A. Guida, A. Carotenuto, Vladimiro Lanza, F. Antonucci, Paola Salerno, Dario Marasca, Umberto Esposito, M. Gargiulo
Understanding the impact of the COVID-19 pandemic on dental emergencies. A systematic review of the literature (PubMed/Scopus) searching for articles on COVID-19 and dental abscess and a retrospective cohort study with quantitative/qualitative data analysis of our hospital E.R. patients admitted for cervico-facial abscess of dental origin were performed. Thirteen studies could be included in the review, concerning characteristics/management of patients with dental emergencies in hospitals/private practices, generally with poor evidence. For the retrospective analysis, 232 consecutive patients were included (100 study vs. 132 control). The prevalence of dental emergencies (abscess) and relative complications (mediastinitis, exitus) increased. Dental care availability was limited, with strong heterogeneity amongst regions/nations. At-risk (aerosol-generating) procedures were generally avoided, and hospitalization length reduced. Comorbidity patients and males seem less likely to restore regular dentist attendance during the post-lockdown pandemic. Despite the poor scientific evidence, COVID-19 seems to have impacted dental emergencies through limited routine dental care availability and influence on physicians’ and patients’ behaviour.
{"title":"Dental Emergencies and Coronavirus Disease-2019: Scoping Review of the Literature and Single Centre Experience","authors":"A. Guida, A. Carotenuto, Vladimiro Lanza, F. Antonucci, Paola Salerno, Dario Marasca, Umberto Esposito, M. Gargiulo","doi":"10.3390/dj10050091","DOIUrl":"https://doi.org/10.3390/dj10050091","url":null,"abstract":"Understanding the impact of the COVID-19 pandemic on dental emergencies. A systematic review of the literature (PubMed/Scopus) searching for articles on COVID-19 and dental abscess and a retrospective cohort study with quantitative/qualitative data analysis of our hospital E.R. patients admitted for cervico-facial abscess of dental origin were performed. Thirteen studies could be included in the review, concerning characteristics/management of patients with dental emergencies in hospitals/private practices, generally with poor evidence. For the retrospective analysis, 232 consecutive patients were included (100 study vs. 132 control). The prevalence of dental emergencies (abscess) and relative complications (mediastinitis, exitus) increased. Dental care availability was limited, with strong heterogeneity amongst regions/nations. At-risk (aerosol-generating) procedures were generally avoided, and hospitalization length reduced. Comorbidity patients and males seem less likely to restore regular dentist attendance during the post-lockdown pandemic. Despite the poor scientific evidence, COVID-19 seems to have impacted dental emergencies through limited routine dental care availability and influence on physicians’ and patients’ behaviour.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"EM-24 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84527865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masahiko Okubo, Ryutaro Kuraji, Hideyuki Kamimura, Y. Numabe, Ko Ito, Tsuyoshi Sato, S. Kokabu
Background: Necrotizing periodontitis (NP) is a reactive and destructive inflammatory process that occurs in response to bacterial infection. Predisposing factors such as compromised host immune responses contribute significantly to NP pathogenesis. NP occasionally progresses to a more advanced and life-threatening state. Case presentation: A 73-year-old man in need of nursing care visited our dental clinic with severe gingival pain and intraoral bleeding. He had a disability and was immunocompromised because his medical history included cerebral infarction and type 2 diabetes mellitus. He was diagnosed with NP based on his typical symptoms, such as prominent bleeding and suppurative discharge from the gingiva, in addition to crater-shaped ulcerations of the interdental papillae. To improve daily oral hygiene, periodontists, dentists, and dental hygienists educated care workers and other staff at the nursing home on appropriate oral cleansing, including brushing three times a day using the Bass technique. Basic periodontal therapy, including whole-mouth scaling and debridement of the root surfaces using hand and ultrasonic instruments, was also performed. After this basic treatment of NP, we extracted the hopeless teeth. Currently, dentists visit the patient fortnightly to manage his oral hygiene. To date, good oral health has been maintained.
{"title":"A Case of Necrotizing Periodontitis in a Care-Requiring Elderly Person Treated and Managed by Interprofessional Collaboration","authors":"Masahiko Okubo, Ryutaro Kuraji, Hideyuki Kamimura, Y. Numabe, Ko Ito, Tsuyoshi Sato, S. Kokabu","doi":"10.3390/dj10050079","DOIUrl":"https://doi.org/10.3390/dj10050079","url":null,"abstract":"Background: Necrotizing periodontitis (NP) is a reactive and destructive inflammatory process that occurs in response to bacterial infection. Predisposing factors such as compromised host immune responses contribute significantly to NP pathogenesis. NP occasionally progresses to a more advanced and life-threatening state. Case presentation: A 73-year-old man in need of nursing care visited our dental clinic with severe gingival pain and intraoral bleeding. He had a disability and was immunocompromised because his medical history included cerebral infarction and type 2 diabetes mellitus. He was diagnosed with NP based on his typical symptoms, such as prominent bleeding and suppurative discharge from the gingiva, in addition to crater-shaped ulcerations of the interdental papillae. To improve daily oral hygiene, periodontists, dentists, and dental hygienists educated care workers and other staff at the nursing home on appropriate oral cleansing, including brushing three times a day using the Bass technique. Basic periodontal therapy, including whole-mouth scaling and debridement of the root surfaces using hand and ultrasonic instruments, was also performed. After this basic treatment of NP, we extracted the hopeless teeth. Currently, dentists visit the patient fortnightly to manage his oral hygiene. To date, good oral health has been maintained.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83528198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Deeban, K. Moharamzadeh, Moosa Abuzayeda, N. Martin
Background: This study aimed to develop a tooth wear classification system that combined the extent, severity, and aesthetic impact of tooth wear and correlated them with the most appropriate clinical management strategy. Methods: Three hundred photographs were used to develop a classification tool that contained four levels of severity and aesthetic impact (0, 1, 2, and 3) in three age groups of patients. Ten examiners assessed and classified the cases using validated forms. Additionally, they selected the recommended treatment modality for each level. The analysis was conducted using a coefficient correlation test. Results: The coefficient correlation for the severity was 0.81, 0.82 in the upper anterior and posterior segments, and 0.85 and 0.77 for the lower anterior and posterior segments, respectively. The aesthetic impact correlation coefficient was 0.84. Examiners had agreed that minor cases required monitoring or simple restorative interventions. The moderate-level cases had variety in the recommended management options depending on the aim of treatment. The severe level cases often required rehabilitation at an increased occlusal vertical dimension. Conclusion: Within the limitations of this preliminary study, a good agreement between the examiners was found using the provided tools. More strict criteria in the classification part of the tool can further improve the examiners’ agreement.
{"title":"Development of a Clinically Relevant Index for Tooth Wear Treatment Needs","authors":"Y. Deeban, K. Moharamzadeh, Moosa Abuzayeda, N. Martin","doi":"10.3390/dj10050080","DOIUrl":"https://doi.org/10.3390/dj10050080","url":null,"abstract":"Background: This study aimed to develop a tooth wear classification system that combined the extent, severity, and aesthetic impact of tooth wear and correlated them with the most appropriate clinical management strategy. Methods: Three hundred photographs were used to develop a classification tool that contained four levels of severity and aesthetic impact (0, 1, 2, and 3) in three age groups of patients. Ten examiners assessed and classified the cases using validated forms. Additionally, they selected the recommended treatment modality for each level. The analysis was conducted using a coefficient correlation test. Results: The coefficient correlation for the severity was 0.81, 0.82 in the upper anterior and posterior segments, and 0.85 and 0.77 for the lower anterior and posterior segments, respectively. The aesthetic impact correlation coefficient was 0.84. Examiners had agreed that minor cases required monitoring or simple restorative interventions. The moderate-level cases had variety in the recommended management options depending on the aim of treatment. The severe level cases often required rehabilitation at an increased occlusal vertical dimension. Conclusion: Within the limitations of this preliminary study, a good agreement between the examiners was found using the provided tools. More strict criteria in the classification part of the tool can further improve the examiners’ agreement.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"21 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90980074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Spinas, G. Di Giorgio, M. Murgia, V. Garau, M. Pinna, N. Zerman
(1) Background: Traumatic dental injuries constitute a major global health problem. Primary deciduous teeth of the upper frontal group are frequently affected by trauma, especially at an early age. It is important to treat primary traumatic injuries because early tooth loss can lead to aesthetic and functional alterations. The most common injuries are extrusion, lateral luxation, and intrusion. Root fracture is a less common complication that can lead to tooth extraction if not properly diagnosed and managed. However, there are a lack of data regarding primary root fracture treatment. The literature was reviewed to study the current knowledge on the treatment of these injuries, and to propose an operative protocol based on the results obtained. (2) Methods: A literature search was performed on Web of Science, PubMed/MEDLINE, and SCOPUS. The research focused on the following features: age of the patient; localization of the root fracture and type of displacement suffered (intrusive, extrusive, or lateral); type of emergency treatment or diagnostic test performed and their compliance with IADT guidelines; follow-up duration. (2) Results: Only 8 articles fully met the inclusion criteria, with a total of 46 patients and 62 root fractures. Out of a total of 62 root fractures, regarding only upper incisors, the most common treatment was splinting (n = 39) for a period ranging from 3 weeks to 3 months (with an average of six weeks). No treatment was performed for 23 of the root fractures. The splinting performed in most of the included cases was semi-rigid, with the splint held in place using a composite resin material. An orthodontic splint using brackets and 0.5 mm stainless steel wire was used in only in one study. (4) Conclusions: We deduced that the root fracture of primary teeth is a rare traumatic dental injury that can cause numerous complications, such as eruptive problems in the permanent teeth. Correct radiological diagnosis, immediate repositioning and semi-rigid splinting could be conservative methods to prevent premature tooth loss in very young patients.
(1)背景:外伤性牙齿损伤是一个重大的全球健康问题。上额组乳牙经常受到外伤的影响，尤其是在早期。治疗原发性创伤性损伤是很重要的，因为早期牙齿脱落会导致美观和功能的改变。最常见的损伤是挤压、外侧脱位和侵入。牙根断裂是一种不常见的并发症，如果诊断和处理不当，可能导致拔牙。然而，缺乏关于主牙根骨折治疗的资料。我们回顾了文献，研究了目前治疗这些损伤的知识，并根据所获得的结果提出了一个手术方案。(2)方法:在Web of Science、PubMed/MEDLINE、SCOPUS上进行文献检索。研究重点关注以下特征:患者的年龄;牙根骨折的定位和移位类型(侵入性、挤压性或外侧性);所进行的紧急治疗或诊断测试的类型及其是否符合IADT指南;后续的持续时间。(2)结果:只有8篇文章完全符合纳入标准，共46例患者，62例牙根骨折。在总共62例牙根骨折中，仅上门牙，最常见的治疗方法是夹板(n = 39)，持续时间为3周到3个月(平均为6周)。23例根骨折未进行治疗。在大多数病例中，夹板是半刚性的，夹板使用复合树脂材料固定。仅在一项研究中使用了使用托架和0.5 mm不锈钢丝的正畸夹板。(4)结论:乳牙牙根断裂是一种罕见的外伤性牙损伤，其并发症较多，如恒牙的出牙问题。正确的放射学诊断，立即复位和半刚性夹板可以预防非常年轻的患者过早脱落牙齿的保守方法。
{"title":"Root Fractures in the Primary Teeth and Their Management: A Scoping Review","authors":"E. Spinas, G. Di Giorgio, M. Murgia, V. Garau, M. Pinna, N. Zerman","doi":"10.3390/dj10050074","DOIUrl":"https://doi.org/10.3390/dj10050074","url":null,"abstract":"(1) Background: Traumatic dental injuries constitute a major global health problem. Primary deciduous teeth of the upper frontal group are frequently affected by trauma, especially at an early age. It is important to treat primary traumatic injuries because early tooth loss can lead to aesthetic and functional alterations. The most common injuries are extrusion, lateral luxation, and intrusion. Root fracture is a less common complication that can lead to tooth extraction if not properly diagnosed and managed. However, there are a lack of data regarding primary root fracture treatment. The literature was reviewed to study the current knowledge on the treatment of these injuries, and to propose an operative protocol based on the results obtained. (2) Methods: A literature search was performed on Web of Science, PubMed/MEDLINE, and SCOPUS. The research focused on the following features: age of the patient; localization of the root fracture and type of displacement suffered (intrusive, extrusive, or lateral); type of emergency treatment or diagnostic test performed and their compliance with IADT guidelines; follow-up duration. (2) Results: Only 8 articles fully met the inclusion criteria, with a total of 46 patients and 62 root fractures. Out of a total of 62 root fractures, regarding only upper incisors, the most common treatment was splinting (n = 39) for a period ranging from 3 weeks to 3 months (with an average of six weeks). No treatment was performed for 23 of the root fractures. The splinting performed in most of the included cases was semi-rigid, with the splint held in place using a composite resin material. An orthodontic splint using brackets and 0.5 mm stainless steel wire was used in only in one study. (4) Conclusions: We deduced that the root fracture of primary teeth is a rare traumatic dental injury that can cause numerous complications, such as eruptive problems in the permanent teeth. Correct radiological diagnosis, immediate repositioning and semi-rigid splinting could be conservative methods to prevent premature tooth loss in very young patients.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"23 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84838052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Anitua, Naiara Larrazabal Saez de Ibarra, Iñigo Morales Martín, Luis Saracho Rotaeche
The aim of the present study is to assess by means of finite element models the effect on bone stresses of implant length and tilting in single-unit implant restorations. The factors that were analyzed in this study were implant length (4.5, 5.5, and 10 mm), implant titling (0, 17°, 30°, and 45°), bone type (0/I, II, and III), and loading (immediate and delayed). An axial load of 200 N was applied to the occlusal surface of the prosthesis at a height of 11 mm and the Von Mises equivalent stress in the bone was analyzed. Finite element analysis indicated that the most determinant factor was implant tilting. Tilting the implant by 17° doubled the Von Mises stress received by bone. The highest increase was in the case of implant tilting at 45° (by 1300%). The use of extra-short implants did not produce a significant increase in Von Mises stress in bone. Moreover, the length of the implant did not affect the stress value in bone types I and II. Based on the obtained results, an axially placed short implant would be a better option than titling a standard-length implant to support a crown restoration in an atrophic mandible from a biomechanical point of view.
{"title":"Influence of Implant Tilting and Length on the Biomechanics of Single-Tooth Restoration: A Finite Element Analysis in Atrophic Mandible","authors":"E. Anitua, Naiara Larrazabal Saez de Ibarra, Iñigo Morales Martín, Luis Saracho Rotaeche","doi":"10.3390/dj10050077","DOIUrl":"https://doi.org/10.3390/dj10050077","url":null,"abstract":"The aim of the present study is to assess by means of finite element models the effect on bone stresses of implant length and tilting in single-unit implant restorations. The factors that were analyzed in this study were implant length (4.5, 5.5, and 10 mm), implant titling (0, 17°, 30°, and 45°), bone type (0/I, II, and III), and loading (immediate and delayed). An axial load of 200 N was applied to the occlusal surface of the prosthesis at a height of 11 mm and the Von Mises equivalent stress in the bone was analyzed. Finite element analysis indicated that the most determinant factor was implant tilting. Tilting the implant by 17° doubled the Von Mises stress received by bone. The highest increase was in the case of implant tilting at 45° (by 1300%). The use of extra-short implants did not produce a significant increase in Von Mises stress in bone. Moreover, the length of the implant did not affect the stress value in bone types I and II. Based on the obtained results, an axially placed short implant would be a better option than titling a standard-length implant to support a crown restoration in an atrophic mandible from a biomechanical point of view.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"38 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78296719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The assessment of the significance of nitrates ingested with food has undergone a fundamental change in recent years after many controversial discussions. While for a long time, a diet as low in nitrates as possible was advocated on the basis of epidemiological data suggesting a cancer-promoting effect of nitrate-rich diets, more recent findings show that dietary nitrate, after its conversion to nitrite by nitrate-reducing bacteria of the oral microbiota, is an indispensable alternative source for the formation of nitric oxide (NO), which comprises a key element in the physiology of a variety of central body functions such as blood pressure control, defense against invading bacteria and maintenance of a eubiotic microbiota in the gut and oral cavity. This compact narrative review aims to present the evidence supported by clinical and in vitro studies on the ambivalent nature of dietary nitrates for general and oral health and to explain how the targeted adjuvant use of nitrate-rich diets could open new opportunities for a more cause-related control of caries and periodontal disease.
{"title":"On the Role of Dietary Nitrate in the Maintenance of Systemic and Oral Health","authors":"U. Schlagenhauf","doi":"10.3390/dj10050084","DOIUrl":"https://doi.org/10.3390/dj10050084","url":null,"abstract":"The assessment of the significance of nitrates ingested with food has undergone a fundamental change in recent years after many controversial discussions. While for a long time, a diet as low in nitrates as possible was advocated on the basis of epidemiological data suggesting a cancer-promoting effect of nitrate-rich diets, more recent findings show that dietary nitrate, after its conversion to nitrite by nitrate-reducing bacteria of the oral microbiota, is an indispensable alternative source for the formation of nitric oxide (NO), which comprises a key element in the physiology of a variety of central body functions such as blood pressure control, defense against invading bacteria and maintenance of a eubiotic microbiota in the gut and oral cavity. This compact narrative review aims to present the evidence supported by clinical and in vitro studies on the ambivalent nature of dietary nitrates for general and oral health and to explain how the targeted adjuvant use of nitrate-rich diets could open new opportunities for a more cause-related control of caries and periodontal disease.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"11 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82794872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paulo Rafael Esteves Fernandes, Ada Isis Pelaez Otero, Juliana Campos Hasse Fernandes, L. Nassani, R. M. Castilho, G. V. de Oliveira Fernandes
Objectives: This study aimed to compare clinical results between titanium (Ti), zirconia (Zr), or titanium–zirconium (TZ) dental implants and to analyze survival rate (SR), bleeding on probing (BoP), marginal bone loss (MBL), and/or probing depth (PD). Data source: Manual and electronic searches were conducted (PubMed and Web of Science) to identify randomized controlled trials that compared the outcomes of at least two implant types (control and test group) within the same study. The focused question was determined according to the PICOT strategy. Seven studies were included out of 202 research studies initially found. The follow-up periods ranged from 12 to 80 months, and the mean age was from 43.3 to 65.8 years old. The SR for Ti, TZ, and Zr implants ranged from 92.6% to 100%, 95.8% to 100%, and 87.5% to 91.25%, respectively; MBL for Ti, TZ, and Zr implants varied from −1.17 mm to −0.125 mm for Ti, −0.6 mm to −0.32 mm for TZ, and −0.25 mm to −1.38 mm for Zr. Studies showed a low incidence of mucositis and peri-implantitis; however, BoP for Zr was 16.43%, Ti ranged between 10% and 20%, and TZ from 10% to 13.8%. PD for Ti ranged from 1.6 mm to 3.05 mm, TZ was 3.12 mm (only one study), and Zr ranged from 2.21 mm to 2.6 mm. Conclusion: All three types of implants showed similar tissue behavior. However, the TZ group had better results when compared with Ti and Zr for SR, MBL, and BoP, except for PD. Furthermore, the worst SR was found in the Zr implants group.
目的:本研究旨在比较钛(Ti)、氧化锆(Zr)或钛锆(TZ)种植体的临床效果，并分析生存率(SR)、探探出血(BoP)、边缘骨质流失(MBL)和/或探探深度(PD)。数据来源:人工和电子检索(PubMed和Web of Science)进行，以确定在同一研究中比较至少两种种植体类型(对照组和试验组)结果的随机对照试验。重点问题是根据PICOT策略确定的。在最初发现的202项研究中，有7项研究被纳入其中。随访时间12 ~ 80个月，平均年龄43.3 ~ 65.8岁。Ti、TZ和Zr植入物的SR分别为92.6% ~ 100%、95.8% ~ 100%和87.5% ~ 91.25%;Ti、TZ和Zr植入物的MBL变化范围为:Ti为- 1.17 mm至- 0.125 mm, TZ为- 0.6 mm至- 0.32 mm, Zr为- 0.25 mm至- 1.38 mm。研究表明，粘膜炎和种植体周围炎的发生率较低;Zr为16.43%，Ti为10% ~ 20%，TZ为10% ~ 13.8%。Ti的PD范围为1.6 ~ 3.05 mm, TZ为3.12 mm(仅有一项研究)，Zr为2.21 mm ~ 2.6 mm。结论:三种种植体均表现出相似的组织行为。然而，TZ组在SR、MBL和BoP方面的效果优于Ti和Zr组，PD除外。此外，Zr种植体组的SR最差。
{"title":"Clinical Performance Comparing Titanium and Titanium–Zirconium or Zirconia Dental Implants: A Systematic Review of Randomized Controlled Trials","authors":"Paulo Rafael Esteves Fernandes, Ada Isis Pelaez Otero, Juliana Campos Hasse Fernandes, L. Nassani, R. M. Castilho, G. V. de Oliveira Fernandes","doi":"10.3390/dj10050083","DOIUrl":"https://doi.org/10.3390/dj10050083","url":null,"abstract":"Objectives: This study aimed to compare clinical results between titanium (Ti), zirconia (Zr), or titanium–zirconium (TZ) dental implants and to analyze survival rate (SR), bleeding on probing (BoP), marginal bone loss (MBL), and/or probing depth (PD). Data source: Manual and electronic searches were conducted (PubMed and Web of Science) to identify randomized controlled trials that compared the outcomes of at least two implant types (control and test group) within the same study. The focused question was determined according to the PICOT strategy. Seven studies were included out of 202 research studies initially found. The follow-up periods ranged from 12 to 80 months, and the mean age was from 43.3 to 65.8 years old. The SR for Ti, TZ, and Zr implants ranged from 92.6% to 100%, 95.8% to 100%, and 87.5% to 91.25%, respectively; MBL for Ti, TZ, and Zr implants varied from −1.17 mm to −0.125 mm for Ti, −0.6 mm to −0.32 mm for TZ, and −0.25 mm to −1.38 mm for Zr. Studies showed a low incidence of mucositis and peri-implantitis; however, BoP for Zr was 16.43%, Ti ranged between 10% and 20%, and TZ from 10% to 13.8%. PD for Ti ranged from 1.6 mm to 3.05 mm, TZ was 3.12 mm (only one study), and Zr ranged from 2.21 mm to 2.6 mm. Conclusion: All three types of implants showed similar tissue behavior. However, the TZ group had better results when compared with Ti and Zr for SR, MBL, and BoP, except for PD. Furthermore, the worst SR was found in the Zr implants group.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"13 5 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87639763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Mirelli, S. Marino, A. Bovio, Sara Pederielli, C. Dall’Agnola, A. Giannì, R. Biagi
A retrospective analysis was performed with the aim of understanding whether the risk factors showed in the literature for medication-related osteonecrosis of the jaws (MRONJ) in cancer patients are also relevant in osteoporotic patients taking antiresorptive drugs (ARDs). Data were retrospectively pooled from health records of patients on ARDs who requested a dental visit between January 2006 and April 2020 in the Dental Unit at Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of Milan. A total of 434 patients were included. The following variables were collected: sex, age, smoking habit, type of ARD, duration of treatment, route of administration, therapeutic indication, concurrent systemic therapies and pathologies. Statistical analysis confirmed the relevance of chemotherapy, smoking, and immunosuppressive drugs as risk factors. In addition, a higher frequency of MRONJ in osteoporotic patients was reported in our cohort in association with an immunodeficiency disorder of variable origin. In conclusion, the identification of individual risk-profile before dental treatments is crucial for prevention. Anamnesis should include main risk factors, such as immunosuppression, dental extractions, smoking, trauma, and poor dental health. Nevertheless, our suggestion for dental professionals is to conduct a complete medical history of patients who mention long-term per oral therapies with ARDs for osteoporosis. Osteoporotic, as well as cancer patients, may also benefit from periodic monitoring of the ARDs therapy in order to prevent MRONJ.
通过回顾性分析，了解文献中癌症患者药物相关性颌骨坏死(MRONJ)的危险因素是否也与服用抗吸收药物(ARDs)的骨质疏松患者相关。回顾性收集了2006年1月至2020年4月期间在米兰大学Ospedale Maggiore Policlinico基金会Granda IRCCS牙科部门要求牙科就诊的ARDs患者的健康记录。共纳入434例患者。收集以下变量:性别、年龄、吸烟习惯、ARD类型、治疗持续时间、给药途径、治疗指征、并发全身治疗和病理。统计分析证实化疗、吸烟和免疫抑制药物是相关的危险因素。此外，在我们的队列中，骨质疏松症患者中MRONJ的发生率较高，与不同来源的免疫缺陷疾病有关。总之，在牙科治疗前确定个人风险状况对预防至关重要。记忆应包括主要危险因素，如免疫抑制、拔牙、吸烟、创伤和牙齿健康状况不佳。然而，我们对牙科专业人员的建议是对骨质疏松症ARDs长期口服治疗的患者进行完整的病史调查。骨质疏松症和癌症患者也可能受益于定期监测ARDs治疗，以防止MRONJ。
{"title":"Medication-Related Osteonecrosis of the Jaw in Dental Practice: A Retrospective Analysis of Data from the Milan Cohort","authors":"Cristina Mirelli, S. Marino, A. Bovio, Sara Pederielli, C. Dall’Agnola, A. Giannì, R. Biagi","doi":"10.3390/dj10050089","DOIUrl":"https://doi.org/10.3390/dj10050089","url":null,"abstract":"A retrospective analysis was performed with the aim of understanding whether the risk factors showed in the literature for medication-related osteonecrosis of the jaws (MRONJ) in cancer patients are also relevant in osteoporotic patients taking antiresorptive drugs (ARDs). Data were retrospectively pooled from health records of patients on ARDs who requested a dental visit between January 2006 and April 2020 in the Dental Unit at Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico, University of Milan. A total of 434 patients were included. The following variables were collected: sex, age, smoking habit, type of ARD, duration of treatment, route of administration, therapeutic indication, concurrent systemic therapies and pathologies. Statistical analysis confirmed the relevance of chemotherapy, smoking, and immunosuppressive drugs as risk factors. In addition, a higher frequency of MRONJ in osteoporotic patients was reported in our cohort in association with an immunodeficiency disorder of variable origin. In conclusion, the identification of individual risk-profile before dental treatments is crucial for prevention. Anamnesis should include main risk factors, such as immunosuppression, dental extractions, smoking, trauma, and poor dental health. Nevertheless, our suggestion for dental professionals is to conduct a complete medical history of patients who mention long-term per oral therapies with ARDs for osteoporosis. Osteoporotic, as well as cancer patients, may also benefit from periodic monitoring of the ARDs therapy in order to prevent MRONJ.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"33 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86341325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan D'haese, C. Matthys, H. Sahak, Jos Besseler, H. De Bruyn
Denture wearers often complain about jeopardized function and reduced quality of life due to lack of prosthesis’ retention. Implant-retained mandibular overdentures, on two non-connected implants (2IOD) are well-proven solutions to overcome these issues. We prospectively assessed 69 patients and scrutinized clinical records until at least seven years of function. Thirty-six were retained on Locator® Abutments (LA) and thirty-tree on Ball Abutments (BA). Both systems were compared regarding the type, amount, and total cost of required maintenance. One implant was lost, yielding 98.7% survival after seven years. In total, 438 technical issues occurred: 121 (27.35%) in BA and 317 (72.4%) in LA. Out of these, 343 events (78%) were solved chairside: 191 (43.6%) were replacements of retention caps, 113 (25.8%) were minor acrylic repairs, 26 (5.9%) pressure ulcers had to be relieved, and 13 (3%) were related to abutments. LA required 179 insert replacements compared to 12 in the BA group. The overall initial treatment cost was EUR 3850 (base year of the analysis: 2003). The average total maintenance cost in relation to the initial cost for the LA and BA groups was 19.11 (range 0–82.24%) and 18.91% (range 0–113.26%) respectively (p = 0.540). Conclusions: The seven-year maintenance costs for a 2IOD is acceptable when the patient is regularly checked and professionally maintained. Most events are easily solvable chairside, but a few patients required more expensive interventions, regardless of the type of attachment used.
{"title":"Implant-Retained Mandibular Overdentures: Patient-Related Outcome Measurements after Seven Years of Function","authors":"Jan D'haese, C. Matthys, H. Sahak, Jos Besseler, H. De Bruyn","doi":"10.3390/dj10050088","DOIUrl":"https://doi.org/10.3390/dj10050088","url":null,"abstract":"Denture wearers often complain about jeopardized function and reduced quality of life due to lack of prosthesis’ retention. Implant-retained mandibular overdentures, on two non-connected implants (2IOD) are well-proven solutions to overcome these issues. We prospectively assessed 69 patients and scrutinized clinical records until at least seven years of function. Thirty-six were retained on Locator® Abutments (LA) and thirty-tree on Ball Abutments (BA). Both systems were compared regarding the type, amount, and total cost of required maintenance. One implant was lost, yielding 98.7% survival after seven years. In total, 438 technical issues occurred: 121 (27.35%) in BA and 317 (72.4%) in LA. Out of these, 343 events (78%) were solved chairside: 191 (43.6%) were replacements of retention caps, 113 (25.8%) were minor acrylic repairs, 26 (5.9%) pressure ulcers had to be relieved, and 13 (3%) were related to abutments. LA required 179 insert replacements compared to 12 in the BA group. The overall initial treatment cost was EUR 3850 (base year of the analysis: 2003). The average total maintenance cost in relation to the initial cost for the LA and BA groups was 19.11 (range 0–82.24%) and 18.91% (range 0–113.26%) respectively (p = 0.540). Conclusions: The seven-year maintenance costs for a 2IOD is acceptable when the patient is regularly checked and professionally maintained. Most events are easily solvable chairside, but a few patients required more expensive interventions, regardless of the type of attachment used.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"18 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82107703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charalampos Kaddas, Eirini Papamanoli, Y. Bobetsis
Implant soft tissue dehiscences compromise not only the aesthetics of the supported restorations but implant survival in the long run. The aim of this narrative review was to briefly present the causative factors of buccal peri-implant soft tissue dehiscences (PSTDs), how these are classified, and the current therapeutic approaches. Implant malposition and the thin peri-implant phenotype are the two major determinants for the occurrence of PSTDs, but other risk factors have also been identified. The most common surgical procedure for treating PSTDs is the split-thickness coronally advanced flap combined with either a connective tissue graft or acellular dermal matrix materials. However, depending on the class and subtype of the dehiscence, the combination of surgical techniques with modifications in the restoration may further ameliorate the final result. In general, within a five-year follow-up period, most techniques lead to a satisfactory aesthetic result, although full coverage of the implant/abutment surface is not always achievable, especially in more extended lesions.
{"title":"Etiology and Treatment of Peri-Implant Soft Tissue Dehiscences: A Narrative Review","authors":"Charalampos Kaddas, Eirini Papamanoli, Y. Bobetsis","doi":"10.3390/dj10050086","DOIUrl":"https://doi.org/10.3390/dj10050086","url":null,"abstract":"Implant soft tissue dehiscences compromise not only the aesthetics of the supported restorations but implant survival in the long run. The aim of this narrative review was to briefly present the causative factors of buccal peri-implant soft tissue dehiscences (PSTDs), how these are classified, and the current therapeutic approaches. Implant malposition and the thin peri-implant phenotype are the two major determinants for the occurrence of PSTDs, but other risk factors have also been identified. The most common surgical procedure for treating PSTDs is the split-thickness coronally advanced flap combined with either a connective tissue graft or acellular dermal matrix materials. However, depending on the class and subtype of the dehiscence, the combination of surgical techniques with modifications in the restoration may further ameliorate the final result. In general, within a five-year follow-up period, most techniques lead to a satisfactory aesthetic result, although full coverage of the implant/abutment surface is not always achievable, especially in more extended lesions.","PeriodicalId":47284,"journal":{"name":"Open Dentistry Journal","volume":"46 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85884799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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