American journal of dentistry最新文献

Purpose: To investigate the relationship between type 1 diabetes mellitus (T1-DM) and apical periodontitis (AP). The periapical and endodontic conditions of T1-DM individuals were compared with healthy people.

Methods: T1-DM subjects aged 18-45 with good glycemic control (HbA1c < 7) were included in this research. Individuals without systemic disease, twice as many as diabetic patients, were selected as the control group by matching them in terms of age and gender. The subjects' periapical and endodontic statuses were determined by assessing their existing digital panoramic radiographs.

Results: This study included 226 subjects with T1-DM, 101 males and 125 females (30.78 ± 8.59 years). For the control group, 452 subjects without systemic disease, 224 males and 228 females (30.26 ± 8.64 years) were selected. The mean number of teeth in the control group was significantly higher than in the T1-DM group (P = 0.001). However, no significant difference was found between the T1-DM and control groups in terms of endodontic and periapical conditions (P > 0.05). Bivariate logistic regression analysis revealed a positive association between T1-DM and the number of teeth with AP only (P = 0.001; OR = 1.476). There was no association between T1-DM and endodontic conditions or other periapical health-related variables.

Clinical significance: T1-DM patients lost more teeth than the control individuals. As the number of teeth with AP increased, individuals were more likely to be in the T1-DM group. Healthcare professionals should inform patients with Type 1 diabetes about oral health for a better quality of life.

Purpose: To evaluate the color match and stability of single-shade resin-based composites (RBCs) in Class V restorations before and after ultra-violet light artificial aging.

Methods: Acrylic resin teeth of A1 and A3 were randomly assigned into seven groups to be restored with single-shade RBCs and universal-shade RBCs, shades A1 and A3. Standardized Class V cavities were restored using RBC and underwent accelerated aging for 480 hours. The color differences between RBC and Class V restorations for A1 and A3 were evaluated before and after artificial aging using a spectrophotometer.

Results: All single-shade RBCs better color-matched the A1 tooth (P= 0.10 to P= 0.32), while universal-shade RBCs color better matched the A3 tooth (P= 0.03 to P= 0.87). Omnichroma was the only single-shade RBC that also color-matched the A3 tooth (P= 0.03). There was a statistically significant difference when comparing measurements before and after the aging only for Vittra APS Unique (P= 0.047) and Omnichroma (P= 0.038) and the A3 tooth.

Clinical significance: When restoring Class V in teeth color A1, single-shade RBCs demonstrated comparable color matching to multi-shade resin composites even after 4 simulated years of service, however universal-shade RBCs were better options to restore Class V in teeth color A3.

Purpose: This mini-review discusses the clinical implication of respiratory pathogens in the biofilm on acrylic resin removable dentures in the elderly.

Methods: A search was conducted using the keywords: "dentures", " acrylic resin", "biofilm", "pneumonia", "elderly", "respiratory pathogens", and "respiratory diseases" in databases PubMed/Medline, Lilacs, SciELO and textbooks between 1999 and 2024.

Results: The elderly are more susceptible to chronic diseases and/or life-threatening infections because of senescence itself and functional and degenerative alterations. Respiratory tract diseases (such as pneumonia) are of greater concern in the elderly because they have been associated with the aspiration of food and oral pathogens and with reflux. This relationship is more aggravating in the presence of removable dentures, common in the elderly after the sixth decade of life, since denture biofilm is a reservoir of respiratory pathogens. Lack of manual dexterity and visual acuity negatively interfere with denture cleaning and favor pathogenic denture biofilm maturation. Reduced salivary flow, a more acidic pH, and a reduced cough reflex associated with poor denture cleaning increase the potential of denture biofilm infections and aspiration pneumonia, which is related to a high mortality rate in the elderly. To prevent respiratory diseases in this population, measures to control denture biofilm should be adopted, such as the superficial or intrinsic modification of the acrylic resin denture bases and the use of effective methods of denture cleaning.

Clinical significance: Respiratory pathogens colonizing denture biofilm can be aspirated into the respiratory tract, increasing the risk of respiratory infections, especially in the elderly. The knowledge of health professionals on methods of biofilm control can prevent respiratory diseases in elderly denture wearers.

Purpose: To evaluate the clinical performance of an alkasite material for Class I and Class II cavities.

Methods: 50 subjects (30 females, 20 males; mean age: 28.7) referred to the Department of Restorative Dentistry, Medipol University, Dental School, Istanbul, Turkey, received 89 Class I and II restorations (Cention N) by two trained operators. All restorations were made in bulk application without an adhesive resin and without photo-polymerization.

Results: 65 restorations were followed in 37 subjects at a 2-year recall. The mean observation period was 27.6 months. 24 restorations (13 subjects) were not followed up at the 2-year recall and were considered as drop out. The restorations were made either due to primary caries (n= 73) or restoration replacement (n= 16). 89 restorations were placed of which 51 were in the maxilla and 38 in the mandible. In deep cavities, a cavity liner was applied (with n= 53; without n= 36). Hypersensitivity was observed in nine cases that disappeared at the latest after 1 month. No debonding, no fracture, and no endodontic complications were observed at 6-month and 1-year recalls whereas four partial retention losses and one pulpal complication occurred at the 2-year recall. The overall survival rate was 88.9% with a mean observation time of 27.6 months (Kaplan-Meier, Log Rank; Mantel-Cox) (95%CI=31.07-32.25).

Clinical significance: This study provided promising evidence for application of alkasite material applied in bulk without retentive features, etching or an adhesive system.

Purpose: To evaluate and compare: (1) the effect of the bacterial biofilm on the dentin mineral density at the restoration-tooth interface and (2) the mineralization potential of three resin-based restorative materials (RBRM).

Methods: 16 extracted human molars free of caries and cracks were collected and stored for disinfection. Each tooth received two standardized Class II preparations with the cervical margin placed in dentin. Teeth were secured into a dentiform with adjacent natural teeth to ensure interproximal contact. All tooth preparations were hybridized using a three-step etch-and-rinse adhesive system (OptiBond FL) and assigned randomly to three experimental groups according to the RBRM (n= 8): Group A - a nanofill resin composite (Filtek Supreme Ultra); Group B - a high-viscosity bulk-fill resin composite (Tetric Powerfill); Group C - a low-viscosity bulk-fill resin composite (SureFil SDR flow+ bulk-fill); and a positive control: Group D - bioactive resin composite (Activa Bioactive-Restorative). All materials were used according to manufacturers' instructions. All specimens were subjected to two distinct challenges: first, thermomechanical cycling was performed within 24 hours of restoring the specimens to simulate 1 year of masticatory function. Subsequently, the specimens were stored for 18 days in a laboratory biofilm model to promote biofilm formation and to mimic the effects of tooth demineralization. Two sessions of micro-CT imaging were conducted: the first immediately after the thermomechanical cycling and the second post-exposure to the biofilm model. All data on mineral profile measurements reconstructed in the Perkin-Elmer Quantum GX-II CT were transferred to Image J software for analysis and interpretation. The ANOVA test (P< 0.05) was used to analyze the mineral density values and mean mineral loss values for each group.

Results: No statistically significant difference in mean mineral loss value (mean ΔZ) was found between the groups (P= 0.209). Regardless, increased mean ΔZ variation was found between SureFil SDR flow+ (-56.95) and the remaining groups, Filtek Supreme Ultra, Tetric Powerfill and Activa Bioactive (-1.17, -1.41, and -7.97, respectively), showing, within the limits of the present laboratory study, the remineralization potential of SureFil SDR flow+. All tested RBRM demonstrated some remineralization capacity under caries risk conditions.

Clinical significance: The mineralization potential of some resin-based composites under caries-risk conditions can represent a paradigm shift in restorative material selection for moderate-to-high-risk patients.

Purpose: To evaluate the efficacy and subjects' perception of the Modified Schirmer Test (MST) to the traditional Unstimulated Salivary Flow Test (USFT) when measuring salivary flow rate for screening and monitoring patients' dry mouth.

Methods: A total of 100 subjects were enrolled including subjects with and without dry mouth. All subjects answered a brief self-reported survey about dry mouth before and after the two types of saliva tests and their preference for the type of test administered. The order of performing MST and USFT were randomized. MST was conducted by the clinician holding a Schirmer strip paper at the bottom of the subject's mouth for 1 minute. USFT was measured by having the subject spit any accumulating saliva into a medicine cup for 5 minutes. Correlation analyses were conducted to test the relationship between MST and USFT using the Pearson correlation coefficient. All analyses were performed at a P< 0.05.

Results: A significant positive correlation existed between the two salivary flow tests (r= 0.556, P< 0.001). Most of the subjects (79%) preferred the MST while 6% preferred USFT; 15% reported no preference. A negative association between MST and USFT with age indicated that as age increased, subjects' salivary flow rate results for both types of tests decreased (r= - 0.287, P= 0.004).

Clinical significance: MST provides dental care providers with an effective, economical, easy-to-perform, and patient-preferred method to screen and monitor salivary flow rate.

Purpose: To evaluate the effect of aging and bleaching on the physico-mechanical properties of the different filled resin composites.

Methods: Samples of resin composites [Arabesk (A), G-aenial Anterior (G), i-LIGHT N (I) and Palfique Estelite Paste (P) were first divided into two subgroups. Thermal aging was applied to half of the samples. Then, fresh and aged samples were divided into three subgroups (n= 8): control (C) (no treatment), office bleaching (O), home bleaching (H), thermal aging (T), thermal aging +office bleaching (TO) and thermal aging +home bleaching (TH). The microhardness (kg/mm²), surface roughness (µm), and compressive strength (MPa) values were measured. The data were analyzed with 3‑way ANOVA and Bonferroni post hoc pairwise comparison tests (P< 0.05).

Results: T significantly decreased the hardness and increased the roughness of all the resin composites (P< 0.05). The compressive strength of all resin composites decreased after aging. O and H increased the roughness of the A, I and P (P< 0.001). H increased the microhardness of the G (P< 0.05).

Clinical significance: Thermal aging and bleaching agents adversely affected the hardness, roughness, and compressive strength of the nonaged composites tested. Bleaching agents have less effect on the physico-mechanical properties of aged composites. Therefore, bleaching can be a safe and conservative esthetic treatment plan for patients who have long-standing composite restorations.

Purpose: To evaluate the effects of various beverages on surface roughness and microhardness of PEEK and PEKK polymers.

Methods: Rectangular-shaped PEEK and PEKK polymers were fabricated and examined in the study. The specimens were immersed for 28 days at 37°C in red wine, coffee, and distilled water. The surface microhardness (Vickers microhardness tester) and roughness (profilometry) measurements of the polymers were performed before and after immersion. The Kolmogorov test was used to evaluate the normal distribution of the variables. Kruskal Wallis test was used to compare independent groups and Wilcoxon Signed Rank test was used to compare two dependent groups (P< 0.05).

Results: Acidic beverages adversely affected the properties of the tested materials. The microhardness of tested materials was significantly decreased after immersion in the various beverages, whereas surface roughness was increased except for distilled water.

Clinical significance: Removable partial dentures can be exposed to chemical agents found in acidic beverages either intermittently or continuously, and this may lead to chemical degradation and changes in surface properties of the denture framework. With the developments in dentistry, framework materials are also developing and diversifying. The clinical performance of PEEK and PEKK polymer-based frameworks is still uncertain.

Purpose: To review the literature on the relationship of milk fat globule EGF and factor V/VIII domain containing (MFGE8) in periodontal osteoimmunology and the clinical significance of MFGE8 in periodontal disease.

Methods: Two reviewers carried out a computer-based literature search using PubMed, Scopus, and Web of Science to identify papers published up to November 2023. The keywords used in the investigation were "MFGE8" and various words related to periodontal disease (periodontal, periodontitis, gingival, gingivitis, gingiva, and periodontium).

Results: MFGE8 plays a critical role in the etiology of periodontal disease via regulating pro-inflammatory cytokines and bone cells. In addition, MFGE8 may be applied as a diagnostic biomarker and a therapeutic target in periodontal disease.

Clinical significance: MFGE8-mediated periodontal osteoimmunology fills the vacant part of the pathogenesis in periodontal disease. This review provides a comprehensive perspective on the potential of MFGE8 in periodontal disease therapy.

Purpose: To explore the latest trends in research on whitening toothpaste and to present the issues and future perspectives of these studies.

Methods: An initial PubMed search was performed, followed by a meticulous manual review. A total of 543 papers were initially retrieved, and 54 final research papers were selected and analyzed through a manual review.

Results: The number of studies on whitening toothpastes has significantly increased, and while initial studies primarily focused on the efficacy of various whitening toothpastes, recent studies have shifted towards investigating the potential effects on dental hard tissues such as enamel and dentin. Common active ingredients used in these whitening toothpastes include hydrogen peroxide, activated charcoal, and blue covarine. Most studies have used commercial toothpastes with fixed ingredients rather than experimentally manufactured toothpaste, and it was noted that toothpastes from specific major manufacturers were frequently used.

Clinical significance: Whitening toothpastes should be treated as separate entities based on their active ingredients, and more standardized experimental designs are required for better comparisons. Accurate analysis and labeling of other components of toothpaste are also essential.