Acta odontologica latinoamericana : AOL最新文献

Dental fear and anxiety are feelings that are often present at dental appointments and have been studied for a long time.

Aim: To identify and critically review the 100 most frequently cited papers on dental fear and dental anxiety (DFA).

Materials and method: The 100 most frequently cited papers on DFA were retrieved from Web of Sciences (All databases) using a combined search strategy. Key bibliometric indicators were extracted. The methodological quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT) except for reviews and systematic reviews, which were evaluated by the Joanna Briggs Institute (JBI) tool.

Results: Citations for the 100 most frequently cited papers ranged from 81 to 882. The largest number of papers was from the United States of America (22 papers; 3850 citations). Community Dentistry and Oral Epidemiology was the journal with highest number of papers (27 papers; 3153 citations). The most frequently cited author was Corah NL (1390 citations). Cross-sectional study design was the most common (67 studies). The topics covered by the studies were diverse, highlighting studies on the development and validation of assessment tools. There were 17 validated assessment tools, of which The Dental Anxiety Scale was the most often used (28 studies). There were five terms used to refer to DFA. Most papers were of intermediate quality.

Conclusion: This bibliometric analysis identified the 100 most frequently cited papers on DFA and the topics covered. "Dental anxiety" was the term most often used, although more recent research includes both "fear" and "anxiety". The Dental Anxiety scale was the most frequently used assessment tool. Higher quality papers are encouraged to improve knowledge on DFA.

The mandible presents morphological variations, even in individuals without syndromes. This variability will determine different skeletal sagittal patterns, generally classified as Class I, II or III. The anatomical position of the mandibular canal has been investigated in different skeletal patterns, often using cone-beam computed tomography (CBCT) images, for diagnostic or surgical planning purposes.

Aim: The aim of this study is to perform a three-dimensional analysis of the position of the mandibular canal (MC) in adults with Class I, II and III skeletal patterns, by means of segmentation and 3D measurements on CBCT images.

Materials and method: 75 CBCT images were obtained from a secondary database, and 3D analysis was performed using ITK-SNAP and 3D Slicer software. The 3D evaluation consisted of determining the orientation of the position of the mandible, segmentation of the mandible and the MC, creating 3D models, and establishing anatomical landmarks. Vertical (supero-inferior, SI), transverse (mediolateral, RL,) and 3D measurements were performed.

Results: The position of the MC is modified according to the skeletal pattern and by morphological factors of the mandible such as sex and gonial angle. The proximity of the MC to the oblique line is smaller in the SI direction in Class III, and the position of the MC is associated with variation in the gonial angle. It may be closer to the cortical lingual in the central region.

Conclusion: The mandibular canal position should be considered in tomographic evaluation during diagnosis and therapeutic planning of mandible surgeries, especially in cases of sagittal ramus osteotomy.

This study evaluated the bond strength of a hybrid PICN ceramic before and after being subjected to 5000 cycles of thermocycling. PICNs are a promising alternative in the field of CAD/CAM dental restorations; however, their adhesive behavior with chemical surface treatments such as silane and 10-MDP, and micromechanical treatments such as hydrofluoric acid and sandblasting is not yet fully understood.

Aim: To compare the bond strength of a hybrid PICN ceramic treated with different surface protocols before and after a thermocycling process.

Materials and method: An in-vitro experimental study was conducted. Forty PICN ceramic slices were prepared and divided into four groups. Each group received a specific surface treatment (sandblasting or acid etching) and a different adhesive technique (silane + adhesive or adhesive only). Composite cylinders of 3 mm diameter mm were bonded to each slice, and shear strength was measured on a universal testing machine immediately, and after a period of thermocycling. Statistics: Data were analyzed by ANOVA followed by Tukey's post hoc test. All statistics were analyzed with a 95% confidence interval.

Results: The group subjected to sandblasting followed by silane and universal adhesive achieved the highest adhesion values, both immediately and after thermocycling (16.3 MPa and 11.2 MPa, respectively), and the group subjected to hydrofluoric acid etching and adhesive had the lowest values, both immediately and after thermocycling (8.6 MPa and 5.4MPa).

Conclusion: Cementation of a hybrid ceramic treated with sandblasting, silane and a 10-MDP-based adhesive ensures high bond values, even when aged under hot, humid conditions. Thermocycling significantly reduced the adhesive strength in all groups, the decrease being more noticeable in those that did not include silane.

Aim: During orthodontic treatment, the presence of brackets increases the accumulation of biofilm, which can increase the surface degradation of brackets. Thus, cleaning methods must address removal of both biofilm and stains, specially acquired due to cigarette smoke. Therefore, color change and surface texture of esthetic brackets subjected to cigarette smoke were evaluated before and after use of different cleaning treatments.

Materials and methods: Three types of conventional esthetic brackets (slot size 0.022" x 0.028" and Roth prescription) were evaluated: polycarbonate/P (Composite/Morelli), polycrystalline ceramic/PC (Iceram/Orthometric) and monocrystalline ceramic/MC (Iceram-S/Orthometric). They were exposed to cigarette smoke (Marlboro Red Box) for 5 days in a machine that simulated the oral conditions of a smoker. Then, they were assigned to one of two different cleaning treatments (n=10): a) bicarbonate jet (sodium bicarbonate particles 4 µm in diameter, at pressure 2.3 bar, distance 5 mm, for 10 seconds), or b) Robinson brush, pumice stone and water. Color analyses (CIEL*a*b*, WID, ΔEab, ΔE00 and ΔWID) and surface micromorphology (500 x magnification) were performed before and after exposure to smoke, and after the cleaning treatments.

Results: Mixed generalized linear models (α=0.05) showed that after exposure to smoke, all brackets showed a significant decrease in L* (p<0.0001) and WID (p<0.0001), and a significant increase in a* (p<0.05) and b* (p<0.0001), with greater staining for the P brackets (p<0.0001).

Conclusions: After the cleaning treatments, it was not possible to recover the initial color of the P brackets with the use of a Robinson brush. Although the cleaning treatment partially or completely removed the surface staining, the P brackets showed more extensive surface degradation, especially with use of the bicarbonate jet.

Osteotomy procedures in dentistry are usually performed with drills, but piezosurgical instruments have also been used to improve surgical conditions for both the patient and the operator. This ex vivo study uses infrared thermography to analyze heat generation in osteotomies.

Aim: The aim of this study was to conduct an infrared thermographic comparison of the heat generated by an ultrasonic insert, either with or without an aerosol dispersion control device, in contrast to a conventional bur, during osteotomy procedures performed on bovine femur specimens.

Materials and method: Osteotomies were performed on nine bovine femur blocks, with each osteotomy consisting of a linear cut 12 mm long and 3 mm deep. Each block underwent a single cut from each instrument examined. The osteotomies were divided into three groups according to the instrument used: Group CARB, carbide bur #701; Group INS, #SFR4 ultrasonic insert coated with diamond-like carbon (DLC); and Group INS-S, #SFR4 ultrasonic insert coated with DLC in combination with an aerosol dispersion control device ("spray control"). All incisions were standardized using an automated device. Thermal variations (ΔT) were assessed using an infrared thermographic camera. The maximum (Tm) and minimum (T0) temperatures recorded were utilized to calculate ΔT, following the equation: ΔT = Tm - T0. Statistical analyses were conducted using Kruskal Wallis test and Dunn's test for multiple comparisons (p <0.05).

Results: : The T0 and Tm recorded for INS (21.5°C ± 0.7ºC and 23.2ºC ± 0.7ºC) and INS-S (20.8ºC ± 0.4ºC and 21.8ºC ± 0.4ºC) were significantly higher (p <0.05) than for CARB (14.9ºC ± 0.8ºC and 17.6ºC ± 1.1ºC, respectively). The observed ΔT for INS (1.7ºC ± 0.4ºC) and INS-S (1.0ºC ± 0.4) were significantly lower (p <0.05) than for CARB (2.7ºC ± 1.1ºC). No significant difference in ΔT was observed for the other comparisons.

Conclusions: INS and INS-S produced significantly higher temperatures than CARB. Use of the "spray control" device resulted in a reduction of the temperature variation observed for the piezoelectric insert.

Type 2 diabetes mellitus is a prevalent chronic disease in the adult population, and its complications include delayed wound healing. Dentists often have to decide whether to prescribe antibiotics for tooth extractions in these patients.

Aim: To compare post-surgical variables for single simple dental extractions from controlled type 2 diabetic patients, administering either antibiotic or placebo.

Materials and method: The study included controlled type 2 diabetic patients requiring a single dental extraction (tooth non-impacted and without acute infection) from April 2021 to May 2023. They were randomized to amoxicillin or placebo prior to surgery. Extractions were performed without raising flaps or bone removal and took no longer than 45 minutes. Before surgery, blood glucose was measured. Age, gender, tooth to be extracted, surgery time, pain, bleeding, trismus, alveolar osteitis, infection, healing, gastric alterations, and number of analgesics taken were evaluated. Patients were checked by telephone call 2 and 14 days after the procedure, and in person after 7 days during the suture removal visit. The data were analyzed using Chi-square, Fisher's exact or Mann-Whitney U tests, as appropriate (p<0.05, significant).

Results: The analysis included 56 extractions in 56 patients, aged 41 to 81 years (mean SD = 59 +/- 9). During the telephone call at 2 days, no significant difference was found between groups for pain, trismus, edema, hemorrhage, gastric alterations, or analgesics taken. At the clinical checkup at 7 days, no significant difference was found between groups for pain, edema, trismus, alveolar osteitis, hemorrhage, delayed healing, or gastric alteration; but there was a significant difference in the number of analgesics taken (p <0.05), which was higher in the amoxicillin group. During the second telephone call at 14 days, no significant difference was found between groups for pain, edema, trismus, hemorrhage, or gastric alterations; but there was a difference in the number of analgesics taken (p <0.05). Patients in the amoxicillin group took more pain relievers. No case of alveolar osteitis or local or systemic infection was recorded in either group. No patient required additional treatment or hospitalization.

Conclusion: : No significant difference was found for alveolar osteitis, infection, or healing delay after single simple dental extractions in controlled type 2 diabetics, whether they took amoxicillin or placebo. The data from the present study suggest that antibiotic medication in these cases would not be necessary.

Microorganisms attached to surfaces form intricate colonies known as biofilms. Dental plaque is the biofilm formed on the tooth surface, including the gingival sulcus. Plaque staining makes it easier to see which areas need more brushing time, and which have higher risk of periodontal disease or caries. Dental plaque is largely influenced by diet, becoming more and more dependent on diet related carbohydrates as it ages. Inadequate dental care and bad eating habits are frequently associated with the presence of visible bacterial plaque.

Aim: The aim of this study is to evaluate the percentage of dental plaque according to body mass index (BMI) and to identify whether the plaque is newly deposited, mature or acidified.

Materials and method: Twenty-five patients from the Pediatric Dentistry Clinics at the University of Guadalajara were evaluated. The percentage and type of plaque were identified using a disclosing gel. The percentage of plaque was compared among children with normal weight, overweight and obesity.

Results: 14 children were normal weight, six were overweight, four were obese, and one was underweight. Average percentage of total plaque was 70.92%. The most predominant plaque was newly deposited (pink staining), followed by mature plaque (purple staining), and a lower percentage of acidified plaque (light blue staining).

Conclusions: The high percentage of plaque indicates lack or inefficacy of tooth brushing, highlighting the importance of using plaque disclosure for diagnostic and educational purposes for children and parents.

Empathy is the ability to be aware of and understand the emotions, feelings and ideas of others. Assessing empathy levels among dental students is essential for improving educational strategies and patient outcomes.

Aim: The aim of this study was to assess the levels of empathy among dental students at the University of Buenos Aires (UBA) and analyze differences based on academic year and gender.

Materials and method: The study involved third- to sixth-year dental students at UBA. Participants provided informed consent and completed a sociodemographic questionnaire: the Jefferson Scale of Empathy - Health Care Provider Student version (JSE-HPS). Data analysis included descriptive statistics, t-tests for gender and academic year differences, and assessment of empathy dimensions.

Results: Among 424 participants, the average JSE-HPS score was 108.2 (SD = 15.0), ranging from 36 to 134. The dimension of emotional and compassionate care had a mean of 35.7 (SD = 5.5), perspective taking had a mean of 59.0 (SD = 9.7) and standing in the patient's shoes had a mean of 13.4 (SD = 3.6). Empathy scores increased from the third year (100.9, SD = 22.4) to the fifth year (111.5, SD = 10.0), with a slight drop in the sixth year (110.6, SD = 12). Females (mean 109.0, SD = 15.5) displayed higher empathy than males (mean 104.4, SD = 12.2).

Conclusion: The study revealed high levels of empathy among dental students at UBA, with variations by academic year and gender. These findings underscore the importance of incorporating empathy into dental education and suggest the need for curricular adjustments to further enhance empathy-related skills. Future research should explore interventions to sustain and improve empathy levels among dental students and faculty, ultimately benefiting both patients and healthcare providers.

Human Cytomegalovirus (HCMV) is a major viral pathogen that causes severe complications in immunosuppressed individuals, particularly hematopoietic stem cell transplant recipients. In these patients, Cytomegalovirus has been associated with gastroenteritis, pneumonia, hepatitis, and even graft-versus-host disease, and a possible relationship has been identified between Cytomegalovirus genotypes and clinical course, complications and outcome. Early detection of Cytomegalovirus infection or reactivation is important, and previous findings show that it could potentially be evaluated in saliva, where HCMV causes asymptomatic viral shedding. Since saliva can be collected easily and safely, it is important to evaluate its potential for HCMV detection and genotyping, especially in pediatric patients who are receiving hematopoietic stem cell transplantation.

Aim: The purpose of this study was to evaluate the feasibility of using saliva to detect and genotype HCMV in a cohort of pediatric hematopoietic stem cell transplant recipients (HSCTR).

Materials and method: This study was conducted at Fundación Hospital Pediátrico la Misericordia, in Bogota, Colombia. Stimulated saliva samples were collected once a week and subjected to HCMV detection by qualitative PCR and genotyping by nested PCR followed by sequencing. Finally, a phylogenetic tree was constructed.

Results: Twenty patients were enrolled, and 105 saliva samples were collected, of which 29 were positive for HCMV. Twelve patients had at least one positive sample. The gB1 genotype was identified with no coinfection with any other genotype. Phylogenetic analysis showed that some saliva samples were closer to the sequence reported for the Towne laboratory strain, while others were closer to the Merlin strain, with slight differences between them.

Conclusions: It was demonstrated that saliva can be used to detect and genotype Cytomegalovirus in pediatric transplant recipients, and that sample collection is easy, with no risk of bleeding or discomfort in the pediatric patients evaluated.

Edentulism causes aesthetic, functional, nutritional, phonetic and psychological damage. One of the best treatments for it is implant-supported full-arch prostheses. However, like all techniques, it involves challenges.

Aim: To evaluate the main complications in implant-supported complete dentures.

Materials and method: This study analyzed the medical records of 140 patients rehabilitated with implant-supported full-arch prostheses with immediate loading using the passive fit technique. The analysis considered the antagonist, and complication location (upper and/or lower jaw). All cases had 1 to 8 years under load.

Results: No complication was reported in 115 (82.1%) patients, while 25 presented complications: 14 (56%) prosthetic tooth fractures, 3 (12%) prosthesis retention screw fractures, 3 (12%) loss of cementation of the cylinder, and 5 (20%) implant losses. There were more complications in implant-supported complete dentures in the upper arch or cases of both jaws (p<0.05). The success rate (patients without complications during follow-up) was 82.1%.

Conclusion: Implant supported complete dentures made by the passive fit technique were predictable in the long term for rehabilitation of completely edentulous patients.