Saudi Dental Journal最新文献

Background

Temporary anchorage devices (TADs) address challenges in traditional orthodontic anchorage like patient compliance and precision, showing significantly improved clinical outcomes, particularly for cases requiring maximum anchorage.

Materials and Methods

A systematic electronic search was performed in five research databases, focusing on studies published between 2015 and 2023. The ROBINS-I tool from the Cochrane Bias Methods Group assessed the risk of bias. Data analysis included categorical and numerical variables, with categorical variables analyzed using Cohen’s method in a random effects model to account for variability. Sensitivity and heterogeneity were evaluated using a ’leave-one-out’ approach and the $I^2$ statistic, respectively. At the same time, publication bias was checked using Egger’s test, with findings presented through Forest and Funnel plots. Numerical variables were subjected to weighted regression analysis.

Results

Examination of 15 studies involving 1981 patients and 3272 orthodontic mini-implants identified key factors affecting implant stability. Failure rates varied significantly, influenced by factors such as the characteristics and insertion site of the orthodontic mini-implants (OMIs), patient-specific variables, and operator experience. Notably, the insertion site and implant characteristics like size did not significantly affect failure rates, but there was a negative correlation between the magnitude of force applied and failure rates.

Conclusion

The success of orthodontic mini-implants is broadly consistent across patient demographics and is not significantly impacted by gender or age, though failure rates were higher in males and when implants were placed in the maxilla. These findings suggest that higher applied forces might reduce failure rates.

Clinical Significance

This review underlines mini-implant efficacy across varied patient demographics, emphasizing the importance of site selection, jaw location, and force application in enhancing success rates and guiding tailored treatment strategies.

PROSPERO ID CRD42023411955.

Background and objectives

Derum, the bark of walnut tree (Juglans regia) has been used as a traditional tooth cleanser and chewed for its ability to bestow purple color to oral mucosa, tongue and lips Studies have shown that derum extract could affect oral epithelium after long term exposure, causing dysplasia. The aim of this in-vivo study was to evaluate the degree of epithelial dysplasia caused by varying durations and frequencies of topical derum application on oral mucosa of rabbits.

Materials and Methods

Following ethical approval, derum extract was applied to the buccal vestibule of New Zealand white rabbits over three different periods (60 days, 120 days, 180 days) and two different protocols were used (daily application and once every 3 days). Accordingly, the animals were divided into four groups (A – daily derum application/B – derum applied once in 3 days/C – Positive control and acetone applied every alternate day/D – negative control), and three batches (I – 60 days/II – 120 days/III – 180 days). The animals were sacrificed, and oral biopsies prepared and examined under light microscope. The magnitude of epithelial changes was evaluated using epithelial atypia index (EAI) based on Smith and Pindborg histological grading system (1969) for epithelial dysplasia.

Results

Mild dysplastic changes were detected in animals treated with derum extract regardless of the period of application. Similar results were noted among positive control group, and highest score was recorded in group A followed by group B with high tendency towards long-term derum application. Moderate changes were encountered only in group A that received derum for 180 days. Statistically, long-term derum application (180 days / Batch III in groups A and B), irrespective of the frequency of application, resulted in significantly higher mean EAI scores than all other groups or batches.

Conclusion

Based on this study, prolonged and frequent use of derum can induce dysplastic changes in rabbit oral mucosa, ranging from mild to moderate dysplasia. Further studies with extended times of exposure of derum to oral mucosa are recommended to document these adverse effects as an evidence base.

Introduction

In recent times, proton pump inhibitors (PPI) are frequently prescribed to manage acid reflux and to aid in completion of course of medication, which cause gastric irritation. Although this practice may minimize compliance to drug therapies and probably prevent development of drug resistance, the adverse effects of chronic PPI use have to be assessed. Inadvertent chronic use of PPIs has been found to inhibit normal gastrointestinal microbiome and even bone metabolism. The current study aimed to review available evidence based literature to understand the beneficial effects of PPIs weighed against their adversities with respect to periodontal and peri-implant health.

Materials and Methods

The search strategy was followed according to the PRISMA guidelines for systematic reviews. Proton pump inhibitors, periodontal disease, dental implant (DI) and bone osseointegration were used as key MESH terms to search and select the required articles for review. While primary inclusion criteria were original researches, published in English, between 2014 to till-date, case reports, reviews and editorial communications were excluded.

Results

The overall search strategy resulted in 445 articles. Applying the inclusion and exclusion criteria 37 articles were selected. Scrutinizing the abstracts for relevance, 17 publications were finally selected for review. This included three in vivo animal studies evaluating DI osseointegration and 14 retrospective clinical studies (nine in patients with dental implants, four in patients with periodontitis and one evaluating bone quality using panoramic radiographs).

Conclusion

Findings from this systematic review revealed a plausible relationship between chronic PPI use and poor peri-implant bone health leading to early DI failure, and mandibular osteoporotic changes. On the contrary, use of PPI among patients with periodontitis, resulted in an improvement in periodontal health and reduction in periodontal disease severity.

Background

The placement of immediate dental implants intrinsically displays crestal gaps, which may compromise implant osseointegration. Several grafting materials have been used to overcome this issue. Of the available materials, the use of bone cement is relatively new in oral implantology. This study aimed to examine the available literature on the utilization of bone cements in immediate placement of dental implants and assess its potential in oral implantology.

Objectives

To synthesize evidence for appraising the impact of bone cements on implant stability and bone-to-implant contact (BIC) of dental implants placed immediately after extraction in humans and animals after 3 months of healing from tooth extraction.

Methods

A systematic search was conducted in PubMed, Medline, and ScienceDirect for relevant studies published from inception to September 2021 using relevant search terms. Of the 1624 studies, 4 were selected for this systematic review.

Results

Three of the four studies concluded that bone cements enhanced implant stability and/or BIC with better quality and/or quantity of bone surrounding the immediate dental implant. The conclusion drawn by one article remained indecisive. Meta-analysis could not be performed owing to the presence of substantial heterogeneity.

Conclusion

Bone cement is a promising treatment alternative as it augments implant stability and/or BIC in immediate dental implants. Nonetheless, further prospective human clinical trials are required to establish its clinical effectiveness and arrive at a definitive conclusion to recommend its clinical use.

Objectives

This study aimed to compare the effect of four decontamination methods on the level of residual contaminants in the re-usage of dental healing abutments.

Materials and methods

In this experimental study, 50 used healing abutments were divided into five groups of ten as follows: 1. Control group: healing abutments were submerged in the ultrasonic device then autoclaved at 121 °C for 15 min; 2. Hypochlorite group: Same procedure as the control group, but the healing abutments were additionally immersed in 3 % hypochlorite for 20 min; 3. Chlorhexidine group: Same procedure as the control group, but the healing abutments were additionally treated with 12 % chlorhexidine; 4. Air polishing group: Same procedure as the control group, but the healing abutments were subjected to air polishing; 5. Hydrogen peroxide group: Same procedure as the control group, but the healing abutments were additionally exposed to 3 % hydrogen peroxide. Then, all healing abutments were stained with a protein-specific stain, Phloxine B. Five photographs were taken of each healing abutment, with four capturing the body (shank)and one capturing the top. All images were analysed, to measure the stained (contaminated) areas of each sample. The obtained data were analysed using statistical software (significance set at p < 0.05).

Results

The one-way ANOVA test indicated that the average percentage of contamination residues on the occlusal surface did not show a significant difference among the five groups: control: 5.5 ± 2.8, sodium hypochlorite: 4.9 ± 2.5, Chlorhexidine: 5.3 ± 2.5, air polisher: 3.1 ± 1.8 and Hydrogen peroxide: 4.8 ± 3.1. (p = 0.26). The average percentage of residual contamination on the body surfaces (shank part) was significantly lower in the air polisher (1.7 ± 1.1) and sodium hypochlorite (2.4 ± 1.1) groups compared to the other three groups (Control: 6.1 ± 2.3, Hydrogen peroxide: 4.6 ± 0.7, Chlorhexidine: 5.4 ± 2.4) (p < 0.05).

Conclusion

The results of this study showed that the use of sodium hypochlorite and air polishing, alongside autoclaving and ultrasonic cleaning, effectively reduced residual contamination on the body surfaces of healing abutments.

Background

Various dressing materials have been evaluated for pulpotomy of primary teeth. However, an ideal pulp dressing material has not been identified yet. This systematic review investigated the effectiveness of TheraCal compared to Formocresol in pulpotomy of primary teeth.

Materials and methods

This research was conducted in the form of a secondary study, with a systematic search of texts until 2023 in Scopus, Web of Science, PubMed and Google Scholar databases. The articles were selected based on the inclusion and exclusion criteria and, finally the search results were reported in the PRISMA chart. The quality of the studies was evaluated based on the NIH checklist. The extracted information was entered into Stata17 software. Heterogeneity was evaluated using Cochran’s chi-square test and I² statistics. Egger’s tests were used to detect publication bias.

Results

After removing duplicate articles and articles that did not meet the inclusion criteria, 4 studies were selected for qualitative analysis. The odds’ ratio of success rate between Formocresol and TheraCal pulpotomy for absence of the pain, abscess, Mobility, internal root resorption and bone radiolucency was obtained 1.12 (95 % CI: 0.32, 3.85, P = 0.86), 0.47 (95 % CI: 0.1, 2.14, P = 0.33), 0.82 (95 % CI: 0.21, 3.21, P = 0.78), 0.89 (95 % CI: 0.3, 2.67, P = 0.84), and 1.96 (95 % CI: 0.68, 5.62, P = 0.21) respectively.

Conclusion

The study results revealed that there was no significant difference in clinical and radiographic success between pulpotomy with TheraCal and Formocresol.

Objectives

We investigated which type of orthopantomography (OPG) was best able to predict neurological alterations of the inferior alveolar nerve (IAN) during extraction of a lower third molar (3 M).

Methods

We analysed cone beam computed tomographies (CBCTs) that were performed at a private dental clinic in Cartagena, Spain over five consecutive years. The CBCTs, together with their corresponding OPGs, had been prescribed for the surgical extraction of a lower 3 M.

Results

We analysed a total of 342 CBCTs and their corresponding OPGs. After explaining the risk of changes in the IAN sensitivity, 37 patients refused to undergo surgical extraction. The incidence of sensitivity alterations in the 332 dental extractions was 62 (19%): 44 were paraesthesias of the IAN, and 18 were associated with darkening of the root and interruption of the cortical line.

Conclusion

When an OPG revealed darkening of the root and interruption of the cortical line, the risk of contact between the lower 3 M and the IAN—that is, the probability of changes in IAN sensitivity—increased by over three-fold.

Purpose

The aim of this study was to compare the efficacies levels of four cleaning solutions for removing debris from rotary Nickel-Titanium (Ni–Ti) endodontic instruments.

Materials and methods

Twelve instruments that fractured during ex vivo instrumentation were used. Fractured surfaces were investigated by SEM before and after 3, 6 and 9 min of ultrasonic cleaning in 17 % EDTA.3NaOH (Group A), 2.5 % NaOCl (Group B), Dentasept 3H Rapide (Group C) and ZymeX™ (Group D) solutions. EDS analyses of selected files from all four groups of untreated and ultrasonically cleaned samples were performed to assess the elemental composition of the alloy surfaces.

Results

SEM analysis revealed that after 9 min of ultrasonic agitation, all four investigated solutions had cleaned fractured surfaces. However, some low-atomic-number regions exhibited random distributions on the fractured surfaces. EDS analyses indicated that only C was retained on surface after 9 min of ultrasonic cleaning. This finding was common in all tested groups.

Conclusions

All four investigated solutions substantially removed debris from the surfaces of the Ni–Ti files and were considered appropriate for clinical practice.

Phytic acid (inositol hexaphosphate/IP6) is a versatile chemical that is abundant in nature and is required for a variety of biological processes. It is harnessed in a wide range of fields, including drug discovery, daily supplies, chemical industries, medicine, and dentistry. IP6 is becoming increasingly popular in dentistry, with promising results. Several properties, such as cariostatic ability, beneficial impact on enamel disintegration, and anti-plaque, anti-tartar, and dental adhesive-forming properties, have been investigated thus far. Due to many constraints in the literature, there was a point in time when IP6 received less attention, which impacted knowledge in this field. Nevertheless, the positive outcomes of the flourishing of IP6 have recently been reconsidered from a number of papers that have improved our understanding of its modes of action in the aforementioned applications. The role of phytic acid in refining the properties and manoeuvring of dental resources is being investigated in novel endeavors in treating diseases of pulp and tissues supporting tooth structure, but to show its novel therapeutic potential, more precisely calibrated clinical trials are needed. This review examines and discusses the various uses proposed in the literature, as well as the applications of IP6 in dentistry.