BMC Oral Health最新文献

Background: During restoring class II and V cavities with resin composite, hemostatic agents are frequently used to control gingival bleeding and/or gingival fluid to provide a dry field which is crucial for efficient bonding. Hemostatic agents may adversely affect the bonding procedure, thus their removal prior to bonding is essential. The current study evaluates the effect of two hemostatic agents and different dentin cleansing protocols on the shear bond strength of resin composite to dentin using a universal adhesive.

Methods: Ninety premolars were sectioned to expose coronal dentinal surfaces which were divided into 3 groups: control group, not treated with hemostatic agent (n = 10); a group treated with Viscostat "20% ferric sulphate" (n = 40); and a group treated with Viscostat clear "25% aluminum chloride" (n = 40). The groups treated with hemostatic agents were subdivided into 4 subgroups according to the cleansing protocol: water, phosphoric acid, katana cleaner, and air abrasion. Shear bond strength (SBS) of resin composite bonded to the treated dentin using a universal adhesive was measured after thermocycling.

Results: Two-way ANOVA showed that hemostatic agent, cleansing protocol and their interaction has significant effect on SBS (p < 0.0001). Viscostat (10 ± 3.3 MPa) exhibited lower SBS than Viscostat Clear (16.2 ± 5.5 MPa). Acid etching (17.3 ± 7.3 MPa) showed higher SBS compared to Katana Cleaner (12.6 ± 4.7 MPa), water (12.1 ± 4.8 MPa) and air abrasion (10.8 ± 2 MPa).

Conclusion: The use of hemostatic agents can adversely affect the bond strength of universal adhesives to dentin. Phosphoric acid provided the best hemostatic agent-cleansing protocol while katana cleaner and air abrasion demonstrated inferior results.

Background: The purpose of the study is to evaluate the effect of 7 different desensitizing agents on the shear bond strength (SBS) of zirconia restorations to dentin with a self-adhesive resin cement and determine the failure modes.

Methods: Eighty molars' occlusal surfaces were ground to expose dentin and were randomly divided into 8 groups (n = 10): 1. Gluma (HEMA/Glutaraldehyde) 2. Bifluoride (Sodium Fluoride/Calcium Fluoride) 3. Admira (Bis-GMA/HEMA) 4. Smart Protect (Glutaraldehyde) 5. Teethmate (Tetracalcium phosphate, Dicalcium phosphate) 6. Clinpro White (Sodium fluoride) 7. BisBlock (Oxalic acid) and 8. Control (No-treatment). After applying the agent, a self-adhesive resin cement (Rely-X U200) was used to lute zirconia discs (4 mm height and 4 mm diameter) to dentin. After stored in distilled water at 37 °C for 24 h, all groups were thermocycled for 2500 cycles between 5 ± 2 °C and 55 ± 2 °C. Specimens were submitted to SBS test with a universal testing machine at a crosshead speed of 0.5 mm/min until failure. SBS values were compared with ANOVA. Post-hoc multiple comparisons were performed with Dunnett T3. The failure modes of specimens were examined with stereomicroscope at a magnification of 20X and the distribution of the failure modes were evaluated with Pearson Chi-Square test.

Results: Regarding mean SBS values in MPa's; Admira (10.70 ± 3.99), Smart Protect (9.62 ± 3.93), and Gluma (8.90 ± 3.76) treatments showed higher SBS values compared to control group (p < .05) according to ANOVA. The SBS values of Teethmate (5.31 ± 2.37) and Clinpro White (4.32 ± 2.44) were higher than control group but the difference was not found significant (p > .05). BisBlock (2.33 ± 1.94) and Bifluouride (1.60 ± 1.47) groups showed the lowest SBS values but their difference between control group was not found statistically significant (p > .05). Most specimens showed adhesive failure but no statistically significant difference was found in the distributions of failure modes according to Chi-square test.

Conclusion: Within the limitation of the study; Admira, Smart Protect, and Gluma increased the SBS of the zirconia restorations to dentin and can be recommended to use on prepared dentin surfaces prior to the cementation.

Background: COSMIN (Consensus-based Standards for the selection of health Measurement INstruments) provides a framework for selecting and validating patient-reported outcome measurements (PROMs). This study aims to validate the Hungarian version of the GOHAI and, for the first time, to assess its Standard Error of Measurement (SEM), Smallest Detectable Change (SDC), and Measurement Invariance (MI) across general and clinical populations as well as different age groups, following COSMIN guidelines.

Materials and methods: The translation was performed using a forward-backward process. A mixed sample (n = 306) was recruited in Budapest from May 2023 to February 2024, consisting of the general population (45.1%), recruited from health kiosks and a nursing home, and the clinical population (54.9%), sourced from Semmelweis University's care units. The sample was further divided into two age groups: 18-64 years old (54.9%) and 65 + years old (45.1%). GOHAI was administered twice to 108 stable participants. For both the additive score (ADD-GOHAI) and simple count (SC-GOHAI), structural validity and measurement invariance by subgroups were assessed via Confirmatory Factor Analysis (CFA). Internal consistency was evaluated using Cronbach's alpha, and test-retest reliability was measured using the intraclass correlation coefficient (ICC). SEM was calculated using the SEM agreement formula, and SDC using: [Formula: see text]. Convergent and known-group validity were tested against predefined hypotheses for structural validity.

Results: Contrary to a three factor model, a single-factor model showed good fit in all subgroups for both scoring methods, with adequate internal consistency (Cronbach 𝛼: 0.76-0.85). Four of the six hypotheses for convergent validity and all ten hypotheses for known-groups validity supported the predefined criteria. Measurement invariance between clinical and general populations, or by age, was not demonstrated, so GOHAI's different measurement properties should be considered when comparing subpopulations. Test-retest reliability was adequate (ICC: 0.87-0.96). SDC was ≈5 points using ADD-GOHAI and 2-3 points using SC-GOHAI.

Conclusion: The Hungarian version of GOHAI demonstrates satisfactory psychometric properties across both general and clinical populations, as well as among both younger and older age groups. While the measurement properties of SC-GOHAI may be more stable between populations, ADD-GOHAI seems more suitable for individual follow-up. However, observed changes must be considered in relation to the measurement error associated with GOHAI.

Background: Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient's facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients.

Methods: A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included.

Results: Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95% CI, 4.11° to 8.74°) and A-McNamara rose by 7.29 mm (95% CI, 6.21 mm to 8.37 mm). The maxilla also showed a slight counterclockwise rotation; however, this reached no statistical significance. The mandibular position did not vary remarkably. Moreover, a significant increase in upper anterior tooth tipping and overjet, a decrease in overbite, and an improvement in nasolabial soft tissue were observed.

Conclusions: MASDO might be a valid therapy option for CLP patients. It causes a significant increase in the maxillary length, anterior tooth crossbite, and nasolabial soft tissue were also greatly improved.

Objectives: The literature lacks comprehensive evidence on the efficacy of advanced platelet rich fibrin(A-PRF) in treating gingival recession. Therefore, this systematic review and meta-analysis aimed to evaluate the effectiveness of A-PRF in the treatment of gingival recession.

Materials and methods: We adhered to the guidelines of PRISMA in searching the following databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus to include all the eligible studies according to the prespecified inclusion and exclusion criteria. We conducted our search up to February 28, 2024. We conducted a meta-analysis of the primary and secondary clinical outcomes to measure the changes from baseline to 6 months after surgery.

Results: Our review included 10 randomized clinical trials in which 146 participants with 457 recession defects were included. We found that combination of A-PRF with various surgical techniques, such as coronally advanced flap (CAF) connective tissue graft (CTG), VISTA, tunneling, and pinhole surgical technique, demonstrated promising outcomes but varied by comparison group. We observed that CTG with CAF showed a higher reduction in recession depth in comparison to A-PRF with CAF. This review indicated no statistical or clinical differences in recession width, width of keratinized gingiva, probing depth, and clinical attachment level between the study and control groups.

Conclusions: Due to the less invasive nature of A-PRF, it provides a better clinical option to improve the outcomes of treating gingival recession. However, more well-designed RCTs with standardized approaches are needed to confirm these results.

Background: Extraction of mandibular third molars (M3Ms) is a routine procedure in oral and maxillofacial surgery, often associated with postoperative symptoms like pain, facial swelling, and trismus. This study aimed to introduce a standardized and automated protocol for swelling analysis following M3M surgery, presenting results regarding clinical conditions immediately and one-week after surgery.

Methods: In a prospective study, 35 patients were enrolled (mean age: 24.4 ± 5.8 years) for removal of 54 M3Ms. Facial swelling was evaluated through 3D facial scans before surgery (T0), at three days (T1), and seven days (T2) post-surgery. The open-source software 3DSlicer facilitated automated analysis, including data anonymization, orientation, surface registration, qualitative comparisons, linear measurements, and volumetric quantification. Pairwise superimposition of facial models enabled qualitative, vectorial, and quantitative assessments, comparing initial conditions with swelling development at T1 and T2. Additionally, changes between T1 and T2 were also evaluated. Secondary outcomes encompassed clinical evaluations of pain, trismus (maximum mouth opening), and surgery time. Statistical analysis involved the paired Student t-test to assess longitudinal changes and analysis of variance to evaluate outcome variables concerning difficulty scores. Linear regression models correlated primary outcome variables with secondary study variables (α < 0.05).

Results: Longitudinal analysis demonstrated significant but variable facial swelling, pain, and trismus at T1, followed by improvement at T2 (p < 0.001). Linear and volumetric differences correlated positively with surgery time (p < 0.05). A direct proportionality between linear and volume differences was observed, higher values at T1 correlated with higher values at T2 (p < 0.05).

Conclusions: An innovative digital workflow for precise quantification of postoperative facial changes was implemented, incorporating volumetric measurements that surpass linear assessments. Clinical conditions demonstrated a direct correlation with surgery time, deteriorating immediately and improving one-week after surgery.

The root canal systems of maxillary first molar (MFM) and maxillary second molar (MSM) variations represent a clinical challenge for endodontists, especially the prevalence of fused C-shaped roots. Having a thorough knowledge of root canal configuration is an extremely important point for a successful root canal treatment to avoid missing extra canals. The aim of this article was to present 2 cases of maxillary molar with an unusual C-shaped configuration diagnosed during root canal retreatment/treatment and conduct a literature review of the MFM and MSM anatomy. Case 1 reports that three separate palatal root canals fused into a C-shaped configuration in the MFM, which with an enamel pearl in the furcation, was classified as Type D and first reported in MFM. Case 2 reflects the fusion of all three buccal canals of the MSM into a C-shaped configuration that finally formed an apical foramen with a supernumerary tooth, and the configuration was Type B. Evaluation at an 18-month and a 9-month recall revealed that two patients were symptom-free after the conduct of a non-surgical retreatment/treatment, and the X-ray revealed normal periapical tissue. In addition, the thickness of the Schneiderian membrane due to odontogenic maxillary sinusitis returns to normal after an effective retreatment in case 1. These reports serve to remind endodontists of the importance and complexity of anatomical variations, which should always be considered when formulating an effective root canal treatment plan. The combined use of cone-beam computerized tomography (CBCT) and a dental operating microscope (DOM) will be profitable to locate and identify extra canals when a periapical radiograph shows signs of an unusual canal morphology.

Background: Silver Diamine Fluoride (SDF) is effective for arresting dental caries, presenting a valuable non-invasive treatment option in dentistry. Despite its therapeutic advantages, a significant drawback is the tooth discoloration that follows its application, which can affect patient acceptance. Addressing this aesthetic concern without diminishing the treatment's efficacy remains challenging in dental practice. This study explores strategies to improve the aesthetic outcomes of SDF treatments.

Methods: This in vitro study assessed the efficacy of Zinc in reducing SDF-induced discoloration on dentin blocks and examined its impact on the physical properties of dentin, including hardness and roughness. Dentin blocks were pre-treated with various concentrations of Zinc, followed by SDF application. Color changes were analyzed using Image J software, and cytotoxicity was evaluated using the CytoTox-ONE™ Homogeneous Membrane Integrity Assay. Dentin surface characteristics, including micro-hardness and roughness, were assessed using scanning electron microscopy.

Results: The study results revealed a dose-dependent efficacy of Zinc in reducing discoloration caused by SDF on dentin, with higher Zinc concentrations showing better improvement in color outcomes. The application of a 20 M Zinc solution prior to SDF treatment significantly reduced discoloration compared to SDF alone, measured on day 14. Additionally, no significant changes in the hardness or roughness of etched dentin were observed in Zinc + SDF group compared to the SDF alone group. Zinc treatments demonstrated a desirable outcome on mucosal cytotoxicity, comparable to that of the negative control.

Conclusion: Zinc significantly reduced SDF-induced tooth discoloration in a dose-dependent manner without affecting the etched dentin's micro-hardness and roughness, potentially improving patient acceptance, especially in visible areas of the mouth. Further research is warranted to validate the effectiveness of this zinc-enhanced treatment protocol in vivo.

Clinical significance: Zinc-enhanced SDF treatments could enhance patient acceptance, especially in visible areas of the mouth, offering an improved option for caries management.

Background: Dentinal hypersensitivity (DH) is a painful condition that can affect a person's quality of life. Laser therapy is a valid treatment option for this problem, which leads to immediate and long-term pain relief. This study aims to comprehensively review the effects of different laser treatments on DH.

Methods: The search was performed in electronic databases, including PubMed, Web of Science, Embase, Google Scholar, and Scopus, published in English from January 2012 to October 2024. The following keywords were searched: Laser, Dentine hypersensitivity, Dental pain. Relevant laboratory and clinical studies were included.

Results: Based on the electronic search, 988 articles were identified. Based on the search strategy and removal of duplicate articles, 47 articles remained. Finally, with the addition of 7 supplementary articles from a manual search, 16 in-vitro and 38 clinical studies were included. Application of high power diode laser at 980 nm and 2 W and Er;Cr:YSGG at a power of 0.5 W in a single session has been found to be a practical therapeutic approach in alleviating DH. The utilization of Nd:YAG was found to be inferior in high-power settings.

Conclusion: Both high/medium and low power lasers have the ability to relieve DH when used with appropriate output settings. These treatments demonstrate an instant pain-relieving effect upon application and also provide long-lasting advantages. Additionally, the simultaneous use of surface desensitizers, such as Gluma and substances that contain potassium nitrate with lasers, can be a practical approach for treating DH, especially when utilizing a low-power laser.