Acta Odontologica Scandinavica最新文献

Objective: The objective of this study was to compare the clinical and patient-related outcomes of root canal therapy (RCT) and dental implants (DIs) in managing severe tooth damage, supporting evidence-based treatment decisions.

Material and methods: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Six databases were searched: Cochrane Library, Embase, Medline, LILACS, Scopus, and Web of Science. Studies comparing clinical and patient-reported outcomes in adult patients treated with either RCT or DIs were included. The Joanna Briggs Institute Critical Appraisal Checklists were used to assess the risk of bias. Due to significant heterogeneity among studies, meta-analysis was not feasible, and findings were synthesised qualitatively. PROSPERO registration: CRD42024584113.

Results: Out of 1,876 initial records, 12 studies met inclusion criteria: 7 cohort studies, 4 case-control studies, and 1 randomised controlled trial. Most studies had low to moderate risk of bias. Both RCT and DIs demonstrated high survival rates, with RCT slightly outperforming DIs in terms of success. Failure rates ranged from 0.7% to 12.0%, with no significant differences between treatments. DIs were associated with a higher frequency of postoperative interventions and complications. Patient-reported outcomes such as pain, satisfaction, and quality of life (QoL) were comparable across both modalities.

Conclusion: RCT and DIs both offer viable and effective solutions for restoring severely damaged teeth, with high survival and success rates and low failure rates. Both treatments were also associated with favourable patient-reported outcomes, including minimal pain, high satisfaction, and improved QoL. The decision between treatments should consider clinical factors, patient preferences, cost, accessibility, potential complications, and patient-centred outcomes. Shared decision-making is essential for optimal patient care.

Objective: The primary aim of this study was to investigate participants' orthodontic treatment expectations and to assess participants' perceptions of their own orthodontic treatment need. A secondary aim was to compare participants' self-perceived treatment need to an orthodontist's opinion.

Material and methods: In this cross-sectional study, a total of 98 participants, aged 7-12 years, completed a modified Sayers questionnaire before an orthodontic screening in a public health center in Finland. After completing the questionnaire, the participants underwent a clinical examination of the occlusion by an orthodontist specialist. A Spearman's rank correlation was conducted to evaluate the relationship between the questionnaire answers. The chi square statistic was applied to assess association between categorical variables.

Results: From the initial orthodontic screening, a sample of 98, 94 participants were included in further analysis. Of them, 89% expressed a self-perceived need for orthodontic treatment. Orthodontic treatment need was determined by an orthodontist for 66% of the participants based on a severe malocclusion. Gender, age, or family history of orthodontic treatment were not associated with subjective treatment need. The main expectations for orthodontic treatment result were to straighten the teeth, to get a better smile, and to avoid problems in the future.

Conclusions: The study found that patients' expectations of treatment did not fully align with reality. More information for patients and their guardians is needed in advance to avoid unrealistic expectations before the orthodontic treatment.

Objective: This study aimed to compare the intensity of post-operative pain after single-visit root canal treatment of symptomatic or asymptomatic teeth following occlusal reduction.

Methods: A total of 140 symptomatic or asymptomatic patients in need of root canal therapy were registered in this prospective, single-centre, single-blind, randomised clinical trial. For all patients, root canal treatment was carried out in a single visit, and the teeth were restored using composite resin. The patients were randomly allocated into four treatment groups, two of which included occlusal reduction while two treatments left the occlusional contacts intact. Patients' pain were assessed using a 0-3 verbal rate scale 1, 3, and 7 days following root canal treatment. The pain incidence and intensity were compared using the chi-square and Fisher's exact tests.

Results: Overall, the post-operative pain intensity was low. Symptomatic individuals had significantly more discomfort at day 1 post-operatively compared to asymptomatic patients (p < 0.008). The pain incidence significantly decreased over time for symptomatic patients. When compared to asymptomatic patients without occlusal reduction, symptomatic patients with occlusal reduction had a greater pain incidence at day 3 (p < 0.011). For other time intervals, no significant differences in post-operative pain incidence or intensity were found.

Conclusion: Single-visit root canal treatments involving occlusal reduction in both symptomatic or asymptomatic molars had no significant effect on post-operative pain.

Objective: There is a well-established association of oral manifestations in the non-infectious chronic diarrhoeal conditions namely, Morbus Crohn, ulcerative colitis, and coeliac disease. Such a connection may exist also for the remaining non-infectious chronic diarrhoeal conditions, that is irritable bowel syndrome (IBS) and microscopic colitis (MC).

Materials and methods: A systematic search was performed in Scopus and PubMed, rendering a total of 710 articles to be screened. All articles were screened independently and assessed for eligibility reporting comorbidity between either IBS or MC, and oral symptoms/disease. Quality assessment and data extraction were performed.

Results: In all, 17 articles were included. Sjögren's syndrome (SS) in patients with IBS ranged from 3% to 33% and for IBS in SS between 29% to 62%. Dry mouth, bad breath, and foul taste were overrepresented in these patients. The occurrence of SS in patients with MC ranged from 2% to 9%, and for MC in SS from 1% to 2%.

Conclusions: An association between SS and IBS and MC, respectively, is plausible. Few articles have explored other oral manifestations. Therefore, no specific conclusions can be drawn. It is pivotal to further explore oral manifestations of these conditions bridging the gap between dental care and general medicine to optimise diagnostics, treatment strategies, and ultimately patient care.

Objectives: The aims this research were to analyze self-reported oral health-related quality of life (OHRQoL) and dental fear and anxiety (DFA) in 11-year-old patients after either restorative treatment or after extraction of first permanent molars (FPM) affected by severe molar incisor hypomineralization (MIH). The research question focused on whether these treatments lead to different outcomes of DFA and OHRQoL over time.

Materials and methods: GuREx-MIH, a multicenter trial, was conducted involving 83 children aged 6-9 years who were diagnosed with severe MIH in FPMs. Patients were randomly assigned to receive either restorative treatment with resin composite or extraction. Patient comfort was assessed through OHRQoL and DFA, using the Swedish version of the Child Perceptions Questionnaire (CPQ11-14) and the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), which were administered before treatment (T0) and at follow-up when patients were 11 years old (T1). Descriptive statistical analyses were conducted and comparisons between the restorative and extraction groups were performed using T-tests.

Results: A total of 79 patients completed the study, with 43 allocated to restorative treatment and 36 to extraction. At follow-up, the mean OHRQoL score was 8.9 (standard deviation [SD] 7.3) for patients in the restorative group and 9.6 (SD 6.7) for those in the extraction group (p: 0.337, T-test). The mean DFA score was 21.5 (SD 5.5) for the restorative group and 23.1 (SD 6.8) for the extraction group (p: 0.130, T-test).

Conclusions: Restorative treatment and extraction of FPMs affected by MIH lead to similar impact on DFA and OHRQoL at 11 years of age.

Objective: To systematically evaluate the efficacy of diode laser for pulpotomy in primary teeth using meta-analysis.  Methods: Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched to include randomised controlled trials (RCTs) evaluating the efficacy of diode laser pulpotomy in primary teeth, with the control group receiving conventional treatment without diode laser. This meta-analysis was based on a systematic literature search. Meta-analyses were conducted based on different follow-up times and control groups to assess the clinical and radiographic success rates of diode laser pulpotomy.  Results: A total of 17 RCTs met the inclusion criteria, involving 1,018 primary teeth. Meta-analysis results based on different follow-up times (≤ 3 months, 6 months, 9 months, ≥12 months) showed similar clinical success rates (total: relative risk [RR], 1.01; 95% confidence interval [CI], 0.99-1.03; I2 = 0%) and radiographic success rates (total: RR, 0.99; 95% CI, 0.97-1.02; I2 = 0%) between diode laser pulpotomy and conventional treatment. Meta-analysis based on different control groups (formocresol-zinc oxide eugenol [FC-ZOE], ferric sulfate-zinc oxide eugenol [FS-ZOE], mineral trioxide aggregate-zinc oxide eugenol [MTA-ZOE], simvastatin gel-resin modified glass ionomer cement [SG-REGIC]) showed similar clinical success rates between diode laser pulpotomy and FC-ZOE (RR: 1.00; 95% CI: 0.98-1.02), MTA-ZOE (RR: 1.01; 95% CI: 0.94-1.09), and SG-REGIC (RR: 0.99; 95% CI: 0.83-1.17), but it was more likely to achieve clinical success compared to FS-ZOE (RR: 1.04; 95% CI: 1.01-1.07). In addition, diode laser pulpotomy showed similar radiographic success rates with different control groups.  Conclusion: Diode laser can be considered as an alternative treatment method to current conventional pulpotomy. However, further high-quality trials are needed to confirm the accuracy and reliability of these findings.

Objective: This study aims to systematically evaluate the effects of different oral barrier membranes on bone regeneration, focusing on their clinical efficacy and safety during dental implant procedures.

Methods: A comprehensive search was conducted in PubMed, EMBASE, ScienceDirect, Cochrane Library, CNKI, VIP, and CBM databases for case-control and cohort studies published between January 2002 and March 2025. Two independent researchers screened and extracted data, and statistical analysis was performed using RevMan 5.3. The study was registered in PROSPERO (CRD492390).

Results: A total of 11 clinical controlled and cohort studies with 1,003 patients were included. The absorbable membrane group demonstrated a significantly higher success rate (p < 0.05), greater bone graft thickness (p < 0.05), and fewer adverse reactions (p < 0.05). Meta-analysis showed no significant difference in osseointegration, total mineralised tissue, and non-mineralised tissue (p > 0.05).

Conclusion: Absorbable oral barrier membranes exhibit superior safety and efficacy profiles, making them a preferred choice for guided bone regeneration. However, further studies with higher methodological quality and longer follow-up durations are required.

N/A.

Objective: The aim of this prospective, clinical study was to follow-up root canal treatments performed by dentists in the practice-based endodontic research network setting, to assess treatment outcome and factors related to treatment outcome.

Material and methods: Baseline information from 536 teeth was included, follow-up information on 269 teeth (50%) was available. Treatments were performed by 12 dentists during 2017-2018. Follow-up period varied from 3.5 months to 3 years. Treatment outcome was assessed in periapical radiographs using the Periapical Index (PAI). Cases were classified as referred or not. Pre-, intra-, and post-operative variables were recorded by the dentists during treatment and analysed at follow-up in relation to treatment outcome.

Results: Periapical status improved or remained healthy in 174 (66%) teeth. If PAI at baseline was 3, 4, or 5, the outcome was affected negatively (p = 0.049). The length and seal of the root filling was assessed adequate in 75% and 63% of the teeth, respectively. Adequate seal (p = 0.02) and length (p = 0.03) resulted in improved treatment outcome.

Conclusions: When initial periapical status and/or quality of the root filling was good, there was a higher chance of a successful treatment outcome.