Acta Stomatologica Croatica最新文献

Objectives: The aim of this cross-sectional survey was to investigate clear aligner therapy (CAT) practices and protocols among orthodontic specialists in the Republic of Croatia.

Materials and methods: The modified version of a previously published questionnaire s was distributed online to 180 orthodontists. It included 46 open- and closed-ended questions across 11 sections, covering demographics, clinical use of CAT, aligner preferences, digital treatment planning (DTP), indications, protocols, interproximal reduction (IPR), refinements, retention, patient-reported issues, and overall perceptions. Respondents not using CAT were directed to a separate section on non-use.

Results: The majority of respondents (88%) reported using CAT in clinical practice, although only 10% of their annual cases involved CAT. Adults were more common patient group (57.9%), and the main indication was mild to moderate crowding. Invisalign was the most frequently used aligner system (58.7%), primarily chosen for the quality of digital treatment planning (DTP) and sophistication of product features. Two-thirds of the respondents reported modifying the digital treatment plan, particularly by adjusting the final tooth position. Refinement was performed in 50% of the cases. IPR was included in 80% of the initial treatment plans and only 20% of the refinement phases. Finally, 52.6% of orthodontists considered CAT to be superior to conventional fixed appliance therapy.

Conclusions: CAT is widely used by orthodontists in Croatia, primarily for mild cases. Nevertheless, aligners are still not perceived as producing superior outcomes compared with fixed appliances.

Background: Dental sexual dimorphism, particularly in maxillary canines, is one of the most reliable markers for sex determination in forensic and anthropological contexts. With the advent of cone beam computed tomography (CBCT), more accurate and population-specific morphometric data can be obtained.

Objective: This study aimed to measure sexual dimorphism in maxillary canine crown sizes in the Kosovo population using cone beam computed tomography (CBCT) scans. It also assessed the potential for determining sex in forensic cases.

Materials and methods: A retrospective analysis was conducted on CBCT scans from 60 subjects (30 males, 30 females) aged 18-30 years at the University Clinical Center of Kosovo. Mesiodistal (MD) and vestibularoral (VO) crown dimensions were measured. Statistical analyses included descriptive statistics, independent t-tests, Cohen's d effect sizes, and sexual dimorphism percentages calculated using the Garn and Lewis formula.

Results: All parameters showed significant sexual dimorphism (p < 0.001), with males exhibiting larger crown sizes. The highest dimorphism was observed in the left canine VO dimension (8.92%), followed by the right canine VO (8.87%). Average sex differences ranged from 0.597-0.724 mm, with large effect sizes (Cohen's d: 1.166-1.435). Bilateral correlations were strong for both MD and VO measurements (r = 0.961-0.966).

Conclusions: Maxillary canines exhibit pronounced sexual dimorphism in the Kosovo population, with VO dimensions showing slightly greater discriminatory potential than MD. These findings highlight their value in forensic sex determination and provide population-specific reference data for Kosovo.

Objective: The aim of this study was to understand perceptions of faculty and student representatives on existing virtual reality (VR) technologies that are being integrated into U.S. dental school curriculum.

Methods: Two validated (face and content) instruments were used for this cross-sectional study. National representatives (68 students and 68 Academic Deans) from U.S. dental schools were invited to participate in the Qualtrics surveys. The surveys were segmented into four parts: general information, knowledge about VR, institutional experience with VR, perception of VR's importance.

Results: Faculty and student representatives from 30 dental schools (44%) participated in the study. Students and faculty unanimously agreed that VR technology should be integrated in the dental school curriculum. Some faculty with prior VR exposure perceived the greatest advantage of VR to be standardization and objectivity (55%, n=12). Students agreed with the faculty regarding the advantages of VR, but found the repeatability to be of greater importance (63%, n=5). The greatest limitation mentioned by faculty was cost, while students mentioned other limitations.

Conclusion: The current study highlighted the differences and similarities in the faculty and students' perspective on the current use of VR in dentistry. The findings indicate that VR offers meaningful advantages for curricular integration, particularly by enabling standardized, objective assessment of learner performance and repeatable skill practice under controlled conditions. In the future, a mixed-methods study design is recommended to investigate further and to confirm the current findings.

Objectives: This study evaluated the effects of propolis extract on dental enamel following tooth bleaching with 35% hydrogen peroxide (HP).

Materials and methods: Sixty bovine enamel specimens were divided into six groups: Artificial Saliva (Control); Whiteness HP35% (HP35%); Whiteness HP35% + potassium nitrate desensitizer (HP35%+KF); Whiteness HP35% + potassium nitrate desensitizer + propolis extract (HP35%+KF+P); Whiteness HP35% + neutral fluoride + propolis extract (HP35%+F+P); and Whiteness HP35% + propolis extract (HP35%+P). The in-office bleaching protocol consisted of three sessions (3 × 15 minutes). Color change (ΔE*, ΔE₀₀, ΔWID), surface roughness (Ra), and microhardness (KHN) were evaluated at baseline (T₁) and after 24 hours (T₂). Color parameters were analyzed using generalized linear models (p ≤ 0.05), and Ra and KHN were assessed using a generalized linear mixed model for repeated measures (p ≤ 0.05).

Results: All HP-treated groups showed significantly greater color change compared to the control group. Surface roughness increased after bleaching; however, groups treated with desensitizers, fluoride, and/or propolis showed lower Ra values at T₂ compared to baseline. For microhardness, only the HP35%+KF+P group maintained KHN values comparable to the control group after bleaching.

Conclusion: Propolis extract did not compromise the whitening efficacy or negatively affect enamel surface roughness or microhardness following treatment with high-concentration hydrogen peroxide.

Objective: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is one of the fastest-growing liver disorders worldwide. It is driven by obesity and type 2 diabetes. Taste perception plays a key role in appetite regulation and nutrition, also influencing other liver diseases progression. This review summarizes past and current evidence on taste disorders in liver diseases and their clinical implications.

Materials and methods: A narrative review of PubMed, Web of Science, Google Scholar, and Research Gate databases was conducted using selected MeSH terms.

Results: Taste disturbances have been reported in viral hepatitis, cirrhosis, Wilson's disease, amebic liver abscesses, and NAFLD/MASLD, as well as in nutritional deficiencies (zinc, magnesium, vitamin A, branched-chain amino acids). Dysgeusia was linked to reduced appetite, sarcopenia, malnutrition, altered food preferences, and obesity risk in MASLD. Taste impairments worsen with liver dysfunction progression. Several drugs (e.g., interferon, metronidazole) contribute to dysgeusia. Zinc deficiency was the most consistent factor. Glucagon-like peptide-1 (GLP-1) receptor modulators, affecting appetite and sweet/umami perception, appear promising in MASLD therapy.

Conclusions: Taste disorders are prevalent and still under-recognized in populations with liver diseases. The cause of these disorders remains unclear. Most of available studies affecting nutrients deficiencies are outdated. More research targeting molecular pathways of taste modulation (e.g., GLP-1 receptors), as well as determining the prevalence and clinical consequences of dysgeusia in specific liver disease stages is needed to better understand how micronutrient deficiencies and medications affect taste disorders.

Objectives: (a) To quantify the relative gene expression of matrix metalloproteinases (MMP) -2, -9, their tissue inhibitor (TIMP) -2, receptor activator of nuclear factor kappa-B ligand (RANKL), and osteoprotegerin (OPG) in human apical periodontitis (AP) and to associate it with levels of these molecules in healthy dental pulps. (b) To assess differences in gene expression among AP lesions stratified by clinical, radiographic, and histopathological features. (c) Finally, a potential correlation of investigated molecules was explored in AP samples.

Materials and methods: The study cohort comprised 80 AP lesions obtained from 80 adult volunteers during apicoectomy procedures. The healthy control cohort consisted of 50 dental pulp samples from intact teeth extracted for orthodontic purposes, collected from 50 voluntary donors. Relative gene expression of MMP-2, MMP-9, TIMP-2, RANKL, and OPG was assessed in all tissue samples using reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). Statistical analyses included the Chi-square test, Student's t-test, Mann-Whitney U test, and Spearman correlation.

Results: Higher gene expression levels of RANKL, OPG, MMP-2, and MMP-9 were observed in the study compared to the healthy cohort (p=0.048, p=0.002, p=0.048, and p=0.012, respectively). Higher relative expression of the MMP2 gene was observed in smaller lesions compared to large lesions (p=0.021). Significant positive correlations were observed between the investigated mediators.

Conclusions: Concurrent overexpression of the studied mediators, along with their positive correlations in AP lesions, indicates their coordinated role in disease progression and alveolar bone resorption.

Objectives: This study aimed to assess the quality of canal obturation in 3D-printed C-shaped canals using Micro-CT and dye penetration with different filling techniques.

Methodology: Sixty 3D-printed teeth with C-shaped canals were obturated using: AH Plus with continuous wave (AHCW), iRoot SP with single cone (SPSC) and iRoot SP with continuous wave (SPCW). Micro-CT was used for 3D reconstruction in two regions: 0~8 mm (overall canal) and 0~3 mm (apical segment). The volume of voids (V1) and total canal volume (V) were used to calculate porosity as (V1/V) × 100%. Sealing quality was assessed by dye penetration.

Results: Results showed that AHCW exhibited significantly lower porosity within 8 mm (5.17%) compared to SPSC (9.02%) and SPCW (8.55%), (P < 05). No significant porosity differences were observed within 3 mm or in dye penetration.

Conclusion: AHCW achieved better obturation in the middle and upper segments, with no significant differences among techniques in the apical segment.

Introduction: Oral mucositis is a common adverse effect of chemotherapy and radiotherapy, characterized by erythematous lesions, edema, ulceration, atrophy, or even hemorrhage. Current evidence highlights the complexity of its management and the importance of tailoring therapeutic approaches to the individual patient profile in order to improve quality of life during cancer treatment.

Objectives: To access the efficacy of pharmacological and non-pharmacological interventions for the prevention and treatment of chemotherapy- and/or radiotherapy-induced oral mucositis.

Materials and methods: A systematic review with meta-analysis of 27 articles published between 2019 and 2024 was also performed, aiming to characterize and contextualize therapeutic interventions for oral mucositis.

Results and discussion: This systematic review and meta-analysis suggests that various non-pharmacological interventions (such as cryotherapy and photobiomodulation) and pharmacological interventions, particularly natural agents (such as honey, curcumin, green tea), are effective for the prevention and treatment of oral mucositis.

Conclusion: Oral mucositis is a highly prevalent adverse effect in patients undergoing chemotherapy and/or radiotherapy, with significant functional, nutritional, and treatment adherence implications. The systematic review with meta-analysis demonstrated the efficacy of non-pharmacological and natural interventions.

Introduction: Conditions such as diabetes and hyperlipidemia, as well as unhealthy habits such as smoking, are known to impair wound healing. Recent studies found that greater surface wettability accelerates osseointegration and increases the bone-to-implant contact ratio. In light of this, the aim of this study was to investigate the potential correlation between impaired healing status and changes in implant surface wettability.

Materials and methods: This study included 18 dental implants from various systems. Blood samples were collected from 40 voluntary participants divided into four groups.

Results: When comparing the blood of smokers and healthy people, the biggest difference was shown by Avinent, BTI UniCa, and Nobel TiUltra, where more blood was absorbed by the implants immersed in the smoker's blood. Also, some implants have shown reverse results, but the difference was smaller. When testing the blood of diabetics, there were many different results; some implants showed that they absorbed more blood when immersed in the blood of diabetics, and some in the blood of healthy people. When testing the blood of hyperlipidemic patients, it is interesting that all tested implants absorbed more blood from hyperlipidemics than blood from healthy people, except for Nobel TiUltra, where the result was reverse, but the difference was very small.

Conclusions: Our findings demonstrate that blood from these patient groups can significantly alter the hydrophilicity of implant surfaces compared to blood from healthy individuals. In vivo research is needed to determine the clinical significance of this finding.

Background: Teeth may serve as alternative matrices for post-mortem toxicological analysis. Although the mechanism of drug incorporation into dental tissues remains unclear, it is hypothesized that orally ingested substances can permeate dental enamel and reach dentin and the pulp.

Objectives: This study investigated enamel permeability to commonly ingested drugs, considering molecular characteristics (methadone - MET and dextromethorphan hydrobromide - DXM), pH, sugar content, and tooth conditions (intact enamel, cement-enamel junction-CEJ exposure, enamel wear).

Materials and methods: Sixteen clinically extracted teeth were divided into three groups and immersed in different substances, including MET with sugar, DXM with and without sugar (pH 4.5, 1 mg/ml), and acidified saliva (pH 5-6), simulating an addicted individual's oral environment. Cyclic immersions (substance-saliva-substance) mimicked chronic drug intake for about six weeks. After treatment, each tooth was separated into enamel, dentin, and pulp, and analyzed using liquid-liquid extraction and LC-MS/MS.

Results: Preliminary results showed that both MET and DXM can penetrate both the enamel and dentin, reaching the pulp regardless of tooth integrity or molecule type. Acidity and sugar content significantly increased the diffusion.

Conclusions: These findings suggest that other substances orally assumed might be endowed with similar effects on dental tissues, especially when combined with sugar or acid solutions, supporting teeth as viable matrices in post-mortem toxicology. However, pulp concentrations may reflect oral contamination rather than systemic levels.