Nederlands tijdschrift voor tandheelkunde最新文献

Dental caries is a major public health problem and untreated caries has serious consequences for children. Psychosocial factors have multiple consequences, among others on the composition of saliva. Therefore, this study investigated whether stress and various salivary protein levels are associated with dental caries experience in children. The activity of the Matrix Metalloproteinases MMP-8 and MMP-9 and the total proteolytic activity in saliva turned out to be indicators for the caries experience. Salivary Alpha-Amylase seems to be a protector and was a strong indicator for caries experience. In cases where children were exposed to two different dental treatments, the level of salivary cortisol- and alpha-amylase increased, in which a distinction could be made between non-invasive and invasive treatment. The results of the study emphasise the need for further research into the way stress and salivary protein concentrations can affect the caries experience and how different dental treatments can influence the behaviour and stress levels in children.

To date, there is no widely accepted system for evaluating soft tissue early healing events in oral surgery. This study aimed to identify variables used to assess early oral soft tissue wound healing. The PubMed-MEDLINE and Cochrane CENTRAL databases were searched up to and including March 1, 2022. Papers were included if they presented scores of wound healing after performing a mucoperiosteal flap operation with the intention of primary closure. The search yielded 2,286 unique titles and abstracts, of which 31 met the eligibility criteria. In general, the available definitions/indices were found to be imprecise. Based on the literature reviewed, six variables were considered relevant for scoring early oral soft tissue wound healing: primary closure, necrosis, redness, swelling, bleeding, and suppuration.

The oral mucosa is made up of an epithelium supported by the lamina propria and the submucosa. When the mucosa is damaged, wound healing is characterized by distinct, sequential phases. How does the healing process proceed? Both primary and secondary wound healing, encompasses haemostasis, inflammation, proliferation, and remodelling. Secondary healing also involves a granulation phase to cover the wound. Saliva and the oral microbiome play a role in the healing process, too. Smoking, certain systemic disorders and medication can have a negative effect on the healing process.

For years, cancer has been one of the diseases that causes the greatest disease burden in the Netherlands. Cancer does not only have a huge impact on patients and their loved ones, but also on society and healthcare. If the number of cancer patients increases further in the coming years, this impact will only aggravate. This development will also impact dental practice. It is therefore important to assess what awaits us in the coming years. Both with regard to supporting and treating (former) oncology patients. Forinstance, detecting secondary effects of cancer treatments such as oral mucositis and medication- and radiation-related jaw necrosis, as well as the early detection of oral cavity carcinomas and sun-related skin damage on the lips and face. Based on this, plans can be made to meet the demand for dental care as well as possible and to reduce the impact of cancer for both the individual patient and for society as a whole.

The diagnosis of an endodontic disease requires thorough research, collecting both clinical and radiographic information. The clinical examination includes history taking, visual inspection of the tooth and surrounding tissues, palpation of the soft and hard tissues, periodontal examination and percussion. The radiographic examination provides valuable information, but can never stand alone in arriving at a diagnosis. It is important to link the findings of the radiographic examination to other information. Sometimes, invasive examination is necessary, during which the coronal restoration is removed to allow better assessment of the tooth. This can provide additional information about the presence of caries, fractures, leakage of the restoration or other reasons for failure of the initial root canal treatment. A good diagnosis is essential for planning successful follow-up treatment.

The purpose of root canal posts is to obtain additional retention for build-up restorations of endodontically treated teeth so they can be functionally reconstructed. Due to developments in adhesive dentistry and a lack of clinical evidence, root canal posts are used less and less. Currently, the advice of the European Society of Endodontology is to use a root canal post only in front teeth and premolars in the absence of remaining coronal dentine walls. It is important to avoid additional preparation when placing a root canal post, because this causes (additional) weakness of the tooth. The loss of dental tissue due to preparation cannot be compensated for by placing a post.

When restoring an endodontically treated tooth, it is important to preserve the pericervical dentin so it is resistant especially to lateral forces occurring during mastication. When little pericervical dentin is seen to be present, an adhesive restoration is indicated. Tooth survival of endodontically treated teeth restored with adhesive direct and indirect restorations varies between 90.5% and 95.0% after 5 years. Deciding between a direct or an indirect restoration depends above all on the possibility to predictably restore the anatomy and on gloss retention. Because endodontically treated teeth are vulnerable to lateral forces, control of these forces after direct or indirect restoration is important. This can be achieved by a reduction in the steepness of the cuspal slope and/or by covering the cusps with the restorative material.

When problems occur in multirooted teeth, such as persistent endodontic problems following endodontic treatment, problems involving fracture or furcation, extraction may be decided on. However, removal of the tooth will result in loss of occlusal units and the alveolar process. By removing the compromised root and preserving the healthy part, the tooth can remain functional, but only after restorative treatment. A correct indication or diagnosis, a properly performed endodontic, restorative and surgical treatment and proper follow-up are mandatory for a successful treatment outcome.