BMC Oral Health最新文献

Background: Virtual bracket removal (VBR) facilitates efficient retainer fabrication for fixed orthodontics in a digital workflow. This study is aimed at assessing the influence of the relative bracket base area (RBA), representing the proportion of the labial/buccal surface area intended for removal, on the surface reconstruction accuracy in the VBR technique.

Methods: 196 teeth from seven resin dental models were included. The maximal bracket base surface area (MBA) was determined by the rectangular area extending to the lateral edges of the tooth labial/buccal surface. On each tooth, diverse RBA percentages (20-100% in 10% increments) of the MBA was removed, respectively. Following removal, the buccal surfaces of the teeth were digitally reconstructed. Subsequently, the root mean square (RMS) values, which represent the surface deviations between the reconstructed and original dentitions was calculated for each tooth. The obtained RMS values were compared within and among groups of different RBAs and compared with the clinically acceptable limit (CAL) of 0.05 mm.

Results: As the RBA increased, there was a discernible trend of elevated RMS values, both for the overall dentition and each specific tooth type. Among the lower teeth, the molars consistently displayed the highest RMS values in almost all groups, with significantly higher mean/median RMS values compared to the lower incisors (P < 0.05), excluding the 0.2MBA group. Specifically, across all tooth types, the mean/median RMS values in groups with 20-80% MBA were significantly lower than CAL of 0.5 mm (P < 0.05). This trend persisted for all tooth types in the 0.9MBA group except the lower canines and molars.

Conclusion: The mean/median RMS values elevated as the RBA increased. VBR technique remains sufficiently accurate for retainer fabrication, provided that the RBA remains below 80% of the MBA for lower canines and molars and 90% for all the other tooth types. Notably, residual bonding materials should be considered in clinical use because they are also removed in VBR and thereby constitute a portion of RBA.

Background: This study aims to validate a machine learning algorithm previously developed in a training population on a different randomly chosen population (i.e., test set). The discrimination potential of the palatal intraoral scan-based geometric and superimposition methods was evaluated.

Methods: A total of 23 participants (16 females and seven males) from different countries underwent palatal scans using the Emerald intraoral scanner. Geometric-based identification involved measuring the height, width, and depth of the palatal vault in each scan. These parameters were then input into Fisher's linear discriminant equations with coefficients determined previously on a training set. Sensitivity and specificity were calculated. For the superimposition method, scan repeatability was compared to between-subjects differences, calculating mean absolute differences (MAD) between aligned scans. Multiple linear regression analysis determined the effects of sex, longitude, and latitude of country of origin on concordance.

Results: The geometric-based method achieved 91.2% sensitivity and 97.1% specificity, consistent with the results from the training set, showing no significant difference. Latitude and longitude did not significantly affect geometric-based matches. In the superimposition method, the between-subjects MAD range (1.068-0.214 mm) and the repeatability range (0.011-0.093 mm) did not overlap. MAD was minimally affected by longitude and not influenced by latitude. The sex determination function recognized females over males with 69.0% sensitivity, similar to the training set. However, the specificity (62.5%) decreased.

Conclusions: The assessment of geometric and superimposition discrimination has unequivocally demonstrated its robust reliability, remaining impervious to population. In contrast, the distinction between sexes carries only moderate reliability. The significant correlation observed among longitude, latitude, and palatal height suggests the feasibility of a comprehensive large-scale study to determine one's country of origin.

Clinical significance: Portable intraoral scanners can aid forensic investigations as adjunct identification methods by applying the proposed discriminant function to palatal geometry without population restrictions.

Trial registration: The Clinicatrial.gov registration number is NCT05349942 (27/04/2022).

Objectives: Proper anchorage control is crucial for predictable tooth movement and preventing inadequate torque during orthodontic treatment. Through clinical and radiographic parameters; this study assesses the association between mini-screws and periodontal health.

Materials and methods: A prospective observational study included 16 systemically healthy non-smoking individuals requiring mini-screws. Mini-screws with a rough, titanium oxide-coated surface were placed. Periodontal assessments (Plaque index, gingival index, probing pocket depth, gingival recession, bleeding on probing, mucosal discomfort, mucosal redness, keratinized tissue width, supracrestal tissue height, and transmucosal soft tissue thickness) were performed at 2nd week and 3 months post-placement. Radiographic evaluations measured distances between mini-screws and adjacent teeth using Image J software.

Results: The study included 13 females and 3 males (mean age 21.9 ± 1.8 years) with 24 mini-screws. Early mini-screw loss was not observed. Significant reductions in site-level Gingival Index and bleeding on probing (p < 0.05) and full-mouth bleeding on probing (p < 0.05) were noted over time. Absence of significant differences was found in mucosal discomfort and redness, keratinized tissue width, or transmucosal soft tissue thickness, but supracrestal tissue height decreased significantly (p < 0.05). Radiographically, significant bone reduction around mini-screws was observed at 3 months, with torque gauge values significantly decreased as well (p < 0.05).

Conclusions: Orthodontic mini-screws can be effectively utilized in orthodontic treatment with proper planning and monitoring. While improvements in gingival health were observed with targeted oral care, the study underscores the need for careful consideration of potential risks to periodontal tissues, such as reductions in supracrestal tissue height and bone levels. A balanced approach that integrates preventive strategies with precise screw placement is essential to maximize the benefits of mini-screws while minimizing potential periodontal complications.

Clinical relevance: While proper oral hygiene can help control inflammation around mini-screw sites, clinicians must also be mindful of potential risks, such as reductions in bone levels and tissue height. Careful patient selection, precise placement, and regular follow-up are crucial to ensure the stability of mini-screws' stability and to prevent complications, ultimately contributing to better treatment outcomes in orthodontic care.

Trial registration: This study was registered on ClinicalTrials.gov with the registration number NCT06491849 on June 28, 2024.

Background: The assessment of plaque indices may be time-consuming and error-prone. Simplification of these indices may increase their utility without compromising their validity. The aim of this study was to evaluate the validity of two simplified versions of the Marginal Plaque Index (MPI).

Methods: Two simplified versions of the MPI as well as the Plaque Control Record (PCR) were derived from full-scale MPI assessments in two studies with four age groups (N = 42 10-year-olds; N = 24 15 year-olds; N = 53 university students (18y-33y); N = 66 parents (32y-57y). Correlations with the Turesky modification of the Quigley-Hein Index (TQHI) and the Papillary Bleeding Index (PBI) were calculated.

Results: The indices derived from the MPI showed high convergence with each other (all r ≥ 0.94) and with the TQHI (r ≥ 0.80). The concurrent validity of the MPI with the PBI was equal to that of the TQHI in all age groups. The simplified versions of the MPI and the PCR show a lower convergent validity with the PBI than the MPI within parents (p < 0.05). In the other age groups, their convergent validity was equal to that of the MPI.

Discussion: Simplification of the MPI does not affect its convergent validity with other plaque indices but may reduce its concurrent validity with the PBI in middle-aged adults.

Background: The expectations for the clinical and laboratory phases of tissue-supported complete dentures (TSCDs) are changing. Currently, there is a trend towards fast, comfortable, reliable, and low-cost methods. In TSCD impressions, simplified impression and digital impression methods involving the use of an intraoral scanner (IOS) are becoming preferable. Given this situation, this study aims to compare different conventional and digital impression methods used in TSCDs.

Methods: Patients with maxillary complete edentulism and healthy oral mucosa were included in this study. In the digital group, two different impressions were made using an IOS (Trios4) without (D1) and with (D2) artificial intelligence scanning (AI-Scan). In addition, a modified impression (D3) was made using the IOS in two steps, including the occlusal rim. In the conventional group, a two-step impression (C1) using an individual tray with zinc oxide eugenol and a one-step simplified impression (C2) using a stock tray with irreversible hydrocolloid were made. The comparison groups were determined to be C1-C2, C1-D1, D1-D2, and D1-D3. The best-fit algorithm was used to superimpose the impressions to be compared. The right and left vestibular areas, postdam area, palatal area, right and left matching area, entire surface, and borders were evaluated separately.

Results: Fifteen patients were included in this study. In the C1-C2 group, the mean deviation at the borders was statistically significant (p = 0.01). No regions in the C1-D1 and D1-D3 groups exhibited significant differences in the mean amount of deviation (p > 0,05). In the D1-D2 group, the mean deviation in the palatal area was significant (p = 0,03).

Conclusion: In maxillary edentulism, digital impressions have shown comparable results to conventional impressions, suggesting promising implications for clinical applications.

Trial registration: The clinical trial has been registered (ClinicalTrials.gov ID NCT06400277, registration date 06/05/2024, 'retrospectively registered').

Background: Although malocclusion is the third most prevalent oral health condition, orthodontics is not part of the minimum list of mandatory specialties to be offered in the Dental Specialty Centers of the Brazilian public health system, but rather as optional. Since the acknowledgment of this field as a part of the Brazilian Unified Health System (SUS), access to orthodontic procedures has become optional by municipal governments. Therefore, this study analyzed the evolution of orthodontic procedure provision within SUS from 2011 to 2022.

Methodology: We conducted a retrospective observational study of time series analysis trends on the number of orthodontic procedures and municipalities offering them. The presentation of findings followed the recommendations of the Reporting of Studies Conducted using Observational Routinely Collected Data. Secondary data from 2011 to 2022 were collected from the SUS Department of Informatics. Orthodontic procedures were organized by year, region, state, and municipality. The study applied descriptive analyses, and the Prais-Winsten generalized linear regressions for time series analysis.

Results: The quantity of municipalities offering orthodontic procedures have shown a small increasing during period analyzed (from 128 to 157). Northeast and South macro-regions have increased consistently the municipalities with orthodontic offering. All regions showed stable trends for each procedure, except for the South, which exhibited increasing rates of space maintainer placement (Annual Percentage Change (APC): 72.95; 95% CI: 31.6, 127.3) and maintenance sessions (APC: 15.40; 95% CI: 4.5, 27.5). The study showed decreasing trends for appliance removal in the South (APC: -38.07; 95% CI: -47.1, -27.5) and Northeast (APC: -25.19; 95% CI: -36.5, -11.9) regions.

Conclusion: From 2011 to 2022, there was a small increase in number of municipalities offering orthodontic procedures in the Brazilian public health system, in addition to a stationary trend for almost all types of procedures.

Background: Oral rehabilitation with dental implants is a common procedure in modern dentistry due to its high success rates. However, complications such as implant displacement can occur, particularly in the maxillary region due to factors like atrophied maxilla, thin alveolar bone, and low bone density. This case series explores scenarios of maxillary dental implant displacement, emphasizing the impact of immediate preoperative imaging on patient outcomes.

Case presentation: Three cases of maxillary implant displacement are presented, each illustrating a different scenario. Complications resulting from the displacement of implants into adjacent structures such as the maxillary sinus and nasal cavity are described. All cases involved implants that were displaced during second-stage surgery, occurring four to six months post-implantation. Removal attempts used transnasal endoscopic, intraoral, or combined approaches, with only one implant successfully retrieved. Delays in surgery ranged up to 72 h, leading to one implant being swallowed and another unlocated. Outcomes varied, with some patients requiring hospitalization for up to five days.

Conclusion: This series highlights the crucial role of immediate preoperative 3D imaging in precisely locating displaced implants to ensure their safe and efficient removal. While implant displacement may not always be preventable, optimizing the timeframe between diagnostic imaging and surgical intervention can significantly enhance management. Accurately locating the implant minimizes treatment invasiveness and patient discomfort, thereby improving clinical outcomes.

Background: The main goal of management of the mandibular fracture is to obtain the pre-injury contour of the bone and pre-injury occlusion as well as regain function early. For Parasymphyseal fractures, the ideal fixation method is still debatable. It could range from rigid to semi-rigid fixation. The current study aimed to compare the clinical and radiographic effect of two miniplates, 2.3 high-profile Miniplates, and three-dimensional (3D) Miniplates for internal fixation treatment of mandibular para-symphyseal fractures.

Methods: The study reviewed 240 medical records, dividing 60 patients into three treatment groups: Group I (25 patients received 2.0 mini plates), Group II (22 patients received 2.3 high profile miniplate), and Group III (13 patients received 3D miniplate). Data included demographics, fracture diagnosis, radiographs, maxillomandibular fixation use, surgical time, intervention, postoperative stability, and complications.

Results: The present study included 60 patients with mandibular parasymphyseal fractures, divided into three treatment groups: Group I (n = 25, 41.67%), Group II (n = 22, 36.67%), and Group III (n = 13, 21.67%). The study found no significant differences in age and sex distribution among the three groups, but the mean surgery time varied significantly. Group II had the highest rate of complications at 22.73%, followed by Group I at 20% and Group III at 7.69%.

Conclusion: In conclusion, the (3D) Miniplates could provide better internal fixation treatment of mandibular para-symphyseal fractures in terms of easy use, short surgery time and less complication such as malocclusion and infection.

Introduction: The alveolar bone defect often was hardly healed naturally by the body's repair mechanism. Implant placement was the most favored option for replacing a missing tooth in the current times, and the preservation of alveolar bone was vital. Tooth components, especially dentin, were very similar to alveolar bone components and could be used for promoting the alveolar bone regeneration process in reconstructive dentistry.

Methods: We exhaustively scoured multiple literature databases, such as PubMed and Embase, from inception to September 2024. The protocol for this meta-analysis was officially registered with PROSPERO (CRD42023400591). Randomized clinical trials (RCTs) that reported alveolar bone preservation through demineralized dentin grafts were chosen from the studies. We extracted both qualitative and quantitative data and evaluated statistical heterogeneity using the I² test. The potential for publication bias was evaluated using both qualitative and quantitative methods. A visual evaluation of the funnel plot was used for the qualitative assessment, with the Begg's test and the Egger's test were used for quantitative analysis.

Results: Ultimately, 7 studies met the inclusion criteria, comprising 230 participants who were adults without systemic diseases and free from caries or peri-apical infections. Compared with the control group, the demineralized dentin matrix (DDM) group was not statistically significant for improving radiographic ridge width change (SMD - 0.09, 95% CI -0.39 to 0.22) and ISQ values (SMD 0.06, 95% CI -2.39 to 2.51). These results indicate that DDM performs comparably to the control, suggesting that it can be considered an effective alternative in achieving similar outcomes in these specific measures.

Conclusions: The DDM grafts appear to be a feasible alternative to other biomaterials used for alveolar bone preservation.

Clinical trial number: Not applicable. This study is a meta-analysis and does not involve a clinical trial. Therefore, no clinical trial number has been assigned.

The occurrence of morphological deviations in root canal anatomy is challenging and can influence treatment outcomes. While mandibular second molars typically have 2 roots and 3 canals, a unique case emerged in a 23-year-old Indian male with a symptomatic permanent left mandibular second molar showing three distal, two mesial canals, and two roots. The tooth presented as non-mobile but tender on percussion. The patient was diagnosed with symptomatic irreversible pulpitis with symptomatic apical periodontitis. The presence of mid distal canal was radiographically and visually confirmed with the aid of limited FOV cone-beam computed tomography and the dental operating microscope. Successful nonsurgical root canal treatment with 6-month follow-up has been documented in this case report.