American journal of dentistry最新文献

Purpose: To evaluate the clinical effect of three impression methods, conventional, closed-mouth, and tissue conditioner, on complete denture fabrication.

Methods: 60 subjects (edentulous with severely resorbed alveolar ridges - Atwood classification III or IV) who visited the Prosthodontic Department of Wuxi Stomatology Hospital, China, between January 2022 and June 2023, were selected for this study. The subjects were randomly divided into three groups of 20: a conventional impression group (CI group), a closed-mouth impression group (CM group), and a tissue conditioner group (TC group). Three months after denture restoration was completed, denture quality was assessed by clinicians in terms of marginal extension, retention, and stability. In addition, patients completed the oral health impact profile-edentulous (OHIP-EDENT) questionnaire to provide subjective satisfaction evaluations of the final denture restoration outcomes.

Results: The comprehensive denture quality evaluation results showed that the TC group had the lowest score, which was significantly lower than that of the CM (P= 0.014) and CI (P< 0.001) groups. The average score of the CM group was also significantly lower than that of the CI group (P= 0.004), indicating that tissue conditioner restoration was the most effective method. The OHIP-EDENT scores gradually decreased across the groups from CI to CM to TC (P= 0.001), indicating patients' oral health was significantly improved using tissue conditioner.

Clinical significance: Tissue conditioner is a suitable dynamic functional impression method. It can significantly improve the effects for edentulous patients and increase their satisfaction.

Purpose: To evaluate the prevalence of acute periapical abscesses (PAs) in obese patients.

Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for obesity and PAs was retrieved by identifying the appropriate ICD 10 codes in the database.

Results: Out of 1,874,214 hospital patients studied, 147,195 patients were classified as obese, of which 3,349 had acute PAs. The difference in prevalence of PAs between obese and average-weight patients was statistically significant (OR 4.22, 95%CI: 4.05-4.39, P< 0.0001). Adjustment for diabetes comorbidity reduced the OR to 2.55; however, the difference remained statistically significant (95%CI: 2.43-2.68, P< 0.0001). Adjustment for smoking reduced the OR to 2.63; however, the difference remained statistically significant (95%CI: 2.51- 2.87, P< 0.0001). Adjustment for periodontal disease comorbidity reduced the OR to 3.85; however, the difference remained statistically significant (95%CI: 3.70-4.01, P< 0.0001). Females were more affected than males; adults were more affected than children; and African Americans were more affected than Whites.

Clinical significance: Oral healthcare providers should be aware of the possible higher prevalence of periapical abscesses in obese patients as compared to average-weight individuals.

Purpose: To evaluate the in vitro antibacterial effect of Softsoap and Efferdent used as solutions to disinfect Lucitone 199 poly(methyl methacrylate) (PMMA) resin used for dentures.

Methods: S. mutans and plaque bacteria were grown for 24 hours, and suspended to a concentration of 1x10⁶ cells/ml. Bacterial suspensions (0.2 mL) were added to the decontaminated PMMA discs placed in a 48-well culture plate and incubated for 3 days at 37°C. The discs were rinsed to remove the unbound bacterial cells and then incubated for 60 minutes with 5% and 1% dilutions (triplicates) of each of the detergent solutions (0.3 ml). Discs were rinsed and then MTT reagent (0.2 ml) was added and incubated for 2 hours, then overnight with a solubilizing agent. An aliquot from each well (0.1 ml) was transferred to a 96-well flat bottom plate and absorbance was measured to OD @ 595 nm (MTT) of four samples for each data point. Normalized data was compared and statistically analyzed using a three-way ANOVA with Student-Newman-Keuls on Rank data with P< 0.05 for significance. Additionally, data were double-checked with the Holm-Sidak test.

Results: There was no statistically significant difference between testing media for C. albicans and mixed plaque (P= 0.078) or testing duration in time at 24 hours and 21 days (P= 0.07). Statistically significant differences were found between all treatment solutions group combinations (P< 0.001) except for 30% Softsoap versus Efferdent (P= 0.056).

Clinical significance: There was no statistically significant difference between testing media for C. albicans and mixed plaque (P= 0.078) or testing duration at 24 hours and 21 days (P= 0.07). Statistically significant differences were noted between all treatment solutions group combinations (P< 0.001), However, there was no difference between 30% Softsoap and Efferdent (P= 0.056).

Purpose: To investigate the stain preventing ability of a new chlorhexidine mouthwash while maintaining efficacy using a randomized clinical trial design.

Methods: 98 subjects were enrolled and completed a 4-week clinical study that evaluated the effectiveness of the new mouthwash on plaque, gingivitis, and staining as compared to a commercially available chlorhexidine mouthwash. A subset of 62 subjects was evaluated for the effectiveness of the mouthwashes against plaque bacteria.

Results: After 4 weeks of use, the new chlorhexidine mouthwash reduced staining by 42.6% (P< 0.05) as compared to the commercially available mouthwash. The two mouthwashes were equivalent with regards to their effect on gingivitis, plaque, and plaque bacteria.

Clinical significance: A new mouthwash, containing 0.12% chlorhexidine gluconate, has been developed that delivers stain reduction while maintaining equivalent efficacy to a commercially available chlorhexidine mouthwash with regards to gingivitis, plaque, and plaque bacteria. These findings should be considered by dental practitioners when making recommendations to patients whose teeth stain easily and need an anti-gingivitis and anti-plaque mouthwash.

Purpose: To evaluate the radiopacities of CAD-CAM materials using digital techniques.

Methods: Five different CAD-CAM materials were used (Cerasmart, LAVA Ultimate, Cerec Blocs C, Tetric CAD, and IPS e.max CAD) in this study (n= 5). For each group, samples with thicknesses of 1 and 2 mm were prepared. As a control, tooth slices with 1 and 2 mm thicknesses and a 99.5% pure aluminum step wedge were used. The samples, tooth slices, and step wedges were placed on a photostimulable phosphor plate. Radiographs were taken at 30 cm distance with 7 mA, 70 kVp, and 0.32 ms exposure time. The images were analyzed using the ImageJ software to measure the mean gray values. Data were analyzed with Kruskal-Wallis H test and the Mann-Whitney U test (P< 0.05).

Results: In the comparison of CAD-CAM materials with 1 and 2-mm thicknesses, the highest radiopacity value was seen in LAVA Ultimate samples (2.67 ± 0.05 for 1 mm samples: 5.74 ± 0.13 for 2 mm samples). The lowest value in 1 mm samples was seen in IPS e.max (0.59 ± 0.07), and in 2 mm samples, in Cerec Blocs C samples (1.49 ± 0.11). The results showed that the radiopacity values of the samples were associated with increased thicknesses. The 2 mm samples' radiopacity values were statistically significantly higher compared with the 1 mm samples. All samples except IPS e.max CAD and Cerec Blocs C had higher radiopacity than dentin (P< 0.05).

Clinical significance: The radiopacity values were affected by thickness and type of materials. Comprehensive knowledge about the radiopacity of materials enables the selection of appropriate materials to achieve clinical success, which serves as a useful diagnostic aid in determining the long-term durability of restorations.

Purpose: To evaluate the impact of coffee attributes on tooth discoloration, emphasizing the importance of potential factors such as serving temperature, bean variety, and chlorogenic acid (CGA) content.

Methods: Coffee preparation involved the extraction of espresso from four types of roasted beans (Vietnam Robusta, Uganda Robusta, Ethiopia Yirgacheffe Arabica, and Colombia Supremo Arabica), followed by chlorogenic content analysis using high-performance liquid chromatography. Bovine tooth enamel specimens were carefully prepared and stained with coffee (hot and iced), with a color assessment conducted at different time intervals (3, 9, 24, 48, and 72 hours). The Vickers hardness tester was employed to ensure specimen quality, while spectrophotometry aided in color analysis using the CIEDE2000 formula.

Results: The results revealed varying effects of serving temperature, bean type, and CGA content on tooth discoloration. It was demonstrated that perceptible color differences occur after a 3-hour immersion in coffee, with hot coffee showing higher staining potential compared to iced variations. Furthermore, chlorogenic acid content and bean type significantly affected tooth discoloration, with higher chlorogenic acid levels associated with increased staining. Notably, Robusta coffee showed less discoloration compared to Arabica, potentially due to differences in pH levels.

Clinical significance: The findings provide valuable insights for both dental practitioners and coffee consumers, assisting in making informed decisions regarding coffee intake and oral hygiene.

Purpose: This retrospective study examined the histomorphometrical outcomes resulting from managing Schneiderian membrane perforation during maxillary sinus floor augmentation using two different approaches and relating the results to perforation size.

Methods: 19 subjects (7 males, 12 females, mean age 53.3±10.5 years), who experienced a sinus membrane perforation during lateral sinus lift procedure, were enrolled. Perforations were addressed utilizing either the "Sinus Pack" technique (test group, 11 subjects) or collagen membranes with absorbable sutures (control group, 8 subjects). The "Sinus Pack" consisted of a combination of collagenated porcine bone, polyunsaturated fatty acids, and a biocompatible synthetic copolymer, wrapped in a resorbable porcine mesenchymal collagen membrane. Histomorphometry outcomes of both techniques were compared.

Results: The percentage of vital bone was significantly higher with the "Sinus Pack" approach (44.5% ± 19.8%) compared to the control group (26.3% ± 21.2%) (P= 0.045).

Clinical significance: The "Sinus Pack" approach for managing sinus membrane perforations appears to be effective and advantageous, as it has resulted in optimal histomorphometric outcomes, indicating a significant increase in vital bone.

Purpose: To provide a surgical strategy for small oroantral communication closure and bone regeneration that can meet the needs of an effective, less invasive, and simpler operation by utilizing procedures and biomaterials commonly employed in guided bone regeneration techniques. The primary goal was to close the communication, while the second aim was to achieve bone regeneration.

Methods: This retrospective and monocentric case series was conducted using data from the medical records of 12 subjects with oroantral communications and bone deficits greater than 3 mm who were treated with a heterologous cortico-cancellous graft covered in resorbable collagen membranes. The primary outcome was communication closure, whereas the secondary outcome was bone augmentation, which was demonstrated radiographically and clinically.

Results: Twelve individuals were treated consecutively for oroantral communication closure. The subjects consisted of eight men and four women. The mean age was 57.5 years. Closure was effective in all 12 subjects, and radiographic examination after 6 months revealed bone reformation in all cases. This procedure effectively isolated the maxillary sinus from the mouth cavity, resulting in seal and healing, as well as bone regeneration.

Clinical significance: Small oroantral communications are frequent in dentistry, often requiring special expertise and interventions that affect patient morbidity. The use of a heterologous cortico-cancellous graft covered with resorbable collagen membranes can allow effective closure of the small communication, preventing migration of pathological epithelia while increasing the bone ridge.

Purpose: To highlight the different risk factors, whether surgical or anatomical, related to Schneiderian membrane perforation, while evaluating the predictability of currently available methods to manage such perforations.

Methods: Charts of subjects experiencing perforation during maxillary sinus augmentation were retrospectively reviewed. Data related to possible anatomical and surgical risk factors were extracted. The correlation between membrane perforation size and anatomical risk factors (e.g., sinus septa, residual bone height and membrane thickness), surgical risk factors (satisfactory clinical management score - SCMs) and implant outcomes was statistically evaluated.

Results: Nine out of 10 subjects with perforation size ≥5 mm presented a less than 1.5 mm (P= 0.011) sinus membrane thickness. About 80% of subjects with easy or fair SCMs presented a residual bone height lower than 4 mm (P= 0.02) The SCMs were significantly worse in subjects with a perforation size ≥ 5 mm (2.8 ± 1.5) compared to those with a perforation size < 5 mm (1.4 ± 0.7) (P= 0.03).

Clinical significance: Techniques for the management of Schneider's membrane perforation should take into consideration anatomical and surgical risk factors, to render surgical therapies more predictable, reducing patient morbidity.

Purpose: To evaluate the efficacy of lateral ridge augmentation (LRA) of porcine cortical barriers when placed in a surgical bone gap, buccal to the defect, using the Bone into Bone (BiB) technique compared to a guided bone regeneration (GBR) technique.

Methods: The study was a retrospective case-control evaluation. A group of 23 subjects (test) underwent horizontal augmentation procedures using the BiB technique. A group of 18 subjects (control) was treated with the guided bone regeneration (GBR) technique, using a resorbable membrane and a mixture of heterologous bovine particles and autologous bone fragments. Radiological and histological analysis of the outcomes were performed.

Results: Mean ridge width varied from a preoperative value of 3.4 mm to a postoperative value, measured 8 months postoperatively, of 7.1 mm in the Control Group. The mean ridge width varied from a preoperative value of 4.8 mm to a postoperative value, measured 8 months after the procedure, of 7.5 mm in the Test Group. Histological images, after 8 months, showed native, mineralized bone with a lamellar pattern of varying thickness (30.3% ± 5.3).

Clinical significance: This technique (Bone-into-Bone) using resorbable heterologous biomaterials and without the use of retention devices for horizontal bone augmentation may be a viable alternative that is easily reproducible and has reduced morbidity for the patient.