BMC Oral Health最新文献

Background: The use of Cone-Beam-Computed-Tomography (CBCT) is rapidly increasing in dentistry. This study aimed to evaluate CBCT use among dentists across various fields and how it is affected by various measures.

Methods: We sent an anonymous questionnaire to Israeli dentists, which assessed the clinical use (including requested output: cross-sectional-images (CSI), DICOM-files, interpretation report), knowledge, and medico-legal issues of CBCT imaging.

Results: Our survey was distributed to dentists in conferences and via e-mails with a response rate of ~ 38% (387 dentists). Most were specialists, almost all of which (93%) utilize CBCT, primarily for implant planning (27%) and impacted third molars (24%). Regarding CBCT output preferences, 31%, 42%, and 9% of respondents requested CSI, CSI with DICOM files, and DICOM files, respectively. Only one-third of participants consistently review the entire scanned volume. Of these, 38% never request DICOM files, and only 36% always do. Most dentists (85.9%) reported encountering incidental findings within scans. The average knowledge test score was 68.1%, with correct answer correlating with younger ages and background CBCT training (p < 0.001 and p = 0.001, respectively). Less than half (41.7%) believed that referring clinicians should review scans, while 57.1% believed it should be reviewed by specialized radiologists. Most respondents (70.7%) expressed interest in CBCT continuing education courses.

Conclusions: Different CBCT outputs are requested by dentists. Although aware of incidental findings, most dentists do not review the entire scanned volume. Better CBCT knowledge was presented by younger dentists. These findings emphasize the necessity for enhancing the knowledge and usage of this imaging modality.

Background: Dental caries is an alarming health problem worldwide and the leading cause of oral infection among children and adolescents. This study aimed to determine the prevalence of dental caries and its associated factors among secondary school students in Kigali, Rwanda.

Methods: A cross-sectional study was conducted among 646 secondary school students aged 12 to 25 in Kigali. Being a student in a secondary school in the city of Kigali was the criteria to participate in the study. Data on dental caries were collected with a structured questionnaire adapted from the World Health Organization. A proportional random sampling was used to select secondary schools. Then a systematic sampling was used to recruit the participants. The data were analyzed with SPSS version 25. Proportions of dental caries and the mean decayed missing and filled teeth index (DMFT) were computed. Bivariate and Poisson regression analyses were used to test the factors associated with dental caries.

Results: The average age of study participants was 16 years. Almost half of the study participants were female (50.5%) and were from an urban place of residence (50%). The overall prevalence of dental caries was 61.1% with a mean decayed missing and filled teeth index of 3.3 (SD = 3.9). Notably, 5.1% of children had missing teeth, however, only 1.7% had filled teeth. The lower molars were the most affected by tooth decay 38.7%. Females were 1.5 times more likely to develop dental caries (AOR = 1.5, CI:1.4-1.6, P = 0.001) compared to males. Children from rural areas had 1.1 times higher odds of dental caries (AOR = 1.1, CI:1.0-1.3, P < 0.001) compared to their urban counterparts. Not using fluoridated toothpaste twice a day or more was 1.2 times more likely to develop dental caries than those who use it regularly (AOR = 1.2, CI:1.1-1.3, P < 0.001). Those visiting a dentist regularly were estimated to have 30% lower odds of dental caries (AOR:0.7, CI:0.6-0.8, P < 0.001). Moreover, being young (12 - 14 years) and coming from a poor family was associated with a 40% and 20% lower likelihood of dental caries compared to their counterparts.

Conclusion: The high prevalence of dental caries among secondary school students in Kigali was linked to factors such as infrequent dental visits, coming from low-income families, residing in rural areas, and being female.

Background: The main cause of pulpal and periapical diseases is bacterial infection, but mechanical and chemical preparation in root canal therapy is difficult to completely remove the bacterial microorganism. Antibacterial photodynamic therapy (aPDT) is a medical method that kills microorganisms by activating a photoactive agent or photosensitizer by exposure to visible light of a specific wave-length in the presence of oxygen. The present study aimed to evaluate the killing in vitro effect of aPDT with 0.01% methylene blue (MB) against young and mature Enterococcus faecalis (E. faecalis) biofilms in bovine and human dentin with the long-term exposure using confocal laser scanning microscopy (CLSM).

Methods: Prepared bovine and human dentin blocks and their structure were observed by scanning electron microscopy (SEM). Semicylindrical bovine dentin blocks and human root canal dentin blocks were inoculated with E. faecalis and incubated in air to form 1- and 3-week-old biofilms. The biofilms in dentin were subjected to aPDT with 0.01% MB, 5% NaOCl and saline with the exposure of 3, 12 and 30 min. The dead portions of bacterial cells in E. faecalis biofilms were analyzed with using LIVE/DEAD bacteria viability staining and CLSM.

Results: A clean dentin surface in bovine dentin blocks were verified with SEM. In bovine and human dentin blocks, significantly more bacteria were dead when aPDT with MB and 5% NaOCl were used with the long exposure time (12 and 30 min) than with 3 min (P < 0.05). The speed of killing was fastest during the first 3 min, and few more bacterial cells were killed after 12 min in the disinfection groups. 5% NaOCl exhibited the highest effectiveness of bacterial killing in dentin at each time point than aPDT with MB groups (P < 0.05). The proportion of killed bacteria was higher in young biofilms than in mature biofilms in aPDT with MB and NaOCl groups (P < 0.05). Moreover, there were no clearly visible changes in structure of bovine dentin surfaces subjected to aPDT with MB for 30 min.

Conclusion: aPDT with 0.01% MB has the capability to kill bacterial cells in E. faecalis biofilms on bovine and human dentin blocks. Young E. faecalis biofilms in dentin canals were more susceptible to disinfection approaches than mature biofilms.

Background: Traditionally, treating dental caries involves using rotary instruments, which can create noise that may frighten and cause discomfort in children. Recent research into caries management has introduced minimal invasive techniques like the Papacarie, which is a chemomechanical caries removal agent.

Objectives: To determine and compare the average time taken for caries removal and pain perception during caries removal by Papacarie as a chemomechanical caries removal method with the use of mechanical method using rotary instrument on carious primary molars.

Methodology: This randomized controlled clinical study carried out at the dental clinic in Lagos university teaching hospital. A split-mouth design was used and it involved 50 primary molars in 25 healthy children aged 5-9 years, each child having at least two primary molar teeth with occlusal dentine caries. Each tooth was allocated to the intervention using simple balloting method and treated with either Papacarie or conventional method for caries removal. Outcome measured were caries removal time, pain during caries removal and preference. Pain assessment was blinded. The statistical package for social sciences (SPSS) version 25.0 IBM was used for data analysis. The significance level was set at p ≤ 0.05 for all statistical tests at 95% confidence interval.

Result: Twenty-five children (with 50 primary molars) met the inclusion criteria and were recruited for the study. The children were between ages 5-9 years. Twenty-five primary molars were treated using Papacarie caries removal method while 25 primary molars were treated using conventional rotary method. There was no statistically significant difference in the time of caries removal between the two groups. Pain perception was lower with the Papacarie method compared to the conventional method, which was statistically significant. More participants preferred the Papacarie method. Twenty-five children (with 50 primary molars) met the inclusion criteria and were recruited for the study. The children were between ages 5-9 years. Twenty-five primary molars were treated using Papacarie caries removal method while 25 primary molars were treated using conventional rotary method. There was no statistically significant difference in the time of caries removal between the two groups. Pain perception was lower with the Papacarie method compared to the conventional method, which was statistically significant. More participants preferred the Papacarie method.

Conclusion: The findings from this study indicates that the Papacarie demonstrated a comparable caries removal time, lesser pain perception and better acceptability compared to the conventional method of caries removal.

Trial registration: Pan African Clinical Trial Registry (PACTR) Trial number PACTR202111738486539. Registered 18th November 2021.

Background: Although mandibular autorotation concept (MAC) surgery is a novel technique for addressing long-term stability issues in patients with mandibular retrusion and open bite accompanied by temporomandibular joint osteoarthritis (TMJOA), studies on MAC surgery in animal models and its mechanisms are scarce. This study aimed to develop an animal model for anterior open bite and investigate the underlying histological and molecular mechanisms of TMJ changes, with the expectation of contributing to the MAC surgery concept.

Materials and methods: Thirty-six, 5-weeks-old female Wistar rats were randomly divided into three groups: (1) Bite-raise group (2-mm resin added to the upper molars at 5 weeks of age) (2), Recovery group (resin added at 5 weeks of age and removed at 13 weeks of age), and (3) Control group (normal rats). Micro-CT imaging was used to assess 3D morphology and bone structure. Histological and immunohistochemical analyses were performed to evaluate the cartilage changes, bone cell differentiation, and extracellular matrix degradation. Gene expression of inflammatory factors (IL-1β, IL-6, TNF-α), TGF-β1, and Postn were measured by qPCR.

Results: At 13 weeks of age, both Bite-raise and Recovery groups exhibited TMJOA-like changes, including decreased cartilage thickness and increased inflammatory gene expression. At 21 weeks of age, the Recovery group showed improved bone volume, reduced osteoclast activity, and lower MMP-13 and Postn levels than the Bite-raise group.

Conclusion: These results suggest the successful development of an animal model for anterior open bite and demonstrate that MAC surgery facilitates the recovery of compromised condyles.

Objective: To assess the efficacy of monochromatic resins in capturing adjacent tooth color across various shades and cavity types, both before and after thermocycling. Furthermore, the surface roughness of the restorations was evaluated.

Methodology: This is a laboratory test that used 40 mandibular incisors with a healthy crown obtained from the Human Teeth Bank of the UFVJM School of Dentistry. The teeth were randomly assigned to two groups: one group was restored with Omnichroma composite resin, while the other one was restored with Vittra APS Unique composite resin. Three preparations were performed on each tooth in both groups, namely: Classes III, IV and V. Evaluations of USPHS and modified FDI criteria, analysis of roughness using a using a digital surface roughness tester and color reading with a spectrophotometer before and after thermocycling were performed. The data were submitted to descriptive statistics, Chi-square test and the T-test using the SPSS software, and a p-value of < 0.05 was considered statistically significant.

Results: There was no significant difference between the groups in relation to the parameters of shape (p > 0.05), marginal integrity (p > 0.05) and color (p > 0.05) in the USPHS analysis, as well as the ΔE in the CIEL* a* b* analysis (p > 0.05) and color in the FDI analysis (p > 0.05), in all classes. Clinically detectable differences were observed between classes IV (ΔE = 3.80) and V (ΔE = 5.02) restorations of the Omnichroma resin compared to the tooth. The ∆E of Vittra resin was considered unacceptable in all classes (ΔE varied from 4.35 to 5.52). The Vittra resin class III restoration showed the best adaptability (L*: p = 0.462; a*: p = 0.252 and b*: p = 0.335). There was no statistically difference between groups in the surface roughness analysis either initially (p = 0.564) or after thermocycling (p = 0.690).

Conclusions: It was concluded that the color match of the composite resins Omnichroma and Vittra APS Unique was found to be clinically satisfactory in USPHS and FDI analysis. Both resins showed low surface roughness.

Background: This study aimed to characterize the pattern of cervical lymph node spread and evaluate prognostic factors and outcomes of surgery and postoperative adjuvant therapy in primary parotid carcinoma (PPC).

Methods: We retrospectively enrolled 136 patients with PPC. The primary outcomes were disease-free survival (DFS) and overall survival (OS). We used Cox hazards models to assess variables influencing survival, and chi-square tests and logistic regression models to evaluate correlations between pN + and clinicopathological factors.

Results: Pathology-confirmed lymph node metastasis was detected in 60.0% and 84.1% of the patients with cT1-2 and cT3-4 tumors, respectively. The occult metastasis rate in cN0 was 55.2%. Level II metastasis was most common (93.2%), followed by level I (49.3%). Histological type, histologic grade, pT stage, and AJCC stage were significant risk factors for lymph node metastasis. One- and five-year OS were 86.0% and 49.3%, respectively (median, 60 months) and 71.6% and 34.8%, respectively, for DFS (median, 24 months). Surgery with ¹²⁵I seed implant brachytherapy conferred survival benefits to patients. Predictive factors for DFS were pT stage, pN stage, histological type, histological grade, and management strategy, and for OS, pT stage, pN stage, histological type, and histological grade.

Conclusion: Histological high grade and advanced T classification were associated with occult lymph node metastasis. Postoperative radiotherapy (RT)/radiochemotherapy (RCT), conferred significant survival benefits in PPC. Neck dissection in patients with cN0 cancer significantly improved DFS and should be performed on those with high-grade and/or advanced T-stage tumors.

Background: To compare the clinical, esthetic, and patient-reported outcomes of the vestibular incision subperiosteal tunnel access (VISTA) technique and the modified tunnel (mTunnel) technique, both combined with connective tissue grafts (CTGs), for treating recession type 1 (RT1) single gingival recessions.

Methods: A total of 24 patients with single non-molar RT1 recessions were randomly assigned to the VISTA + CTG or the mTunnel + CTG group. A blinded examiner assessed the recession reduction (RecRed), mean root coverage (MRC), complete root coverage (CRC), keratinized tissue width, patient-reported outcomes, and root coverage esthetic score (RES).

Results: At 12 months, both groups achieved significant recession reduction. However, there were no significant differences in RecRed and MRC between the groups (VISTA: 2.38 ± 0.96 mm and 90.28 ± 18.06%, mTunnel: 2.08 ± 1.10 mm and 81.25 ± 29.16%; P = 1 and P = 0.834, respectively). The CRC was significantly higher in the VISTA group (VISTA: 75%, mTunnel: 50%; P < 0.001). Both groups obtained high RES scores (VISTA: 8.75 ± 1.14, mTunnel: 7.75 ± 2.99, P = 0.786), but the mTunnel group demonstrated significantly less scar formation (P = 0.014).

Conclusions: Both procedures effectively treated single RT1 recessions at 12-months follow-up. However, the VISTA technique demonstrated superior CRC results compared to the modified tunnel technique.

Trial registration: The trial had been registered prospectively at http://www.chictr.org.cn on 19/12/2015 (Registration number: ChiCTR-INR-16007845), and structured according to the CONSORT statement.

Background: Child Drawing: Hospital (CD: H) was developed as a tool to measure the emotional state of hospitalized school-age children. This scale consists of sections A, B and C, which allow understanding of anxiety through children's drawings. The CD: H Scale, which is widely used in medicine, has only been validated in two different cultures. The adaptation and validation of the scale in the field of dentistry has recently started to take place in the literature. In our study, we aimed to conduct a Turkish validation study of the Child Drawing: Hospital (CD: H) Scale and to evaluate dental anxiety and pain experienced during treatment through drawing.

Methods: Pediatric patients between the ages of 5-12 who attended the Pediatric Dentistry Department between 2018 and 2020 were included in the study. Following the translation of the CD: H Scale into Turkish and linguistic-cultural validation, the behaviors of pediatric patients during treatment were evaluated with the Frankl Behavior Rating Scale, the pain they experienced during treatment with the Wong- Baker Face Rating Scale, and their anxiety levels were evaluated with the pictures drawn by the patients at the end of the treatment. The data were analyzed with IBM SPSS v23, and the significance level was taken as p < 0.05.

Results: Within the scope of the scale's reliability-validity study, the Intra-Class Correlation Coefficient (ICC) was evaluated with test-retest consistency. For section A, B,C and total score reliability was found to be positive and strong level correlation.

Conclusions: The Turkish version of the CD: H Scale is a reliable and valid scale that can be used to evaluate the dental anxiety of Turkish pediatric patients.

Trial registration: ClinicalTrials (NCT05236101/11.02.2022), 'retrospectively registered'.