learning curve for the practical dentist after which high-quality restorations can be implemented with this technique.

The aim was to evaluate the effect of dissolved calcium and phosphate on dissolution rate of enamel, dentin and compressed hydroxyapatite (HA) in citric acid solution as a function of pH. At pH 2.5, dissolution rate of enamel increased significantly by 6% in 20 mmol/L added calcium but, otherwise, dissolution rates of neither enamel, dentin nor HA were significantly affected by 10 or 20 mmol/L calcium. However, enamel dissolution rate was reduced by > 50 mmol/L calcium. At pH 3.25 and 4.0, 10-20 mmol/L calcium inhibited dissolution of enamel by 29-100% and HA by 65-75% but did not affect dentin dissolution. Phosphate (10 or 20 mmol/L) did not inhibit dissolution of enamel, dentin or HA at any pH, but there were increases in dissolution rate of all three substrates at pH 2.5 and, in one test with dentine (at 20 mmol/L phosphate), at pH 3.25. The results suggest that calcium addition to soft drinks and other acidic products such as medications may reduce erosivity against enamel, provided that pH is not too low; that phosphate would not reduce erosivity against enamel; and that neither calcium nor phosphate at these concentrations would reduce erosivity against dentin.

This article discusses the treatment of tooth structure loss due to erosion using indirect lithium disilicate ceramic restorations. Minimally invasive approaches, in which the eroded teeth are conservatively prepared and restored with minimally invasive restorations, are recommended. Lithium disilicate ceramics are currently the material of choice for this type of treatment as they can withstand maximum occlusal forces in the posterior region. The restorative process should be guided by diagnostic procedures that define the clinical therapeutic goal at the beginning of treatment. Adhesive cementation with the correct protocol is crucial for full mechanical strength of the restoration. At the end of the treatment, in addition to preventive measures, an overnight protective splint is recommended to ensure long-term clinical stability.

Two forms of non-carious dental disorder - erosive tooth hard tissue loss and dental erosion - have been increasingly observed in recent years. Dental erosion is the chemical loss of dental hard substances caused by exposure to acids not derived from oral bacteria. Mechanical forces from, for example, the tongue, the cheeks or toothbrushing, increase loss of partly-demineralized tooth surfaces and the cumulative loss of dental hard tissue is defined as erosive tooth wear (ETW). Dental hard tissue losses which occur because of very frequent acid exposure, such as through increased vomiting, but without mechanical stress, are also assigned to tooth erosion. Without prior softening, practically no loss of enamel takes place due to abrasion with the modern Western diet. The present work is a continuation of earlier work. A total of 226 beverages, food, stimulants as well as medicines and mouthwashes were tested for their erosive potential on premolars and deciduous molars covered with a human pellicle. The influence of temperature, phosphate and calcium was also investigated in additional experiments. The change in hardness before and after immersion in the respective test substance was measured and the erosive potential was classified. For each test product, we determined pH and other properties which were possibly related to erosive potential. There were considerable and sometimes surprising differences between the tested products. The addition of phosphate did not influence the erosive potential of the liquids, but calcium did. A modified erosion scheme is presented, which incorporates these and other new findings.

The aim of this scoping review was to identify clinical guidance for maintaining oral hygiene in patients undergoing chemotherapy, radiation therapy, or both. Electronic searches were conducted in PubMed, Embase, Cochrane Library, and Google Scholar for articles published between January 2000 and May 2020. Systematic reviews, meta-analyses, clinical trials, case series, and expert consensus reports were considered eligible for inclusion. The SIGN Guideline system was used to evaluate the level evidence and the grade of recommendations. A total of 53 studies met the eligibility criteria. The results showed the presence of recommendation for oral care in three domains: management of oral mucositis, prevention and control of radiation caries, and management of xerostomia. However, most of the included studies had low levels of evidence. The review provides recommendations for healthcare professionals caring for patients undergoing chemotherapy, radiation therapy, or both, but a standard oral care protocol could not be established owing to a paucity of evidence-based data.

Oral mucoceles are cystic changes in the minor salivary glands caused by traumatic damage to the salivary gland ducts or their obstruction with subsequent salivary congestion. In extravasation mucocele, saliva leaks from the ruptured duct into the surrounding tissue and causes a local inflammatory reaction. Thus, histopathologically, granulation tissue is seen around the salivary fluid, but no epithelial lining.

This evaluation assessed the influence of a new implant shoulder design on cleanability using a now established in-vitro study model. Eight test (Botticelli, Di Meliora AG, Basel, Switzerland) and eight control implants (T3 Osseotite, ZimVie, Winterthur, Switzerland), were embedded in standardized defects in simulated bone. The implant surfaces were painted to be visually distinguishable and debrided with ultrasonic instruments (US) and an air powder waterjet device (AIR). Uncleaned implants served as positive controls. After the standardized cleaning, the implants were photographed and divided into three zones (upper marginal shoulder zone (A); lower marginal shoulder zone (B); fully threaded sub-shoulder zone (C)), and analyzed with an image processing software. On test implants, AIR was almost 100% efficacious compared to 80-90% with US, in both upper zones (A/B). In control implants, results of both AIR and US were almost 100% in zone A, but only 55-75% in zone B. In both implants, AIR showed statistically significant higher efficacy than US (P<0.05). Within the limitations of the present in-vitro model, a new macro-structured micro-rough dental implant shoulder with a new coronal vertical groove design shows similar cleanability in comparison to a smooth and machined surface.

The present report exemplifies a translational method, which could assist the clinical preevaluation of patients at risk before surgical interventions. In this study, a presurgical implant decision in a case of SAPHO (synovitis, acne, palmoplantar pustulosis, hyperostosis, osteitis) is described. Since the etiology of this syndrome is likely to involve genetic, infectious and immunological components, lipopolysaccharides (LPS) may conceptually trigger cytokine production leading to a specific chronic inflammation and immunological host response. This may hamper proper healing or accentuate the destruction of periodontal host tissues. In our approach, we examined the ex vivo cell viability and immune responses of primary osteoblasts and keratinocytes under sterile inflammation induced by P. gingivalis LPS. Keratinocytes and osteoblasts were obtained from biopsies of the keratinized gingiva and alveolar bone tissues of a SAPHO human subject. Enzymatically dissociated cells were thus cultured and incubated to LPS at different concentrations (50ng/ml, 200ng/ml, 500ng/ml and 1μg/ml) for 24 h in order to test inflammatory cytokine response (quantitative real time PCR) and toxicity (cell viability). Healthy primary keratinocytes and osteoblasts were used as control cells. The highest concentration of LPS (1μg/ml) significantly reduced cell viability (p < 0.05). Meanwhile, all tested LPS concentrations similarly enhanced the mRNA expressions of selected inflammatory cytokines (TNFα, IL-6, IL-8, IL-1β and IL-1𝛼) up to ≈3.5-fold, when compared to the healthy cell controls (p < 0.05). This study demonstrated a valuable inflammatory risk evaluation before implant placement, which was successfully performed based on the presented laboratory diagnostic/prognostic approach.Sapho.

Imposing redness and swelling of the gingiva repeatedly cause uncertainty in the dental practice. Insufficient oral hygiene plays a dominant modifying role here. An intensive oral hygiene protocol as an initial screening procedure can therefore often prevent complex diagnostic or therapeutic steps.